Health behavior change in advance care planning: an agent-based model

Directory of Open Access Journals (Sweden)

Natalie C. Ernecoff

2016-02-01

Full Text Available Abstract Background A practical and ethical challenge in advance care planning research is controlling and intervening on human behavior. Additionally, observing dynamic changes in advance care planning (ACP behavior proves difficult, though tracking changes over time is important for intervention development. Agent-based modeling (ABM allows researchers to integrate complex behavioral data about advance care planning behaviors and thought processes into a controlled environment that is more easily alterable and observable. Literature to date has not addressed how best to motivate individuals, increase facilitators and reduce barriers associated with ACP. We aimed to build an ABM that applies the Transtheoretical Model of behavior change to ACP as a health behavior and accurately reflects: 1 the rates at which individuals complete the process, 2 how individuals respond to barriers, facilitators, and behavioral variables, and 3 the interactions between these variables. Methods We developed a dynamic ABM of the ACP decision making process based on the stages of change posited by the Transtheoretical Model. We integrated barriers, facilitators, and other behavioral variables that agents encounter as they move through the process. Results We successfully incorporated ACP barriers, facilitators, and other behavioral variables into our ABM, forming a plausible representation of ACP behavior and decision-making. The resulting distributions across the stages of change replicated those found in the literature, with approximately half of participants in the action-maintenance stage in both the model and the literature. Conclusions Our ABM is a useful method for representing dynamic social and experiential influences on the ACP decision making process. This model suggests structural interventions, e.g. increasing access to ACP materials in primary care clinics, in addition to improved methods of data collection for behavioral studies, e.g. incorporating

Health behavior change in advance care planning: an agent-based model.

Science.gov (United States)

Ernecoff, Natalie C; Keane, Christopher R; Albert, Steven M

2016-02-29

A practical and ethical challenge in advance care planning research is controlling and intervening on human behavior. Additionally, observing dynamic changes in advance care planning (ACP) behavior proves difficult, though tracking changes over time is important for intervention development. Agent-based modeling (ABM) allows researchers to integrate complex behavioral data about advance care planning behaviors and thought processes into a controlled environment that is more easily alterable and observable. Literature to date has not addressed how best to motivate individuals, increase facilitators and reduce barriers associated with ACP. We aimed to build an ABM that applies the Transtheoretical Model of behavior change to ACP as a health behavior and accurately reflects: 1) the rates at which individuals complete the process, 2) how individuals respond to barriers, facilitators, and behavioral variables, and 3) the interactions between these variables. We developed a dynamic ABM of the ACP decision making process based on the stages of change posited by the Transtheoretical Model. We integrated barriers, facilitators, and other behavioral variables that agents encounter as they move through the process. We successfully incorporated ACP barriers, facilitators, and other behavioral variables into our ABM, forming a plausible representation of ACP behavior and decision-making. The resulting distributions across the stages of change replicated those found in the literature, with approximately half of participants in the action-maintenance stage in both the model and the literature. Our ABM is a useful method for representing dynamic social and experiential influences on the ACP decision making process. This model suggests structural interventions, e.g. increasing access to ACP materials in primary care clinics, in addition to improved methods of data collection for behavioral studies, e.g. incorporating longitudinal data to capture behavioral dynamics.

The importance of role sending in the sensemaking of change agent roles.

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Tucker, Danielle A; Hendy, Jane; Barlow, James

2015-01-01

The purpose of this paper is to investigate what happens when a lack of role-sending results in ambiguous change agent roles during a large scale organisational reconfiguration. The authors consider the role of sensemaking in resolving role ambiguity of middle manager change agents and the consequences of this for organisational restructuring. Data were collected from a case study analysis of significant organisational reconfiguration across a local National Health Service Trust in the UK. Data consists of 82 interviews, complemented by analysis of over 100 documents and field notes from 51 hours of observations collected over five phases covering a three year period before, during and after the reconfiguration. An inductive qualitative analysis revealed the sensemaking processes by which ambiguity in role definition was resolved. The data explains how change agents collectively make sense of a role in their own way, drawing on their own experiences and views as well as cues from other organisational members. The authors also identified the organisational outcomes which resulted from this freedom in sensemaking. This study demonstrates that by leaving too much flexibility in the definition of the role, agents developed their own sensemaking which was subsequently very difficult to manipulate. In creating new roles, management first needs to have a realistic vision of the task and roles that their agents will perform, and second, to communicate these expectations to both those responsible for recruiting these roles and to the agents themselves. Much of the focus in sensemaking research has been on the importance of change agents' sensemaking of the change but there has been little focus on how change agents sensemake their own role in the change.

Change agent's contribution to recipients' resistance to change: A two-sided story

NARCIS (Netherlands)

Vos, Janita F.J.; Rupert, Joyce

2018-01-01

In the change management literature, most studies on recipients’ resistance to change include only the views of agents or of recipients, thereby ignoring that these parties may have different perceptions. In this quantitative study, we include the perceptions of both parties in studying the

Advance directives: the clinical nurse specialist as a change agent.

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Meehan, Karen Anne

2009-01-01

The purpose of this article is to describe the impact the clinical nurse specialist (CNS) has on the advance directive process within the cardiac surgery patient population. As a change agent, the CNS needs to be able to increase the number of advance directives obtained and increase the provision of dignified, self-directed, quality patient care. With requirements from The Joint Commission and the Patient Self-determination Act, the change in process must take place to ensure that healthcare professionals are doing all they can do to carry out a patient's wishes. The 6-Source Influencer Model is applied to a case study to illustrate the role of the CNS as a change agent. Following this model, the CNS can facilitate lasting institutional change in the advance directive process. Based on the example, it is possible that a CNS can act as a change agent for other patient populations within the healthcare setting.

Persuasion Model and Its Evaluation Based on Positive Change Degree of Agent Emotion

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Jinghua, Wu; Wenguang, Lu; Hailiang, Meng

For it can meet needs of negotiation among organizations take place in different time and place, and for it can make its course more rationality and result more ideal, persuasion based on agent can improve cooperation among organizations well. Integrated emotion change in agent persuasion can further bring agent advantage of artificial intelligence into play. Emotion of agent persuasion is classified, and the concept of positive change degree is given. Based on this, persuasion model based on positive change degree of agent emotion is constructed, which is explained clearly through an example. Finally, the method of relative evaluation is given, which is also verified through a calculation example.

Beyond Needs Assessments: Marketing as Change Agent.

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Piland, William E.

1984-01-01

Views marketing techniques as agents of change providing valuable assistance to community college decision makers. Discusses the importance of a balance among the four P's of marketing (i.e., promotion, price, place, and product); and seven procedural steps in developing a sound marketing strategy. (DMM)

Conceptual Modeling of Events as Information Objects and Change Agents

DEFF Research Database (Denmark)

Bækgaard, Lars

as a totality of an information object and a change agent. When an event is modeled as an information object it is comparable to an entity that exists only at a specific point in time. It has attributes and can be used for querying and specification of constraints. When an event is modeled as a change agent...... it is comparable to an executable transaction schema. Finally, we briefly compare our approach to object-oriented approaches based on encapsulated objects....

Land-use change arising from rural land exchange : an agent-based simulation model

NARCIS (Netherlands)

Bakker, Martha M.; Alam, Shah Jamal; van Dijk, Jerry|info:eu-repo/dai/nl/29612642X; Rounsevell, Mark D. A.

Land exchange can be a major factor driving land-use change in regions with high pressure on land, but is generally not incorporated in land-use change models. Here we present an agent-based model to simulate land-use change arising from land exchange between multiple agent types representing

From change agent to sustainable scaffolding?

DEFF Research Database (Denmark)

Khalid, Md. Saifuddin; Nyvang, Tom

2014-01-01

that the change process in the institution has begun with the action research project, but also that it is probably too early to say for sure if the change is sustainable. With respect to doing action research in rural Bangladesh it is concluded that an action oriented approach is promising. The action research......Educational institutions in rural Bangladesh are faced with multiple problems and barriers when implementing ICT in teaching and learning. The paper reports from an ethnographic action research project set up in rural Bangladesh to induce change in a specific institution and to inform research...... about the barriers to ICT. The authors set out to research how a researcher and change agent by means of a participatory process can construct and distribute knowledge together with local stakeholders so that the local stakeholders ultimately can take charge of a continued development. It is concluded...

An Agent-Based Model for Addressing the Impact of a Disaster on Access to Primary Care Services.

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Guclu, Hasan; Kumar, Supriya; Galloway, David; Krauland, Mary; Sood, Rishi; Bocour, Angelica; Hershey, Tina Batra; van Nostrand, Elizabeth; Potter, Margaret

2016-06-01

Hurricane Sandy in the Rockaways, Queens, forced residents to evacuate and primary care providers to close or curtail operations. A large deficit in primary care access was apparent in the immediate aftermath of the storm. Our objective was to build a computational model to aid responders in planning to situate primary care services in a disaster-affected area. Using an agent-based modeling platform, HAZEL, we simulated the Rockaways population, its evacuation behavior, and primary care providers' availability in the aftermath of Hurricane Sandy. Data sources for this model included post-storm and community health surveys from New York City, a survey of the Rockaways primary care providers, and research literature. The model then tested geospatially specific interventions to address storm-related access deficits. The model revealed that areas of high primary care access deficit were concentrated in the eastern part of the Rockaways. Placing mobile health clinics in the most populous census tracts reduced the access deficit significantly, whereas increasing providers' capacity by 50% reduced the deficit to a lesser degree. An agent-based model may be a useful tool to have in place so that policy makers can conduct scenario-based analyses to plan interventions optimally in the event of a disaster. (Disaster Med Public Health Preparedness. 2016;10:386-393).

A qualitative study of a food intervention in a primary school: Pupils as agents of change.

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Ensaff, H; Canavon, C; Crawford, R; Barker, M E

2015-12-01

This study explored the impact of a school-based kitchen project at a large inner London school. Timetabled kitchen classroom sessions (90 min every fortnight) were held with all 7-9 year old pupils. Semi-structured focus group discussions (with 76 pupils, 16 parents) and interviews (with headteachers, catering managers and specialist staff) were conducted at the intervention school and a matched control school. Categories and concepts were derived using a grounded theory approach. Data analysis provided three main categories each with their related concepts: Pupil factors (enthusiasm and enjoyment of cooking, trying new foods, food knowledge and awareness, producing something tangible); School factors (learning and curriculum links, resource implications and external pressures) and Home factors (take home effects, confidence in cooking and self-esteem, parents' difficulties cooking at home with children). Children's engagement and the opportunity to cook supported increased food awareness, skills and food confidence. In the grounded theory that emerged, take home effects beyond the school gate dominate, as children act as agents of change and influence cooking and food choice at home. These short term outcomes have the potential to lead to longer term outcomes including changing eating behaviour and diet. Copyright © 2015 Elsevier Ltd. All rights reserved.

Leading Change in the Primary Science Curriculum

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Waller, Nicky; Baker, Chris

2014-01-01

Nicky Waller and Chris Baker believe that change can be a good thing and explain how their training has helped others to adjust to the new science curriculum. In September 2013, teachers across England received the definitive version of the new primary curriculum "Leading Change in the Primary Science Curriculum." This course aimed to…

[Effects of nootropic agents on visual functions and lacrimal antioxidative activity in patients with primary open-angle glaucoma].

Science.gov (United States)

Davydova, N G; Kuznetsova, T P; Borisova, S A; Abdulkadyrova, M Zh

2006-01-01

The paper presents the results of an investigation of the effect of the nootropic agents pantogam and nooclerine on visual functions in patients with primary open-angle glaucoma. These agents have been found to have a beneficial effect on the functional activity of the retina and optic nerve, light sensitivity, hemo- and hydrodynamics of the eye.

PRESCRIBING OF ANTIHYPERTENSIVE AGENTS IN PUBLIC PRIMARY CARE CLINICS – IS IT IN ACCORDANCE WITH CURRENT EVIDENCE?

Directory of Open Access Journals (Sweden)

SAJARI J

2010-01-01

Full Text Available Background: Large population surveys in Malaysia have consistently shown minimal improvement of blood pressure control rates over the last 10 years. Poor adherence to antihypertensive medication has been recognized as a major reason for poor control of hypertension. This study aimed to describe the prescribing pattern of antihypertensive agents in 2 public primary care clinics and assess its appropriateness in relation to current evidence and guidelines. Methods: A cross-sectional survey to describe the prescribing pattern of antihypertensive agents was carried out in 2 publicprimary care clinics in Selangor from May to June 2009. Hypertensive patients on pharmacological treatment for ≥1 year who attended the clinics within the study period of 7 weeks were selected. Appropriate use of antihypertensive agents was defined based on current evidence and the recommendations by the Malaysian Clinical Practice Guidelines (CPG on the Management of Hypertension, 2008. Data were obtained from patients’ medical records and were analysed using the SPSS software version 16.0. Results: A total of 400 hypertensive patients on treatment were included. Mean age was 59.5 years (SD ±10.9, range 28 to91 years, of which 52.8% were females and 47.2% were males. With regards to pharmacotherapy, 45.7% were on monotherapy,43.3% were on 2 agents and 11.0% were on ≥3 agents. Target blood pressure of <140/90mmHg was achieved in 51.4% of patients on monotherapy, and 33.2% of patients on combination of ≥2 agents. The commonest monotherapy agents being prescribed were β-blockers (atenolol or propranolol, followed by the short-acting calcium channel blocker (nifedipine. The commonest combination of 2-drug therapy prescribed was β-blockers and short-acting calcium channel blocker. Conclusion: This study shows that the prescribing pattern of antihypertensive agents in the 2 primary care clinics was not in accordance with current evidence and guidelines. �

Mixed Messages: How Primary Agents of Socialization Influence Adolescent Females Who Identify as Multiracial-Bisexual

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King, Alissa R.

2013-01-01

The goals of this study were to highlight the often stigmatized and invisible identities of six female participants who identify as multiracial/biracial-bisexual/pansexual, focusing on the pre-college context. Findings, using in-depth interviews, indicated that the primary socializing agents within the pre-college context strongly influenced…

Change Agents and Collective Experience- Making as Part of ...

African Journals Online (AJOL)

agents can enable and facilitate collective learning about climate change, as well as ... transcend such approaches through the development of longer-term social .... 'acquisition of mediated experiences in the learning rhythm of the immediate ...

Change Agents and Collective Experience-Making as Part of ...

African Journals Online (AJOL)

agents can enable and facilitate collective learning about climate change, as well ... interconnected global problems, meaning that efforts to reduce and adapt to ..... 'acquisition of mediated experiences in the learning rhythm of the immediate ...

Reforming primary healthcare: from public policy to organizational change.

Science.gov (United States)

Gilbert, Frédéric; Denis, Jean-Louis; Lamothe, Lise; Beaulieu, Marie-Dominique; D'amour, Danielle; Goudreau, Johanne

2015-01-01

Governments everywhere are implementing reform to improve primary care. However, the existence of a high degree of professional autonomy makes large-scale change difficult to achieve. The purpose of this paper is to elucidate the change dynamics and the involvement of professionals in a primary healthcare reform initiative carried out in the Canadian province of Quebec. An empirical approach was used to investigate change processes from the inception of a public policy to the execution of changes in professional practices. The data were analysed from a multi-level, combined contextualist-processual perspective. Results are based on a longitudinal multiple-case study of five family medicine groups, which was informed by over 100 interviews, questionnaires, and documentary analysis. The results illustrate the multiple processes observed with the introduction of planned large-scale change in primary care services. The analysis of change content revealed that similar post-change states concealed variations between groups in the scale of their respective changes. The analysis also demonstrated more precisely how change evolved through the introduction of "intermediate change" and how cycles of prescribed and emergent mechanisms distinctively drove change process and change content, from the emergence of the public policy to the change in primary care service delivery. This research was conducted among a limited number of early policy adopters. However, given the international interest in turning to the medical profession to improve primary care, the results offer avenues for both policy development and implementation. The findings offer practical insights for those studying and managing large-scale transformations. They provide a better understanding of how deliberate reforms coexist with professional autonomy through an intertwining of change content and processes. This research is one of few studies to examine a primary care reform from emergence to implementation

Agents of Change: Studies on the Policy Environment for Small ...

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

Agents of Change presents the results of an international conference held in Africa. It provides practical solutions and suggestions for real change. It discusses national strategies for small enterprises, examines legal, regulatory, and tax reform, and makes proposals on how to improve competitiveness and access to credit.

Weight Control: Attitudes of Dieters and Change Agents.

Science.gov (United States)

Parham, Ellen S.; And Others

1991-01-01

Survey explores attitudes toward weight loss/weight control among 2 groups of change agents--40 dietitians and 42 fitness instructors--and among 96 people trying to lose weight. Significant differences were found in terms of importance in weight control of diet, drugs, exercise, religion, and will power; in importance of being of normal weight;…

Decadal Changes in Global Ocean Annual Primary Production

Science.gov (United States)

Gregg, Watson; Conkright, Margarita E.; Behrenfeld, Michael J.; Ginoux, Paul; Casey, Nancy W.; Koblinsky, Chester J. (Technical Monitor)

2002-01-01

The Sea-viewing Wide Field-of-View Sensor (SeaWiFS) has produced the first multi-year time series of global ocean chlorophyll observations since the demise of the Coastal Zone Color Scanner (CZCS) in 1986. Global observations from 1997-present from SeaWiFS combined with observations from 1979-1986 from the CZCS should in principle provide an opportunity to observe decadal changes in global ocean annual primary production, since chlorophyll is the primary driver for estimates of primary production. However, incompatibilities between algorithms have so far precluded quantitative analysis. We have developed and applied compatible processing methods for the CZCS, using modern advances in atmospheric correction and consistent bio-optical algorithms to advance the CZCS archive to comparable quality with SeaWiFS. We applied blending methodologies, where in situ data observations are incorporated into the CZCS and SeaWiFS data records, to provide improvement of the residuals. These re-analyzed, blended data records provide maximum compatibility and permit, for the first time, a quantitative analysis of the changes in global ocean primary production in the early-to-mid 1980's and the present, using synoptic satellite observations. An intercomparison of the global and regional primary production from these blended satellite observations is important to understand global climate change and the effects on ocean biota. Photosynthesis by chlorophyll-containing phytoplankton is responsible for biotic uptake of carbon in the oceans and potentially ultimately from the atmosphere. Global ocean annual primary decreased from the CZCS record to SeaWiFS, by nearly 6% from the early 1980s to the present. Annual primary production in the high latitudes was responsible for most of the decadal change. Conversely, primary production in the low latitudes generally increased, with the exception of the tropical Pacific. The differences and similarities of the two data records provide evidence

Persuasive Embodied Agents: Using Embodied Agents to Change People's Behavior, Beliefs, and Assessments

Science.gov (United States)

Pickard, Matthew David

2012-01-01

Embodied Conversational Agents (i.e., avatars; ECAs) are appearing in increasingly many everyday contexts, such as e-commerce, occupational training, and airport security. Also common to a typical person's daily life is persuasion. Whether being persuaded or persuading, the ability to change another person's attitude or behavior is a…

The Cost of Performance? Students' Learning about Acting as Change Agents in Their Schools

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Kehoe, Ian

2015-01-01

This paper explores how performance culture could affect students' learning about, and disposition towards, acting as organisational change agents in schools. This is based on findings from an initiative aimed to enable students to experience acting as change agents on an aspect of the school's culture that concerned them. The initiative was…

Views of Primary School Administrators on Change in Schools and Change Management Practices

Science.gov (United States)

Hosgörür, Vural

2016-01-01

The aim of this study is to determine the opinions of primary school administrators about change, and to reveal which strategies they use to manage change in schools. This is a qualitative study conducted in 2014 academic year in Mugla province. Research data were collected from primary school administrators through semi-structured interviews.…

Cultivar-Specific Changes in Primary and Secondary Metabolites in Pak Choi (Brassica Rapa, Chinensis Group by Methyl Jasmonate

Directory of Open Access Journals (Sweden)

Moo Jung Kim

2017-05-01

Full Text Available Glucosinolates, their hydrolysis products and primary metabolites were analyzed in five pak choi cultivars to determine the effect of methyl jasmonate (MeJA on metabolite flux from primary metabolites to glucosinolates and their hydrolysis products. Among detected glucosinolates (total 14 glucosinolates; 9 aliphatic, 4 indole and 1 aromatic glucosinolates, indole glucosinolate concentrations (153–229% and their hydrolysis products increased with MeJA treatment. Changes in the total isothiocyanates by MeJA were associated with epithiospecifier protein activity estimated as nitrile formation. Goitrin, a goitrogenic compound, significantly decreased by MeJA treatment in all cultivars. Changes in glucosinolates, especially aliphatic, significantly differed among cultivars. Primary metabolites including amino acids, organic acids and sugars also changed with MeJA treatment in a cultivar-specific manner. A decreased sugar level suggests that they might be a carbon source for secondary metabolite biosynthesis in MeJA-treated pak choi. The result of the present study suggests that MeJA can be an effective agent to elevate indole glucosinolates and their hydrolysis products and to reduce a goitrogenic compound in pak choi. The total glucosinolate concentration was the highest in “Chinese cabbage” in the control group (32.5 µmol/g DW, but indole glucosinolates increased the greatest in “Asian” when treated with MeJA.

Bis(trialkylsilyl) peroxides as alkylating agents in the copper-catalyzed selective mono-N-alkylation of primary amides.

Science.gov (United States)

Sakamoto, Ryu; Sakurai, Shunya; Maruoka, Keiji

2017-06-13

The copper-catalyzed selective mono-N-alkylation of primary amides with bis(trialkylsilyl) peroxides as alkylating agents was reported. The results of a mechanistic study suggest that this reaction should proceed via a free radical process that includes the generation of alkyl radicals from bis(trialkylsilyl) peroxides.

Linking Cognitive and Social Aspects of Sound Change Using Agent-Based Modeling.

Science.gov (United States)

Harrington, Jonathan; Kleber, Felicitas; Reubold, Ulrich; Schiel, Florian; Stevens, Mary

2018-03-26

The paper defines the core components of an interactive-phonetic (IP) sound change model. The starting point for the IP-model is that a phonological category is often skewed phonetically in a certain direction by the production and perception of speech. A prediction of the model is that sound change is likely to come about as a result of perceiving phonetic variants in the direction of the skew and at the probabilistic edge of the listener's phonological category. The results of agent-based computational simulations applied to the sound change in progress, /u/-fronting in Standard Southern British, were consistent with this hypothesis. The model was extended to sound changes involving splits and mergers by using the interaction between the agents to drive the phonological reclassification of perceived speech signals. The simulations showed no evidence of any acoustic change when this extended model was applied to Australian English data in which /s/ has been shown to retract due to coarticulation in /str/ clusters. Some agents nevertheless varied in their phonological categorizations during interaction between /str/ and /ʃtr/: This vacillation may represent the potential for sound change to occur. The general conclusion is that many types of sound change are the outcome of how phonetic distributions are oriented with respect to each other, their association to phonological classes, and how these types of information vary between speakers that happen to interact with each other. Copyright © 2018 The Authors. Topics in Cognitive Science published by Wiley Periodicals, Inc. on behalf of Cognitive Science Society.

Climate as an agent of change in forest landscapes

Science.gov (United States)

Louis R. Iverson; Anantha M. Prasad; Stephen N. Matthews; Matthew P. Peters

2014-01-01

Climate is the primary force that controls forest composition and the broad-scale distribution of forests. The climate has always been changing, but the changes now underway are different—they are faster and they are intermingled with other disturbances promoted by increasing human pressures. The projected climate change during the twenty-first century will...

Children as agents of change in combatting antibiotic resistance.

Science.gov (United States)

Molnar, Andreea

2017-01-01

Antibiotic resistance is a worldwide problem and changes are needed in the way antibiotics are used. The value of engaging children as key contributors in health care campaigns to increase the appropriate use of antibiotics has not been fully recognized. Little is known about how to design educational materials for children in order to enable them to be agents of change in their communities. Science education needs to improve the way it engages children so as to give them the tools needed to make responsible decisions on antibiotic use.

Immunosuppressive Agents for the Treatment of Primary Sclerosing Cholangitis: A Systematic Review and Meta-Analysis.

Science.gov (United States)

Peng, Xia; Luo, Xin; Hou, Jing-Ying; Wu, Shu-Yun; Li, Liang-Zong; Zheng, Ming-Hua; Wang, Ling-Yun

2017-01-01

Currently, there are no effective therapeutic agents for patients with primary sclerosing cholangitis (PSC). This study aimed to evaluate the safety and efficiency of immunosuppressive agents (IAs) for the treatment of PSC. The literatures were searched using the following keywords singly or in combination: PSC, treatments, IAs. The primary outcome was defined as the need for liver transplantation or mortality. Two hundred sixty six patients from 7 eligible studies were analyzed. IAs had no remarkable effects on the rate of mortality or liver transplantation (relative risk, RR 1.02, 95% CI 0.58-1.62, p = 0.92). Subgroup analyses showed no significant effect of IAs co-administration therapy (IAs co-administered with ursodeoxycholic acid, IA co-administered with IA; RR 1.41, 95% CI 0.40-4.95, p = 0.60). IAs caused adverse events (AEs) such as diarrhea, abdominal pain, and pruritus (RR 1.81, 95% CI 1.07-3.07, p = 0.03). IAs therapy did not significantly improve markers of liver function except for aspartate transaminase (weighted mean difference -9.76, 95% CI -12.92 to -6.6, p IAs administrated as either monotherapy or combination therapy do not reduce the risk of mortality or liver transplantation. IAs monotherapy is associated with AEs. © 2017 S. Karger AG, Basel.

A simple culture method inducing sexual reproduction by Fusarium graminearum, the primary causal agent of Fusarium head blight

Science.gov (United States)

The homothallic ascomycete fungus Fusarium graminearum is the primary causal agent of Fusarium head blight (FHB), a devastating disease of wheat and barley worldwide. The fungus undergoes both asexual and sexual stages in its life cycle. The asexual stage produces conidiospores, whereas the sexual s...

Alkylsilyl Peroxides as Alkylating Agents in the Copper-Catalyzed Selective Mono-N-Alkylation of Primary Amides and Arylamines.

Science.gov (United States)

Sakamoto, Ryu; Sakurai, Shunya; Maruoka, Keiji

2017-07-06

The copper-catalyzed selective mono-N-alkylation of primary amides or arylamines using alkylsilyl peroxides as alkylating agents is reported. The reaction proceeds under mild reaction conditions and exhibits a broad substrate scope with respect to the alkylsilyl peroxides, as well as to the primary amides and arylamines. Mechanistic studies suggest that the present reaction should proceed through a free-radical process that includes alkyl radicals generated from the alkylsilyl peroxides. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Dual-Energy Micro-Computed Tomography Imaging of Radiation-Induced Vascular Changes in Primary Mouse Sarcomas

International Nuclear Information System (INIS)

Moding, Everett J.; Clark, Darin P.; Qi, Yi; Li, Yifan; Ma, Yan; Ghaghada, Ketan; Johnson, G. Allan; Kirsch, David G.; Badea, Cristian T.

2013-01-01

Purpose: To evaluate the effects of radiation therapy on primary tumor vasculature using dual-energy (DE) micro-computed tomography (micro-CT). Methods and Materials: Primary sarcomas were generated with mutant Kras and p53. Unirradiated tumors were compared with tumors irradiated with 20 Gy. A liposomal-iodinated contrast agent was administered 1 day after treatment, and mice were imaged immediately after injection (day 1) and 3 days later (day 4) with DE micro-CT. CT-derived tumor sizes were used to assess tumor growth. After DE decomposition, iodine maps were used to assess tumor fractional blood volume (FBV) at day 1 and tumor vascular permeability at day 4. For comparison, tumor vascularity and vascular permeability were also evaluated histologically by use of CD31 immunofluorescence and fluorescently-labeled dextrans. Results: Radiation treatment significantly decreased tumor growth from day 1 to day 4 (P 2 =0.53) and dextran accumulation (R 2 =0.63) on day 4, respectively. Despite no change in MVD measured by histology, tumor FBV significantly increased after irradiation as measured by DE micro-CT (0.070 vs 0.091, P<.05). Both dextran and liposomal-iodine accumulation in tumors increased significantly after irradiation, with dextran fractional area increasing 5.2-fold and liposomal-iodine concentration increasing 4.0-fold. Conclusions: DE micro-CT is an effective tool for noninvasive assessment of vascular changes in primary tumors. Tumor blood volume and vascular permeability increased after a single therapeutic dose of radiation treatment

Magnetic resonance imaging with liver-specific contrast agent in primary amyloidosis and intrahepatic cholestasis

Energy Technology Data Exchange (ETDEWEB)

Moeller, J.M.; Santoni-Rugiu, E.; Chabanova, E.; Logager, V.; Hansen, A.B.; Thomsen, H.S. [Depts. of Radiology and Pathology, Copenhagen Univ. Hospital, Herlev (Denmark)

2007-02-15

Magnetic resonance imaging (MRI) findings in hepatic amyloidosis are not well defined. Here, we report on a patient with renal failure caused by primary amyloidosis (AL type) who developed jaundice. Ultrasound and computed tomography were normal except for some ascites. MRI with oral manganese-containing contrast agent revealed several focal areas without contrast uptake in the hepatocytes and no bile secretion after 8 hours. No extrahepatic bile obstructions were found. Liver biopsy showed severe intraportal, vascular, and parenchymal amyloidosis causing severe cholestasis and atrophy of hepatocytes.

An agent-based approach equipped with game theory. Strategic collaboration among learning agents during a dynamic market change in the California electricity crisis

Energy Technology Data Exchange (ETDEWEB)

Sueyoshi, Toshiyuki [Department of Management, New Mexico Institute of Mining and Technology, Socorro, NM 87801 (United States); Department of Industrial and Information Management, National Cheng Kung University, Tainan (China)

2010-09-15

An agent-based approach is a numerical (computer-intensive) method to explore the complex characteristics and dynamics of microeconomics. Using the agent-based approach, this study investigates the learning speed of traders and their strategic collaboration in a dynamic market change of electricity. An example of such a market change can be found in the California electricity crisis (2000-2001). This study incorporates the concept of partial reinforcement learning into trading agents and finds that they have two learning components: learning from a dynamic market change and learning from collaboration with other traders. The learning speed of traders becomes slow when a large fluctuation occurs in the power exchange market. The learning speed depends upon the type of traders, their learning capabilities and the fluctuation of market fundamentals. The degree of collaboration among traders gradually reduces during the electricity crisis. The strategic collaboration among traders is examined by a large simulator equipped with multiple learning capabilities. (author)

An agent-based approach equipped with game theory. Strategic collaboration among learning agents during a dynamic market change in the California electricity crisis

International Nuclear Information System (INIS)

Sueyoshi, Toshiyuki

2010-01-01

An agent-based approach is a numerical (computer-intensive) method to explore the complex characteristics and dynamics of microeconomics. Using the agent-based approach, this study investigates the learning speed of traders and their strategic collaboration in a dynamic market change of electricity. An example of such a market change can be found in the California electricity crisis (2000-2001). This study incorporates the concept of partial reinforcement learning into trading agents and finds that they have two learning components: learning from a dynamic market change and learning from collaboration with other traders. The learning speed of traders becomes slow when a large fluctuation occurs in the power exchange market. The learning speed depends upon the type of traders, their learning capabilities and the fluctuation of market fundamentals. The degree of collaboration among traders gradually reduces during the electricity crisis. The strategic collaboration among traders is examined by a large simulator equipped with multiple learning capabilities. (author)

An Agent-Based Reasoning of Impacts of Regional Climate Changes on Land Use Changes in the Three-River Headwaters Region of China

Directory of Open Access Journals (Sweden)

Tao Zhang

2013-01-01

Full Text Available The land surface in Three-River Headwaters Region (TRHR, a typical ecological fragile zone of China, is quite sensitive to the climate changes which will destabilize certain ecosystem services valuable to the entire nation and neighboring countries. This study aimed to analyze the impacts of climate changes and agents’ adaptive behaviors on the regional land use changes with the agent based model (ABM. First, the main agents were extracted according to the production resources endowments and socioeconomic background. Then the agents’ land use behaviors were analyzed and parameterized. Thereafter, the ABM model was built to simulate the impacts of the climate changes on the regional land use changes and agents’ economic benefits. The results showed that the land use changes were mainly characterized by the increase of grassland and decrease of unused land area. Besides, the agents would get more wealth under the scenario without climate changes in the long term, even though the total income is lower than that under the scenario with climate changes. In addition, the sensitivity analysis indicated that the model is sensitive to the climatic conditions, market price of agricultural and animal husbandry products, government subsidies, and cost control.

Pulp tissue response to Portland cement associated with different radio pacifying agents on pulpotomy of human primary molars.

Science.gov (United States)

Marques, N; Lourenço Neto, N; Fernandes, A P; Rodini, C; Hungaro Duarte, M; Rios, D; Machado, M A; Oliveira, T

2015-12-01

The objective of this research was to evaluate the response of Portland cement associated with different radio pacifying agents on pulp treatment of human primary teeth by clinical and radiographic exams and microscopic analysis. Thirty mandibular primary molars were randomly divided into the following groups: Group I - Portland cement; Group II - Portland cement with iodoform (Portland cement + CHI3 ); Group III - Portland cement with zirconium oxide (Portland cement + ZrO2 ); and treated by pulpotomy technique (removal of a portion of the pulp aiming to maintain the vitally of the remaining radicular pulp tissue using a therapeutic dressing). Clinical and radiographic evaluations were recorded at 6, 12 and 24 months follow-up. The teeth at the regular exfoliation period were extracted and processed for histological analysis. Data were tested using statistical analysis with a significance level of 5%. The microscopic findings were descriptively analysed. All treated teeth were clinically and radiographically successful at follow-up appointments. The microscopic analysis revealed positive response to pulp repair with hard tissue barrier formation and pulp calcification in the remaining roots of all available teeth. The findings of this study suggest that primary teeth pulp tissue exhibited satisfactory biological response to Portland cement associated with radio pacifying agents. However, further studies with long-term follow-up are needed to determine the safe clinical indication of this alternative material for pulp therapy of primary teeth. © 2015 The Authors Journal of Microscopy © 2015 Royal Microscopical Society.

Gendering democratisation: women as change agents in transition contexts

Directory of Open Access Journals (Sweden)

Andrea Fleschenberg Fleschenberg

2012-02-01

Full Text Available During the last two decades, women politicians have emerged as female democratisation agents, i.e. change agents who actively lobby, struggle and organize for a pro-democracy regime change and a subsequent functioning democratic system, often with a (or the only mass following – whose personal sacrifices, political contributions and legacies arelargely overlooked or contested in related democratisation and gender studies. This article aims to critically assess in how far democratisation and gender studies have systematically studied and analysed the contributions towards democratisation and the consolidation of democracy made by women as head of state or government. It is argued, that there is a strong research desideratum with regard to this phenomenon despite statistical evidence in Latin America, Europe, sub-Saharan Africa and Asia. An overview of different case studies of women heads of state and government in Southern and Eastern Europe, Latin America, South and Southeast Asia is presented, outlining the career paths, political agenda and democratisation record of the respective female democratisation agents. Nevertheless, systematic and substantial research needs to be conducted to allow a profound and appropriate assessment of the political performance and legacies of female democratisation agents at the top echelons of political power. These studies can contribute to a better understanding of the nexus of gender and democratisation, gender and politics as well as to enlarge the explanatory strength of democratisation theories in general.Durante las dos últimas décadas, las mujeres políticas han emergido como agentes femeninos de democratización, es decir agentes de cambio como grupos de presión activos, que luchan y se organizan en pro de un cambio hacia el régimen democrático y al subsiguiente funcionamiento del sistema, a menudo con el seguimiento de las masas (incluso el único – quienes con sus sacrificios

Radiation proctitis in the rat. Sequential changes and effects of anti-inflammatory agents

Energy Technology Data Exchange (ETDEWEB)

Northway, M.G.; Scobey, M.W.; Geisinger, K.R.

1988-11-01

Female Wistar rats were treated with single exposure irradiation to 2 cm of distal colon to cause radiation proctitis. All animals were evaluated by examination, colonoscopy and histologic evaluation for changes post-irradiation. Exposures of 10, 12.5, 15, 17.5, 20, 22.5, 25, 27.5 and 30 Gy caused dose-related clinical and histologic changes peaking at 7 to 15 days post-exposure. Rats treated with 20 Gy were colonoscoped and biopsied daily and showed sequential post-irradiation endoscopic changes ranging from mucosal edema and mild inflammatory changes to erosion and ulcers. Histologically, crypt abscess and mural wall necrosis similar to changes found in the human rectum after radiotherapy were noted. Treatment with nonsteroidal anti-inflammatory agents, (aspirin, indomethacin, piroxicam), misoprostol (a prostaglandin E1 analogue), or sucralfate (an anti-ulcer agent) did not ameliorate nor exacerbate radiation proctitis in rats exposed to 22.5 Gy. We conclude from these data that the female Wistar rat is a good model for studying radiation proctitis because endoscopic, histologic, and clinical changes seen post-exposure closely resemble those found in man.

Radiation proctitis in the rat. Sequential changes and effects of anti-inflammatory agents

International Nuclear Information System (INIS)

Northway, M.G.; Scobey, M.W.; Geisinger, K.R.

1988-01-01

Female Wistar rats were treated with single exposure irradiation to 2 cm of distal colon to cause radiation proctitis. All animals were evaluated by examination, colonoscopy and histologic evaluation for changes post-irradiation. Exposures of 10, 12.5, 15, 17.5, 20, 22.5, 25, 27.5 and 30 Gy caused dose-related clinical and histologic changes peaking at 7 to 15 days post-exposure. Rats treated with 20 Gy were colonoscoped and biopsied daily and showed sequential post-irradiation endoscopic changes ranging from mucosal edema and mild inflammatory changes to erosion and ulcers. Histologically, crypt abscess and mural wall necrosis similar to changes found in the human rectum after radiotherapy were noted. Treatment with nonsteroidal anti-inflammatory agents, (aspirin, indomethacin, piroxicam), misoprostol (a prostaglandin E1 analogue), or sucralfate (an anti-ulcer agent) did not ameliorate nor exacerbate radiation proctitis in rats exposed to 22.5 Gy. We conclude from these data that the female Wistar rat is a good model for studying radiation proctitis because endoscopic, histologic, and clinical changes seen post-exposure closely resemble those found in man

Your company's secret change agents.

Science.gov (United States)

Pascale, Richard Tanner; Sternin, Jerry

2005-05-01

Organizational change has traditionally come about through top-down initiatives such as hiring experts or importing best-of-breed practices. Such methods usually result in companywide rollouts of templates mandated from on high. These do little to get people excited. But within every organization, there are a few individuals who find unique ways to look at problems that seem impossible to solve. Although these change agents start out with the same tools and access to resources as their peers, they are able to see solutions where others do not. They find a way to bridge the divide between what is happening and what is possible. These positive deviants are the key, the authors believe, to a better way of creating organizational change. Your company can make the most of their methods by following six steps. In Step 1, Make the group the guru, the members of the community are engaged in the process of their own evolution. Step 2, Reframe through facts, entails restating the problem in a way that opens minds to new possibilities. Step 3, Make it safe to learn, involves creating an environment that supports innovative ideas. In Step 4, Make the problem concrete, the community combats abstraction by stating uncomfortable truths. In Step 5, Leverage social proof, the community looks to the larger society for examples of solutions that have worked in parallel situations. In Step 6, Confound the immune defense response, solutions are introduced organically from within the group in a way that promotes acceptance. Throughout the steps, the leader must suspend his or her traditional role in favor of more facilitatory practices. The positive-deviance approach has unearthed solutions to such complicated and diverse problems as malnutrition in Mali and human trafficking in East Java. This methodology can help solve even the most extreme dilemmas.

Teachers as Agents of Change: Promoting Peacebuilding and Social Cohesion in Schools in Rwanda

Science.gov (United States)

Rubagiza, Jolly; Umutoni, Jane; Kaleeba, Ali

2016-01-01

Education is seen to play a crucial role in the reconstruction of post-conflict countries, particularly in transforming people's mindsets and rebuilding social relations. In this regard, teachers are often perceived as key agents to bring about this transformative change through their role as agents of peace. This paper seeks to understand how…

Teaching Primary School Music: Coping with Changing Work Conditions

Science.gov (United States)

de Vries, Peter Andrew

2018-01-01

The changing roles of two primary (elementary) school music teachers are explored in this article, and how these changed roles have impacted on music programmes in their respective schools. Change readiness provides the theoretical framework for investigating the way both teachers responded to their changing roles. The first teacher's role changed…

Gelatin sponge particle used as an embolic agent in transcatheter arterial chemoembolization treatment for primary hepatocellular carcinoma: its current situation in research

International Nuclear Information System (INIS)

Ao Jin; Zhang Yuewei; Xu Ke

2011-01-01

Transcatheter arterial chemoembolization (TACE) is one of the most commonly used therapeutic procedures for primary hepatocellular carcinoma (HCC). As an important and easily-available embolic agent, gelatin sponge (Gelfoam) particles have been constantly and widely employed in clinical practice. Various types of embolic agents have been continuously developed and effectively used in TACE for liver cancers. For recent years, great progress has been made in the clinical use of gelatin sponge particles, as the most traditional embolic agent, in the interventional therapeutic field for HCC. This article aims to make a comprehensive review about gelatin sponge. (authors)

Performance analysis of spectrum sensing with multiple status changes in primary user traffic

KAUST Repository

Tang, Liang

2012-06-01

In this letter, the impact of primary user traffic with multiple status changes on the spectrum sensing performance is analyzed. Closed-form expressions for the probabilities of false alarm and detection are derived. Numerical results show that the multiple status changes of the primary user cause considerable degradation in the sensing performance. This degradation depends on the number of changes, the primary user traffic model, the primary user traffic intensity and the signal-to-noise ratio of the received signal. Numerical results also show that the amount of degradation decreases when the number of changes increases, and converges to a minimum sensing performance due to the limited sensing period and primary holding time. © 2012 IEEE.

Changing the lens: widening the approach to primary care research.

Science.gov (United States)

Checkland, Kath

2003-10-01

After years of being shielded from most of the managerial and organisational changes in health care, primary care is going through a period of change in many countries. Much of the research that has been done in primary care, in common with that in secondary care, puts at the centre of its methodology the concept of professionalism. However, there are other ways of theorising medical work, and using a wider range of theoretical 'lenses' when planning research into the impact of change will enhance and enrich that research. Viewing primary care physicians as 'workers', concerned, like other workers, with constructing understanding of what they do that helps them cope with pressures and uncertainties, shifts the focus of research questions away from issues of professional status towards the practical ways in which they deal with change in their local contexts. Research using this theoretical approach may be able to explain phenomena that other, more broad-brush approaches cannot.

How can we become agents for change toward a better, greener world?

DEFF Research Database (Denmark)

Musaeus, Peter; Crossley, Elizabeth; Mueller, Matthew

2017-01-01

In spite of the increasing global urgency of social and environmental impacts on health, medical students and other health professionals do not necessarily appreciate their potential role in becoming agents for social change. Research demonstrates a variety of barriers exist which prevent us from...... a means for encouraging students and others to be green social change agents. The Activity: A balloon will be decorated to look like the earth, and the audience will be required to try to keep the balloon in the air. One participant will be identified as the student. We will identify barriers the student...... may face by attaching objects to the balloon (external barriers) or to the participant (internal barriers), thus increasing the difficulty of suspending the balloon. We will then identify solutions to these barriers and gradually remove the objects, leaving the participant unimpeded. Finally, we...

Dual-Energy Micro-Computed Tomography Imaging of Radiation-Induced Vascular Changes in Primary Mouse Sarcomas

Energy Technology Data Exchange (ETDEWEB)

Moding, Everett J. [Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, North Carolina (United States); Clark, Darin P.; Qi, Yi [Center for In Vivo Microscopy, Department of Radiology, Duke University Medical Center, Durham, North Carolina (United States); Li, Yifan; Ma, Yan [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Ghaghada, Ketan [The Edward B. Singleton Department of Pediatric Radiology, Texas Children' s Hospital, Houston, Texas (United States); Johnson, G. Allan [Center for In Vivo Microscopy, Department of Radiology, Duke University Medical Center, Durham, North Carolina (United States); Kirsch, David G. [Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, North Carolina (United States); Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Badea, Cristian T., E-mail: cristian.badea@duke.edu [Center for In Vivo Microscopy, Department of Radiology, Duke University Medical Center, Durham, North Carolina (United States)

2013-04-01

Purpose: To evaluate the effects of radiation therapy on primary tumor vasculature using dual-energy (DE) micro-computed tomography (micro-CT). Methods and Materials: Primary sarcomas were generated with mutant Kras and p53. Unirradiated tumors were compared with tumors irradiated with 20 Gy. A liposomal-iodinated contrast agent was administered 1 day after treatment, and mice were imaged immediately after injection (day 1) and 3 days later (day 4) with DE micro-CT. CT-derived tumor sizes were used to assess tumor growth. After DE decomposition, iodine maps were used to assess tumor fractional blood volume (FBV) at day 1 and tumor vascular permeability at day 4. For comparison, tumor vascularity and vascular permeability were also evaluated histologically by use of CD31 immunofluorescence and fluorescently-labeled dextrans. Results: Radiation treatment significantly decreased tumor growth from day 1 to day 4 (P<.05). There was a positive correlation between CT measurement of tumor FBV on day 1 and extravasated iodine on day 4 with microvascular density (MVD) on day 4 (R{sup 2}=0.53) and dextran accumulation (R{sup 2}=0.63) on day 4, respectively. Despite no change in MVD measured by histology, tumor FBV significantly increased after irradiation as measured by DE micro-CT (0.070 vs 0.091, P<.05). Both dextran and liposomal-iodine accumulation in tumors increased significantly after irradiation, with dextran fractional area increasing 5.2-fold and liposomal-iodine concentration increasing 4.0-fold. Conclusions: DE micro-CT is an effective tool for noninvasive assessment of vascular changes in primary tumors. Tumor blood volume and vascular permeability increased after a single therapeutic dose of radiation treatment.

Primary health care lessons from the Northeast of Brazil: the Agentes de Saúde Program Lecciones del Nordeste de Brasil sobre la atención primaria de salud: el Programa de Agentes de Salud

Directory of Open Access Journals (Sweden)

Ennio Cufino Svitone

2000-05-01

Full Text Available Market-led economic reforms are usually viewed as being in conflict with government-stimulated socioeconomic development for disadvantaged groups. Nevertheless, Ceará, a poor state in the Northeast of Brazil, has since 1987 pursued both of those strategies simultaneously. One part of that approach has been a program of nurse-directed auxiliary health workers serving about 5 million people--almost all the persons outside the capital city and half of those in the capital. The system requires that the auxiliaries, called agentes de saúde, live in the local communities that they serve. The health agents visit each home once a month to carry out a small number of priority health activities. While health agent positions are in high demand, the minimum-wage salary that the agents receive makes up only a small portion of the state budget. A key aspect of the system is timely and comprehensive information, which is based on agent visits and is managed by trained nurses. Since the health agents system was launched, there has been a rapid decline in infant mortality, a rapid rise in immunization, identification of bottlenecks limiting the utilization of other medical resources, and timely interventions in times of crisis. The health agents system has combined administrative decentralization with financial centralization during a period of electoral democratization. The system has strengthened Ceará's commitment to primary care even as market-oriented changes have reduced the overall role of government. The Ceará program is being copied throughout the Northeast and other regions of Brazil. The key role that nurses play in the Ceará program in organizing and leading a system of basic primary care in poor neighborhoods and rural areas may provide useful lessons for other countries. In addition, Ceará does not have many of the favorable characteristics of other countries that have successfully invested in primary health care. Ceará thus represents a

Wetlands in Canada's western boreal forest: Agents of change

Energy Technology Data Exchange (ETDEWEB)

Foote, L.; Krogman, N. [University of Alberta, Edmonton, AB (Canada). Dept. of Renewable Resources

2006-11-15

Wetlands of the western boreal forest are poorly studied. In the last decade (1990-2000) there were approximately 1810 northern hemisphere scientific papers published addressing boreal wetlands, tundra, taiga, or bogs. We explore the extent of understanding and impacts of six major agents of change affecting forested wetlands of the boreal zone: (1) commercial forestry, (2) petroleum extraction, (3) mining (bitumen, coal, peat, ore, and diamonds), (4) agriculture, (5) climate change, and (6) hydrologic alteration. Finally, we address the social context, costs, and recommendations for wetland maintenance.

Mesenchymal Stem Cells as New Therapeutic Agents for the Treatment of Primary Biliary Cholangitis

Directory of Open Access Journals (Sweden)

Aleksandar Arsenijevic

2017-01-01

Full Text Available Primary biliary cholangitis (PBC is a chronic autoimmune cholestatic liver disease characterized by the progressive destruction of small- and medium-sized intrahepatic bile ducts with resultant cholestasis and progressive fibrosis. Ursodeoxycholic acid and obethicholic acid are the only agents approved by the US Food and Drug Administration (FDA for the treatment of PBC. However, for patients with advanced, end-stage PBC, liver transplantation is still the most effective treatment. Accordingly, the alternative approaches, such as mesenchymal stem cell (MSC transplantation, have been suggested as an effective alternative therapy for these patients. Due to their immunomodulatory characteristics, MSCs are considered as promising therapeutic agents for the therapy of autoimmune liver diseases, including PBC. In this review, we have summarized the therapeutic potential of MSCs for the treatment of these diseases, emphasizing molecular and cellular mechanisms responsible for MSC-based effects in an animal model of PBC and therapeutic potential observed in recently conducted clinical trials. We have also presented several outstanding problems including safety issues regarding unwanted differentiation of transplanted MSCs which limit their therapeutic use. Efficient and safe MSC-based therapy for PBC remains a challenging issue that requires continuous cooperation between clinicians, researchers, and patients.

Ocular changes in primary hypothyroidism.

Science.gov (United States)

Ozturk, Banu T; Kerimoglu, Hurkan; Dikbas, Oguz; Pekel, Hamiyet; Gonen, Mustafa S

2009-12-29

To determine the ocular changes related to hypothyrodism in newly diagnosed patients without orbitopathy. Thirty-three patients diagnosed to have primary overt hypothyroidism were enrolled in the study. All subjects were assigned to underwent central corneal thickness (CCT), anterior chamber volume, depth and angle measurements with the Scheimpflug camera (Pentacam, Oculus) and cup to disc ratio (C/D), mean retinal thickness and mean retinal nerve fiber layer (RNFL) thickness measurements with optical coherence tomography (OCT) in addition to ophthalmological examination preceeding the replacement therapy and at the 1(st), 3(rd )and 6(th )months of treatment. The mean age of the patients included in the study were 40.58 +/- 1.32 years. The thyroid hormone levels return to normal levels in all patients during the follow-up period, however the mean intraocular pressure (IOP) revealed no significant change. The mean CCT was 538.05 +/- 3.85 mu initially and demonstrated no statistically significant change as the anterior chamber volume, depth and angle measurements did. The mean C/D ratio was 0.29 +/- 0.03 and the mean retinal thickness was 255.83 +/- 19.49 mu initially and the treatment did not give rise to any significant change. The mean RNFL thickness was also stable during the control visits, so no statistically significant change was encountered. Neither hypothyroidism, nor its replacement therapy gave rise to any change of IOP, CCT, anterior chamber parameters, RNFL, retinal thickness and C/D ratio.

Endocrine active agents: implications of adverse and non-adverse changes.

Science.gov (United States)

Foster, Paul M D; McIntyre, Barry S

2002-01-01

The US Environmental Protection Agency (EPA) is currently in the process of developing screening and testing methodologies for the assessment of agents that may possess endocrine-like activity--the so-called endocrine disruptors. Moreover, the EPA has signaled its intention of placing information arising from such studies on the worldwide web. This has created significant interest in how such information may be used in risk assessment and by policymakers and the public in the potential regulation or deselection of specific chemical agents. The construction of lists of endocrine disruptors, although fulfilling the requirements of some parties, is really of little use when the nature of the response, the dose level employed, and the lifestage of the test species used are not given. Thus, we have already seen positive in vitro information available on the interaction with a receptor being used as a key indicator when the results of large, high quality in vivo studies showing no adverse changes have been ignored. Clearly a number of in vitro systems are available to ascertain chemical interaction with specific (mainly steroid) hormone receptors including a number of reporter gene assays. These assays only provide indicators of potential problems and should not be, in isolation, indicators of toxicity. Likewise, short-term in vivo screens such as the uterotrophic and Hershberger studies are frequently conducted in castrated animals and thus indicate the potential for a pharmacological response in vivo rather than an adverse effect. A number of new end points have been added to standard rodent testing protocols in the belief of providing more sensitivity to detect endocrine related changes. These include the measurement of anogenital distance (AGD), developmental landmarks [vaginal opening (VO), preputial separation (PPS)], and in some studies the counting of nipples and areolae on males. AGD, VO, and PPS are all affected by the size of the pup in which they are measured

Physicians with MBA degrees: change agents for healthcare improvement.

Science.gov (United States)

Lazarus, Arthur

2010-01-01

Increasingly, physicians gravitating toward the fields of quality improvement and healthcare management are seeking MBA degrees to supplement their medical training. Approximately half of all U.S. medical schools offer combined MD-MBA degrees, and numerous executive MBA programs exist for physicians in practice. Physicians who enter management are considered change agents for healthcare improvement, yet they receive little support and encouragement from their medical teachers and practicing colleagues. This situation can be rectified by placing greater value on the role of business-trained physicians and subsidizing their tuition for business school.

Efficacy of antidotes (midazolam, atropine and HI-6) on nerve agent induced molecular and neuropathological changes

OpenAIRE

RamaRao, Golime; Afley, Prachiti; Acharya, Jyothiranjan; Bhattacharya, Bijoy Krishna

2014-01-01

Background Recent alleged attacks with nerve agent sarin on civilians in Syria indicate their potential threat to both civilian and military population. Acute nerve agent exposure can cause rapid death or leads to multiple and long term neurological effects. The biochemical changes that occur following nerve agent exposure needs to be elucidated to understand the mechanisms behind their long term neurological effects and to design better therapeutic drugs to block their multiple neurotoxic ef...

MOOCs as Change Agents to Boost Innovation in Higher Education Learning Arenas

Science.gov (United States)

Ossiannilsson, Ebba; Altinay, Fahriye; Altinay, Zehra

2016-01-01

Massive open online courses (MOOCs) provide opportunities for learners to benefit from initiatives that are promoted by prestigious universities worldwide. The introduction of MOOCs in 2008 has since then transformed education globally. Consequently, MOOCs should be acknowledged as a pedagogical innovation and recognized as change agents and…

Primary screen for potential sheep scab control agents.

Science.gov (United States)

Dunn, J A; Prickett, J C; Collins, D A; Weaver, R J

2016-07-15

The efficacy of potential acaricidal agents were assessed against the sheep scab mite Psoroptes ovis using a series of in vitro assays in modified test arenas designed initially to maintain P. ovis off-host. The mortality effects of 45 control agents, including essential oils, detergents, desiccants, growth regulators, lipid synthesis inhibitors, nerve action/energy metabolism disruptors and ecdysteroids were assessed against adults and nymphs. The most effective candidates were the desiccants (diatomaceous earth, nanoclay and sorex), the growth regulators (buprofezin, hexythiazox and teflubenzuron), the lipid synthesis inhibitors (spirodiclofen, spirotetramat and spiromesifen) and the nerve action and energy metabolism inhibitors (fenpyroximate, spinosad, tolfenpyrad, and chlorantraniliprole). Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

Does It Matter Whom an Agent Serves? Evidence from Recent Changes in Real Estate Agency Law.

OpenAIRE

Curran, Christopher; Schrag, Joel

2000-01-01

Recent changes in real estate law hastened the shift from a seller's agency regime, in which real estate agents serve the interests of sellers, to a buyer's agency regime, in which agents serve the interests of buyers. Using data from the Atlanta real estate market, we show that the shift to buyer's agency led to a significant decline in real estate prices in the market for relatively expensive houses, while real estate prices did not significantly change in the market for relatively inexpens...

Ocular changes in primary hypothyroidism

Directory of Open Access Journals (Sweden)

Pekel Hamiyet

2009-12-01

Full Text Available Abstract Background To determine the ocular changes related to hypothyrodism in newly diagnosed patients without orbitopathy. Findings Thirty-three patients diagnosed to have primary overt hypothyroidism were enrolled in the study. All subjects were assigned to underwent central corneal thickness (CCT, anterior chamber volume, depth and angle measurements with the Scheimpflug camera (Pentacam, Oculus and cup to disc ratio (C/D, mean retinal thickness and mean retinal nerve fiber layer (RNFL thickness measurements with optical coherence tomography (OCT in addition to ophthalmological examination preceeding the replacement therapy and at the 1st, 3rd and 6th months of treatment. The mean age of the patients included in the study were 40.58 ± 1.32 years. The thyroid hormone levels return to normal levels in all patients during the follow-up period, however the mean intraocular pressure (IOP revealed no significant change. The mean CCT was 538.05 ± 3.85 μ initially and demonstrated no statistically significant change as the anterior chamber volume, depth and angle measurements did. The mean C/D ratio was 0.29 ± 0.03 and the mean retinal thickness was 255.83 ± 19.49 μ initially and the treatment did not give rise to any significant change. The mean RNFL thickness was also stable during the control visits, so no statistically significant change was encountered. Conclusions Neither hypothyroidism, nor its replacement therapy gave rise to any change of IOP, CCT, anterior chamber parameters, RNFL, retinal thickness and C/D ratio.

Change-Agent-for-Equity (CAFE) Model: A Framework for School Counselor Identity

Science.gov (United States)

Mason, Erin C. M.; Ockerman, Melissa S.; Chen-Hayes, Stuart F.

2013-01-01

Significant recent influences in the profession have provided clear direction about what school counseling programs should look like but have not explicitly defined the professional identity necessary to enact these programs. A Change-Agent-for-Equity (CAFE) Model draws from the American School Counselor Association National Model (2003, 2005,…

Three-dimensional space changes after premature loss of a maxillary primary first molar.

Science.gov (United States)

Park, Kitae; Jung, Da-Woon; Kim, Ji-Yeon

2009-11-01

A space maintainer is generally preferred when a primary first molar is lost before or during active eruption of the first permanent molars in order to prevent space loss. However, controversy prevails regarding the space loss after eruption of the permanent first molars. The purpose of this study was to examine spatial changes subsequent to premature loss of a maxillary primary first molar after the eruption of the permanent first molars. Thirteen children, five girls and eight boys, expecting premature extraction of a maxillary primary first molar because of caries and/or failed pulp therapy, were selected. Spatial changes were investigated using a three-dimensional laser scanner by comparing the primary molar space, arch width, arch length, and arch perimeter before and after the extraction of a maxillary primary first molar. Also, the inclination and angulation changes in the maxillary primary canines, primary second molars, and permanent first molars adjacent to the extraction site were investigated before and after the extraction of the maxillary primary first molar in order to examine the source of space loss. There was no statistically significant space loss on the extraction side compared to the control side (P = 0.33). No consistent findings were seen on the inclination and angulation changes on the extraction side. The premature loss of a maxillary primary first molar, in cases with class I molar relationship, has limited influence on the space in permanent dentition.

Anthropogenic climate change has altered primary productivity in Lake Superior.

Science.gov (United States)

O'Beirne, M D; Werne, J P; Hecky, R E; Johnson, T C; Katsev, S; Reavie, E D

2017-06-09

Anthropogenic climate change has the potential to alter many facets of Earth's freshwater resources, especially lacustrine ecosystems. The effects of anthropogenic changes in Lake Superior, which is Earth's largest freshwater lake by area, are not well documented (spatially or temporally) and predicted future states in response to climate change vary. Here we show that Lake Superior experienced a slow, steady increase in production throughout the Holocene using (paleo)productivity proxies in lacustrine sediments to reconstruct past changes in primary production. Furthermore, data from the last century indicate a rapid increase in primary production, which we attribute to increasing surface water temperatures and longer seasonal stratification related to longer ice-free periods in Lake Superior due to anthropogenic climate warming. These observations demonstrate that anthropogenic effects have become a prominent influence on one of Earth's largest, most pristine lacustrine ecosystems.

Tropical Forest Gain and Interactions amongst Agents of Forest Change

Directory of Open Access Journals (Sweden)

Sean Sloan

2016-02-01

Full Text Available The tropical deforestation literature advocates multi-agent enquiry in recognition that key dynamics arise from inter-agent interactions. Studies of tropical forest-cover gain have lagged in this respect. This article explores the roles and key aspects of interactions shaping natural forest regeneration and active reforestation in Eastern Panama since 1990. It employs household surveys of agricultural landholders, interviews with community forest-restoration organisations, archival analysis of plantation reforestation interests, satellite image analysis of forest-cover change, and the consideration of State reforestation policies. Forest-cover gain reflected a convergence of interests and land-use trends amongst agents. Low social and economic costs of sustained interaction and organisation enabled extensive forest-cover gain, but low transaction costs did not. Corporate plantation reforestation rose to the fore of regional forest-cover gain via opportunistic land sales by ranchers and economic subsidies indicative of a State preference for autonomous, self-organising forest-cover gain. This reforestation follows a recent history of neoliberal frontier development in which State-backed loggers and ranchers similarly displaced agriculturalists. Community institutions, long neglected by the State, struggled to coordinate landholders and so effected far less forest-cover gain. National and international commitments to tropical forest restoration risk being similarly characterised as ineffective by a predominance of industrial plantation reforestation without greater State support for community forest management.

Agent-based land markets: Heterogeneous agents, land proces and urban land use change

NARCIS (Netherlands)

Filatova, Tatiana; Parker, Dawn C.; van der Veen, A.; Amblard, F.

2007-01-01

We construct a spatially explicit agent-based model of a bilateral land market. Heterogeneous agents form their bid and ask prices for land based on the utility that they obtain from a certain location (houte/land) and base on the state of the market (an excess of demand or supply). We underline the

Bayesian Nonparametric Estimation of Targeted Agent Effects on Biomarker Change to Predict Clinical Outcome

Science.gov (United States)

Graziani, Rebecca; Guindani, Michele; Thall, Peter F.

2015-01-01

Summary The effect of a targeted agent on a cancer patient's clinical outcome putatively is mediated through the agent's effect on one or more early biological events. This is motivated by pre-clinical experiments with cells or animals that identify such events, represented by binary or quantitative biomarkers. When evaluating targeted agents in humans, central questions are whether the distribution of a targeted biomarker changes following treatment, the nature and magnitude of this change, and whether it is associated with clinical outcome. Major difficulties in estimating these effects are that a biomarker's distribution may be complex, vary substantially between patients, and have complicated relationships with clinical outcomes. We present a probabilistically coherent framework for modeling and estimation in this setting, including a hierarchical Bayesian nonparametric mixture model for biomarkers that we use to define a functional profile of pre-versus-post treatment biomarker distribution change. The functional is similar to the receiver operating characteristic used in diagnostic testing. The hierarchical model yields clusters of individual patient biomarker profile functionals, and we use the profile as a covariate in a regression model for clinical outcome. The methodology is illustrated by analysis of a dataset from a clinical trial in prostate cancer using imatinib to target platelet-derived growth factor, with the clinical aim to improve progression-free survival time. PMID:25319212

Change Agent Strategies: A Study of the Michigan-Ohio Regional Educational Laboratory.

Science.gov (United States)

Miller, Peggy Lynne

This dissertation reports on a study of the planning and development activities of the Michigan-Ohio Regional Educational Laboratory (MOREL). The study attempted to assess (1) whether MOREL has accepted a change agent role, and (2) whether it has taken action that indicates recognition of what is known through the literature and research about…

Implementing change in primary care practices using electronic medical records: a conceptual framework.

Science.gov (United States)

Nemeth, Lynne S; Feifer, Chris; Stuart, Gail W; Ornstein, Steven M

2008-01-16

Implementing change in primary care is difficult, and little practical guidance is available to assist small primary care practices. Methods to structure care and develop new roles are often needed to implement an evidence-based practice that improves care. This study explored the process of change used to implement clinical guidelines for primary and secondary prevention of cardiovascular disease in primary care practices that used a common electronic medical record (EMR). Multiple conceptual frameworks informed the design of this study designed to explain the complex phenomena of implementing change in primary care practice. Qualitative methods were used to examine the processes of change that practice members used to implement the guidelines. Purposive sampling in eight primary care practices within the Practice Partner Research Network-Translating Researching into Practice (PPRNet-TRIP II) clinical trial yielded 28 staff members and clinicians who were interviewed regarding how change in practice occurred while implementing clinical guidelines for primary and secondary prevention of cardiovascular disease and strokes. A conceptual framework for implementing clinical guidelines into primary care practice was developed through this research. Seven concepts and their relationships were modelled within this framework: leaders setting a vision with clear goals for staff to embrace; involving the team to enable the goals and vision for the practice to be achieved; enhancing communication systems to reinforce goals for patient care; developing the team to enable the staff to contribute toward practice improvement; taking small steps, encouraging practices' tests of small changes in practice; assimilating the electronic medical record to maximize clinical effectiveness, enhancing practices' use of the electronic tool they have invested in for patient care improvement; and providing feedback within a culture of improvement, leading to an iterative cycle of goal setting

Agents of Structural Change : The Role of Firms and Entrepreneurs in Regional Diversification

NARCIS (Netherlands)

Neffke, Frank; Hartog, Matté; Boschma, Ron; Henning, Martin

2018-01-01

Who introduces structural change in regional economies: Entrepreneurs or existing firms? And do local or nonlocal establishment founders create most novelty in a region? We develop a theoretical framework that focuses on the roles different agents play in regional transformation. We then apply this

Persistence and concomitant medication in patients with overactive bladder treated with antimuscarinic agents in primary care. An observational baseline study.

Science.gov (United States)

Sicras-Mainar, A; Navarro-Artieda, R; Ruiz-Torrejón, A; Sáez-Zafra, M; Coll-de Tuero, G

2016-03-01

To assess therapeutic persistence and its relationship with concomitant medication in patients treated with fesoterodine versus tolterodine and solifenacin for overactive bladder (OAB) in standard clinical practice conditions. An observational, multicentre retrospective study was performed based on medical registries of patients followed-up in primary care (PC). Three study groups were analysed. Persistence was defined as the time (in months) without withdrawing from the initial therapy or without changing to another medication for at least 30 days after the initial prescription. The concomitant medications were antidepressants, anxiolytic/hypnotic agents, antibiotics, antiseptic agents, laxatives and skin products. We employed the SPSSWIN program version 17 (statistical significance, P<.05). We selected 3094 patients for the study. The median age was 54.0 years and 62.2% were women. The patients treated with fesoterodine shown greater treatment persistence (12 months) when compared with those who took solifenacin and tolterodine (40.2% vs. 34.7% and 33.6%, respectively; P=.008). They also showed a lower use of concomitant medication (1.1 vs. 1.2 and 1.2 drugs, respectively; percentages: 61.6% vs. 67.1% and 70.1%, respectively; P<.03). The patients undergoing OAB treatment with fesoterodine, when compared with those taking solifenacin and tolterodine, were associated with greater treatment persistence and a reduced use of concomitant medication. Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Artist as Change Agent: A Pedagogy of Practice in Artist Proof Studio

Science.gov (United States)

Berman, Kim

2012-01-01

In this article, the author discusses how art, politics, and life intersect in a South African community visual arts studio program that seeks to educate artists as change agents. Artist Proof Studio (APS) was founded in 1991 and responded to the challenge of building democracy in a postapartheid South Africa. It is a community art center in…

The continental shelf benthic ecosystem: Current status, agents for change and future prospects

OpenAIRE

Hall, S.J.

2002-01-01

Metadata only record Continental shelf benthic ecosystems play an important role in the economy of many coastal states through the provision of food, non-living resources and through control of climate. Changes in the status of these ecosystems, through either natural or human-induced environmental drivers can be expected to have important economic and social consequences. Agents that could induce change include climate and oceanography, hydrology (river discharge), land-use and waste disp...

Spatial-temporal changes in phytoplankton biomass and primary ...

African Journals Online (AJOL)

Spatial-temporal variations in phytoplankton primary production (PP) and biomass (B) were studied for a period of about one year, from July 1999 to July 2000. In addition, changes in corresponding environmental variables were examined. Sampling took place at two stations in Chwaka Bay, one located in mangrove areas, ...

An agent-based approach to model land-use change at a regional scale

NARCIS (Netherlands)

Valbuena, D.F.; Verburg, P.H.; Bregt, A.K.; Ligtenberg, A.

2010-01-01

Land-use/cover change (LUCC) is a complex process that includes actors and factors at different social and spatial levels. A common approach to analyse and simulate LUCC as the result of individual decisions is agent-based modelling (ABM). However, ABM is often applied to simulate processes at local

Topical antifungal agents: an update.

Science.gov (United States)

Diehl, K B

1996-10-01

So many topical antifungal agents have been introduced that it has become very difficult to select the proper agent for a given infection. Nonspecific agents have been available for many years, and they are still effective in many situations. These agents include Whitfield's ointment, Castellani paint, gentian violet, potassium permanganate, undecylenic acid and selenium sulfide. Specific antifungal agents include, among others, the polyenes (nystatin, amphotericin B), the imidazoles (metronidazole, clotrimazole) and the allylamines (terbinafine, naftifine). Although the choice of an antifungal agent should be based on an accurate diagnosis, many clinicians believe that topical miconazole is a relatively effective agent for the treatment of most mycotic infections. Terbinafine and other newer drugs have primary fungicidal effects. Compared with older antifungal agents, these newer drugs can be used in lower concentrations and shorter therapeutic courses. Studies are needed to evaluate the clinical efficacies and cost advantages of both newer and traditional agents.

Entrepreneurial Attitudes and Behaviors that Can Help Prepare Successful Change-Agents in Education

Science.gov (United States)

Borasi, Raffaella; Finnigan, Kara

2010-01-01

This article explores how the preparation of educators committed to improving education can capitalize on entrepreneurship when broadly defined as "transforming ideas into enterprises that generate economic, intellectual and/or social value." The article reports on the case-studies of six educators who have been successful change-agents in a…

Possibility Thinking and Social Change in Primary Schools

Science.gov (United States)

Craft, Anna Rachel; Chappell, Kerry Anne

2016-01-01

This paper reviews the nature of possibility thinking (PT) (transformation from what is to what might be, in everyday contexts for children and teachers) and reports on how PT manifested in two English primary schools engaged in social change. It identifies shared characteristics across the schools as well as unique ways in which PT manifested.…

Failed surgery in primary hyperparathyroidism - what has changed with time.

Science.gov (United States)

Wirowski, D; Goretzki, P E; Schwarz, K; Lammers, B J; Dotzenrath, C; Röher, H-D

2013-06-01

Advanced preoperative imaging of parathyroid adenomas and intraoperative parathyroid hormone determination optimized the results in the surgical treatment of primary hyperparathyroidism patients. We asked, whether reasons for failure have changed during the last 25 years.We retrospectively analyzed operations for persistent primary hyperparathyroidism in our department between 2001 and 2011 (n=67), and compared these results to our experience between 1986 and 2001 (n=80).From 2001 to 2011, 765 primary hyperparathyroidism patients were operated on at our department. All but 4 patients were cured (761/765, 99.5%). 67 operations were performed for persistent primary hyperparathyroidism. Main reasons for failure were a misdiagnosed sporadic multiple gland disease in our own patients (18/29, 62.1%), and an undetected solitary adenoma in patients referred to us after -initial operation in another hospital (22/38, 57.9%) (statistically significant). From 1986 to 2001 (1 105 primary hyperparathyroidism patients), main indications for re-operation due to persistent disease were an undiagnosed sporadic multiple gland disease in our own patients (15/24, 62.5%), and a missed solitary adenoma in patients being operated on primarily somewhere else (38/56, 67.9%) (statistically significant).Comparing our experience in 147 patients with persistent primary hyperparathyroidism being operated on between 2001-2011 and 1986-2001, not much has changed with the modern armamentarium of improved preoperative imaging or intraoperative biochemical control. Whereas sporadic multiple gland disease was the most common reason for unsuccessful surgery in experienced hands, other units mainly failed due to an undetected solitary adenoma. Re-operations for persistent primary hyperparathyroidism performed by us were successful in 93.8% (2001-2011) and 96.0% (1986-2001), respectively. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.

An Agent-Based Assessment of Land Use and Ecosystem Changes in Traditional Agricultural Landscape of Portugal

NARCIS (Netherlands)

Acosta, L.; Rounsevell, M.D.A.; Bakker, M.M.; Doorn, van A.M.; Gómez-Delgado, M.; Delgado, M.

2014-01-01

This paper presents an assessment of land use changes and their impacts on the ecosystem in the Montado, a traditional agricultural landscape of Portugal in response to global environmental change. The assessment uses an agent- based model (ABM) of the adaptive decisions of farmers to simulate the

Climate Change and the Representative Agent

Energy Technology Data Exchange (ETDEWEB)

Howarth, R.B. [Environmental Studies Program, Dartmouth College, Hanover, New Hampshire 03755 (United States)

2000-02-01

The artifice of an infinitely-lived representative agent is commonly invoked to balance the present costs and future benefits of climate stabilization policies. Since actual economies are populated by overlapping generations of finite-lived persons, this approach begs important questions of welfare aggregation. This paper compares the results of representative agent and overlapping generations models that are numerically calibrated based on standard assumptions regarding climate economy interactions. Under two social choice rules - Pareto efficiency and classical utilitarianism - the models generate closely similar simulation results. In the absence of policies to redistribute income between present and future generations, efficient rates of carbon dioxide emissions abatement rise from 15 to 20% between the years 2000 and 2105. Under classical utilitarianism, in contrast, optimal control rates rise from 48 to 79% this same period. 23 refs.

Islamic Religious Leaders in Israel as Social Agents for Change on Health-Related Issues.

Science.gov (United States)

Cohen-Dar, Michal; Obeid, Samira

2017-12-01

Islamic religious leaders (IRLs) have the potential to influence health education, health promotion, and positive health outcomes among their own communities. This study aims to examine the role and effectiveness of Arab Muslim religious leaders, in Israel, as social agents for change on health-related issues, focusing on reduction in infant mortality, prematurity, and congenital malformations attributed to consanguineous marriage. A self-administrated questionnaire was distributed to 127 IRLs, in 2012, to gain insights into practice, attitudes, and perceptions of IRLs toward their role as social agents for change on health-related issues. The results indicate that two-thirds (58%) of the surveyed IRLs have provided frequent advice on issues related to preventing infant mortality, congenital malformation, and prematurity over the past two years. Most IRLs indicated that they have keen interest in their communities' health matters (97%) and regard dealing with them as part of their job (85%). The study identified three enabling factors that had significant influence on the IRLs' attitude. These influences are: awareness and knowledge of the health issues, the perception that these issues and their impact on the community are part of their responsibility, and the empowerment they felt through the participation in the Ministry of Health (Northern Region Health Office) educational seminar series, in the year 2000. The main conclusion from this study indicates that IRLs are effective social agents for change and that the educational interventions can be a useful and effective strategy to encourage IRLs to cooperate with health providers and promote public health among their own communities.

Behavior Change without Behavior Change Communication: Nudging Handwashing among Primary School Students in Bangladesh

OpenAIRE

Dreibelbis, Robert; Kroeger, Anne; Hossain, Kamal; Venkatesh, Mohini; Ram, Pavani K.

2016-01-01

Behavior change communication for improving handwashing with soap can be labor and resource intensive, yet quality results are difficult to achieve. Nudges are environmental cues engaging unconscious decision-making processes to prompt behavior change. In this proof-of-concept study, we developed an inexpensive set of nudges to encourage handwashing with soap after toilet use in two primary schools in rural Bangladesh. We completed direct observation of behaviors at baseline, after providing ...

Contrast agents for cardiac angiography: effects of a nonionic agent vs. a standard ionic agent

International Nuclear Information System (INIS)

Bettmann, M.A.; Bourdillon, P.D.; Barry, W.H.; Brush, K.A.; Levin, D.C.

1984-01-01

The effects on cardiac hemodynamics and of a standard contrast agent, sodium methylglucamine diatrizoate [Renografin 76] were compared with the effects of a new nonionic agent (iohexol) in a double-blind study in 51 patietns undergoing coronary angiography and left ventriculography. No significant alteration in measured blood parameters occurred with either contrast agent. Hemodynamic changes occurred with both, but were significantly greater with the standard renografin than with the low-osmolality, nonionic iohexol. After left ventriculography, heart rate increased and peripheral arterial pressure fell with both agents, but less with iohexol. It is concluded that iohexol causes less alteration in cardiac function than does the agent currently most widely used. Nonionic contrast material is likely to improve the safety of coronary angiography, particularly in those patients at greatest risk

What Influences Agents to Pursue a Career in Extension?

Science.gov (United States)

Arnold, Shannon; Place, Nick

2010-01-01

The qualitative study reported here explored why agricultural agents pursue an Extension career. A purposive sample was used to select twelve Florida agricultural agents. Interviews investigated positive and negative influences that affected agents' employment decisions. Grounded theory was used as the primary data analysis method (Strauss &…

The Missing Elements of Change. A Response to "Youth Change Agents: Comparing the Sociopolitical Identities of Youth Organizers and Youth Commissioners"

Science.gov (United States)

Goldwasser, Matthew L.

2016-01-01

By establishing a set of theoretical frameworks to view and compare the work of youth organizers and youth commissioners, and through personal interviews, the authors of the paper "Youth Change Agents: Comparing the Sociopolitical Identities of Youth Organizers and Youth Commissioners" presented their explanation of the development of…

Changing Role of the Personnel Manager

Science.gov (United States)

Schein, Edgar H.

1975-01-01

Arguing that the personnel manager will increasingly have to become a change agent and process consultant, the author discusses tasks involved and skills required for the new role. A shift in focus toward top management as the primary client and utilization of more flexible intervention into organizational processes are predicted. (JT)

Long-term space changes after premature loss of a primary maxillary first molar

OpenAIRE

Lin, Yng-Tzer J.; Lin, Yai-Tin

2016-01-01

Background/purpose: The consequence of premature loss of primary teeth resulting in the need for space maintainers has been controversial for many years. There is no longitudinal long-term report in literature regarding the premature loss of a primary maxillary first molar. The aim of this study was to continue observing the long-term space changes of 19 cases following premature loss of a primary maxillary first molar during the transition from primary to permanent dentition. Materials an...

Bridging the Data Talent Gap: Positioning the iSchool as an Agent for Change

Directory of Open Access Journals (Sweden)

Liz Lyon

2015-02-01

Full Text Available This paper examines the role, functions and value of the “iSchool” as an agent of change in the data informatics and data curation arena. A brief background to the iSchool movement is given followed by a brief review of the data decade, which highlights key data trends from the iSchool perspective: open data and open science, big data and disciplinary data diversity. The growing emphasis on the shortage of data talent is noted and a family of data science roles identified. The paper moves on to describe three primary functions of iSchools: education, research intelligence and professional practice, which form the foundations of a new Capability Ramp Model. The model is illustrated by mini-case studies from the School of Information Sciences, University of Pittsburgh: the immersive (laboratory-based component of two new Research Data Management and Research Data Infrastructures graduate courses, a new practice partnership with the University Library System centred on RDM, and the mapping of disciplinary data practice using the Community Capability Model Profile Tool. The paper closes with a look to the future and, based on the assertion that data is mission-critical for iSchools, some steps are proposed for the next data decade: moving data education programs into the mainstream core curriculum, adopting a translational data science perspective and strengthening engagement with the Research Data Alliance.

Introduction: Agents of Change? Staging and Governing Diasporas and the African State

DEFF Research Database (Denmark)

Turner, Simon; Kleist, Nauja

2013-01-01

During the last decade, African diasporas have emerged as agents of change in international development thinking. Diasporas are being courted by donors, sending states, and NGOs for their contributions to development in their countries of origin; praised for their remittances, investments...... and knowledge transfer. This Introduction seeks to scrutinise critically these processes, examining issues of governance and categorisation in relation to African states and diasporas. We explore the theoretical and political implications of the emergence of diasporas in relation to questions of hybridity...

Linking spatial patterns of land-use to agents of deforestation in the Brazilian Amazon

OpenAIRE

Borrego Lorena, Rodrigo

2008-01-01

Changes in land use and land cover are associated with many environmental issues observed on the earth’s surface. In the last decades, these changes were unprece-dented, mainly in tropical forest areas. The Brazilian Amazon, the world’s largest tropical forest, lost around 200.000 km² of primary forest in the last ten years (INPE, 2005). Considering this, and the consequences caused by this deforestation, it is important to know and define correctly the responsible agents, aiming at better pu...

Clinical and radiographic comparison of platelet-rich fibrin and mineral trioxide aggregate as pulpotomy agents in primary molars

Directory of Open Access Journals (Sweden)

Surendra Patidar

2017-01-01

Full Text Available Aim: This study aimed to evaluate and compare the Platelet-rich fibrin (PRF and Mineral trioxide aggregate (MTA as a pulpotomy agent in primary molars. Material and Methods: In this study, 50 primary molars from 50 healthy children aged 5–9 years requiring pulpotomy were randomly allocated into two groups. In PRF group, after coronal pulp removal and hemostasis, remaining pulp tissue was covered with PRF preparation. In the MTA group, the pulp stumps were covered with MTA (Pro Root MTA-Root Canal Repair Material, Dentsply International Inc. paste obtained by mixing MTA powder with sterile water at a 3:1 powder to water ratio. All teeth were restored with reinforced zinc oxide eugenol base and glass – ionomer cement. Stainless steel crowns were given in both groups 24 h after treatment. Clinical evaluation was undertaken at 1, 3, and 6 months intervals whereas radiographic evaluation of the treated teeth was carried out at the interval of 6 months. Results: By the end of 6 months, the overall success rate was 90% in PRF group and 92% in MTA Group. A statistically significant difference was observed between the groups at 6 months of follow-up (P 0.05. Conclusion: Radiographic and clinical outcome in PRF group could suggest it as an acceptable alternative in pulpotomy of primary teeth. PRF holds a promising future in the area of primary tooth vital pulp therapy.

Changes in Student Populations and Average Test Scores of Dutch Primary Schools

Science.gov (United States)

Luyten, Hans; de Wolf, Inge

2011-01-01

This article focuses on the relation between student population characteristics and average test scores per school in the final grade of primary education from a dynamic perspective. Aggregated data of over 5,000 Dutch primary schools covering a 6-year period were used to study the relation between changes in school populations and shifts in mean…

Econophysics of agent-based models

CERN Document Server

Aoyama, Hideaki; Chakrabarti, Bikas; Chakraborti, Anirban; Ghosh, Asim

2014-01-01

The primary goal of this book is to present the research findings and conclusions of physicists, economists, mathematicians and financial engineers working in the field of "Econophysics" who have undertaken agent-based modelling, comparison with empirical studies and related investigations. Most standard economic models assume the existence of the representative agent, who is “perfectly rational” and applies the utility maximization principle when taking action. One reason for this is the desire to keep models mathematically tractable: no tools are available to economists for solving non-linear models of heterogeneous adaptive agents without explicit optimization. In contrast, multi-agent models, which originated from statistical physics considerations, allow us to go beyond the prototype theories of traditional economics involving the representative agent. This book is based on the Econophys-Kolkata VII Workshop, at which many such modelling efforts were presented. In the book, leading researchers in the...

Examining organizational change in primary care practices: experiences from using ethnographic methods.

Science.gov (United States)

Russell, Grant; Advocat, Jenny; Geneau, Robert; Farrell, Barbara; Thille, Patricia; Ward, Natalie; Evans, Samantha

2012-08-01

Qualitative methods are an important part of the primary care researcher's toolkit providing a nuanced view of the complexity in primary care reform and delivery. Ethnographic research is a comprehensive approach to qualitative data collection, including observation, in-depth interviews and document analysis. Few studies have been published outlining methodological issues related to ethnography in this setting. This paper examines some of the challenges of conducting an ethnographic study in primary care setting in Canada, where there recently have been major reforms to traditional methods of organizing primary care services. This paper is based on an ethnographic study set in primary care practices in Ontario, Canada, designed to investigate changes to organizational and clinical routines in practices undergoing transition to new, interdisciplinary Family Health Teams (FHTs). The study was set in six new FHTs in Ontario. This paper is a reflexive examination of some of the challenges encountered while conducting an ethnographic study in a primary care setting. Our experiences in this study highlight some potential benefits of and difficulties in conducting an ethnographic study in family practice. Our study design gave us an opportunity to highlight the changes in routines within an organization in transition. A study with a clinical perspective requires training, support, a mixture of backgrounds and perspectives and ongoing communication. Despite some of the difficulties, the richness of this method has allowed the exploration of a number of additional research questions that emerged during data analysis.

Continuum deformation of multi-agent systems

CERN Document Server

Rastgoftar, Hossein

2016-01-01

This monograph presents new algorithms for formation control of multi-agent systems (MAS) based on principles of continuum mechanics. Beginning with an overview of traditional methods, the author then introduces an innovative new approach whereby agents of an MAS are considered as particles in a continuum evolving in ℝn whose desired configuration is required to satisfy an admissible deformation function. The necessary theory and its validation on a mobile-agent-based swarm test bed are considered for two primary tasks: homogeneous transformation of the MAS and deployment of a random distribution of agents on a desired configuration. The framework for this model is based on homogeneous transformations for the evolution of an MAS under no inter-agent communication, local inter-agent communication, and intelligent perception by agents. Different communication protocols for MAS evolution, the robustness of tracking of a desired motion by an MAS evolving in ℝn, and the effect of communication delays in an MAS...

Twelve-month space changes after premature loss of a primary maxillary first molar.

Science.gov (United States)

Lin, Yai-Tin; Lin, Wen-Hsien; Lin, Yng-Tzer J

2011-05-01

Many early investigations concerning space changes following premature extraction of primary molars had a cross-sectional design, a small sample size, and a somewhat crude methodology, which may have led to misunderstandings. The aim of this study was to use established longitudinal data to investigate ongoing (12-month) dental-arch space problems arising as a result of premature loss of a primary maxillary first molar. Thirteen children (mean ± SD age at time of tooth extraction, 6.0 ± 0.74 years) with unilateral premature loss of a primary maxillary first molar were selected for this study. Maxillary dental study casts were obtained from participants 2 or 3 days after the tooth was removed, as well as at a follow-up appointment 12 months later. Six reference lines were measured on the study cast: D + E space, arch width, arch length, intercanine width, intercanine length, and arch perimeter. For each participant, the D + E space of the contralateral intact primary molar served as a control. A paired t-test was used to compare the cast measurements between initial examination and 12-month follow-up. A t-test was used to compare D + E space changes with those of the control group. The D + E space of the extraction side after 12 months was significantly smaller than that of the control side (P 0.05). The 12-month space changes in the maxillary dental arch after premature loss of a primary maxillary first molar consist mainly of distal drift of the primary canine toward the extraction site. Mesial movement of permanent molars or tilting of the primary molars did not occur. An increased arch dimension was found especially in the anterior segment (intercanine width and length). There is no need for the use of space maintainers from the results in this study in cases of premature loss of a primary first molar. © 2010 The Authors. International Journal of Paediatric Dentistry © 2010 BSPD, IAPD and Blackwell Publishing Ltd.

The role of family planning communications--an agent of reinforcement or change.

Science.gov (United States)

Chen, E C

1981-12-01

Results are presented of a multiple classification analysis of responses to a 1972 KAP survey in Taiwan of 2013 married women aged 18-34 designed to determine whether family planning communication is primarily a reinforcement agent or a change agent. 2 types of independent variables, social demographic variables including age, number of children, residence, education, employment status, and duration of marriage; and social climate variables including ever receiving family planning information from mass media and ever discussing family planning with others, were used. KAP levels, the dependent variables, were measured by 2 variables each: awareness of effective methods and awareness of government supply of contraceptives for knowledge, wish for additional children and approve of 2-child family for attitude, and never use contraception and neither want children nor use contraception for practice. Social demographic and attitudinal variables were found to be the critical ones, while social climate and knowledge variables had only negligible effects on various stages of family planning adoption, indicating that family planning communications functioned primarily as a reinforcement agent. The effects of social demographic variables were prominent in all stages of contraceptive adoption. Examination of effects of individual variables on various stages of family planning adoption still supported the argument that family planning communications played a reinforcement role. Family planning communications functioned well in diffusing family planning knowledge and accessibility, but social demographic variables and desire for additional children were the most decisive influences on use of contraception.

Mineral trioxide aggregate as a pulpotomy agent in primary molars: An in vivo study

Directory of Open Access Journals (Sweden)

Naik S

2005-03-01

Full Text Available The retention of pulpally involved deciduous tooth in a healthy state until the time of normal exfoliation remains to be one of the challenges for Pedodontists. A scientific noise has been generated about several materials some of which have been popular pulpotomy medicaments. Concerns have been raised about the toxicity and potential carcinogenicity of these materials, and alternatives have been proposed to maintain the partial pulp vitality, however to date no material has been accepted as an ideal pulpotomy agent. Mineral trioxide aggregate (MTA is a biocompatible material which provides a biological seal. MTA has been proposed as a potential medicament for various pulpal procedures like pulp capping with reversible pulpitis, apexification, repair of root perforations, etc. Hence the present study was done to evaluate the efficacy of MTA as a pulpotomy medicament. A clinical and radiographic evaluation was done on children where MTA was used as pulpotomy medicament in primary molars for a period of 6 months and it was found to be a successful material.

Multi-Agent Systems for E-Commerce

OpenAIRE

Solodukha, T. V.; Sosnovskiy, O. A.; Zhelezko, B. A.

2009-01-01

The article focuses on multi-agent systems (MAS) and domains that can benefit from multi-agent technology. In the last few years, the agent based modeling (ABM) community has developed several practical agent based modeling toolkits that enable individuals to develop agent-based applications. The comparison of agent-based modeling toolkits is given. Multi-agent systems are designed to handle changing and dynamic business processes. Any organization with complex and distributed business pro...

Analyzing Katana referral hospital as a complex adaptive system: agents, interactions and adaptation to a changing environment.

Science.gov (United States)

Karemere, Hermès; Ribesse, Nathalie; Marchal, Bruno; Macq, Jean

2015-01-01

This study deals with the adaptation of Katana referral hospital in Eastern Democratic Republic of Congo in a changing environment that is affected for more than a decade by intermittent armed conflicts. His objective is to generate theoretical proposals for addressing differently the analysis of hospitals governance in the aims to assess their performance and how to improve that performance. The methodology applied approach uses a case study using mixed methods ( qualitative and quantitative) for data collection. It uses (1) hospital data to measure the output of hospitals, (2) literature review to identify among others, events and interventions recorded in the history of hospital during the study period and (3) information from individual interviews to validate the interpretation of the results of the previous two sources of data and understand the responsiveness of management team referral hospital during times of change. The study brings four theoretical propositions: (1) Interaction between key agents is a positive force driving adaptation if the actors share a same vision, (2) The strength of the interaction between agents is largely based on the nature of institutional arrangements, which in turn are shaped by the actors themselves, (3) The owner and the management team play a decisive role in the implementation of effective institutional arrangements and establishment of positive interactions between agents, (4) The analysis of recipient population's perception of health services provided allow to better tailor and adapt the health services offer to the population's needs and expectations. Research shows that it isn't enough just to provide support (financial and technical), to manage a hospital for operate and adapt to a changing environment but must still animate, considering that it is a complex adaptive system and that this animation is nothing other than the induction of a positive interaction between agents.

Simulating Land-Use Change using an Agent-Based Land Transaction Model

Science.gov (United States)

Bakker, M. M.; van Dijk, J.; Alam, S. J.

2013-12-01

In the densely populated cultural landscapes of Europe, the vast majority of all land is owned by private parties, be it farmers (the majority), nature organizations, property developers, or citizens. Therewith, the vast majority of all land-use change arises from land transactions between different owner types: successful farms expand at the expense of less successful farms, and meanwhile property developers, individual citizens, and nature organizations also actively purchase land. These land transactions are driven by specific properties of the land, by governmental policies, and by the (economic) motives of both buyers and sellers. Climate/global change can affect these drivers at various scales: at the local scale changes in hydrology can make certain land less or more desirable; at the global scale the agricultural markets will affect motives of farmers to buy or sell land; while at intermediate (e.g. provincial) scales property developers and nature conservationists may be encouraged or discouraged to purchase land. The cumulative result of all these transactions becomes manifest in changing land-use patterns, and consequent environmental responses. Within the project Climate Adaptation for Rural Areas an agent-based land-use model was developed that explores the future response of individual land users to climate change, within the context of wider global change (i.e. policy and market change). It simulates the exchange of land among farmers and between farmers and nature organizations and property developers, for a specific case study area in the east of the Netherlands. Results show that local impacts of climate change can result in a relative stagnation in the land market in waterlogged areas. Furthermore, the increase in dairying at the expense of arable cultivation - as has been observed in the area in the past - is slowing down as arable produce shows a favourable trend in the agricultural world market. Furthermore, budgets for nature managers are

Enzymatic Decontamination of Chemical Warfare Agents

National Research Council Canada - National Science Library

Raushel, Frank

2000-01-01

The primary objective of this research program is the development of a versatile enzyme-based system that is fully optimized for the decontamination, destruction, and detection of know chemical warfare agents...

Agents of Change in Promoting Reflective Abstraction: A Quasi-Experimental, Study on Limits in College Calculus

Science.gov (United States)

Cappetta, Robert W.; Zollman, Alan

2013-01-01

We measured student performance on the concept of limit by promoting reflection through four agents of change: instructor, peer, curriculum and individual. It is based on Piaget's four constructs of reflective abstraction: interiorization, coordination, encapsulation, and generalization, and includes the notion of reversal, as refined into a…

Agent-based modeling and network dynamics

CERN Document Server

Namatame, Akira

2016-01-01

The book integrates agent-based modeling and network science. It is divided into three parts, namely, foundations, primary dynamics on and of social networks, and applications. The book begins with the network origin of agent-based models, known as cellular automata, and introduce a number of classic models, such as Schelling’s segregation model and Axelrod’s spatial game. The essence of the foundation part is the network-based agent-based models in which agents follow network-based decision rules. Under the influence of the substantial progress in network science in late 1990s, these models have been extended from using lattices into using small-world networks, scale-free networks, etc. The book also shows that the modern network science mainly driven by game-theorists and sociophysicists has inspired agent-based social scientists to develop alternative formation algorithms, known as agent-based social networks. The book reviews a number of pioneering and representative models in this family. Upon the gi...

Preparation, purification and primary bioevaluation of radioiodinated ofloxacin. An imaging agent

International Nuclear Information System (INIS)

Kandil, Shaban; Seddik, Usama; Hussien, Hiba; Shaltot, Mohamed; El-Tabl, Abdou

2015-01-01

The broad-spectrum antibiotic agents have been demonstrated as promising diagnostic tools for early detection of infectious lesions. We set out ofloxacin (Oflo), a second-generation fluoroquinolone, for the radioiodination process. In particular, this was carried out with 125 I via an electrophilic substitution reaction. The radiochemical yield was influenced by different factors; drug concentration, different oxidizing agents, e.g. chloramine-T, iodogen and n-bromosuccinimide, pH of medium, reaction time, temperature and different organic media. These parameters were studied to optimize the best conditions for labeling with ofloxacin. We found that radiolabeling in ethanol medium showed a 70% radiochemical yield of 125 I-ofloxacin. The radioiodination was determined by means of TLC and HPLC. The cold labeled Oflo ( 127 I-Oflo) was prepared and controlled by HPLC. The cold labeled Oflo was also confirmed by NMR and MS techniques. Furthermore, biodistribution studies for labeled 125 I-Oflo were examined in two independent groups (3 mice in each one); control and E. Coli-injected (inflamed). The radiotracer showed a good localization in muscle of thigh for inflamed group as compared to control. In conclusion, ofloxacine might be a promising target as an anti-inflammatory imaging agent.

Learning from induced changes in opponent (re)actions in multi-agent games

NARCIS (Netherlands)

P.J. 't Hoen (Pieter Jan); S.M. Bohte (Sander); J.A. La Poutré (Han)

2005-01-01

textabstractMulti-agent learning is a growing area of research. An important topic is to formulate how an agent can learn a good policy in the face of adaptive, competitive opponents. Most research has focused on extensions of single agent learning techniques originally designed for agents in more

The impact of changing antiseptic skin preparation agent used for cardiac implantable electronic device (CIED) procedures on the risk of infection.

Science.gov (United States)

Qintar, Mohammed; Zardkoohi, Omeed; Hammadah, Muhammad; Hsu, Amy; Wazni, Oussama; Wilkoff, Bruce L; Tarakji, Khaldoun G

2015-02-01

Cardiac implantable electronic device (CIED) infection is a major complication that is associated with increased morbidity and mortality. Recent data suggested a relationship between the antiseptic agent used for skin preparation at time of CIED procedure and risk for infection. On April 30, 2011, we changed the antiseptic agent used for skin preparation at our tertiary care facility from chlorhexidine-alcohol to povidone-iodine for all CIED procedures. We retrospectively reviewed records of all patients who underwent CIED procedure 1 year before and after the change. CIED infection was defined as pocket or endovascular systemic infection that required removal within 1 year of the index procedure. We examined if the change affected the risk of CIED infection. A total of 2,792 patients underwent 2,840 CIED procedures; 1,748 (61.5%) had implantable cardioverter defibrillator procedures and 1,092 (38.4%) had permanent pacemaker procedures. Chlorhexidine-alcohol agent was used in 1,450 (51.1%) procedures, and povidone-iodine agent was used in 1,390 (48.9%). After 1 year of follow-up, 31 patients (1.09%) developed CIED infection that required system removal. The 1-year infection rate was 1.1% among both antiseptic agent groups and there were no significant differences in the infection presentations among both groups (P = 0.950). Multivariate Cox proportional hazards regression model showed that risk factors for infection within 1 year included age, diabetes, and African American race. In one large cohort of patients undergoing CIED procedures, the antiseptic agent used for skin preparation (chlorhexidine-alcohol vs povidone-iodine) was not associated with increased risk of developing CIED infection. ©2014 Wiley Periodicals, Inc.

Vascular Targeting in Pancreatic Cancer: The Novel Tubulin-Binding Agent ZD6126 Reveals Antitumor Activity in Primary and Metastatic Tumor Models

Directory of Open Access Journals (Sweden)

Axel Kleespies

2005-10-01

Full Text Available ZD6126 is a novel vascular-targeting agent that acts by disrupting the tubulin cytoskeleton of an immature tumor endothelium, leading to an occlusion of tumor blood vessels and a subsequent tumor necrosis. We wanted to evaluate ZD6126 in primary and metastatic tumor models of human pancreatic cancer. Nude mice were injected orthotopically with L3.6pl pancreatic cancer cells. In single and multiple dosing experiments, mice received ZD6126, gemcitabine, a combination of both agents, or no treatment. For the induction of metastatic disease, additional groups of mice were injected with L3.6pl cells into the spleen. Twenty-four hours after a single-dose treatment, ZD6126 therapy led to an extensive central tumor necrosis, which was not seen after gemcitabine treatment. Multiple dosing of ZD6126 resulted in a significant growth inhibition of primary tumors and a marked reduction of spontaneous liver and lymph node metastases. Experimental metastatic disease could be significantly controlled by a combination of ZD6126 and gemcitabine, as shown by a reduction of the number and size of established liver metastases. As shown by additional in vitro and in vivo experiments, possible mechanisms involve antivascular activities and subsequent antiproliferative and proapoptotic effects of ZD6126 on tumor cells, whereas direct activities against tumor cells seem unlikely. These data highlight the antitumor and antimetastatic effects of ZD6126 in human pancreatic cancer and reveal benefits of adding ZD6126 to standard gemcitabine therapy.

Lifestyle counseling in primary care: opportunities and challenges for changing practice.

Science.gov (United States)

Sargeant, Joan; Valli, Michel; Ferrier, Suzanne; MacLeod, Heather

2008-01-01

Many patients today have health concerns related to lifestyle factors. This has created a situation where physicians are regularly confronted with the challenge of how to conduct lifestyle counseling with patients. Specific strategies can enable physicians to more effectively navigate this complex area of communication with patients, improving patient response in adopting healthy behaviours and increasing physician satisfaction with this task. To evaluate the impact of a lifestyle counseling workshop incorporating the motivational enhancement and transtheoretical models upon primary care clinicians' counseling practice patterns, especially communication and counseling skills, and attitudes toward lifestyle counseling. This study used a mixed method research design. Forty-three clinicians completed a post-workshop evaluation and identified intended changes to practice following the workshop. Twelve participated in interviews several months later to explore the kinds of changes made and influences upon them. Forty-one (95.3%) questionnaire respondents reported an intention to change their practice. Main changes reported were: asking more questions, listening more, assessing patients' readiness to change, tailoring counseling to patients' readiness to change. They seemed to have acquired and retained new knowledge and most were able to apply the new skills in their practices. Many reported feeling more comfortable and/or confident when interacting with patients in need of lifestyle change. But, time constraints, comfort with current skills, lack of self-efficacy, and fears of missing opportunities to influence patients, moderated participants' ability to adopt and maintain new approaches. While primary care clinicians can successfully learn specific lifestyle counseling skills and incorporate them into their practice following a two-hour evidence-based workshop, individual, educational and system factors can interfere.

Preparation, purification and primary bioevaluation of radioiodinated ofloxacin. An imaging agent

Energy Technology Data Exchange (ETDEWEB)

Kandil, Shaban; Seddik, Usama; Hussien, Hiba; Shaltot, Mohamed [Atomic Energy Authority, Cairo (Egypt). Cyclotron Project; El-Tabl, Abdou [Monofia Univ. (Egypt). Faculty of Science

2015-07-01

The broad-spectrum antibiotic agents have been demonstrated as promising diagnostic tools for early detection of infectious lesions. We set out ofloxacin (Oflo), a second-generation fluoroquinolone, for the radioiodination process. In particular, this was carried out with {sup 125}I via an electrophilic substitution reaction. The radiochemical yield was influenced by different factors; drug concentration, different oxidizing agents, e.g. chloramine-T, iodogen and n-bromosuccinimide, pH of medium, reaction time, temperature and different organic media. These parameters were studied to optimize the best conditions for labeling with ofloxacin. We found that radiolabeling in ethanol medium showed a 70% radiochemical yield of {sup 125}I-ofloxacin. The radioiodination was determined by means of TLC and HPLC. The cold labeled Oflo ({sup 127}I-Oflo) was prepared and controlled by HPLC. The cold labeled Oflo was also confirmed by NMR and MS techniques. Furthermore, biodistribution studies for labeled {sup 125}I-Oflo were examined in two independent groups (3 mice in each one); control and E. Coli-injected (inflamed). The radiotracer showed a good localization in muscle of thigh for inflamed group as compared to control. In conclusion, ofloxacine might be a promising target as an anti-inflammatory imaging agent.

Space changes after premature loss of the mandibular primary first molar: a longitudinal study.

Science.gov (United States)

Lin, Y T; Chang, L C

1998-01-01

The purpose of this study was to evaluate the space changes after premature loss of the primary mandibular first molar. Twenty-one children (12 boys and 9 girls), with premature loss of the primary mandibular first molar, were selected from the children's dental clinic for this study. The age ranged from 5.1 to 7.2 years with an average of 6 years and 11 months. Mandibular study casts were made from alginate impression for each initial examination and a follow-up examination eight months later. Four measurements including D+E (first and second primary molars) space, arch width, arch length and arch perimeter were tested for comparisons between the initial examination and the follow-up examination eight months later. The D+E space of intact primary molars served as a control. The results showed that the D+E space on the extraction side after the follow-up examination eight months later was significantly shorter than the control side (p = 0.025) and less than the initial D+E space (p 0.05). It is concluded that the space change after the eruption of the first permanent molar in the mandible is mostly distal movement of the primary cuspid during the early stage of premature loss of the primary first molar.

[The prospects for using potable mineral waters as agents for the primary prevention of gastroduodenal ulcers].

Science.gov (United States)

Polushina, N D; Frolkov, V K

1990-01-01

Primary preventive effects of mineral water Essentuki 17 were investigated on 500 male Wistar rats (body mass 200-250 g). It is demonstrated that oral pretreatment with the above water can prevent the onset of gastroduodenal ulcers. Changes in secretion of gastrin, insulin, glucagon, triiodothyronine and thyroxin support the clinical evidence.

A food environments feedback system (FoodBack) for empowering citizens and change agents to create healthier community food places.

Science.gov (United States)

Vandevijvere, Stefanie; Williams, Rachel; Tawfiq, Essa; Swinburn, Boyd

2017-11-14

This study developed a systems-based approach (called FoodBack) to empower citizens and change agents to create healthier community food places. Formative evaluations were held with citizens and change agents in six diverse New Zealand communities, supplemented by semi-structured interviews with 85 change agents in Auckland and Hamilton in 2015-2016. The emerging system was additionally reviewed by public health experts from diverse organizations. A food environments feedback system was constructed to crowdsource key indicators of the healthiness of diverse community food places (i.e. schools, hospitals, supermarkets, fast food outlets, sport centers) and outdoor spaces (i.e. around schools), comments/pictures about barriers and facilitators to healthy eating and exemplar stories on improving the healthiness of food environments. All the information collected is centrally processed and translated into 'short' (immediate) and 'long' (after analyses) feedback loops to stimulate actions to create healthier food places. FoodBack, as a comprehensive food environment feedback system (with evidence databases and feedback and recognition processes), has the potential to increase food sovereignty, and generate a sustainable, fine-grained database of food environments for real-time food policy research. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Analysis of T Cell Subsets in Adult Primary/Idiopathic Minimal Change Disease: A Pilot Study

Directory of Open Access Journals (Sweden)

Francisco Salcido-Ochoa

2017-01-01

Full Text Available Aim. To characterise infiltrating T cells in kidneys and circulating lymphocyte subsets of adult patients with primary/idiopathic minimal change disease. Methods. In a cohort of 9 adult patients with primary/idiopathic minimal change recruited consecutively at disease onset, we characterized (1 infiltrating immune cells in the kidneys using immunohistochemistry and (2 circulating lymphocyte subsets using flow cytometry. As an exploratory analysis, association of the numbers and percentages of both kidney-infiltrating immune cells and the circulating lymphocyte subsets with kidney outcomes including deterioration of kidney function and proteinuria, as well as time to complete clinical remission up to 48 months of follow-up, was investigated. Results. In the recruited patients with primary/idiopathic minimal change disease, we observed (a a dominance of infiltrating T helper 17 cells and cytotoxic cells, comprising cytotoxic T cells and natural killer cells, over Foxp3+ Treg cells in the renal interstitium; (b an increase in the circulating total CD8+ T cells in peripheral blood; and (c an association of some of these parameters with kidney function and proteinuria. Conclusions. In primary/idiopathic minimal change disease, a relative numerical dominance of effector over regulatory T cells can be observed in kidney tissue and peripheral blood. However, larger confirmatory studies are necessary.

Young deafblind adults in action: becoming self-determined change agents through advocacy.

Science.gov (United States)

Bruce, Susan M; Parker, Amy T

2012-01-01

Six young deafblind adults took a 1-week course on civic engagement and advocacy, which provided the focus for a participatory action research study with a collective case study design. They selected advocacy topics, were briefed on these policy issues, and were paired with experienced mentors for meetings with legislators in Washington, DC. Eight themes were identified from constant comparative and in vivo analysis of classroom discussion notes, interviews, and journals: (a) defining advocacy and advocate, (b) rights and equality, (c) expectations, (d) role of education in change, (e) deafblind expertise, (f) characteristics of effective change agents, (g) advocacy is teamwork, (h) future advocacy. In the classroom, the participants learned about policy issues, communication considerations, and leadership, then applied this knowledge in the legislative arena. Through the advocacy process, they learned to apply their personal strengths as advocates and experienced the importance of teamwork in advocacy.

Creating Agent-Based Energy Transition Management Models That Can Uncover Profitable Pathways to Climate Change Mitigation

Directory of Open Access Journals (Sweden)

Auke Hoekstra

2017-01-01

Full Text Available The energy domain is still dominated by equilibrium models that underestimate both the dangers and opportunities related to climate change. In reality, climate and energy systems contain tipping points, feedback loops, and exponential developments. This paper describes how to create realistic energy transition management models: quantitative models that can discover profitable pathways from fossil fuels to renewable energy. We review the literature regarding agent-based economics, disruptive innovation, and transition management and determine the following requirements. Actors must be detailed, heterogeneous, interacting, learning, and strategizing. Technology should be represented as a detailed and heterogeneous portfolio that can develop in a bottom-up manner, using endogenous feedback loops. Assumptions about discount rates and the social cost of carbon should be configurable. The model should contain interactions between the global, national, local, and individual level. A review of modelling techniques shows that equilibrium models are unsuitable and that system dynamics and discrete event simulation are too limited. The agent-based approach is found to be uniquely suited for the complex adaptive sociotechnical systems that must be modelled. But the choice for agent-based models does not mean a rejection of other approaches because they can be accommodated within the agent-based framework. We conclude with practical guidelines.

The toxicity of uranyl nitrate on primary brain cell culture of L. Hoevenii

International Nuclear Information System (INIS)

Ismail Bahari; Fauziah Mohd Noor

1995-01-01

In Malaysia, uranium is indirectly being concentrated by mining and petroleum industries that have no relevance to its use. Concentration of uranium and the production of TENORM may give rise to radiological risk to workers and the environment. A study was conducted to determine the toxicity of a uranium compound, uranyl nitrate. For this purpose a primary brain cell culture derived from L. hoevenii was used. The nature of uranil nitrate toxicity was determined by comparing with the effects induced by mitomycin C and gamma radiation. The toxicity of these agents were measured by observing changes in Unschedule DNA Synthesis (UDS) and the induction of micronucleus. Result from the study showed that UO sub 2 sup 2+ is UDS positive and is toxic to the primary brain cells of L. hoevenii. It gives a response profile that is almost similar to that induced by gamma radiation and mitomycin C. We believed that a low concentration, UO sub 2 sup 2+ acts as a chemo toxic agent rather than as an ionising radiation. At higher concentration the toxicity of UO sub 2 sup 2+ comes from both its chemo toxic and radiation effects. Results of this study also show the ability of the primary culture to carry out repair on its DNA damaged by the UDS positive agents

Agent-based enterprise integration

Energy Technology Data Exchange (ETDEWEB)

N. M. Berry; C. M. Pancerella

1998-12-01

The authors are developing and deploying software agents in an enterprise information architecture such that the agents manage enterprise resources and facilitate user interaction with these resources. The enterprise agents are built on top of a robust software architecture for data exchange and tool integration across heterogeneous hardware and software. The resulting distributed multi-agent system serves as a method of enhancing enterprises in the following ways: providing users with knowledge about enterprise resources and applications; accessing the dynamically changing enterprise; locating enterprise applications and services; and improving search capabilities for applications and data. Furthermore, agents can access non-agents (i.e., databases and tools) through the enterprise framework. The ultimate target of the effort is the user; they are attempting to increase user productivity in the enterprise. This paper describes their design and early implementation and discusses the planned future work.

Towards Culturally-Aware Virtual Agent Systems

DEFF Research Database (Denmark)

Endrass, Birgit; André, Elisabeth; Rehm, Matthias

2010-01-01

Globalization leads to an increase in intercultural encounters with a risk of misunderstandings due to different patterns of behavior and understanding. Learning applications have been proposed that employ virtual agents as their primary tool. Through their embodiment, learning can be done...... in a game-like environment in a more interesting way than for example learning with a textbook. The authors support the idea that virtual agents are a great opportunity for teaching cultural awareness. Realizing this, the concept of culture needs to be translated into computational models and the advantages...... of different systems using virtual agents need to be considered. Therefore, the authors reflect in this chapter on how virtual agents can help to learn about culture, scan definitions of culture from the social sciences, give an overview on how multiagent systems developed over time and classify the state...

The primary applications of Gd-DTPA as an oral negative gastrointestinal contrast agent for MRCP

International Nuclear Information System (INIS)

Chen Yanping; Zhang Xuelin; Cheng Guanxun; Chang Renmin; Zhang Yuzhong; Cang Peng; Xia Qiong

2003-01-01

Objective: Using oral Gd-DTPA as a negative contrast agent to null the bowel signal during MR cholangiopancreatography (MRCP) to improve the quality of MRCP. Methods: A phantom study was performed to select the optimal concentration of Gd-DTPA to be used as an oral negative contrast agent in MRCP. 15 patients suspected of biliary tract and pancreatic disease were performed with MRCP before and after using 250 ml oral contrast agents (1:5 diluted Gd-DTPA, 1.488 g/L). All MR images were acquired using a 1.5 T whole body MR scanner (Vision Plus, Siemens). MRCP was acquired using two-dimensional single slice fast spin-echo sequence and HASTE (half-fourier acquisition single-shot fast spin echo) sequence. Results: The phantom study showed that the dilution ratio 1:5 of Gd-DTPA oral contrast agent was best in decreasing the signal intensity both in T 2 WI (59.3%) and in HASTE sequence (82.45%). All the dilution ratio of Gd-DTPA oral contrast agent decreased the signal intensity up to 90% on single slice MRCP. In all the patients the high signal intensity from the stomach and intestinal fluid was completely suppressed. The depictions of common bile duct and pancreatic duct were markedly improved by the oral contrast agent (P<0.05). Conclusion: 1:5 diluted (1.488 g/L) oral MR contrast agent Gd-DTPA can be an effective and safe negative contrast agent in eliminating signal intensity of the gastrointestinal tract, thus improving the depiction of the biliary system in MRCP

Infectious agents and inflammation in donated hearts and dilated cardiomyopathies related to cardiovascular diseases, Chagas' heart disease, primary and secondary dilated cardiomyopathies.

Science.gov (United States)

Mangini, Sandrigo; Higuchi, Maria de Lourdes; Kawakami, Joyce Tiyeko; Reis, Marcia Martins; Ikegami, Renata Nishiyama; Palomino, Suely Aparecida Pinheiro; Pomerantzeff, Pablo Maria Alberto; Fiorelli, Alfredo Inácio; Marcondes-Braga, Fabiana Goulart; Bacal, Fernando; Ferreira, Sílvia Moreira Ayub; Issa, Victor Sarli; Souza, Germano Emílio Conceição; Chizzola, Paulo Roberto; Bocchi, Edimar Alcides

2015-01-15

Clinical and experimental conflicting data have questioned the relationship between infectious agents, inflammation and dilated cardiomyopathy (DCM). The aim of this study was to determine the frequency of infectious agents and inflammation in endomyocardial biopsy (EMB) specimens from patients with idiopathic DCM, explanted hearts from different etiologies, including Chagas' disease, compared to donated hearts. From 2008 to 2011, myocardial samples from 29 heart donors and 55 patients with DCMs from different etiologies were studied (32 idiopathic, 9 chagasic, 6 ischemic and 8 other specific etiologies). Inflammation was investigated by immunohistochemistry and infectious agents by immunohistochemistry, molecular biology, in situ hybridization and electron microscopy. There were no differences regarding the presence of macrophages, expression of HLA class II and ICAM-I in donors and DCM. Inflammation in Chagas' disease was predominant. By immunohistochemistry, in donors, there was a higher expression of antigens of enterovirus and Borrelia, hepatitis B and C in DCMs. By molecular biology, in all groups, the positivity was elevated to microorganisms, including co-infections, with a higher positivity to adenovirus and HHV6 in donors towards DCMs. This study was the first to demonstrate the presence of virus in the heart tissue of chagasic DCM. The presence of inflammation and infectious agents is frequent in donated hearts, in the myocardium of patients with idiopathic DCM, myocardial dysfunction related to cardiovascular diseases, and primary and secondary cardiomyopathies, including Chagas' disease. The role of co-infection in Chagas' heart disease physiopathology deserves to be investigated in future studies. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Avatars and virtual agents - relationship interfaces for the elderly.

Science.gov (United States)

Shaked, Nava A

2017-06-01

In the Digital Era, the authors witness a change in the relationship between the patient and the care-giver or Health Maintenance Organization's providing the health services. Another fact is the use of various technologies to increase the effectiveness and quality of health services across all primary and secondary users. These technologies range from telemedicine systems, decision making tools, online and self-services applications and virtual agents; all providing information and assistance. The common thread between all these digital implementations, is they all require human machine interfaces. These interfaces must be interactive, user friendly and inviting, to create user involvement and cooperation incentives. The challenge is to design interfaces which will best fit the target users and enable smooth interaction especially, for the elderly users. Avatars and Virtual Agents are one of the interfaces used for both home care monitoring and companionship. They are also inherently multimodal in nature and allow an intimate relation between the elderly users and the Avatar. This study discusses the need and nature of these relationship models, the challenges of designing for the elderly. The study proposes key features for the design and evaluation in the area of assistive applications using Avatar and Virtual agents for the elderly users.

Change Agents & Impact Assessment

DEFF Research Database (Denmark)

Kørnøv, Lone; Larsen, Sanne Vammen; Hansen, Anne Merrild

2010-01-01

One of the challenges facing impact assessment is finding ways to work in research and practice that allow appropriate action and critical interrogation og action to enable and support sustainable change.......One of the challenges facing impact assessment is finding ways to work in research and practice that allow appropriate action and critical interrogation og action to enable and support sustainable change....

Self-employed nurses as change agents in healthcare: strategies, consequences, and possibilities.

Science.gov (United States)

Wall, Sarah

2014-01-01

The purpose of this paper is to report on ethnographic research that investigated how self-employed nurses perceive the contemporary healthcare field, what attributes they possess that facilitate their roles as change agents, what strategies they use to influence change, and what consequences they face for their actions, thus contributing to what is known about organizational change in institutionalized settings such as healthcare. Focussed ethnography was used to explore self-employed nurses' work experiences and elucidate the cultural elements of their social contexts, including customs, ideologies, beliefs, and knowledge and the ways that these impact upon the possibilities for change in the system. These self-employed nurses reflected on the shortcomings in the healthcare system and took entrepreneurial risks that would allow them to practice nursing according to their professional values. They used a number of strategies to influence change such as capitalizing on opportunities, preparing themselves for innovative work, managing and expanding the scope of nursing practice, and building new ideas on foundational nursing knowledge and experience. They had high job satisfaction and a strong sense of contribution but they faced significant resistance because of their non-traditional approach to nursing practice. Despite dramatic restructuring in the Canadian healthcare system, the system remains physician-centered and hospital-based. Nursing's professional potential has been largely untapped in any change efforts. Self-employed nurses have positioned themselves to deliver care based on nursing values and to promote alternative conceptions of health and healthcare. This study offers a rare exploration of this unique form of nursing practice and its potential to influence health system reform.

Changes in primary health care centres over the transition period in Slovenia.

NARCIS (Netherlands)

Albreht, T.; Delnoij, D.M.J.; Klazinga, N.

2006-01-01

BACKGROUND: Primary health care centres (PHCCs) were a characteristic of the former Yugoslav health care system introduced widely in Slovenia. Transition brought structural changes to health care and the position of the PHCC's was challenged. This paper investigates (i) PHCCs' perception of

Changes in primary health care centres over the transition period in Slovenia

NARCIS (Netherlands)

Albreht, Tit; Delnoij, Diana M. J.; Klazinga, Niek

2006-01-01

BACKGROUND: Primary health care centres (PHCCs) were a characteristic of the former Yugoslav health care system introduced widely in Slovenia. Transition brought structural changes to health care and the position of the PHCC's was challenged. This paper investigates (i) PHCCs' perception of

Efficacy of antidotes (midazolam, atropine and HI-6) on nerve agent induced molecular and neuropathological changes.

Science.gov (United States)

RamaRao, Golime; Afley, Prachiti; Acharya, Jyothiranjan; Bhattacharya, Bijoy Krishna

2014-04-04

Recent alleged attacks with nerve agent sarin on civilians in Syria indicate their potential threat to both civilian and military population. Acute nerve agent exposure can cause rapid death or leads to multiple and long term neurological effects. The biochemical changes that occur following nerve agent exposure needs to be elucidated to understand the mechanisms behind their long term neurological effects and to design better therapeutic drugs to block their multiple neurotoxic effects. In the present study, we intend to study the efficacy of antidotes comprising of HI-6 (1-[[[4-(aminocarbonyl)-pyridinio]-methoxy]-methyl]-2-[(hydroxyimino) methyl] pyridinium dichloride), atropine and midazolam on soman induced neurodegeneration and the expression of c-Fos, Calpain, and Bax levels in discrete rat brain areas. Therapeutic regime consisting of HI-6 (50 mg/kg, i.m), atropine (10 mg/kg, i.m) and midazolam (5 mg/kg, i.m) protected animals against soman (2×LD50, s.c) lethality completely at 2 h and 80% at 24 h. HI-6 treatment reactivated soman inhibited plasma and RBC cholinesterase up to 40%. Fluoro-Jade B (FJ-B) staining of neurodegenerative neurons showed that soman induced significant necrotic neuronal cell death, which was reduced by this antidotal treatment. Soman increased the expression of neuronal proteins including c-Fos, Bax and Calpain levels in the hippocampus, cerebral cortex and cerebellum regions of the brain. This therapeutic regime also reduced the soman induced Bax, Calpain expression levels to near control levels in the different brain regions studied, except a mild induction of c-Fos expression in the hippocampus. Rats that received antidotal treatment after soman exposure were protected from mortality and showed reduction in the soman induced expression of c-Fos, Bax and Calpain and necrosis. Results highlight the need for timely administration of better antidotes than standard therapy in order to prevent the molecular and biochemical changes and

Assessment of postoperative changes in antihypertensive drug consumption in patients with primary aldosteronism using the defined daily dose

Directory of Open Access Journals (Sweden)

Takanobu Utsumi

2014-10-01

Conclusion: The defined daily dose is a useful tool for assessing total changes in the consumption of antihypertensive drugs in patients with primary aldosteronism. Using the defined daily dose, clinicians could explain in detail to patients with primary aldosteronism the predicted postoperative change in antihypertensive drug consumption.

Imaging Primary Mouse Sarcomas After Radiation Therapy Using Cathepsin-Activatable Fluorescent Imaging Agents

Energy Technology Data Exchange (ETDEWEB)

Cuneo, Kyle C. [Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina (United States); Mito, Jeffrey K.; Javid, Melodi P. [Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, North Carolina (United States); Ferrer, Jorge M. [Department of Chemistry, Massachusetts Institute of Technology, Cambridge, Massachusetts (United States); Kim, Yongbaek [Department of Clinical Pathology, College of Veterinary Medicine, Seoul National University, Seoul (Korea, Republic of); Lee, W. David [The David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts (United States); Bawendi, Moungi G. [Department of Chemistry, Massachusetts Institute of Technology, Cambridge, Massachusetts (United States); Brigman, Brian E. [Department of Orthopedic Surgery, Duke University School of Medicine, Durham, North Carolina (United States); Kirsch, David G., E-mail: david.kirsch@duke.edu [Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina (United States); Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, North Carolina (United States)

2013-05-01

Purpose: Cathepsin-activated fluorescent probes can detect tumors in mice and in canine patients. We previously showed that these probes can detect microscopic residual sarcoma in the tumor bed of mice during gross total resection. Many patients with soft tissue sarcoma (STS) and other tumors undergo radiation therapy (RT) before surgery. This study assesses the effect of RT on the ability of cathepsin-activated probes to differentiate between normal and cancerous tissue. Methods and Materials: A genetically engineered mouse model of STS was used to generate primary hind limb sarcomas that were treated with hypofractionated RT. Mice were injected intravenously with cathepsin-activated fluorescent probes, and various tissues, including the tumor, were imaged using a hand-held imaging device. Resected tumor and normal muscle samples were harvested to assess cathepsin expression by Western blot. Uptake of activated probe was analyzed by flow cytometry and confocal microscopy. Parallel in vitro studies using mouse sarcoma cells were performed. Results: RT of primary STS in mice and mouse sarcoma cell lines caused no change in probe activation or cathepsin protease expression. Increasing radiation dose resulted in an upward trend in probe activation. Flow cytometry and immunofluorescence showed that a substantial proportion of probe-labeled cells were CD11b-positive tumor-associated immune cells. Conclusions: In this primary murine model of STS, RT did not affect the ability of cathepsin-activated probes to differentiate between tumor and normal muscle. Cathepsin-activated probes labeled tumor cells and tumor-associated macrophages. Our results suggest that it would be feasible to include patients who have received preoperative RT in clinical studies evaluating cathepsin-activated imaging probes.

Modeling and Monitoring Terrestrial Primary Production in a Changing Global Environment: Toward a Multiscale Synthesis of Observation and Simulation

Directory of Open Access Journals (Sweden)

Shufen Pan

2014-01-01

Full Text Available There is a critical need to monitor and predict terrestrial primary production, the key indicator of ecosystem functioning, in a changing global environment. Here we provide a brief review of three major approaches to monitoring and predicting terrestrial primary production: (1 ground-based field measurements, (2 satellite-based observations, and (3 process-based ecosystem modelling. Much uncertainty exists in the multi-approach estimations of terrestrial gross primary production (GPP and net primary production (NPP. To improve the capacity of model simulation and prediction, it is essential to evaluate ecosystem models against ground and satellite-based measurements and observations. As a case, we have shown the performance of the dynamic land ecosystem model (DLEM at various scales from site to region to global. We also discuss how terrestrial primary production might respond to climate change and increasing atmospheric CO2 and uncertainties associated with model and data. Further progress in monitoring and predicting terrestrial primary production requires a multiscale synthesis of observations and model simulations. In the Anthropocene era in which human activity has indeed changed the Earth’s biosphere, therefore, it is essential to incorporate the socioeconomic component into terrestrial ecosystem models for accurately estimating and predicting terrestrial primary production in a changing global environment.

The effectiveness of motivational interviewing for health behaviour change in primary care settings: a systematic review.

Science.gov (United States)

Morton, Katie; Beauchamp, Mark; Prothero, Anna; Joyce, Lauren; Saunders, Laura; Spencer-Bowdage, Sarah; Dancy, Bernadette; Pedlar, Charles

2015-01-01

Motivational interviewing (MI) is a patient-centred approach to behaviour change that was originally developed in the addiction field but has increasingly been applied to public health settings with a focus on health promotion. The purpose of this review was to examine the evidence base for MI interventions in primary care settings with non-clinical populations to achieve behaviour change for physical activity, dietary behaviours and/or alcohol intake. We also sought to explore the specific behaviour change techniques included in MI interventions within primary care. Electronic databases were searched for relevant articles and 33 papers met inclusion criteria and were included. Approximately 50% of the included studies (n = 18) demonstrated positive effects in relation to health behaviour change. The efficacy of MI approaches is unclear given the inconsistency of MI descriptions and intervention components. Furthermore, research designs that do not isolate the effects of MI make it difficult to determine the effectiveness of such approaches. We offer a number of recommendations for researchers and practitioners seeking to include MI within behaviour change interventions to help improve the quality of the research and the effectiveness of MI-based interventions within primary care settings.

Exposure to a First World War blistering agent.

Science.gov (United States)

Le, H Q; Knudsen, S J

2006-04-01

Sulfur mustards act as vesicants and alkylating agents. They have been used as chemical warfare since 1917 during the first world war. This brief report illustrates the progression of injury on a primary exposed patient to a first world war blistering agent. This case documents the rapid timeline and progression of symptoms. It emphasises the importance of appropriate personal protective equipment and immediate medical response plan with rapid decontamination and proper action from military and civilian medical treatment facilities. This case reports the first US active duty military exposure to a blistering agent in the age of global terrorism.

Peak electricity demand and social practice theories: Reframing the role of change agents in the energy sector

International Nuclear Information System (INIS)

Strengers, Yolande

2012-01-01

Demand managers currently draw on a limited range of psychology and economic theories in order to shift and shed peak electricity demand. These theories place individual consumers and their attitudes, behaviours and choices at the centre of the problem. This paper reframes the issue of peak electricity demand using theories of social practices, contending that the ‘problem’ is one of transforming, technologically-mediated social practices. It reflects on how this body of theory repositions and refocuses the roles and practices of professions charged with the responsibility and agency for affecting and managing energy demand. The paper identifies three areas where demand managers could refocus their attention: (i) enabling co-management relationships with consumers; (ii) working beyond their siloed roles with a broader range of human and non-human actors; and (iii) promoting new practice ‘needs’ and expectations. It concludes by critically reflecting on the limited agency attributed to ‘change agents’ such as demand managers in dominant understandings of change. Instead, the paper proposes the need to identify and establish a new group of change agents who are actively but often unwittingly involved in reconfiguring the elements of problematic peaky practices. - Highlights: ► I reframe peak electricity demand as a problem of changing social practices. ► Micro-grids, and dynamic pricing reorient household routines and enable co-management. ► Infrastructures inside and outside the home configure peaky practices. ► Demand managers are encouraged to promote and challenge consumer ‘needs’. ► I identify a new group of change agents implicated in peaky practices.

Performance analysis of spectrum sensing with multiple status changes in primary user traffic

KAUST Repository

Tang, Liang; Chen, Yunfei; Hines, Evor L.; Alouini, Mohamed-Slim

2012-01-01

In this letter, the impact of primary user traffic with multiple status changes on the spectrum sensing performance is analyzed. Closed-form expressions for the probabilities of false alarm and detection are derived. Numerical results show

Becoming Technosocial Change Agents: Intersectionality and Culturally Responsive Pedagogies as Vital Resources for Increasing Girls' Participation in Computing

Science.gov (United States)

Ashcraft, Catherine; Eger, Elizabeth K.; Scott, Kimberly A.

2017-01-01

Drawing from our two-year ethnography, we juxtapose the experiences of two cohorts in one culturally responsive computing program, examining how the program fostered girls' emerging identities as technosocial change agents. In presenting this in-depth and up-close exploration, we simultaneously identify conditions that both facilitated and limited…

Functional and Structural Changes in a Canine Model of Hereditary Primary Angle-Closure Glaucoma

Science.gov (United States)

Kecova, Helga; Harper, Matthew M.; Nilaweera, Wijitha; Kuehn, Markus H.; Kardon, Randy H.

2010-01-01

Purpose. To characterize functional and structural changes in a canine model of hereditary primary angle-closure glaucoma. Methods. Intraocular pressure (IOP) was evaluated with tonometry in a colony of glaucomatous dogs at 8, 15, 18, 20, and 30 months of age. Retinal function was evaluated using electroretinography (scotopic, photopic, and pattern). Examination of anterior segment structures was performed using gonioscopy and high-frequency ultrasonography (HFU). Results. A gradual rise in IOP was observed with an increase in age: 8 months, 14 mm Hg (median value); 15 months, 15.5 mm Hg; 18 months, 17.5 mm Hg; 20 months, 24 mm Hg; 30 months, 36 mm Hg. Provocative testing with mydriatic agents (tropicamide and atropine 1%) caused significant increases in IOP (35% and 50%, respectively). HFU analysis showed complete collapse of iridocorneal angles by 20 months of age. Scotopic and photopic ERG analysis did not reveal significant deficits, but pattern ERG analysis showed significantly reduced amplitudes in glaucomatous dogs (glaucoma, 3.5 ± 0.4 μV; control, 6.2 ± 0.3 μV; P = 0.004; Student's t-test). Histologic analysis revealed collapse of the iridocorneal angle, posterior bowing of the lamina cribrosa, swelling and loss of large retinal ganglion cells, increased glial reactivity, and increased thickening of the lamina cribrosa. Conclusions. Canine hereditary angle-closure glaucoma is characterized by a progressive increase in intraocular pressure, loss of optic nerve function, and retinal ganglion cell loss. PMID:19661222

Parents as Agents of Change (PAC in pediatric weight management: The protocol for the PAC randomized clinical trial

Directory of Open Access Journals (Sweden)

Ball Geoff D C

2012-08-01

Full Text Available Abstract Background There is an urgent need to develop and evaluate weight management interventions to address childhood obesity. Recent research suggests that interventions designed for parents exclusively, which have been named parents as agents of change (PAC approaches, have yielded positive outcomes for managing pediatric obesity. To date, no research has combined a PAC intervention approach with cognitive behavioural therapy (CBT to examine whether these combined elements enhance intervention effectiveness. This paper describes the protocol our team is using to examine two PAC-based interventions for pediatric weight management. We hypothesize that children with obesity whose parents complete a CBT-based PAC intervention will achieve greater reductions in adiposity and improvements in cardiometabolic risk factors, lifestyle behaviours, and psychosocial outcomes than children whose parents complete a psycho-education-based PAC intervention (PEP. Methods/Design This study is a pragmatic, two-armed, parallel, single-blinded, superiority, randomized clinical trial. The primary objective is to examine the differential effects of a CBT-based PAC vs PEP-based PAC intervention on children’s BMI z-score (primary outcome. Secondary objectives are to assess intervention-mediated changes in cardiometabolic, lifestyle, and psychosocial variables in children and parents. Both interventions are similar in frequency of contact, session duration, group facilitation, lifestyle behaviour goals, and educational content. However, the interventions differ insofar as the CBT-based intervention incorporates theory-based concepts to help parents link their thoughts, feelings, and behaviours; these cognitive activities are enabled by group leaders who possess formal training in CBT. Mothers and fathers of children (8–12 years of age; BMI ≥85th percentile are eligible to participate if they are proficient in English (written and spoken and agree for at least

Persuasive Conversational Agent with Persuasion Tactics

Science.gov (United States)

Narita, Tatsuya; Kitamura, Yasuhiko

Persuasive conversational agents persuade people to change their attitudes or behaviors through conversation, and are expected to be applied as virtual sales clerks in e-shopping sites. As an approach to create such an agent, we have developed a learning agent with the Wizard of Oz method in which a person called Wizard talks to the user pretending to be the agent. The agent observes the conversations between the Wizard and the user, and learns how to persuade people. In this method, the Wizard has to reply to most of the user's inputs at the beginning, but the burden gradually falls because the agent learns how to reply as the conversation model grows.

Spatio-temporal Dynamics of Land-use and Land-cover Change: A Multi-agent Simulation Model and Its Application to an Upland Watershed in Central Vietnam

Science.gov (United States)

Le, Q.; Vlek, P. L.; Park, S.

2005-12-01

Land-use and land-cover change (LUCC) is an essential environmental process that should be monitored and prognosticated to provide a basis for better land management policy. However, LUCC modeling is a challenge due to the complex nature and unexpected behavior of both human drivers and natural constraints. This paper presents a multi-agent-based model to simulate spatio-temporal land-use changes and the interdependent socio-economic dynamics emerging from the complex socio-ecological interactions at micro levels resulting from land-use policy interventions. The model provides land-use scenarios under alternative policy to support decisions on land management for improved rural livelihoods while protecting the environment. In the multi-agent simulation model, the human community is represented by household agents (heterogeneous farming households) with their profiles and decision-making mechanisms about land use. The household profile defines the five asset dimensions of household livelihood (e.g., social, human, financial, natural and physical assets). The land-use decision-making program works by taking inputs from the household profile, perceived spatial environmental attributes, and introduced policies. The decision-making program is a logical procedure that combines a land-use choice model (multi-nominal logistic choices) and anthropological rules. The landscape environment is represented by landscape agents (congruent land patches of 30mx30m) with their state variables and ecological response mechanisms to environmental changes and human interventions. State variables of landscape agents correspond to spatial GIS-raster layers of biophysical, economic, and institutional variables. Ecological mechanisms of landscape agents are represented by internal sub-models of agricultural and forest productivity dynamics, which work in response to the current state, history, and spatial neighbourhood of the landscape agents. A multi-agent based protocol coordinates the

The changes of bone mineralization after parathyroidectomy in primary hyperparathyroidism. Case report

International Nuclear Information System (INIS)

Przedlacki, J.; Nawrot, I.; Chudzinski, W.

1995-01-01

The aim of the study was to evaluate the changes of bone demineralization in the patient after parathyroidectomy in primary hyperparathyroidism. Bone mineralization was evaluated by Lunar DPX-L equipment in lumbar spine, femoral neck, radius and total skeleton area in 3 months intervals during 18 months period. Because of transient after surgical hypocalcemia she has received active metabolite of vitamin D - Alfacalcidolum during one year. After removal of parathyroid adenoma there was disappearance of clinical and biochemical signs of primary hyperparathyroidism. At the same time there was total normalization of bone mineral density in lumbar spine, femoral neck, ultradistal site of radius and total area. There was partial normalization of bone mineralization in radius shaft. The surgery of adenoma in primary hyperparathyroidism with transient treatment with active metabolite of vitamin D is successful therapy of bone demineralization in this disease. (author). 5 refs, 2 figs

Phase change events of volatile liquid perfluorocarbon contrast agents produce unique acoustic signatures

International Nuclear Information System (INIS)

Sheeran, Paul S; Dayton, Paul A; Matsunaga, Terry O

2014-01-01

Phase-change contrast agents (PCCAs) provide a dynamic platform to approach problems in medical ultrasound (US). Upon US-mediated activation, the liquid core vaporizes and expands to produce a gas bubble ideal for US imaging and therapy. In this study, we demonstrate through high-speed video microscopy and US interrogation that PCCAs composed of highly volatile perfluorocarbons (PFCs) exhibit unique acoustic behavior that can be detected and differentiated from standard microbubble contrast agents. Experimental results show that when activated with short pulses PCCAs will over-expand and undergo unforced radial oscillation while settling to a final bubble diameter. The size-dependent oscillation phenomenon generates a unique acoustic signal that can be passively detected in both time and frequency domain using confocal piston transducers with an ‘activate high’ (8 MHz, 2 cycles), ‘listen low’ (1 MHz) scheme. Results show that the magnitude of the acoustic ‘signature’ increases as PFC boiling point decreases. By using a band-limited spectral processing technique, the droplet signals can be isolated from controls and used to build experimental relationships between concentration and vaporization pressure. The techniques shown here may be useful for physical studies as well as development of droplet-specific imaging techniques. (paper)

Land-cover impacts on streamflow: a change-detection modelling approach that incorporates parameter uncertainty

Science.gov (United States)

Jan Seibert; Jeffrey J. McDonnell

2010-01-01

The effect of land-use or land-cover change on stream runoff dynamics is not fully understood. In many parts of the world, forest management is the major land-cover change agent. While the paired catchment approach has been the primary methodology used to quantify such effects, it is only possible for small headwater catchments where there is uniformity in...

A Watershed-Scale Agent-Based Model Incorporating Agent Learning and Interaction of Farmers' Decisions Subject to Carbon and Miscanthus Prices

Science.gov (United States)

Ng, T.; Eheart, J.; Cai, X.; Braden, J. B.

2010-12-01

Agricultural watersheds are coupled human-natural systems where the land use decisions of human agents (farmers) affect surface water quality, and in turn, are affected by the weather and yields. The reliable modeling of such systems requires an approach that considers both the human and natural aspects. Agent-based modeling (ABM), representing the human aspect, coupled with hydrologic modeling, representing the natural aspect, is one such approach. ABM is a relatively new modeling paradigm that formulates the system from the perspectives of the individual agents, i.e., each agent is modeled as a discrete autonomous entity with distinct goals and actions. The primary objective of this study is to demonstrate the applicability of this approach to agricultural watershed management. This is done using a semi-hypothetical case study of farmers in the Salt Creek watershed in East-Central Illinois under the influence markets for carbon and second-generation bioenergy crop (specifically, miscanthus). An agent-based model of the system is developed and linked to a hydrologic model of the watershed. The former is based on fundamental economic and mathematical programming principles, while the latter is based on the Soil and Water Assessment Tool (SWAT). Carbon and second-generation bioenergy crop markets are of interest here due to climate change and energy independence concerns. The agent-based model is applied to fifty hypothetical heterogeneous farmers. The farmers' decisions depend on their perceptions of future conditions. Those perceptions are updated, according to a pre-defined algorithm, as the farmers make new observations of prices, costs, yields and the weather with time. The perceptions are also updated as the farmers interact with each other as they share new information on initially unfamiliar activities (e.g., carbon trading, miscanthus cultivation). The updating algorithm is set differently for different farmers such that each is unique in his processing of

Behavior Change without Behavior Change Communication: Nudging Handwashing among Primary School Students in Bangladesh

Science.gov (United States)

Dreibelbis, Robert; Kroeger, Anne; Hossain, Kamal; Venkatesh, Mohini; Ram, Pavani K.

2016-01-01

Behavior change communication for improving handwashing with soap can be labor and resource intensive, yet quality results are difficult to achieve. Nudges are environmental cues engaging unconscious decision-making processes to prompt behavior change. In this proof-of-concept study, we developed an inexpensive set of nudges to encourage handwashing with soap after toilet use in two primary schools in rural Bangladesh. We completed direct observation of behaviors at baseline, after providing traditional handwashing infrastructure, and at multiple time periods following targeted handwashing nudges (1 day, 2 weeks, and 6 weeks). No additional handwashing education or motivational messages were completed. Handwashing with soap among school children was low at baseline (4%), increasing to 68% the day after nudges were completed and 74% at both 2 weeks and 6 weeks post intervention. Results indicate that nudge-based interventions have the potential to improve handwashing with soap among school-aged children in Bangladesh and specific areas of further inquiry are discussed. PMID:26784210

Behavior Change without Behavior Change Communication: Nudging Handwashing among Primary School Students in Bangladesh

Directory of Open Access Journals (Sweden)

Robert Dreibelbis

2016-01-01

Full Text Available Behavior change communication for improving handwashing with soap can be labor and resource intensive, yet quality results are difficult to achieve. Nudges are environmental cues engaging unconscious decision-making processes to prompt behavior change. In this proof-of-concept study, we developed an inexpensive set of nudges to encourage handwashing with soap after toilet use in two primary schools in rural Bangladesh. We completed direct observation of behaviors at baseline, after providing traditional handwashing infrastructure, and at multiple time periods following targeted handwashing nudges (1 day, 2 weeks, and 6 weeks. No additional handwashing education or motivational messages were completed. Handwashing with soap among school children was low at baseline (4%, increasing to 68% the day after nudges were completed and 74% at both 2 weeks and 6 weeks post intervention. Results indicate that nudge-based interventions have the potential to improve handwashing with soap among school-aged children in Bangladesh and specific areas of further inquiry are discussed.

Behavior Change without Behavior Change Communication: Nudging Handwashing among Primary School Students in Bangladesh.

Science.gov (United States)

Dreibelbis, Robert; Kroeger, Anne; Hossain, Kamal; Venkatesh, Mohini; Ram, Pavani K

2016-01-14

Behavior change communication for improving handwashing with soap can be labor and resource intensive, yet quality results are difficult to achieve. Nudges are environmental cues engaging unconscious decision-making processes to prompt behavior change. In this proof-of-concept study, we developed an inexpensive set of nudges to encourage handwashing with soap after toilet use in two primary schools in rural Bangladesh. We completed direct observation of behaviors at baseline, after providing traditional handwashing infrastructure, and at multiple time periods following targeted handwashing nudges (1 day, 2 weeks, and 6 weeks). No additional handwashing education or motivational messages were completed. Handwashing with soap among school children was low at baseline (4%), increasing to 68% the day after nudges were completed and 74% at both 2 weeks and 6 weeks post intervention. Results indicate that nudge-based interventions have the potential to improve handwashing with soap among school-aged children in Bangladesh and specific areas of further inquiry are discussed.

Women's Health Leadership to Enhance Community Health Workers as Change Agents.

Science.gov (United States)

Ingram, Maia; Chang, Jean; Kunz, Susan; Piper, Rosie; de Zapien, Jill Guernsey; Strawder, Kay

2016-05-01

Objectives A community health worker (CHW) is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. While natural leadership may incline individuals to the CHW profession, they do not always have skills to address broad social issues. We describe evaluation of the Women's Health Leadership Institute (WHLI), a 3-year training initiative to increase the capacity of CHWs as change agents. Methods Pre-/postquestionnaires measured the confidence of 254 participants in mastering WHLI leadership competencies. In-depth interviews with CHW participants 6 to 9 months after the training documented application of WHLI competencies in the community. A national CHW survey measured the extent to which WHLI graduates used leadership skills that resulted in concrete changes to benefit community members. Multivariate logistic regressions controlling for covariates compared WHLI graduates' leadership skills to the national sample. Results Participants reported statistically significant pre-/postimprovements in all competencies. Interviewees credited WHLI with increasing their capacity to listen to others, create partnerships, and initiate efforts to address community needs. Compared to a national CHW sample, WHLI participants were more likely to engage community members in attending public meetings and organizing events. These activities led to community members taking action on an issue and a concrete policy change. Conclusions Leadership training can increase the ability of experienced CHWs to address underlying issues related to community health across different types of organizational affiliations and job responsibilities. © 2016 Society for Public Health Education.

Estimating climate change effects on net primary production of rangelands in the United States

Science.gov (United States)

Matthew C. Reeves; Adam L. Moreno; Karen E. Bagne; Steven W. Running

2014-01-01

The potential effects of climate change on net primary productivity (NPP) of U.S. rangelands were evaluated using estimated climate regimes from the A1B, A2 and B2 global change scenarios imposed on the biogeochemical cycling model, Biome-BGC from 2001 to 2100. Temperature, precipitation, vapor pressure deficit, day length, solar radiation, CO2 enrichment and nitrogen...

Developing Agents of Change

National Research Council Canada - National Science Library

Dorr, Kirk

2003-01-01

... a situation where the consequences of peacetime choices become irretrievable in war. This study addresses the role of professional military education in creating cultural change within the military...

Comparison between risperidone, an atypical antipsychotic agent and haloperidol, a conventional agent used to treat schizophrenia

International Nuclear Information System (INIS)

Rehman, A.; Jawed, M.; Maheshwari, M.P.

2012-01-01

An observational and comparative study was conducted to compare the functional outcome between the patients treated with conventional antipsychotic agent haloperidol and typical antipsychotic agent, Risperidone (Risperidal). A total of 32 patients were included in the study with established schizophrenia according to (DSM iv). The data was processed on SSPE 10th version. The primary outcome measure was the improvement of negative symptoms of schizophrenia and secondary outcome measure was to observe the superiority of the atypical drug Risperid one over conventional agent haloperidol regarding side effects. Patients were assessed at baseline, 2nd and 8th week, using four tools of assessment. For treatment group receiving haloperidol mean was 47.2+-11.50 at 8th week and for Risperidone treatment group mean was 43+-14.68. The P values for all the parameters in the Clozapine group were significant as compared to haloperidol. (author)

A trial of ACNU and radiation therapy with sensitizing agents for malignant gliomas

Energy Technology Data Exchange (ETDEWEB)

Kawano, Hirokazu; Hayashi, Minoru; Satoh, Kazufumi; Ishii, Hisamasa; Nakatsugawa, Shigekazu; Ishii, Yasushi (Fukui Medical School, Yoshida, Fukui (Japan))

1989-11-01

Twelve cases of malignant gliomas (anaplastic astrocytoma 4, glioblatoma 8, recurrent 3, primary 9) were treated with ACNU and radiation with sensitizing agents after the surgical removal of the tumor. BUdR, Vidarabine (Ara-A), Aciclovir (ACV) were applied for sensitizing agents. BUdR was administrated intraarterially prior to radiation (380 rad, two times a week), and Ara-A and ACV intravenously during and after the radiation. Total dosage of the radiation was 50-60 Grey for each case. All recurrent and eight primary patients died. The mean survival time of the recurrent patients was 17.7 months, while that of the primary patients was 13.4 months. One of the primary patients was glioblastoma and is still surviving more than 24 months by now. The complete response (CR) rate of the primary tumor patients observed by computerized tomography (CT) scan was 5/9. We can expect the availability of this trial for malignant gliomas because of high CR rate in primary tumor cases. (author).

Preparing culture change agents for academic medicine in a multi-institutional consortium: the C - change learning action network.

Science.gov (United States)

Pololi, Linda H; Krupat, Edward; Schnell, Eugene R; Kern, David E

2013-01-01

Research suggests an ongoing need for change in the culture of academic medicine. This article describes the structure, activities and evaluation of a culture change project: the C - Change Learning Action Network (LAN) and its impact on participants. The LAN was developed to create the experience of a culture that would prepare participants to facilitate a culture in academic medicine that would be more collaborative, inclusive, relational, and that supports the humanity and vitality of faculty. Purposefully diverse faculty, leaders, and deans from 5 US medical schools convened in 2 1/2-day meetings biannually over 4 years. LAN meetings employed experiential, cognitive, and affective learning modes; innovative dialogue strategies; and reflective practice aimed at facilitating deep dialogue, relationship formation, collaboration, authenticity, and transformative learning to help members experience the desired culture. Robust aggregated qualitative and quantitative data collected from the 5 schools were used to inform and stimulate culture-change plans. Quantitative and qualitative evaluation methods were used. Participants indicated that a safe, supportive, inclusive, collaborative culture was established in LAN and highly valued. LAN members reported a deepened understanding of organizational change, new and valued interpersonal connections, increased motivation and resilience, new skills and approaches, increased self-awareness and personal growth, emotional connection to the issues of diversity and inclusion, and application of new learnings in their work. A carefully designed multi-institutional learning community can transform the way participants experience and view institutional culture. It can motivate and prepare them to be change agents in their own institutions. Copyright © 2013 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical

Strategic farsighted learning in competitive multi-agent games

NARCIS (Netherlands)

t Hoen, P.J.; Bohté, S.M.; Poutré, la J.A.; Brewka, G.; Coradeschi, S.; Perini, A.

2006-01-01

We describe a generalized Q-learning type algorithm for reinforcement learning in competitive multi-agent games. We make the observation that in a competitive setting with adaptive agents an agent's actions will (likely) result in changes in the opponents policies. In addition to accounting for the

Agentes Comunitários de Saúde e os sentidos de "ser agente" Community Health Agents and the meanings of "being an agent"

Directory of Open Access Journals (Sweden)

Viviane Milan Pupin

2008-08-01

Full Text Available O Programa Saúde da Família constitui-se enquanto estratégia de mudança do modelo assistencial. O artigo apresenta os resultados de uma pesquisa qualitativa sobre os sentidos de "ser agente" produzidos, por meio de entrevistas abertas, com Agentes Comunitários de Saúde que trabalham nos cinco Núcleos de Saúde da Família da cidade de Ribeirão Preto - São Paulo, vinculados à Faculdade de Medicina de Ribeirão Preto - USP. As entrevistas foram gravadas e transcritas na íntegra e analisadas segundo princípios da análise de conteúdo. A análise permitiu a descrição de sentidos acerca de ser agente subdivididos em: Sentidos produzidos na relação com a comunidade e Sentidos produzidos na relação com a equipe. A análise dos sentidos de ser agente possibilitou construir um diálogo sobre as tensões relacionadas a um fazer em saúde ora permeado por concepções atreladas ao modelo biomédico, ora atrelado aos novos paradigmas em saúde.The Family Health Program consists of a strategy to change the health care model. This article presents the results from a qualitative study about the meanings of "being an agent" obtained through open interviews with Community Health Agents who work in five Family Health Centers of the Ribeirão Preto School of Medicine (University of São Paulo, located in Ribeirão Preto, São Paulo. Interviews were tape recorded, fully transcribed, and then content analyzed. The analysis allowed for descriptions of meanings toward "being an agent", subdivided into: Meanings produced by relationships with the community, and Meanings produced by relationships with the team. Analyzing the meanings of being an agent provided the establishment of a dialogue about the tensions related to a health practice that is at times influenced by conceptions associated with the biomedical method, and at other times with the new health paradigm.

Factors Related to the Selection of a Real Estate Agency or Agent

OpenAIRE

Joyce M. Johnson; Hugh O. Nourse; Ellen Day

1988-01-01

Real estate firms attempting to maintain or increase their market share want to know the characteristics of the firm or individual agents that are important to market participants. A survey of homeowners conducted during August 1987 found the following: 1) the individual agent is more important than the firm itself in the selection of a real estate firm; 2) knowing an agent of the firm was the primary factor considered in the selection of a real estate firm; and 3) agent characteristics of se...

Bound by debt: Nutmeg trees and changing relations between farmers and agents in a Moluccan agroforestry systems

Directory of Open Access Journals (Sweden)

Messalina Lovenia Salampessy

2017-11-01

Full Text Available Agroforestry is a land management system long practiced by communities in the Moluccas. The practice is commonly known as "Dusung", where one cash crop in particular, nutmeg, is interspersed throughout farmer groves. Farmers have faced a number of challenges in recent years, especially concerning a system of debt bondage inflicting undue losses upon them. This study aims to explain the involvement of farmers within the debt bondage system, otherwise known as the tree mortgage system. We utilize a case study methodology, whereby data were collected through interviews and participant observation and results analyzed using principal agent theory. Findings highlight that nutmeg farmers, what we call the Principal, incur high risks when debt bondage is applied by an Agent that has the increasing ability to deny and change the terms of an agreement. This occurs when Agents exploit information unavailable to farmers about nutmeg marketing prospects, which weakens farmer negotiating positions. Improving institutional support for contracts in the tree mortgage system could help to ensure a more equitable arrangement, improving the terms for nutmeg farmers, meanwhile also encouraging the continued preservation of the dusung system, which has long helped to manage forest resources sustainably.

SECOND BUYING AGENT

CERN Multimedia

SPL - SERVICES ACHATS

2000-01-01

Last year the buying agent LOGITRADE started operations on the CERN site, processing purchasing requests for well-defined families of products up to a certain value. It was planned from the outset that a second buying agent would be brought in to handle the remaining product families. So, according to that plan, the company CHARLES KENDALL will be commencing operations at CERN on 8 May 2000 in Building 73, 1st floor, offices 31 and 35 (phone and fax numbers to be announced).Each buying agent will have its own specific list of product families and will handle purchasing requests up to 10'000 CHF.Whenever possible they will provide the requested supplies at a price (including the cost of their own services) which must be equivalent to or lower than the price mentioned on the purchasing request, changing the supplier if necessary. If a lower price cannot be obtained, agents will provide the necessary administrative support free of charge.To ensure that all orders are processed in the best possible conditions, us...

Monitoring volatile anaesthetic agents

International Nuclear Information System (INIS)

Russell, W.J.

2000-01-01

Full text: The methods that have been used for monitoring volatile anaesthetic agents depend on some physical property such as Density, Refractometry, Mass, Solubility, Raman scattering, or Infra-red absorption. Today, refractometry and infra-red techniques are the most common. Refractometry is used for the calibration of vaporizers. All anaesthetic agents increase the refractive index of the carrier gas. Provided the mixture is known then the refractive change measures the concentration of the volatile anaesthetic agent. Raman Scattering is when energy hits a molecule a very small fraction of the energy is absorbed and re-emitted at one or more lower frequencies. The shift in frequency is a function of the chemical bonds and is a fingerprint of the substance irradiated. Electromagnetic (Infra-red) has been the commonest method of detection of volatile agents. Most systems use a subtractive system, i.e. the agent in the sampling cell absorbed some of the infrared energy and the photo-detector therefore received less energy. A different approach is where the absorbed energy is converted into a pressure change and detected as sound (Acoustic monitor). This gives a more stable zero reference. More recently, the detector systems have used multiple narrow-band wavelengths in the infrared bands and by shape matching or matrix computing specific agent identification is achieved and the concentration calculated. In the early Datex AS3 monitors, a spectral sweep across the 3 micron infrared band was used to create spectral fingerprints. The recently released AS3 monitors use a different system with five very narrow band filters in the 8-10 micron region. The transmission through each of these filters is a value in a matrix which is solved by a micro computer to identify the agent and its concentration. These monitors can assist in improving the safety and efficiency of our anaesthetics but do not ensure that the patient is completely anaesthetized. Copyright (2000

Monitoring volatile anaesthetic agents

Energy Technology Data Exchange (ETDEWEB)

Russell, W J [Royal Adelaide Hospital, SA (Australia). Department of Anaesthesia and Intensive Care

2000-12-01

Full text: The methods that have been used for monitoring volatile anaesthetic agents depend on some physical property such as Density, Refractometry, Mass, Solubility, Raman scattering, or Infra-red absorption. Today, refractometry and infra-red techniques are the most common. Refractometry is used for the calibration of vaporizers. All anaesthetic agents increase the refractive index of the carrier gas. Provided the mixture is known then the refractive change measures the concentration of the volatile anaesthetic agent. Raman Scattering is when energy hits a molecule a very small fraction of the energy is absorbed and re-emitted at one or more lower frequencies. The shift in frequency is a function of the chemical bonds and is a fingerprint of the substance irradiated. Electromagnetic (Infra-red) has been the commonest method of detection of volatile agents. Most systems use a subtractive system, i.e. the agent in the sampling cell absorbed some of the infrared energy and the photo-detector therefore received less energy. A different approach is where the absorbed energy is converted into a pressure change and detected as sound (Acoustic monitor). This gives a more stable zero reference. More recently, the detector systems have used multiple narrow-band wavelengths in the infrared bands and by shape matching or matrix computing specific agent identification is achieved and the concentration calculated. In the early Datex AS3 monitors, a spectral sweep across the 3 micron infrared band was used to create spectral fingerprints. The recently released AS3 monitors use a different system with five very narrow band filters in the 8-10 micron region. The transmission through each of these filters is a value in a matrix which is solved by a micro computer to identify the agent and its concentration. These monitors can assist in improving the safety and efficiency of our anaesthetics but do not ensure that the patient is completely anaesthetized. Copyright (2000

Bacterial agents and sensitivity pattern of neonatal conjuctivitis in ...

African Journals Online (AJOL)

Introduction: In Africa alone, between 1000 – 4000 children are blinded annually by conjunctivitis. In view of the changing aetiological agents documented in other parts of the world and evolving resistance of infective agents to therapeutic agents, the present study was designed to define the bacterial agents, their antibiotic ...

Changes in Nutrients and Primary Production in Barrow Tundra Ponds Over the Past 40 Years

Science.gov (United States)

Lougheed, V.; Andresen, C.; Hernandez, C.; Miller, N.; Reyes, F.

2012-12-01

The Arctic tundra ponds at the International Biological Program (IBP) site in Barrow, Alaska were studied extensively in the 1970's; however, very little research has occurred there since that time. Due to the sensitivity of this region to climate warming, understanding any changes in the ponds' structure and function over the past 40 years can help identify any potential climate-related impacts. The goal of this study was to determine if the structure and function of primary producers had changed through time, and the association between these changes, urban encroachment and nutrient limitation. Nutrient levels, as well as the biomass of aquatic graminoids (Carex aquatilis and Arctophila fulva), phytoplankton and periphyton were determined in the IBP tundra ponds in both 1971-3 and 2010-12, and in 2010-11 from nearby ponds along an anthropogenic disturbance gradient. Uptake of 14C was also used to measure algal primary production in both time periods and nutrient addition experiments were performed to identify the nutrients limiting algal growth. Similar methods were utilized in the past and present studies. Overall, biomass of graminoids, phytoplankton and periphyton was greater in 2010-12 than that observed in the 1970s. This increased biomass was coincident with warmer water temperatures, increased water column nutrients and deeper active layer depth. Biomass of plants and algae was highest in the ponds closest to the village of Barrow, but no effect of urban encroachment was observed at the IBP ponds. Laboratory incubations indicated that nutrient release from thawing permafrost can explain part of these increases in nutrients and has likely contributed to changes in the primary limiting nutrient. Further studies are necessary to better understand the implications of these trends in primary production to nutrient budgets in the Arctic. The Barrow IBP tundra ponds represent one of the very few locations in the Arctic where long-term data are available on

Prescription changes and drug costs at the interface between primary and specialist care

NARCIS (Netherlands)

Bijl, D; van Sonderen, E; Haaijer-Ruskamp, FM

Objective: To explore the relevance of prescription changes and related drug costs when patients are referred from primary to secondary care. Patients and methods: Secondary analysis of data derived from a study on the quality of referrals, which was performed in 1989-1990. New and non-acute

Incidence and mortality of primary liver cancer in England and Wales: changing patterns and ethnic variations.

Science.gov (United States)

Ladep, Nimzing G; Khan, Shahid A; Crossey, Mary Me; Thillainayagam, Andrew V; Taylor-Robinson, Simon D; Toledano, Mireille B

2014-02-14

To explore recent trends, modes of diagnosis, ethnic distribution and the mortality to incidence ratio of primary liver cancer by subtypes in England and Wales. We obtained incidence (1979-2008) and mortality (1968-2008) data for primary liver cancer for England and Wales and calculated age-standardised incidence and mortality rates. Trends in age-standardised mortality (ASMR) and incidence (ASIR) rates and basis of diagnosis of primary liver cancer and subcategories: hepatocellular carcinoma, intrahepatic bile duct and unspecified liver tumours, were analysed over the study period. Changes in guidelines for the diagnosis of primary liver cancer (PLC) may impact changing trends in the rates that may be obtained. We thus explored changes in the mode of diagnosis as reported to cancer registries. Furthermore, we examined the distribution of these tumours by ethnicity. Most of the statistical manipulations of these data was carried out in Microsoft excel® (Seattle, Washington, United Sttaes). Additional epidemiological statistics were done in Epi Info software (Atlanta, GA, United Sttaes). To define patterns of change over time, we evaluated trends in ASMR and ASIR of PLC and intrahepatic bile duct carcinoma (IHBD) using a least squares regression line fitted to the natural logarithm of the mortality and incidence rates. We estimated the patterns of survival over subsequent 5 and 10 years using complement of mortality to incidence ratio (1-MIR). Age-standardised mortality rate of primary liver cancer increased in both sexes: from 2.56 and 1.29/100000 in 1968 to 5.10 and 2.63/100000 in 2008 for men and women respectively. The use of histology for diagnostic confirmation of primary liver cancer increased from 35.7% of registered cases in 1993 to plateau at about 50% during 2005 to 2008. Reliance on cytology as a basis of diagnosis has maintained a downward trend throughout the study period. Although approximately 30% of the PLC registrations had information on

Using Conflict Mapping to Foster Peace-Related Learning and Change in Schools

Science.gov (United States)

John, Vaughn M.

2016-01-01

South African societies, including learners in primary and secondary schools, experience high levels of violent conflict. The lack of interventions in terms of peace education and peace building is cause for concern. Driven by an interest to build educators' capacity and agency to become agents of change in the face of growing conflict and…

A Course Exploration: Guiding Instruction to Prepare Students as Change Agents in Educational Reform

Directory of Open Access Journals (Sweden)

Kathy L. Church, EdD

2010-08-01

Full Text Available This article explores the premise of teacher identity development through course experiences directed at inquiry and social awareness. The course exploration examines the use of various strategies used to help promote educators as change agents. Pre-service students enrolled in a one-year master’s program with teaching credential participated in a yearlong course designed to engage them in guided inquiry while making connections between theory and practice. Evaluation of the projects and student perceptions of their work suggest that guided inquiry into educational issues builds critical thinking skills and a sense of purpose, leadership, and service through shaping teacher identity.

Comparison of Communication Models for Mobile Agents

Directory of Open Access Journals (Sweden)

Xining Li

2003-04-01

Full Text Available An agent is a self-contained process being acting on behalf of a user. A Mobile Agent is an agent roaming the internet to access data and services, and carry out its assigned task remotely. This paper will focus on the communication models for Mobile Agents. Generally speaking, communication models concern with problems of how to name Mobile Agents, how to establish communication relationships, how to trace moving agents, and how to guarantee reliable communication. Some existing MA systems are purely based on RPC-style communication, whereas some adopts asynchronous message passing, or event registration/handling. Different communication concepts suitable for Mobile Agents are well discussed in [1]. However, we will investigate these concepts and existing models from a different point view: how to track down agents and deliver messages in a dynamic, changing world.

Glucocorticosteroids for primary sclerosing cholangitis

DEFF Research Database (Denmark)

Giljaca, Vanja; Poropat, Goran; Stimac, Davor

2010-01-01

Primary sclerosing cholangitis is a chronic cholestatic disease of intrahepatic and extrahepatic biliary ducts, characterised by chronic periductal inflammation and sclerosis of the ducts, which results in segmental stenoses of bile ducts, cholestasis, fibrosis, and ultimately, liver cirrhosis...... sclerosing cholangitis, like ursodeoxycholic acid, glucocorticosteroids, and immunomodulatory agents, but none has been successful in reversing the process of the disease. To date, liver transplantation is the only definite therapeutic solution for patients with advanced primary sclerosing cholangitis...

[Primary prevention of coronary thrombosis by antithrombotic agents].

Science.gov (United States)

Milon, H; Lantelme, P; Khettab, F; Mestre-Fernandes, C; Lasserre-Remy, S

2001-11-01

At the start of the eighties, in the wake of the good results obtained with aspirin in secondary prevention, two studies were launched aimed at testing the effect of aspirin on the primary prevention of myocardial infarction. The results published in 1988 and 1989 were divergent: the study conducted by British doctors showed no benefit with aspirin, that conducted by American doctors showed a very distinct benefit concerning myocardial infarction but no advantage for cerebral vascular accidents. Besides, in both studies an additional risk of haemorrhagic cerebral vascular accident was described. Methodological reasons were the origin of these facts, but it resulted in a certain confusion as to the practical conduct to adopt. Ten years later it is much more clear after the publication of three supplementary trials. The benefits of aspirin in terms of prevention of myocardial infarction are certain and considerable, at the price of a haemorrhagic risk equally certain but moderate. On the other hand, questions remain concerning the preventive effect of aspirin on cerebral vascular accidents and also on the expected benefits in the female sex. In practice, the prescription of aspirin with the objective of primary prevention must take into account the absolute benefit which can be expected. This is a function of the individual absolute risk before treatment which therefore signifies an evaluation based on the risk factors. Only subjects exposed to a substantial risk before treatment are likely to benefit from aspirin. For the others, the risks linked with aspirin could counterbalance its preventive advantages.

Institutions, Behavior of Agents and Efficiency

Directory of Open Access Journals (Sweden)

Sukharev Oleg, S.

2016-03-01

Full Text Available We study the efficiency criterion, describing the behavior and choices of agents, the influence of moral norms on the model of behavior, as well as the criterion of efficiency as an institution to assess the behavior and development of the economic system. Curve proposed institutional compromise that allows to determine the possibility of changes in the welfare of interacting agents and their compliance with ethical standards when welfare increases due to violation or compliance with these standards. For the purposes of this demonstration of the influence of the model of chart-based dilemmas Holmes-Moriarty. Incentives in determining the agents behaviors play a key role in their formation due to the moral principles of behavior. However, in economics there are situations when moral principles are derived certain behaviors or interactions agents. Holmes and Moriarty there is an alternative interaction, which they can not take advantage of, and there is a full range of alternatives that actually programs the strategic outcomes of interactions that reflect the curves of "institutional compromise." Choosing an agent of moral standards as a potential model determines its behavior and, most importantly, interaction with other agents, adhering to certain moral principles. Assess the condition and the possibility of using a static criterion of Pareto efficiency for the analysis of situations where it is important to measure the economic efficiency. Showing institutional aspects that must be considered in the application or formulation of new performance criteria. It is proved that there is a connection microeconomic efficiency / inefficiency and parameters of behavior of agents that actualizes the need to impact on the behavior of agents incentives to solve the task of changing the structure.

Change agents and sustainable supply chain collaboration : A longitudinal study in the Dutch pig farming sector from a sensemaking perspective

NARCIS (Netherlands)

van der Heijden, Angela; Cramer, Jacqueline M.

2017-01-01

Academic research on sustainability issues in supply chain collaboration has recently begun to focus more on a network-oriented view. Both horizontal and vertical relationships are being explored, which has led to recognition of the significance of the active participation of change agents in this

Pancreatic changes in patients with primary sclerosing cholangitis: MR cholangiopancreatography and MRI findings

International Nuclear Information System (INIS)

Ozkavukcu, Esra; Erden, Ayse; Erden, Ilhan

2009-01-01

Purpose: To evaluate the possible pancreatic changes and their frequencies in patients with primary sclerosing cholangitis (PSC) on MR cholangiopancreatography (MRCP), and conventional abdominal MRI. Materials and Methods: Patient group consisted of 29 PSC (13 male, 16 female) cases, whereas cohort 1 consisted of 12 female patients with primary biliary cirrhosis, and cohort 2 consisted of 17 patients (6 male, 11 female) with non-immune chronic liver disease. Two radiologists retrospectively evaluated the MR examinations paying special attention to the pancreatic size (atrophy or enlargement), T1- and T2-signal intensity of the pancreas, focal pancreatic lesion, capsule-like rim, peripancreatic edema or fluid, fascial thickening, and pancreatic ducts (dilatation or narrowing). The results are expressed as percentages. Three groups were compared using Pearson chi-square test for each feature. However, only p-value for 'dilatation of the pancreatic duct' was determined, whereas p-value could not be calculated because of the insufficient number of subjects/sequences for the other features. Results: Twelve PSC patients (41.3%) had pancreatic abnormalities. The most common pancreatic changes in PSC patients were decreased T1-signal intensity (44%) and dilatation of the pancreatic duct (13.8%), respectively. Increased T2-signal intensity was also shown in 2 PSC patients (6.9%). Conclusion: Even PSC patients without any sign of pancreatitis, can show MR changes in the pancreatic parenchyma or the pancreatic duct. The etiologies of these changes, and whether they are unique to PSC, are still controversial. Histopathological studies bringing light to these pancreatic changes are needed.

Managing chronic diseases in the malaysian primary health care - a need for change.

Science.gov (United States)

Ramli, As; Taher, Sw

2008-01-01

Chronic diseases are the major cause of death and disability in Malaysia, accounted for 71% of all deaths and 69% of the total burden of disease. The WHO in its report Preventing Chronic Disease: A Vital Investment has highlighted the inaction of most governments of the low and middle income countries in tackling the problem urgently, is clear and unacceptable. The acute care paradigm is no longer adequate for the changing pattern of diseases in today's and tomorrow's world. An evolution of primary health care system beyond the acute care model to embrace the concept of caring for long term health problems is imperative in the wake of the rising epidemic of chronic diseases and its crushing burden resulting in escalating healthcare costs. Compelling evidence from around the world showed that there are innovative and cost-effective community-based interventions to reduce the morbidity and mortality attributable to chronic diseases, but these are rarely translated into high quality population-wide chronic disease care. This paper describes the current situation of chronic disease management in the Malaysian primary care setting - to highlight the need for change, discuss the barriers to the implementation of effective chronic disease management programmes in the community, and consider fundamental solutions needed to instigate the change in our setting.

Understanding performance management in primary care.

Science.gov (United States)

Rogan, Lisa; Boaden, Ruth

2017-02-13

Purpose Principal-agent theory (PAT) has been used to understand relationships among different professional groups and explain performance management between organisations, but is rarely used for research within primary care. The purpose of this paper is to explore whether PAT can be used to attain a better understanding of performance management in primary care. Design/methodology/approach Purposive sampling was used to identify a range of general practices in the North-west of England. Interviews were carried out with directors, managers and clinicians in commissioning and regional performance management organisations and within general practices, and the data analysed using matrix analysis techniques to produce a case study of performance management. Findings There are various elements of the principal-agent framework that can be applied in primary care. Goal alignment is relevant, but can only be achieved through clear, strategic direction and consistent interpretation of objectives at all levels. There is confusion between performance measurement and performance management and a tendency to focus on things that are easy to measure whilst omitting aspects of care that are more difficult to capture. Appropriate use of incentives, good communication, clinical engagement, ownership and trust affect the degree to which information asymmetry is overcome and goal alignment achieved. Achieving the right balance between accountability and clinical autonomy is important to ensure governance and financial balance without stifling innovation. Originality/value The principal-agent theoretical framework can be used to attain a better understanding of performance management in primary care; although it is likely that only partial goal alignment will be achieved, dependent on the extent and level of alignment of a range of factors.

Changes of muscarinic cholinergic receptors during aging process of primary cultured neutrons

International Nuclear Information System (INIS)

Fan Guohuang; Yi Ningyu; Xia Zongqin

1996-01-01

The dynamic changes of muscarinic receptor density and its reactivity during aging process in primary cultured neutrons were studied. Muscarinic receptor density was measured by 3 H-QNB binding assay, and muscarinic receptor reactivity was assessed by carbachol stimulation of cGMP formation, the latter was measured by RIA. After 2 weeks' incubation of neonatal rat brain cells, the nutrients began to rupture and the cell bodies shrank markedly showing senescent feature. The muscarinic receptor density reached peak at the 12th day in vitro (12 DIV), but the muscarinic receptor reactivity reached peak at 9 DIV and declined significantly at 12 DIV. The results demonstrated that during aging process of primary cultured neutrons, the decline of muscarinic receptor reactivity is likely prior to the decrease of receptor density

Societal Changes Affecting Primary School Education after the Second World War in Finland

Science.gov (United States)

Paksuniemi, Merja; Niemisalo, Sari

2016-01-01

To demonstrate how changes in both foreign and domestic environments after the Second World War affected primary education and teacher training in Finland, the article presents a historical picture of the post-war reality of the school system, based on a review of sources that include laws, decrees, curricula, textbooks and previous research. The…

Enterprising education - a research on students as agents of change in social entrepreneurship

Directory of Open Access Journals (Sweden)

Gauca Oana Codruta

2017-07-01

Full Text Available This article is a study on the awareness and understanding of social entrepreneurship among students. Moreover, the article aims to emphasize the different meanings this buzz word has developed, whether it is the purpose of social entrepreneurship, the fields it activates in or the profit which should or should not be distributed. We aim to cover aspects of the definition of the social entrepreneurship field, as well as the ways in which students act as agents of change. The main research methodologies used except for literature review are interviews and case studies for several social business developed by students. The interviews are with no predetermined questions, in order to allow flexibility. The article wants to demonstrate that students are the emerging social entrepreneurs and important initiators of change in this field. In this regards, students should be educated and should develop skills within the universities programs, skills that are very specific compared to simple entrepreneurship. The main theoretical contribution to the field of education is the proven necessity that education facilities need to educate themselves. In order to create our future entrepreneurs as well as provide them with the skills set necessary to become entrepreneurs, education needs to become enterprising. The main practical contribution is the proof of students being involved in the change of society around them and main contributors to their environment.

Modelling a traditional game as an agent in HIV/AIDS behaviour ...

African Journals Online (AJOL)

Modelling a traditional game as an agent in HIV/AIDS behaviour-change education and communication. ... such as traditional games as a means of health communication and agent of behaviour change. ... AJOL African Journals Online.

Land Use Change on Household Farms in the Ecuadorian Amazon: Design and Implementation of an Agent-Based Model.

Science.gov (United States)

Mena, Carlos F; Walsh, Stephen J; Frizzelle, Brian G; Xiaozheng, Yao; Malanson, George P

2011-01-01

This paper describes the design and implementation of an Agent-Based Model (ABM) used to simulate land use change on household farms in the Northern Ecuadorian Amazon (NEA). The ABM simulates decision-making processes at the household level that is examined through a longitudinal, socio-economic and demographic survey that was conducted in 1990 and 1999. Geographic Information Systems (GIS) are used to establish spatial relationships between farms and their environment, while classified Landsat Thematic Mapper (TM) imagery is used to set initial land use/land cover conditions for the spatial simulation, assess from-to land use/land cover change patterns, and describe trajectories of land use change at the farm and landscape levels. Results from prior studies in the NEA provide insights into the key social and ecological variables, describe human behavioral functions, and examine population-environment interactions that are linked to deforestation and agricultural extensification, population migration, and demographic change. Within the architecture of the model, agents are classified as active or passive. The model comprises four modules, i.e., initialization, demography, agriculture, and migration that operate individually, but are linked through key household processes. The main outputs of the model include a spatially-explicit representation of the land use/land cover on survey and non-survey farms and at the landscape level for each annual time-step, as well as simulated socio-economic and demographic characteristics of households and communities. The work describes the design and implementation of the model and how population-environment interactions can be addressed in a frontier setting. The paper contributes to land change science by examining important pattern-process relations, advocating a spatial modeling approach that is capable of synthesizing fundamental relationships at the farm level, and links people and environment in complex ways.

Agent Model Development for Assessing Climate-Induced Geopolitical Instability.

Energy Technology Data Exchange (ETDEWEB)

Boslough, Mark B.; Backus, George A.

2005-12-01

We present the initial stages of development of new agent-based computational methods to generate and test hypotheses about linkages between environmental change and international instability. This report summarizes the first year's effort of an originally proposed three-year Laboratory Directed Research and Development (LDRD) project. The preliminary work focused on a set of simple agent-based models and benefited from lessons learned in previous related projects and case studies of human response to climate change and environmental scarcity. Our approach was to define a qualitative model using extremely simple cellular agent models akin to Lovelock's Daisyworld and Schelling's segregation model. Such models do not require significant computing resources, and users can modify behavior rules to gain insights. One of the difficulties in agent-based modeling is finding the right balance between model simplicity and real-world representation. Our approach was to keep agent behaviors as simple as possible during the development stage (described herein) and to ground them with a realistic geospatial Earth system model in subsequent years. This work is directed toward incorporating projected climate data--including various C02 scenarios from the Intergovernmental Panel on Climate Change (IPCC) Third Assessment Report--and ultimately toward coupling a useful agent-based model to a general circulation model.3

Value of an hepatobiliary imaging agent for diagnosing hepatoma. Example of diethyl-IDA

Energy Technology Data Exchange (ETDEWEB)

Bourguet, P; Estable, P; Herry, J Y

1985-01-01

A comparative study was performed using two hepatic tracers, a Tc 99m labelled colloid and an hepatobiliary agent Tc 99m labelled diethyl-IDA. In some patients with isolated primary hepatocarcinoma the uptake of the hepatobiliary agent was observed but the colloid was not taken up. In the contrary, the hepatobiliary agent has proved to be of limited value for the diagnosis of hepatomas coexisting with cirrhosis and for the detection of secondary hepatocarcinoma.

Sensitivity Analysis of a Land-Use Change Model with and without Agents to Assess Land Abandonment and Long-Term Re-Forestation in a Swiss Mountain Region

Directory of Open Access Journals (Sweden)

Julia Maria Brändle

2015-06-01

Full Text Available Land abandonment and the subsequent re-forestation are important drivers behind the loss of ecosystem services in mountain regions. Agent-based models can help to identify global change impacts on farmland abandonment and can test policy and management options to counteract this development. Realigning the representation of human decision making with time scales of ecological processes such as reforestation presents a major challenge in this context. Models either focus on the agent-specific behavior anchored in the current generation of farmers at the expense of representing longer scale environmental processes or they emphasize the simulation of long-term economic and forest developments where representation of human behavior is simplified in time and space. In this context, we compare the representation of individual and aggregated decision-making in the same model structure and by doing so address some implications of choosing short or long term time horizons in land-use modeling. Based on survey data, we integrate dynamic agents into a comparative static economic sector supply model in a Swiss mountain region. The results from an extensive sensitivity analysis show that this agent-based land-use change model can reproduce observed data correctly and that both model versions are sensitive to the same model parameters. In particular, in both models the specification of opportunity costs determines the extent of production activities and land-use changes by restricting the output space. Our results point out that the agent-based model can capture short and medium term developments in land abandonment better than the aggregated version without losing its sensitivity to important socio-economic drivers. For comparative static approaches, extensive sensitivity analysis with respect to opportunity costs, i.e., the measure of benefits forgone due to alternative uses of labor is essential for the assessment of the impact of climate change on land

Immunological effects of hypomethylating agents.

Science.gov (United States)

Lindblad, Katherine E; Goswami, Meghali; Hourigan, Christopher S; Oetjen, Karolyn A

2017-08-01

Epigenetic changes resulting from aberrant methylation patterns are a recurrent observation in hematologic malignancies. Hypomethylating agents have a well-established role in the management of patients with high-risk myelodysplastic syndrome or acute myeloid leukemia. In addition to the direct effects of hypomethylating agents on cancer cells, there are several lines of evidence indicating a role for immune-mediated anti-tumor benefits from hypomethylating therapy. Areas covered: We reviewed the clinical and basic science literature for the effects of hypomethylating agents, including the most commonly utilized therapeutics azacitidine and decitabine, on immune cell subsets. We summarized the effects of hypomethylating agents on the frequency and function of natural killer cells, T cells, and dendritic cells. In particular, we highlight the effects of hypomethylating agents on expression of immune checkpoint inhibitors, leukemia-associated antigens, and endogenous retroviral elements. Expert commentary: In vitro and ex vivo studies indicate mixed effects on the function of natural killer, dendritic cells and T cells following treatment with hypomethylating agents. Clinical correlates of immune function have suggested that hypomethylating agents have immunomodulatory functions with the potential to synergize with immune checkpoint therapy for the treatment of hematologic malignancy, and has become an active area of clinical research.

Modelling of robotic work cells using agent based-approach

Science.gov (United States)

Sękala, A.; Banaś, W.; Gwiazda, A.; Monica, Z.; Kost, G.; Hryniewicz, P.

2016-08-01

In the case of modern manufacturing systems the requirements, both according the scope and according characteristics of technical procedures are dynamically changing. This results in production system organization inability to keep up with changes in a market demand. Accordingly, there is a need for new design methods, characterized, on the one hand with a high efficiency and on the other with the adequate level of the generated organizational solutions. One of the tools that could be used for this purpose is the concept of agent systems. These systems are the tools of artificial intelligence. They allow assigning to agents the proper domains of procedures and knowledge so that they represent in a self-organizing system of an agent environment, components of a real system. The agent-based system for modelling robotic work cell should be designed taking into consideration many limitations considered with the characteristic of this production unit. It is possible to distinguish some grouped of structural components that constitute such a system. This confirms the structural complexity of a work cell as a specific production system. So it is necessary to develop agents depicting various aspects of the work cell structure. The main groups of agents that are used to model a robotic work cell should at least include next pattern representatives: machine tool agents, auxiliary equipment agents, robots agents, transport equipment agents, organizational agents as well as data and knowledge bases agents. In this way it is possible to create the holarchy of the agent-based system.

C-11-labeled octadecylamine, a potential agent for positron tomographic pulmonary metabolism studies

International Nuclear Information System (INIS)

Washburn, L.C.; Wallace, R.T.; Byrd, B.L.; Sun, T.T.; Coffey, J.L.; Hubner, K.F.

1984-01-01

C-11-Labeled straight-chain primary aliphatic amines are rapidly and selectively sequestered by lung endothelial cells, making these agents potentially useful for positron tomographic studies of the lung as a metabolic organ. However, because amines having straight chains containing 4 to 13 carbon atoms are rapidly catabolized in vivo with loss of radiolabel, quantitation of pulmonary concentration is difficult. The authors have studied the effect of structural changes on the uptake and retention of primary aliphatic amines in rat lung and found that the metabolic loss form the lung decreased with increasing length of the straight carbon chain. In fact, the lung concentration of octadecylamine, a straight-chain amine with 18 carbon atoms, was constant between 1 and 30 minutes after intravenous administration. This highly insoluble amine was solubilized using 3% aqueous human serum albumin. Unilateral, radiation-induced lung injury in the rat was used as a model to study the potential of C-11-labeled octadecylamine. Radiation-damaged (3000 and 5000 Rads) lungs had significantly lower 15-minute uptakes of the labeled amine than the corresponding nonirradiated lungs. However, at 8000 Rads the concentration in both lungs was greatly suppressed, indicating that the decrease in metabolism becomes systemic at high radiation doses. These results suggest that C-11-labeled octadecylamine is a potentially useful agent for quantitative evaluation of pulmonary metabolism by positron tomography

Embedding effective depression care: using theory for primary care organisational and systems change.

Science.gov (United States)

Gunn, Jane M; Palmer, Victoria J; Dowrick, Christopher F; Herrman, Helen E; Griffiths, Frances E; Kokanovic, Renata; Blashki, Grant A; Hegarty, Kelsey L; Johnson, Caroline L; Potiriadis, Maria; May, Carl R

2010-08-06

Depression and related disorders represent a significant part of general practitioners (GPs) daily work. Implementing the evidence about what works for depression care into routine practice presents a challenge for researchers and service designers. The emerging consensus is that the transfer of efficacious interventions into routine practice is strongly linked to how well the interventions are based upon theory and take into account the contextual factors of the setting into which they are to be transferred. We set out to develop a conceptual framework to guide change and the implementation of best practice depression care in the primary care setting. We used a mixed method, observational approach to gather data about routine depression care in a range of primary care settings via: audit of electronic health records; observation of routine clinical care; and structured, facilitated whole of organisation meetings. Audit data were summarised using simple descriptive statistics. Observational data were collected using field notes. Organisational meetings were audio taped and transcribed. All the data sets were grouped, by organisation, and considered as a whole case. Normalisation Process Theory (NPT) was identified as an analytical theory to guide the conceptual framework development. Five privately owned primary care organisations (general practices) and one community health centre took part over the course of 18 months. We successfully developed a conceptual framework for implementing an effective model of depression care based on the four constructs of NPT: coherence, which proposes that depression work requires the conceptualisation of boundaries of who is depressed and who is not depressed and techniques for dealing with diffuseness; cognitive participation, which proposes that depression work requires engagement with a shared set of techniques that deal with depression as a health problem; collective action, which proposes that agreement is reached about how

Imaging of vaporised sub-micron phase change contrast agents with high frame rate ultrasound and optics

Science.gov (United States)

Lin, Shengtao; Zhang, Ge; Jamburidze, Akaki; Chee, Melisse; Hau Leow, Chee; Garbin, Valeria; Tang, Meng-Xing

2018-03-01

Phase-change ultrasound contrast agent (PCCA), or nanodroplet, shows promise as an alternative to the conventional microbubble agent over a wide range of diagnostic applications. Meanwhile, high-frame-rate (HFR) ultrasound imaging with microbubbles enables unprecedented temporal resolution compared to traditional contrast-enhanced ultrasound imaging. The combination of HFR ultrasound imaging and PCCAs can offer the opportunity to observe and better understand PCCA behaviour after vaporisation captures the fast phenomenon at a high temporal resolution. In this study, we utilised HFR ultrasound at frame rates in the kilohertz range (5-20 kHz) to image native and size-selected PCCA populations immediately after vaporisation in vitro within clinical acoustic parameters. The size-selected PCCAs through filtration are shown to preserve a sub-micron-sized (mean diameter  1 µm) that originate from native PCCA emulsion. The results demonstrate imaging signals with different amplitudes and temporal features compared to that of microbubbles. Compared with the microbubbles, both the B-mode and pulse-inversion (PI) signals from the vaporised PCCA populations were reduced significantly in the first tens of milliseconds, while only the B-mode signals from the PCCAs were recovered during the next 400 ms, suggesting significant changes to the size distribution of the PCCAs after vaporisation. It is also shown that such recovery in signal over time is not evident when using size-selective PCCAs. Furthermore, it was found that signals from the vaporised PCCA populations are affected by the amplitude and frame rate of the HFR ultrasound imaging. Using high-speed optical camera observation (30 kHz), we observed a change in particle size in the vaporised PCCA populations exposed to the HFR ultrasound imaging pulses. These findings can further the understanding of PCCA behaviour under HFR ultrasound imaging.

Funding source and primary outcome changes in clinical trials registered on ClinicalTrials.gov are associated with the reporting of a statistically significant primary outcome: a cross-sectional study [v2; ref status: indexed, http://f1000r.es/5bj

Directory of Open Access Journals (Sweden)

Sreeram V Ramagopalan

2015-04-01

Full Text Available Background: We and others have shown a significant proportion of interventional trials registered on ClinicalTrials.gov have their primary outcomes altered after the listed study start and completion dates. The objectives of this study were to investigate whether changes made to primary outcomes are associated with the likelihood of reporting a statistically significant primary outcome on ClinicalTrials.gov. Methods: A cross-sectional analysis of all interventional clinical trials registered on ClinicalTrials.gov as of 20 November 2014 was performed. The main outcome was any change made to the initially listed primary outcome and the time of the change in relation to the trial start and end date. Findings: 13,238 completed interventional trials were registered with ClinicalTrials.gov that also had study results posted on the website. 2555 (19.3% had one or more statistically significant primary outcomes. Statistical analysis showed that registration year, funding source and primary outcome change after trial completion were associated with reporting a statistically significant primary outcome. Conclusions: Funding source and primary outcome change after trial completion are associated with a statistically significant primary outcome report on clinicaltrials.gov.

Agents for change: nonphysician medical providers and health care quality.

Science.gov (United States)

Boucher, Nathan A; Mcmillen, Marvin A; Gould, James S

2015-01-01

Quality medical care is a clinical and public health imperative, but defining quality and achieving improved, measureable outcomes are extremely complex challenges. Adherence to best practice invariably improves outcomes. Nonphysician medical providers (NPMPs), such as physician assistants and advanced practice nurses (eg, nurse practitioners, advanced practice registered nurses, certified registered nurse anesthetists, and certified nurse midwives), may be the first caregivers to encounter the patient and can act as agents for change for an organization's quality-improvement mandate. NPMPs are well positioned to both initiate and ensure optimal adherence to best practices and care processes from the moment of initial contact because they have robust clinical training and are integral to trainee/staff education and the timely delivery of care. The health care quality aspects that the practicing NPMP can affect are objective, appreciative, and perceptive. As bedside practitioners and participants in the administrative and team process, NPMPs can fine-tune care delivery, avoiding the problem areas defined by the Institute of Medicine: misuse, overuse, and underuse of care. This commentary explores how NPMPs can affect quality by 1) supporting best practices through the promotion of guidelines and protocols, and 2) playing active, if not leadership, roles in patient engagement and organizational quality-improvement efforts.

Value of an hepatobiliary imaging agent for diagnosing hepatoma. Example of diethyl-IDA

International Nuclear Information System (INIS)

Bourguet, P.; Estable, P.; Herry, J.Y.

1985-01-01

A comparative study was performed using two hepatic tracers, a Tc 99m labelled colloid and an hepatobiliary agent Tc 99m labelled diethyl-IDA. In some patients with isolated primary hepatocarcinoma the uptake of the hepatobiliary agent was observed but the colloid was not taken up. In the contrary, the hepatobiliary agent has proved to be of limited value for the diagnosis of hepatomas coexisting with cirrhosis and for the detection of secondary hepatocarcinoma [fr

TEACHERS AS AGENTS OF CHANGE: PROMOTING PEACEBUILDING AND SOCIAL COHESION IN SCHOOLS IN RWANDA

Directory of Open Access Journals (Sweden)

Jolly Rubagiza

2016-12-01

Full Text Available Education is seen to play a crucial role in the reconstruction of post-conflict countries, particularly in transforming people’s mindsets and rebuilding social relations. In this regard, teachers are often perceived as key agents to bring about this transformative change through their role as agents of peace. This paper seeks to understand how teachers are positioned to promote peacebuilding and social cohesion in Rwandan schools in the aftermath of the 1994 genocide against the Tutsi. The paper draws on data collected for an on-going broader study researching the role of teachers in peacebuilding in post-conflict contexts of Rwanda and South Africa. The methods used for data collection were semi-structured interviews, focus-group discussions, questionnaires and classroom observations. Theoretically the paper is informed by the broader research framework on sustainable peacebuilding in post-conflict situations, using the four dimensions of recognition, redistribution, representation and reconciliation (4Rs. The findings show that the policy environment is conducive to peacebuilding and recognises the important role of teachers and education in general, in the social, political and economic reconstruction of post-genocide Rwanda. However, there are a number of inter-related factors that pertain to teachers’ professional development, teacher management and the school environment that pose challenges to sustainable peacebuilding and social cohesion.

Anticlotting agents and the surgical management of glaucoma.

Science.gov (United States)

Sozeri, Yasemin; Salim, Sarwat

2018-03-01

A large subset of patients with glaucoma uses anticlotting agents. No standardized guidelines currently exist for managing these agents in the specific perioperative setting of glaucoma surgery. The present review focuses on currently available anticlotting agents, their influence on hemorrhagic complications following glaucoma surgery, and management strategies for their use in the perioperative period RECENT FINDINGS: Anticlotting agents increase the risk of perioperative hemorrhagic complications following glaucoma surgery. Other factors that increase that risk have been identified as well, including the type of glaucoma surgery, preoperative intraocular pressure, postoperative hypotony, previous ocular surgeries, and race. Although general guidelines in the perioperative management of blood thinning agents exist, the best way to apply these guidelines specifically to glaucoma surgery remains unclear. Blood thinners are widely used and can increase the risk of hemorrhagic complications in patients undergoing glaucoma surgery. Managing these agents in the perioperative setting is challenging and should be done in collaboration with the patient's primary care provider, hematologist, or cardiologist. Management strategies should be tailored to each individual's risk of hemorrhage versus thromboembolism. Additionally, surgical plans can be modified to help minimize hemorrhagic outcomes, especially in patients who are deemed to be at high risk for perioperative bleeding.

Effects of microchannel confinement on acoustic vaporisation of ultrasound phase change contrast agents

Science.gov (United States)

Lin, Shengtao; Zhang, Ge; Hau Leow, Chee; Tang, Meng-Xing

2017-09-01

The sub-micron phase change contrast agent (PCCA) composed of a perfluorocarbon liquid core can be activated into gaseous state and form stable echogenic microbubbles for contrast-enhanced ultrasound imaging. It has shown great promise in imaging microvasculature, tumour microenvironment, and cancer cells. Although PCCAs have been extensively studied for different diagnostic and therapeutic applications, the effect of biologically geometrical confinement on the acoustic vaporisation of PCCAs is still not clear. We have investigated the difference in PCCA-produced ultrasound contrast enhancement after acoustic activation with and without a microvessel confinement on a microchannel phantom. The experimental results indicated more than one-order of magnitude less acoustic vaporisation in a microchannel than that in a free environment taking into account the attenuation effect of the vessel on the microbubble scattering. This may provide an improved understanding in the applications of PCCAs in vivo.

Training practitioners to deliver opportunistic multiple behaviour change counselling in primary care: a cluster randomised trial.

Science.gov (United States)

Butler, Christopher C; Simpson, Sharon A; Hood, Kerenza; Cohen, David; Pickles, Tim; Spanou, Clio; McCambridge, Jim; Moore, Laurence; Randell, Elizabeth; Alam, M Fasihul; Kinnersley, Paul; Edwards, Adrian; Smith, Christine; Rollnick, Stephen

2013-03-19

To evaluate the effect of training primary care health professionals in behaviour change counselling on the proportion of patients self reporting change in four risk behaviours (smoking, alcohol use, exercise, and healthy eating). Cluster randomised trial with general practices as the unit of randomisation. General practices in Wales. 53 general practitioners and practice nurses from 27 general practices (one each at all but one practice) recruited 1827 patients who screened positive for at least one risky behaviour. Behaviour change counselling was developed from motivational interviewing to enable clinicians to enhance patients' motivation to change health related behaviour. Clinicians were trained using a blended learning programme called Talking Lifestyles. Proportion of patients who reported making beneficial changes in at least one of the four risky behaviours at three months. 1308 patients from 13 intervention and 1496 from 14 control practices were approached: 76% and 72% respectively agreed to participate, with 831 (84%) and 996 (92%) respectively screening eligible for an intervention. There was no effect on the primary outcome (beneficial change in behaviour) at three months (362 (44%) v 404 (41%), odds ratio 1.12 (95% CI 0.90 to 1.39)) or on biochemical or biometric measures at 12 months. More patients who had consulted with trained clinicians recalled consultation discussion about a health behaviour (724/795 (91%) v 531/966 (55%), odds ratio 12.44 (5.85 to 26.46)) and intended to change (599/831 (72%) v 491/996 (49%), odds ratio 2.88 (2.05 to 4.05)). More intervention practice patients reported making an attempt to change (328 (39%) v 317 (32%), odds ratio 1.40 (1.15 to 1.70)), a sustained behaviour change at three months (288 (35%) v 280 (28%), odds ratio 1.36 (1.11 to 1.65)), and reported slightly greater improvements in healthy eating at three and 12 months, plus improved activity at 12 months. Training cost £1597 per practice. Training primary

Educating change agents: a qualitative descriptive study of graduates of a Master's program in evidence-based practice.

Science.gov (United States)

Hole, Grete Oline; Brenna, Sissel Johansson; Graverholt, Birgitte; Ciliska, Donna; Nortvedt, Monica Wammen

2016-02-25

Health care professionals are expected to build decisions upon evidence. This implies decisions based on the best available, current, valid and relevant evidence, informed by clinical expertise and patient values. A multi-professional master's program in evidence-based practice was developed and offered. The aims of this study were to explore how students in this program viewed their ability to apply evidence-based practice and their perceptions of what constitute necessary conditions to implement evidence-based practice in health care organizations, one year after graduation. A qualitative descriptive design was chosen to examine the graduates' experiences. All students in the first two cohorts of the program were invited to participate. Six focus-group interviews, with a total of 21 participants, and a telephone interview of one participant were conducted. The data was analyzed thematically, using the themes from the interview guide as the starting point. The graduates reported that an overall necessary condition for evidence-based practice to occur is the existence of a "readiness for change" both at an individual level and at the organizational level. They described that they gained personal knowledge and skills to be "change-agents" with "self-efficacy, "analytic competence" and "tools" to implement evidence based practice in clinical care. An organizational culture of a "learning organization" was also required, where leaders have an "awareness of evidence- based practice", and see the need for creating "evidence-based networks". One year after graduation the participants saw themselves as "change agents" prepared to improve clinical care within a learning organization. The results of this study provides useful information for facilitating the implementation of EBP both from educational and health care organizational perspectives.

Predictors and correlates for weight changes in patients co-treated with olanzapine and weight mitigating agents; a post-hoc analysis

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Heinloth Alexandra N

2009-03-01

Full Text Available Abstract Background This study focuses on exploring the relationship between changes in appetite or eating behaviors and subsequent weight change for adult patients with schizophrenia or bipolar disorder treated with olanzapine and adjunctive potential weight mitigating pharmacotherapy. The aim is not to compare different weight mitigating agents, but to evaluate patients' characteristics and changes in their eating behaviors during treatment. Identification of patient subgroups with different degrees of susceptibility to the effect of weight mitigating agents during olanzapine treatment may aid clinicians in treatment decisions. Methods Data were obtained from 3 randomized, double-blind, placebo-controlled, 16-week clinical trials. Included were 158 patients with schizophrenia or bipolar disorder and a body mass index (BMI ≥ 25 kg/m2 who had received olanzapine treatment in combination with nizatidine (n = 68, sibutramine (n = 42, or amantadine (n = 48. Individual patients were analyzed for categorical weight loss ≥ 2 kg and weight gain ≥ 1 kg. Variables that were evaluated as potential predictors of weight outcomes included baseline patient characteristics, factors of the Eating Inventory, individual items of the Eating Behavior Assessment, and the Visual Analog Scale. Results Predictors/correlates of weight loss ≥ 2 kg included: high baseline BMI, low baseline interest in food, and a decrease from baseline to endpoint in appetite, hunger, or cravings for carbohydrates. Reduced cognitive restraint, increase in hunger, and increased overeating were associated with a higher probability of weight gain ≥ 1 kg. Conclusion The association between weight gain and lack of cognitive restraint in the presence of increased appetite suggests potential benefit of psychoeducational counseling in conjunction with adjunctive pharmacotherapeutic agents in limiting weight gain during antipsychotic drug therapy. Trial Registration This analysis was not

Predictors and correlates for weight changes in patients co-treated with olanzapine and weight mitigating agents; a post-hoc analysis.

Science.gov (United States)

Stauffer, Virginia L; Lipkovich, Ilya; Hoffmann, Vicki Poole; Heinloth, Alexandra N; McGregor, H Scott; Kinon, Bruce J

2009-03-28

This study focuses on exploring the relationship between changes in appetite or eating behaviors and subsequent weight change for adult patients with schizophrenia or bipolar disorder treated with olanzapine and adjunctive potential weight mitigating pharmacotherapy. The aim is not to compare different weight mitigating agents, but to evaluate patients' characteristics and changes in their eating behaviors during treatment. Identification of patient subgroups with different degrees of susceptibility to the effect of weight mitigating agents during olanzapine treatment may aid clinicians in treatment decisions. Data were obtained from 3 randomized, double-blind, placebo-controlled, 16-week clinical trials. Included were 158 patients with schizophrenia or bipolar disorder and a body mass index (BMI) > or = 25 kg/m2 who had received olanzapine treatment in combination with nizatidine (n = 68), sibutramine (n = 42), or amantadine (n = 48). Individual patients were analyzed for categorical weight loss > or= 2 kg and weight gain > or = 1 kg. Variables that were evaluated as potential predictors of weight outcomes included baseline patient characteristics, factors of the Eating Inventory, individual items of the Eating Behavior Assessment, and the Visual Analog Scale. Predictors/correlates of weight loss > or = 2 kg included: high baseline BMI, low baseline interest in food, and a decrease from baseline to endpoint in appetite, hunger, or cravings for carbohydrates. Reduced cognitive restraint, increase in hunger, and increased overeating were associated with a higher probability of weight gain > or = 1 kg. The association between weight gain and lack of cognitive restraint in the presence of increased appetite suggests potential benefit of psychoeducational counseling in conjunction with adjunctive pharmacotherapeutic agents in limiting weight gain during antipsychotic drug therapy. This analysis was not a clinical trial and did not involve any medical intervention.

The primary care amplification model: taking the best of primary care forward

Directory of Open Access Journals (Sweden)

Nicholson Caroline

2008-12-01

Full Text Available Abstract Background Primary care internationally is approaching a new paradigm. The change agenda implicit in this threatens to de-stabilise and challenge established general practice and primary care. Discussion The Primary Care Amplification Model offers a means to harness the change agenda by 'amplifying' the strengths of established general practices around a 'beacon' practice. Conclusion Such 'beacon' practices can provide a mustering point for an expanded scope of practice for primary care, integrated primary/secondary service delivery, interprofessional learning, relevant local clinical research, and a focus on local service innovation, enhancing rather than fragmenting the collective capacity of existing primary care.

Applying Maxi-adjustment to Adaptive Information Filtering Agents

OpenAIRE

Lau, Raymond; ter Hofstede, Arthur H. M.; Bruza, Peter D.

2000-01-01

Learning and adaptation is a fundamental property of intelligent agents. In the context of adaptive information filtering, a filtering agent's beliefs about a user's information needs have to be revised regularly with reference to the user's most current information preferences. This learning and adaptation process is essential for maintaining the agent's filtering performance. The AGM belief revision paradigm provides a rigorous foundation for modelling rational and minimal changes to an age...

El agente de cambio en el desarrollo de las organizaciones

Directory of Open Access Journals (Sweden)

Joaquín GAIRÍN SALLÁN

2009-08-01

Full Text Available RESUMEN: Los directivos desempeñan un papel crucial en el éxito de las reformas e innovaciones cuando actúan como agentes de cambio. La presente aportación caracteriza el agente de cambio, reparando en sus principales cualidades, capacidades y actitudes; también, destaca la importancia de una intervención que prime la visión global y estratégica frente a intervenciones parciales, gestione y lidere a la vez y asuma la necesidad permanente de aprender de la práctica. Las actuaciones de los agentes de cambio no acostumbran a desempeñarse en un escenario de facilidades y, a menudo, se encuentran con determinadas problemáticas y resistencias que dificultan la implantación de las mejoras institucionales pretendidas. En cualquier caso, avanzar en el desarrollo de organizaciones educativas exitosas exige otorgar a los agentes de cambio un cierto liderazgo capaz de contribuir al desarrollo de las mismas.ABSTRACT: Directors play a crucial role in the success of reforms and innovations when they act as agents of change. This contribution characterises agents of change, examining their main qualities, capacities and attitudes; it also highlights the importance of an intervention that rewards a global and strategic vision, as opposed to biased interventions, that manages and leads at the same time and that assumes the permanent need to learn from experience. The actions of agents of change do not tend to take place in easy scenarios, and often encounter certain problems and resistances that make it hard to implant the institutional improvements being sought. In whatever case, advancing the development of successful educational organisations requires granting agents of change a certain leadership that is able to contribute to the development of the same. Finally, the confluence between curricular development, organisational development and professional development in efficiency and improvement processes at education centres reminds us of the

The contribution of behavioural science to primary care research: development and evaluation of behaviour change interventions.

Science.gov (United States)

Sutton, Stephen

2011-10-01

Behavioural science is concerned with predicting, explaining and changing behaviour. Taking a personal perspective, this article aims to show how behavioural science can contribute to primary care research, specifically in relation to the development and evaluation of interventions to change behaviour. After discussing the definition and measurement of behaviour, the principle of compatibility and theories of behaviour change, the article outlines two examples of behaviour change trials (one on medication adherence and the other on physical activity), which were part of a research programme on prevention of chronic disease and its consequences. The examples demonstrate how, in a multidisciplinary context, behavioural science can contribute to primary care research in several important ways, including posing relevant research questions, defining the target behaviour, understanding the psychological determinants of behaviour, developing behaviour change interventions and selection or development of measures. The article concludes with a number of recommendations: (i) whether the aim is prediction, explanation or change, defining the target behaviour is a crucial first step; (ii) interventions should be explicitly based on theories that specify the factors that need to be changed in order to produce the desired change in behaviour; (iii) intervention developers need to be aware of the differences between different theories and select a theory only after careful consideration of the alternatives assessed against relevant criteria; and (iv) developers need to be aware that interventions can never be entirely theory based.

Towards thresholds of disaster management performance under demographic change: exploring functional relationships using agent-based modeling

Directory of Open Access Journals (Sweden)

G. Dressler

2016-10-01

Full Text Available Effective disaster management is a core feature for the protection of communities against natural disasters such as floods. Disaster management organizations (DMOs are expected to contribute to ensuring this protection. However, what happens when their resources to cope with a flood are at stake or the intensity and frequency of the event exceeds their capacities? Many cities in the Free State of Saxony, Germany, were strongly hit by several floods in the last years and are additionally challenged by demographic change, with an ageing society and out-migration leading to population shrinkage in many parts of Saxony. Disaster management, which is mostly volunteer-based in Germany, is particularly affected by this change, leading to a loss of members. We propose an agent-based simulation model that acts as a "virtual lab" to explore the impact of various changes on disaster management performance. Using different scenarios we examine the impact of changes in personal resources of DMOs, their access to operation relevant information, flood characteristics as well as differences between geographic regions. A loss of DMOs and associated manpower caused by demographic change has the most profound impact on the performance. Especially in rural, upstream regions population decline in combination with very short lead times can put disaster management performance at risk.

99mTc-GHA: A promising agent for assessing tumour viability

International Nuclear Information System (INIS)

Choudhury, P.S.; Gupta, A.; Sharma, P.K.; Bhatia, S.; Nambiar, U.; Jena, A.

2004-01-01

Full text: Biochemical investigations have a major role to play in the management of primary malignancies. Major biochemical changes occur during cancerous transformation including changes in the energy metabolism of the cell. Changes can take place in terms of utilization of glucose and other substrates, protein synthesis and expression of antigens and receptors. Changes also take place in disruption of transport mechanism across cell membranes and other physiological boundaries like blood brain barrier. Anatomical imaging is aimed at the diagnosis of tumours whereas biochemical imaging is better suited for tissue characterization. We report here the utility of 99mTc GHA as a radiopharmaceutical for assessing tumour viability. Evaluation was done for 44 patients who had undergone 72 studies based on objective parameters like histopathological correlation and serial clinical and other radiological evaluation in long-term follow-up. All the evaluated patients had undergone magnetic resonance imaging (MRI) of the local site within one week of 99m GHA study and had some sort of morphological abnormality and suspicious contrast behaviour. 41 patients had cerebral lesions (37 primary brain tumours during initial diagnosis, evaluation of residual or recurrent disease and 4 patients of brain metastasis) and 3 patients had Ewing's Sarcoma evaluated during the course of treatment. 29 patients of suspected brain tumour (21 primary and 8 residual / recurrence) had surgical decompression along with 2/4 in metastatic brain lesions. Out of the 29 patients who underwent surgery, 28 patients had histopathology positive for malignancy. 27 patients showed abnormal GHA concentration corresponding to the morphological abnormality (1 false negative). One patient of pseudo-tumour also showed avid tracer concentration (false positive). 2/4 patients of solitary metastatic foci in brain, with positive GHA scan, underwent surgery and showed positive histopathology. 2/4 patients treated by

The Strategy to Survive Primary Malaria Infection: An Experimental Study on Behavioural Changes in Parasitized Birds.

Directory of Open Access Journals (Sweden)

Andrey Mukhin

Full Text Available Avian malaria parasites (Haemosporida, Plasmodium are of cosmopolitan distribution, and they have a significant impact on vertebrate host fitness. Experimental studies show that high parasitemia often develops during primary malaria infections. However, field studies only occasionally reveal high parasitemia in free-living birds sampled using the traditional methods of mist-netting or trapping, and light chronic infections predominate. The reason for this discrepancy between field observation and experimental data remains insufficiently understood. Since mist-netting is a passive capture method, two main parameters determine its success in sampling infected birds in wildlife, i. e. the presence of parasitized birds at a study site and their mobility. In other words, the trapping probability depends on the survival rate of birds and their locomotor activity during infection. Here we test (1 the mortality rate of wild birds infected with Plasmodium relictum (the lineage pSGS1, (2 the changes in their behaviour during presence of an aerial predator, and (3 the changes in their locomotor activity at the stage of high primary parasitemia.We show that some behavioural features which might affect a bird's survival during a predator attack (time of reaction, speed of flush flight and take off angle did not change significantly during primary infection. However, the locomotor activity of infected birds was almost halved compared to control (non-infected birds during the peak of parasitemia. We report (1 the markedly reduced mobility and (2 the 20% mortality rate caused by P. relictum and conclude that these factors are responsible for the underrepresentation of birds in mist nets and traps during the stage of high primary parasitemia in wildlife. This study indicates that the widespread parasite, P. relictum (pSGS1 influences the behaviour of birds during primary parasitemia. Experimental studies combined with field observations are needed to better

The Strategy to Survive Primary Malaria Infection: An Experimental Study on Behavioural Changes in Parasitized Birds

Science.gov (United States)

Mukhin, Andrey; Palinauskas, Vaidas; Platonova, Elena; Kobylkov, Dmitry; Vakoliuk, Irina; Valkiūnas, Gediminas

2016-01-01

Avian malaria parasites (Haemosporida, Plasmodium) are of cosmopolitan distribution, and they have a significant impact on vertebrate host fitness. Experimental studies show that high parasitemia often develops during primary malaria infections. However, field studies only occasionally reveal high parasitemia in free-living birds sampled using the traditional methods of mist-netting or trapping, and light chronic infections predominate. The reason for this discrepancy between field observation and experimental data remains insufficiently understood. Since mist-netting is a passive capture method, two main parameters determine its success in sampling infected birds in wildlife, i. e. the presence of parasitized birds at a study site and their mobility. In other words, the trapping probability depends on the survival rate of birds and their locomotor activity during infection. Here we test (1) the mortality rate of wild birds infected with Plasmodium relictum (the lineage pSGS1), (2) the changes in their behaviour during presence of an aerial predator, and (3) the changes in their locomotor activity at the stage of high primary parasitemia.We show that some behavioural features which might affect a bird's survival during a predator attack (time of reaction, speed of flush flight and take off angle) did not change significantly during primary infection. However, the locomotor activity of infected birds was almost halved compared to control (non-infected) birds during the peak of parasitemia. We report (1) the markedly reduced mobility and (2) the 20% mortality rate caused by P. relictum and conclude that these factors are responsible for the underrepresentation of birds in mist nets and traps during the stage of high primary parasitemia in wildlife. This study indicates that the widespread parasite, P. relictum (pSGS1) influences the behaviour of birds during primary parasitemia. Experimental studies combined with field observations are needed to better understand the

Dopamine agents for hepatic encephalopathy

DEFF Research Database (Denmark)

Junker, Anders Ellekær; Als-Nielsen, Bodil; Gluud, Christian

2014-01-01

BACKGROUND: Patients with hepatic encephalopathy may present with extrapyramidal symptoms and changes in basal ganglia. These changes are similar to those seen in patients with Parkinson's disease. Dopamine agents (such as bromocriptine and levodopa, used for patients with Parkinson's disease) have...... therefore been assessed as a potential treatment for patients with hepatic encephalopathy. OBJECTIVES: To evaluate the beneficial and harmful effects of dopamine agents versus placebo or no intervention for patients with hepatic encephalopathy. SEARCH METHODS: Trials were identified through the Cochrane...... hepatic encephalopathy that were published during 1979 to 1982 were included. Three trials assessed levodopa, and two trials assessed bromocriptine. The mean daily dose was 4 grams for levodopa and 15 grams for bromocriptine. The median duration of treatment was 14 days (range seven to 56 days). None...

Small diversity effects on ocean primary production under environmental change in a diversity-resolving ocean ecosystem model

DEFF Research Database (Denmark)

Prowe, Friederike; Pahlow, M.; Dutkiewicz, S.

2013-01-01

Marine ecosystem models used to investigate how global change affects ocean ecosystems and their functioning typically omit pelagic diversity. Diversity, however, can affect functions such as primary production and their sensitivity to environmental changes. Using a global ocean ecosystem model...... the diversity effects on ecosystem functioning captured in ocean ecosystem models....

Outcomes with single agent LIPO-DOX in platinum-resistant ovarian and fallopian tube cancers and primary peritoneal adenocarcinoma - Chiang Mai University Hospital experience.

Science.gov (United States)

Suprasert, Prapaporn; Manopunya, Manatsawee; Cheewakriangkrai, Chalong

2014-01-01

Single pegylated liposomal doxorubicin (PLD) is commonly used as a salvage treatment in platinum-resistant ovarian cancer, fallopian tube cancer and primary peritoneal adenocarcinoma (PPA) with a satisfactory outcome. However, the data for second generation PLD administered in this setting are still limited. We conducted a retrospective study to evaluate the outcome of patients who received single-agent second generation PLD (LIPO-DOX) after the development of clinical platinum resistance. The study period was between March 2008 and March 2013. LIPO-DOX was administered intravenously 40 mg/m2 every 28 days until disease progression, but for not more than six cycles. The response rate was evaluated using the Gynecologic Cancer Intergroup (GCIG) criteria while the toxicity was evaluated according to WHO criteria. Twenty-nine patients met the inclusion criteria in the study period with an overall response rate of 13.8%. The median progression free survival and overall survival were three and eleven months, respectively. With the total of 96 cycles of chemotherapy, the patients developed grades 3 and 4 hematologic toxicity as follows: anemia, 0%, leukopenia, 9.6%, neutropenia, 32.3% and thrombocytopenia, 0%. In conclusion, the single agent second generation PLD demonstrated modest efficacy in patients with platinum-resistant ovarian cancer, fallopian tube cancer and PPA without serious toxicity.

Behavioral change in rural practice: improving patient motivation in primary care.

Science.gov (United States)

Clark, Karen; Weir, Christine

2013-01-01

As the disparities in rural healthcare have become better understood, the need to adjust and compensate for these unique challenges becomes a priority. This manuscript suggests three constructs that can be readily integrated into rural care providers' daily work to improve treatment outcomes. Autonomy support, relational support, and competence support are among the motivational constructs discussed with a special consideration for the unique cultural and environmental influences of rural West Virginia residents. The overall objective of this review is to renew the basic tenants of shared decision making as they related to successful behavioral change in primary care.

Predictors of long-term change of a physical activity promotion programme in primary care.

Science.gov (United States)

Sanchez, Alvaro; Grandes, Gonzalo; Ortega Sánchez-Pinilla, Ricardo; Torcal, Jesus; Montoya, Imanol

2014-02-04

Further research is needed to improve the evidence regarding determinants of physical activity (PA) as a crucial step to plan higher effective intervention strategies. The goal of the present study is to identify socio-demographic and clinical characteristics of primary care (PHC) insufficiently active patients that are associated with longitudinal changes in the level of physical activity. Longitudinal analysis of baseline socio-demographic and clinical predictors of physical activity change in insufficiently active PHC patients who participated in a PA-promoting multi-centre randomized clinical trial conducted from October 2003 through March 2006. The primary outcome measure was the self-reported physical activity assessed with the 7-day Physical Activity Recall (PAR), at baseline, 6, 12 and 24 months. Baseline covariates included sex, age, social class, anthropometric measures and other cardiovascular risk factors or associated diseases (Diabetes, HTA, tobacco use, etc.), and stage of readiness to change PA. Generalized linear mixed models were used to estimate longitudinal association of studied variables on PA change over the three follow-up measurements. A total of 3691 patients (85% of the 4317 recruited in the trial) with at least one follow-up measurement were included in the longitudinal analysis. At baseline, analysed patients (mean age: 50.6 years; 64.6% women) devoted 34.7 minutes and 2.36 metabolic equivalent hours per week (MET.h/week) to moderate and vigorous physical activity. Older age, male gender, higher social class, lower BMI, diagnosis of diabetes or hypertension, and measurement season were significant predictors of PA longitudinal change. The effect of baseline readiness to change on PA dose was modified by time, showing a positive gradient in favour of those with more readiness to change that increases significantly at 12 and 24 months (p-value interaction < .0001). Identified baseline characteristics such as readiness to change and

Intra-individual, randomised comparison of the MRI contrast agents gadobutrol versus gadoteridol in patients with primary and secondary brain tumours, evaluated in a blinded read

International Nuclear Information System (INIS)

Koenig, M.; Schulte-Altedorneburg, G.; Piontek, M.; Heuser, L.; Hentsch, A.; Spangenberg, P.; Schwenke, C.; Harders, A.

2013-01-01

To prove that 1.0 M gadobutrol provides superior contrast enhancement and MRI image characteristics of primary and secondary brain tumours compared with 0.5 M gadoteridol, thereby providing superior diagnostic information. Brain MRI was performed in two separate examinations in patients scheduled for neurosurgery. Independent injections of 1.0 M gadobutrol and 0.5 M gadoteridol at doses of 0.1 mmol Gd/kg body weight were administered per patient in randomised order. Evaluation was performed in an off-site blinded read. Fifty-one patients in the full analysis set (FAS) were eligible for efficacy analysis and 44 for the per-protocol analysis. For the primary efficacy variable ''preference in contrast enhancement for one contrast agent or the other'', the rate of ''gadobutrol preferred'' was estimated at 0.73 (95 % confidence interval 0.61; 0.83), showing significant superiority of gadobutrol over gadoteridol. Calculated lesion-to-brain contrast and the results of all qualitative secondary efficacy variables were also in favour of gadobutrol. Keeping a sufficient time delay after contrast application proved to be essential to get optimal image quality. Compared with 0.5 M gadoteridol, 1.0 M gadobutrol was proven to have significantly superior contrast enhancement characteristics in a routine MRI protocol of primary and secondary brain tumours. (orig.)

A review of the use of common antiplatelet agents in orthopaedic practice.

LENUS (Irish Health Repository)

Dineen, P F

2010-09-01

Antiplatelet agents are widely prescribed for the primary and secondary prevention of cardiovascular events. A common clinical problem facing orthopaedic and trauma surgeons is how to manage patients receiving these agents who require surgery, either electively or following trauma. The dilemma is to balance the risk of increased blood loss if the antiplatelet agents are continued peri-operatively against the risk of coronary artery\\/stent thrombosis and\\/or other vascular event if the drugs are stopped. The traditional approach of stopping these medications up to two weeks before surgery appears to pose significant danger to patients and may require review. This paper covers the important aspects regarding the two most commonly prescribed antiplatelet agents, aspirin and clopidogrel.

Towards a Calendar Agent Society with Intelligent Agents in ASP-Updates

Directory of Open Access Journals (Sweden)

Marco A. Ramos C.

2012-03-01

Full Text Available Se presenta el análisis y algunas especificaciones para describir una sociedad multi-agente que representa agendas dinámicas en Answer Sets Programming, por medio de actualización de bases de conocimiento. Se trata de un estudio de caso para representar un grupo de agentes BD Iinteligentes con el fin común de programar una reunión, y se utiliza un ejemplo para mostrar la manera de distribuir y cambiar sus especificaciones bajo circunstancias imprevistas, así como un protocolo sencillo para realizar una reunión consensual. Sostenemos que el marco propuesto es apropiado para tener los beneficios de una base sólida como Answer Sets Programming, de la simplicidad de su programación lógica declarativa, así como de la practicidad para resolvedores existentes implementados, que pueden ser utilizados para un sistema más completo y útil de sociedades de agentes.We present the analysis and some preliminary specifications to describe a multi-agent society to represent dynamic appointments under in Answer-Sets Programming, by means of knowledge-base updates. This is a case study to represent a group of intelligent BDI agents with a common goal of scheduling a meeting, and we use an example to show how to distribute and change their specifications under unforeseen circumstances, as well as a simple protocol to realise a consensual meeting. We claim that the proposed framework is appropriate to have the benefits from a strong foundation like Answer-Sets Programming, simplicity for its declarative logic programming, as well as practicality for existent implemented solvers, which can be used to implement a more-complete and useful system of agent societies.

78 FR 58608 - Proposed Collection; Comment Request for the EFTPS Primary Contact Information Change Form

Science.gov (United States)

2013-09-24

... form is being submitted for renewal purposes only. Type of Review: Extension of a currently approved... EFTPS Primary Contact Information Change Form AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... effort to reduce paperwork and respondent burden, invites the general public and other Federal agencies...

Perfect match? Generation Y as change agents for information communication technology implementation in healthcare.

Science.gov (United States)

Yee, Kwang Chien; Miils, Erin; Airey, Caroline

2008-01-01

The current healthcare delivery model will not meet future healthcare demands. The only sustainable healthcare future is one that best leverages advances in technology to improve productivity and efficiency. Information communication technology (ICT) has, therefore, been touted as the panacea of future healthcare challenges. Many ICT projects in healthcare, however, fail to deliver on their promises to transform the healthcare system. From a technologist's perspective, this is often due to the lack of socio-technical consideration. From a socio-cultural perspective, however, there is often strong inertia to change. While the utilisation of user-centred design principles will generate a new wave of enthusiasm among technologists, this has to be matched with socio-cultural changes within the healthcare system. Generation Y healthcare workers might be the socio-cultural factor required, in combination with new technology, to transform the healthcare system. Generation Y has generated significant technology-driven changes in many other industries. The socio-cultural understanding of generation Y healthcare workers is essential to guide the design and implementation of ICT solutions for a sustainable healthcare future. This paper presents the initial analysis of our qualitative study which aims to generate in-depth conceptual insights of generation Y healthcare workers and their view of ICT in healthcare. Our results show that generation Y healthcare workers might assist future ICT implementation in healthcare. This paper, however, argues that significant changes to the current healthcare organisation will be required in order to unleash the full potential of generation Y workers and ICT implementation. Finally, this paper presents some strategies to empower generation Y workers as change agents for a sustainable future healthcare system.

AN INTELLIGENT CONVERSATION AGENT FOR HEALTH CARE DOMAIN

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K. Karpagam

2014-04-01

Full Text Available Human Computer Interaction is one of the pervasive application areas of computer science to develop with multimodal interaction for information sharings. The conversation agent acts as the major core area for developing interfaces between a system and user with applied AI for proper responses. In this paper, the interactive system plays a vital role in improving knowledge in the domain of health through the intelligent interface between machine and human with text and speech. The primary aim is to enrich the knowledge and help the user in the domain of health using conversation agent to offer immediate response with human companion feel.

An agent-based method for simulating porous fluid-saturated structures with indistinguishable components

Science.gov (United States)

Kashani, Jamal; Pettet, Graeme John; Gu, YuanTong; Zhang, Lihai; Oloyede, Adekunle

2017-10-01

Single-phase porous materials contain multiple components that intermingle up to the ultramicroscopic level. Although the structures of the porous materials have been simulated with agent-based methods, the results of the available methods continue to provide patterns of distinguishable solid and fluid agents which do not represent materials with indistinguishable phases. This paper introduces a new agent (hybrid agent) and category of rules (intra-agent rule) that can be used to create emergent structures that would more accurately represent single-phase structures and materials. The novel hybrid agent carries the characteristics of system's elements and it is capable of changing within itself, while also responding to its neighbours as they also change. As an example, the hybrid agent under one-dimensional cellular automata formalism in a two-dimensional domain is used to generate patterns that demonstrate the striking morphological and characteristic similarities with the porous saturated single-phase structures where each agent of the ;structure; carries semi-permeability property and consists of both fluid and solid in space and at all times. We conclude that the ability of the hybrid agent to change locally provides an enhanced protocol to simulate complex porous structures such as biological tissues which could facilitate models for agent-based techniques and numerical methods.

Effect of a re‑wetting agent on bond strength of an adhesive to ...

African Journals Online (AJOL)

Objective: This study investigated the effect of a re‑wetting agent on the microtensile bond strengths (μTBS) of primary and permanent dentin after acid or laser etching. Materials and Methods: Twelve permanent and 12 primary molar teeth were ground to expose an occlusal dentin surface. Each group teeth were randomly ...

Persistent agents in Axelrod's social dynamics model

Science.gov (United States)

Reia, Sandro M.; Neves, Ubiraci P. C.

2016-01-01

Axelrod's model of social dynamics has been studied under the effect of external media. Here we study the formation of cultural domains in the model by introducing persistent agents. These are agents whose cultural traits are not allowed to change but may be spread through local neighborhood. In the absence of persistent agents, the system is known to present a transition from a monocultural to a multicultural regime at some critical Q (number of traits). Our results reveal a dependence of critical Q on the occupation probability p of persistent agents and we obtain the phase diagram of the model in the (p,Q) -plane. The critical locus is explained by the competition of two opposite forces named here barrier and bonding effects. Such forces are verified to be caused by non-persistent agents which adhere (adherent agents) to the set of traits of persistent ones. The adherence (concentration of adherent agents) as a function of p is found to decay for constant Q. Furthermore, adherence as a function of Q is found to decay as a power law with constant p.

Diabetes-Related Behavior Change Knowledge Transfer to Primary Care Practitioners and Patients: Implementation and Evaluation of a Digital Health Platform.

Science.gov (United States)

Abidi, Samina; Vallis, Michael; Piccinini-Vallis, Helena; Imran, Syed Ali; Abidi, Syed Sibte Raza

2018-04-18

Behavioral science is now being integrated into diabetes self-management interventions. However, the challenge that presents itself is how to translate these knowledge resources during care so that primary care practitioners can use them to offer evidence-informed behavior change support and diabetes management recommendations to patients with diabetes. The aim of this study was to develop and evaluate a computerized decision support platform called "Diabetes Web-Centric Information and Support Environment" (DWISE) that assists primary care practitioners in applying standardized behavior change strategies and clinical practice guidelines-based recommendations to an individual patient and empower the patient with the skills and knowledge required to self-manage their diabetes through planned, personalized, and pervasive behavior change strategies. A health care knowledge management approach is used to implement DWISE so that it features the following functionalities: (1) assessment of primary care practitioners' readiness to administer validated behavior change interventions to patients with diabetes; (2) educational support for primary care practitioners to help them offer behavior change interventions to patients; (3) access to evidence-based material, such as the Canadian Diabetes Association's (CDA) clinical practice guidelines, to primary care practitioners; (4) development of personalized patient self-management programs to help patients with diabetes achieve healthy behaviors to meet CDA targets for managing type 2 diabetes; (5) educational support for patients to help them achieve behavior change; and (6) monitoring of the patients' progress to assess their adherence to the behavior change program and motivating them to ensure compliance with their program. DWISE offers these functionalities through an interactive Web-based interface to primary care practitioners, whereas the patient's self-management program and associated behavior interventions are

Oxidation of the Primary Alcoholic Moiety Selectively in the Presence of the Secondary Alcoholic Moieties

International Nuclear Information System (INIS)

Tin Myint Htwe

2011-12-01

Both primary and secondary alcoholic moieties are very sensitive to oxidation reactions. But sometimes it is necessary to oxidized only the primary alcoholic moiety. Such cases are usually found in Food Industries. In this situation, TEMPO (1, 1, 6, 6-Tetramethyl-1-Piperidine Oxoammonium) was used as an oxidizing agent. In this paper, Alpha starch was successfully oxidized using TEMPO as the oxidizing agent in combination with sodium hypochlorite with and without sodium bromide. The oxidation of primary alcoholic moiety only and the remaining untouched secondary alcoholic moiety were proved by infrared spectroscopy method.

Relation between anchorings of liquid crystals and conformation changes in aligning agents by the Langmuir-Blodgett film technique investigation

International Nuclear Information System (INIS)

Zhu, Y.; Lu, Z.; Wei, Y.

1995-01-01

The anchoring direction of liquid crystals on a solid substrate surface depends upon many parameters characterizing the liquid-crystal--substrate interface, a variation of which may change this anchoring direction leading to the so-called anchoring transition. Here, based on the Langmuir-Blodgett film technique, we present two model systems to study the relation between anchoring directions and the conformation changes in aligning agents. A double-armed crown ether liquid crystal and a side chain polymer liquid crystal at an air-water interface both show phase transitions, accompanied by conformation changes. However, when the monolayers in different phases were transferred onto solid substrates to orient liquid crystals, we found that for the crown ether material the conformation change can alter the anchoring of liquid crystals between homeotropic and homogeneous alignments, while for the polymer liquid crystal, despite the conformation changes, the liquid crystals can only be aligned homeotropically. The involved mechanisms were briefly discussed in terms of the Landau-type phenomenological theory

75 FR 36099 - Legislative Changes to Primary Care Loan Program Authorized Under Title VII of the Public Health...

Science.gov (United States)

2010-06-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Legislative Changes to Primary Care Loan Program Authorized Under Title VII of the Public Health Service Act AGENCY... changes Section 723 of the Public Health Service Act (PHSA) regarding administration of the PCL program...

The role of agency in becoming and being a teacher : identifying teachers as change agents in primary education

NARCIS (Netherlands)

van der Heijden, H.R.M.A.

2013-01-01

Teachers themselves play a key role in school development. Every school needs teachers who are ‘change agents’ at both classroom and school level. However, little is known about what characterizes these teachers. Therefore, an interview study has been conducted to obtain a broad and coherent insight

Biliary excretion of cadmium in rat. III. Effects of chelating agents and change in intracellular thiol content on billiary transport and tissue distribution of cadmium

Energy Technology Data Exchange (ETDEWEB)

Cherian, M.G.

1980-03-01

The effects of changes in sulfur-containing intracellular ligands on biliary excretion of cadmium were studied in rats. Injection of zinc or copper salts 24 h before intravenous injection of /sup 109/CdCl/sub 2/ (1 mg/kg Cd) decreased biliary excretion of Cd. Pretreatment with cysteine (25 mg/kg) had a similar effect. Depletion of intracellular thiol by injection of diethylmaleate had little effect. The effect of chelating agents on the pharmacokinetics of Cd depended on time of administration of the agents after exposure to Cd. When chelating agents were administered 1/2 h after Cd injection (before the synthesis of metallothionein), the thiol-containing agents (2,3-dimercapto-1-propanol (BAL), DL-penicillamine, N-acetylpenicillamine, and dithioerythritol increased the biliary excretion of Cd, while the carboxyl-containing ones (EDTA and nitrilotriacetate) increased the urinary excretion of Cd. BAL was the most effective chelating agent, but there was also an increase in the renal concentration of Cd. However, when these chelating agents were administered 24 h after Cd injection (after the synthesis of metallothionein), only BAL increased the biliary excretion of Cd. Renal and hepatic Cd concentrations decreased concurrently after BAL treatment.

Transarterial chemoembolization for primary and metastatic liver tumors

Directory of Open Access Journals (Sweden)

Popov M.V.

2016-12-01

Full Text Available The literature review presents the methodology of transarterial chemoembolization (TACE — widely used method of treatment of primary and secondary liver tumors. The TACE role as a neoadjuvant therapy and the role in the management of unresectable primary and secondary liver tumors are shown. The morphofunctional basis of TACE, benefits of superselective intra-arterial administration of cytostatic agents especially in combination with ischemic impact on a tumor are described. The subject of the choice of the chemotherapeutic agent is also touched; modern drug-loaded microspheres which allow the use of higher doses of the chemotherapeutic drug without increasing systemic effect and prolong its effect on tumor are described. Lack of correlation of presence and severity of a post-embolization syndrome with success of the procedure is noted.

MANAGING CHRONIC DISEASES IN THE MALAYSIAN PRIMARY HEALTH CARE – A NEED FOR CHANGE

Directory of Open Access Journals (Sweden)

TAHER SW

2008-01-01

Full Text Available Chronic diseases are the major cause of death and disability in Malaysia, accounted for 71% of all deaths and 69% of the total burden of disease. The WHO in its report Preventing Chronic Disease: A Vital Investment has highlighted the inaction of most governments of the low and middle income countries in tackling the problem urgently, is clear and unacceptable. The acute care paradigm is no longer adequate for the changing pattern of diseases in today’s and tomorrow’s world. An evolution of primary health care system beyond the acute care model to embrace the concept of caring for long term health problems is imperative in the wake of the rising epidemic of chronic diseases and its crushing burden resulting in escalating healthcare costs. Compelling evidence from around the world showed that there are innovative and cost-effective community-based interventions to reduce the morbidity and mortality attributable to chronic diseases, but these are rarely translated into high quality population-wide chronic disease care. This paper describes the current situation of chronic disease management in the Malaysian primary care setting - to highlight the need for change, discuss the barriers to the implementation of effective chronic disease management programmes in the community, and consider fundamental solutions needed to instigate the change in our setting.

Multi-agent modeling and simulation of farmland use change in the farming-pastoral zone: A case study of Qianjingou Town in Inner Mongolia, China

Science.gov (United States)

Yan, H.

2015-12-01

Farmland is the most basic material conditions for guaranteeing rural livelihoods and national food security, and exploring management strategies that take both of the sustainable rural livelihoods and sustainable farmland use into account has vital significance of theory and practice. Farmland is a complex and self-adaptive system that couples human and natural systems together, and natural factors and social factors that are related to its changing process need to be considered when modeling farmland changing process. This paper takes Qianjingou Town in Inner Mongolia farming-pastoral zone as study area. From the perspective of the relationship between households' livelihoods and farmland use, this study builds the process mechanism of farmland use change based on questionnaires data, and constructs multi-agent simulation model of farmland use change with the help of Eclipse and Repast toolbox. Through simulating the relationship between natural factors (with geographical location) and households' behaviors, this paper systematically simulates households' renting and abandoning farmland behaviors, and truly describes dynamic interactions between households' livelihoods and factors related to farmland use change. These factors include natural factors (net primary productivity, road accessibility, slope and relief amplitude) and social factors (households' family structures, economic development and government policies). In the end, this study scientifically predicts farmland use change trend in the future 30 years. The simulation results show that, the number of abandoned and sublet farmland plots has a gradually increasing trend, the number of non-farm households and pure-outwork households has a remarkable increasing trend, and the number of part-farm households and pure-farm households shows a decreasing trend. Households' livelihoods sustainability in the study area is confronted with increasing pressure, and households' nonfarm employment has an increasing

Multi-Agent Modeling and Simulation of Farmland Use Change in a Farming–Pastoral Zone: A Case Study of Qianjingou Town in Inner Mongolia, China

Directory of Open Access Journals (Sweden)

Xuehong Bai

2015-11-01

Full Text Available Farmland is the most basic material condition for guaranteeing rural livelihoods and national food security, and exploring management strategies that take both stable rural livelihoods and sustainable farmland use into account has vital significance in theory and practice. Farmland is a complex and self-adaptive system that couples human and natural systems, and natural and social factors that are related to its changing process need to be considered when modeling farmland changing processes. This paper uses Qianjingou Town in the Inner Mongolian farming–pastoral zone as a study area. From the perspective of the relationship between household livelihood and farmland use, this study establishes the process mechanism of farmland use change based on questionnaire data, and constructs a multi-agent simulation model of farmland use change using the Eclipse and Repast toolbox. Through simulating the relationship between natural factors (including geographical location and household behavior, this paper systematically simulates household farmland abandonment and rent behaviors, and accurately describes the dynamic interactions between household livelihoods and the factors related to farmland use change. These factors include natural factors (net primary productivity, road accessibility, slope and relief amplitude and social factors (household family structures, economic development and government policies. Ultimately, this study scientifically predicts the future farmland use change trend in the next 30 years. The simulation results show that the number of abandoned and sublet farmland plots has a gradually increasing trend, and the number of non-farming households and pure-outworking households has a remarkable increasing trend, whereas the number of part-farming households and pure-farming households has a decreasing trend. Household livelihood sustainability in the study area is confronted with increasing pressure, and household non

[RIU project: perceived changes by health agents and professionals after a health intervention in an urban area of socioeconomic disadvantage].

Science.gov (United States)

Aviñó, Dory; Paredes-Carbonell, Joan J; Peiró-Pérez, Rosana; La Parra Casado, Daniel; Álvarez-Dardet, Carlos

2014-12-01

To describe how health agents and professionals working in a community project perceive the changes related to the population health status and their use of health-care services after the RIU intervention in an urban area of socioeconomic disadvantage. A qualitative descriptive study based on individual and group interviews and participant observation conducted between October 2008-July 2009. Raval (Algemesí-Valencia) We selected by purposive sample 7 women health agents, all persons who completed the intervention, and 10 professionals for their involvement in the intervention. We conducted a group interview with the women at 6 months and a group and 7 individuals interviews both at 9 months of intervention. We realized a thematic descriptive analysis from health promotion framework. We used participant observation in a meeting with professionals at 9 months and analyzed field notes as: appraisal project, detected changes, challenges and recommendations. Women acquired information about health, contraception, pregnancy and heath services; they noted changes in self-care and social skills and leadership; they internalized the role of health worker disseminating what they learned and showed improvement in self-esteem and social recognition. They caused changes in the people related on health care and access to services. Professionals didn't incorporate at their work the community perspective; they valued positively the project; professionals and women agreed on improving access and use of services and closeness population-professionals. RIU increases the capabilities of the participants, their social recognition and improves access and use of health services. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Agent-based simulation of electricity markets : a literature review

International Nuclear Information System (INIS)

Sensfuss, F.; Genoese, M.; Genoese, M.; Most, D.

2007-01-01

The electricity sector in Europe and North America is undergoing considerable changes as a result of deregulation, issues related to climate change, and the integration of renewable resources within the electricity grid. This article reviewed agent-based simulation methods of analyzing electricity markets. The paper provided an analysis of research currently being conducted on electricity market designs and examined methods of modelling agent decisions. Methods of coupling long term and short term decisions were also reviewed. Issues related to single and multiple market analysis methods were discussed, as well as different approaches to integrating agent-based models with models of other commodities. The integration of transmission constraints within agent-based models was also discussed, and methods of measuring market efficiency were evaluated. Other topics examined in the paper included approaches to integrating investment decisions, carbon dioxide (CO 2 ) trading, and renewable support schemes. It was concluded that agent-based models serve as a test bed for the electricity sector, and will help to provide insights for future policy decisions. 74 refs., 6 figs

Coinfection with EBV/CMV and other respiratory agents in children with suspected infectious mononucleosis

Directory of Open Access Journals (Sweden)

Wei Cong

2010-09-01

Full Text Available Abstract Background Numerous studies have shown that Epstein-Barr virus (EBV and cytomegalovirus (CMV can infect immunocompetent patients simultaneously with other agents. Nonetheless, multiple infections with other agents in EBV/CMV-infected children have received little attention. We conducted a retrospective study of children with suspected infectious mononucleosis. Peripheral blood samples were analyzed by indirect immunofluorescence to detect EBV, CMV and other respiratory agents including respiratory syncytial virus; adenovirus; influenza virus types A and B; parainfluenza virus types 1, 2 and 3; Chlamydia pneumoniae and Mycoplasma pneumoniae. A medical history was collected for each child. Results The occurrence of multipathogen infections was 68.9%, 81.3% and 63.6% in the children with primary EBV, CMV or EBV/CMV, respectively, which was significantly higher than that in the past-infected group or the uninfected group (p C. pneumoniae in children with primary infection was as high as 50%, significantly higher than in the other groups (p Conclusion Our study suggests that there is a high incidence of multipathogen infections in children admitted with EBV/CMV primary infection and that the distribution of these pathogens is not random.

Agent Control for Reconfigurable Open Kinematic Chain Manipulators

Directory of Open Access Journals (Sweden)

Janez Sluga

2013-10-01

Full Text Available This paper presents a method for the autonomous control of differently structured open kinematic chains based on multi-agent system technology. The appropriate level of distributing local autonomy (agents to a manipulative structure is defined, which makes it possible to dynamically change the number, type and structure of manipulative components without modifying their behavioural logic. To achieve fast reconfigurable and scalable manipulative systems, a new multi-agent method is developed for controlling the manipulator kinematics. The new method enables independent manipulator structure from the control system because of its structural and system modularity. The proposed method consists of kinematic equations for use in an agent environment, agent motion-planning algorithms, evaluation functions, agent control logic and kinematic algorithms. The results of simulations and real-world experiments demonstrate the usefulness of the approach for different non-redundant and redundant manipulation structures.

People and Teams Matter in Organizational Change: Professionals’ and Managers’ Experiences of Changing Governance and Incentives in Primary Care

Science.gov (United States)

Allan, Helen T; Brearley, Sally; Byng, Richard; Christian, Sara; Clayton, Julie; Mackintosh, Maureen; Price, Linnie; Smith, Pam; Ross, Fiona

2014-01-01

ObjectivesTo explore the experiences of governance and incentives during organizational change for managers and clinical staff. Study SettingThree primary care settings in England in 2006–2008. Study DesignData collection involved three group interviews with 32 service users, individual interviews with 32 managers, and 56 frontline professionals in three sites. The Realistic Evaluation framework was used in analysis to examine the effects of new policies and their implementation. Principal FindingsIntegrating new interprofessional teams to work effectively is a slow process, especially if structures in place do not acknowledge the painful feelings involved in change and do not support staff during periods of uncertainty. ConclusionsEliciting multiple perspectives, often dependent on individual occupational positioning or place in new team configurations, illuminates the need to incorporate the emotional as well as technocratic and system factors when implementing change. Some suggestions are made for facilitating change in health care systems. These are discussed in the context of similar health care reform initiatives in the United States. PMID:23829292

Adrenal scintiscanning with NP-59: a new radioiodinated cholesterol agent

International Nuclear Information System (INIS)

Miles, J.M.; Wahner, H.W.; Carpenter, P.C.; Salassa, R.M.; Northcutt, R.C.

1979-01-01

Adrenal imaging in the past has been limited in its clinical application by the long interval between administration of dose and visualization of adrenal glands. We review our experience with the use of a newer labeling agent, NP-59, in 29 patients with various adrenal disorders and in 4 normal subjects. With this agent, identification of adrenal lesions is possible with a high degree of accuracy, and diagnostic information is usually available within 48 hrs. NP-59 is particularly useful in evaluating primary aldosteronism and selected cases of Cushing's syndrome

Primary prevention of periodontitis: managing gingivitis.

Science.gov (United States)

Chapple, Iain L C; Van der Weijden, Fridus; Doerfer, Christof; Herrera, David; Shapira, Lior; Polak, David; Madianos, Phoebus; Louropoulou, Anna; Machtei, Eli; Donos, Nikos; Greenwell, Henry; Van Winkelhoff, Ari J; Eren Kuru, Bahar; Arweiler, Nicole; Teughels, Wim; Aimetti, Mario; Molina, Ana; Montero, Eduardo; Graziani, Filippo

2015-04-01

Periodontitis is a ubiquitous and irreversible inflammatory condition and represents a significant public health burden. Severe periodontitis affects over 11% of adults, is a major cause of tooth loss impacting negatively upon speech, nutrition, quality of life and self-esteem, and has systemic inflammatory consequences. Periodontitis is preventable and treatment leads to reduced rates of tooth loss and improved quality of life. However, successful treatment necessitates behaviour change in patients to address lifestyle risk factors (e.g. smoking) and, most importantly, to attain and sustain high standards of daily plaque removal, lifelong. While mechanical plaque removal remains the bedrock of successful periodontal disease management, in high-risk patients it appears that the critical threshold for plaque accumulation to trigger periodontitis is low, and such patients may benefit from adjunctive agents for primary prevention of periodontitis. The aims of this working group were to systematically review the evidence for primary prevention of periodontitis by preventing gingivitis via four approaches: 1) the efficacy of mechanical self-administered plaque control regimes; 2) the efficacy of self-administered inter-dental mechanical plaque control; 3) the efficacy of adjunctive chemical plaque control; and 4) anti-inflammatory (sole or adjunctive) approaches. Two meta-reviews (mechanical plaque removal) and two traditional systematic reviews (chemical plaque control/anti-inflammatory agents) formed the basis of this consensus. Data support the belief that professionally administered plaque control significantly improves gingival inflammation and lowers plaque scores, with some evidence that reinforcement of oral hygiene provides further benefit. Re-chargeable power toothbrushes provide small but statistically significant additional reductions in gingival inflammation and plaque levels. Flossing cannot be recommended other than for sites of gingival and periodontal

Green primary explosives: 5-nitrotetrazolato-N2-ferrate hierarchies.

Science.gov (United States)

Huynh, My Hang V; Coburn, Michael D; Meyer, Thomas J; Wetzler, Modi

2006-07-05

The sensitive explosives used in initiating devices like primers and detonators are called primary explosives. Successful detonations of secondary explosives are accomplished by suitable sources of initiation energy that is transmitted directly from the primaries or through secondary explosive boosters. Reliable initiating mechanisms are available in numerous forms of primers and detonators depending upon the nature of the secondary explosives. The technology of initiation devices used for military and civilian purposes continues to expand owing to variations in initiating method, chemical composition, quantity, sensitivity, explosive performance, and other necessary built-in mechanisms. Although the most widely used primaries contain toxic lead azide and lead styphnate, mixtures of thermally unstable primaries, like diazodinitrophenol and tetracene, or poisonous agents, like antimony sulfide and barium nitrate, are also used. Novel environmentally friendly primary explosives are expanded here to include cat[Fe(II)(NT)(3)(H(2)O)(3)], cat(2)[Fe(II)(NT)(4)(H(2)O)(2)], cat(3)[Fe(II)(NT)(5)(H(2)O)], and cat(4)[Fe(II)(NT)(6)] with cat = cation and NT(-) = 5-nitrotetrazolato-N(2). With available alkaline, alkaline earth, and organic cations as partners, four series of 5-nitrotetrazolato-N(2)-ferrate hierarchies have been prepared that provide a plethora of green primaries with diverse initiating sensitivity and explosive performance. They hold great promise for replacing not only toxic lead primaries but also thermally unstable primaries and poisonous agents. Strategies are also described for the systematic preparation of coordination complex green primaries based on appropriate selection of ligands, metals, and synthetic procedures. These strategies allow for maximum versatility in initiating sensitivity and explosive performance while retaining properties required for green primaries.

Development of (F-18)-Labeled Amyloid Imaging Agents for PET

International Nuclear Information System (INIS)

Mathis, C.A.

2007-01-01

The applicant proposes to design and synthesize a series of fluorine-18-labeled radiopharmaceuticals to be used as amyloid imaging agents for positron emission tomography (PET). The investigators will conduct comprehensive iterative in vitro and in vivo studies based upon well defined acceptance criteria in order to identify lead agents suitable for human studies. The long term goals are to apply the selected radiotracers as potential diagnostic agents of Alzheimer's disease (AD), as surrogate markers of amyloid in the brain to determine the efficacy of anti-amyloid therapeutic drugs, and as tools to help address basic scientific questions regarding the progression of the neuropathology of AD, such as testing the 'amyloid cascade hypothesis' which holds that amyloid accumulation is the primary cause of AD.

Contemporary Medical Management of Primary Hyperparathyroidism: A Systematic Review

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Julius Simoni Leere

2017-04-01

Full Text Available IntroductionPrimary hyperparathyroidism is increasingly an asymptomatic disease at diagnosis, but the recognized guidelines for management are based on evidence obtained from studies on patients with symptomatic disease, and surgery is not always indicated. Other patients are unable to undergo surgery, and thus a medical treatment is warranted. This systematic review provides an overview of the existing literature on contemporary pharmaceutical options available for the medical management of primary hyperparathyroidism.MethodsDatabases of medical literature were searched for articles including terms for primary hyperparathyroidism and each of the included drugs. Data on s-calcium, s-parathyroid hormone, bone turnover markers, bone mineral density (BMD and hard endpoints were extracted and tabulated, and level of evidence was determined. Changes in s-calcium were estimated and a meta-regression analysis was performed.ResultsThe 1,999 articles were screened for eligibility and 54 were included in the review. Weighted mean changes calculated for each drug in s-total calcium (mean change from baseline ± SEM were pamidronate (0.31 ± 0.034 mmol/l; alendronate (0.07 ± 0.05 mmol/l; clodronate (0.20 ± 0.040 mmol/l; mixed bisphosphonates (0.16 ± 0.049 mmol/l; and cinacalcet (0.37 ± 0.013 mmol/l. The meta-analysis revealed a significant decrease of effect on s-calcium with time for the bisphosphonates (Coef. −0.049 ± 0.023, p = 0.035, while cinacalcet proved to maintain its effect on s-calcium over time. Bisphosphonates improved BMD while cinacalcet had no effect.DiscussionThe included studies demonstrate advantages and drawbacks of the available pharmaceutical options that can prove helpful in the clinical setting. The great variation in how primary hyperparathyroidism is manifested requires that management should rely on an individual evaluation when counseling patients. Combining resorptive agents with

Dissemination of Cultural Norms and Values: Agent-Based Modeling

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Denis Andreevich Degterev

2016-12-01

Full Text Available This article shows how agent-based modeling allows us to explore the mechanisms of the dissemination of cultural norms and values both within one country and in the whole world. In recent years, this type of simulation is particularly prevalent in the analysis of international relations, becoming more popular than the system dynamics and discrete event simulation. The use of agent-based modeling in the analysis of international relations is connected with the agent-structure problem in international relations. Structure and agents act as interdependent and dynamically changing in the process of interaction between entities. Agent-structure interaction could be modeled by means of the theory of complex adaptive systems with the use of agent-based modeling techniques. One of the first examples of the use of agent-based modeling in political science is a model of racial segregation T. Shellinga. On the basis of this model, the author shows how the change in behavioral patterns at micro-level impacts on the macro-level. Patterns are changing due to the dynamics of cultural norms and values, formed by mass-media and other social institutes. The author shows the main areas of modern application of agent-based modeling in international studies including the analysis of ethnic conflicts, the formation of international coalitions. Particular attention is paid to Robert Axelrod approach based on the use of genetic algorithms to the spread of cultural norms and values. Agent-based modeling shows how to how to create such conditions that the norms that originally are not shared by a significant part of the population, eventually spread everywhere. Practical application of these algorithms is shown by the author of the article on the example of the situation in Ukraine in 2015-2016. The article also reveals the mechanisms of international spread of cultural norms and values. The main think-tanks using agent-based modeling in international studies are

Dendrimer-based Macromolecular MRI Contrast Agents: Characteristics and Application

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Hisataka Kobayashi

2003-01-01

Full Text Available Numerous macromolecular MRI contrast agents prepared employing relatively simple chemistry may be readily available that can provide sufficient enhancement for multiple applications. These agents operate using a ~100-fold lower concentration of gadolinium ions in comparison to the necessary concentration of iodine employed in CT imaging. Herein, we describe some of the general potential directions of macromolecular MRI contrast agents using our recently reported families of dendrimer-based agents as examples. Changes in molecular size altered the route of excretion. Smaller-sized contrast agents less than 60 kDa molecular weight were excreted through the kidney resulting in these agents being potentially suitable as functional renal contrast agents. Hydrophilic and larger-sized contrast agents were found better suited for use as blood pool contrast agents. Hydrophobic variants formed with polypropylenimine diaminobutane dendrimer cores created liver contrast agents. Larger hydrophilic agents are useful for lymphatic imaging. Finally, contrast agents conjugated with either monoclonal antibodies or with avidin are able to function as tumor-specific contrast agents, which also might be employed as therapeutic drugs for either gadolinium neutron capture therapy or in conjunction with radioimmunotherapy.

Biomorphic Multi-Agent Architecture for Persistent Computing

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Lodding, Kenneth N.; Brewster, Paul

2009-01-01

A multi-agent software/hardware architecture, inspired by the multicellular nature of living organisms, has been proposed as the basis of design of a robust, reliable, persistent computing system. Just as a multicellular organism can adapt to changing environmental conditions and can survive despite the failure of individual cells, a multi-agent computing system, as envisioned, could adapt to changing hardware, software, and environmental conditions. In particular, the computing system could continue to function (perhaps at a reduced but still reasonable level of performance) if one or more component( s) of the system were to fail. One of the defining characteristics of a multicellular organism is unity of purpose. In biology, the purpose is survival of the organism. The purpose of the proposed multi-agent architecture is to provide a persistent computing environment in harsh conditions in which repair is difficult or impossible. A multi-agent, organism-like computing system would be a single entity built from agents or cells. Each agent or cell would be a discrete hardware processing unit that would include a data processor with local memory, an internal clock, and a suite of communication equipment capable of both local line-of-sight communications and global broadcast communications. Some cells, denoted specialist cells, could contain such additional hardware as sensors and emitters. Each cell would be independent in the sense that there would be no global clock, no global (shared) memory, no pre-assigned cell identifiers, no pre-defined network topology, and no centralized brain or control structure. Like each cell in a living organism, each agent or cell of the computing system would contain a full description of the system encoded as genes, but in this case, the genes would be components of a software genome.

The Leeds Evaluation of Efficacy of Detoxification Study (LEEDS project: An open-label pragmatic randomised control trial comparing the efficacy of differing therapeutic agents for primary care detoxification from either street heroin or methadone [ISRCTN07752728

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Sheard Laura

2004-04-01

Full Text Available Abstract Background Heroin is a synthetic opioid with an extensive illicit market leading to large numbers of people becoming addicted. Heroin users often present to community treatment services requesting detoxification and in the UK various agents are used to control symptoms of withdrawal. Dissatisfaction with methadone detoxification 8 has lead to the use of clonidine, lofexidine, buprenorphine and dihydrocodeine; however, there remains limited evaluative research. In Leeds, a city of 700,000 people in the North of England, dihydrocodeine is the detoxification agent of choice. Sublingual buprenorphine, however, is being introduced. The comparative value of these two drugs for helping people successfully and comfortably withdraw from heroin has never been compared in a randomised trial. Additionally, there is a paucity of research evaluating interventions among drug users in the primary care setting. This study seeks to address this by randomising drug users presenting in primary care to receive either dihydrocodeine or buprenorphine. Methods/design The Leeds Evaluation of Efficacy of Detoxification Study (LEEDS project is a pragmatic randomised trial which will compare the open use of buprenorphine with dihydrocodeine for illicit opiate detoxification, in the UK primary care setting. The LEEDS project will involve consenting adults and will be run in specialist general practice surgeries throughout Leeds. The primary outcome will be the results of a urine opiate screening at the end of the detoxification regimen. Adverse effects and limited data to three and six months will be acquired.

Evolutionary autonomous agents and the nature of apraxia

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Jin Frank

2005-01-01

Full Text Available Abstract Background Evolutionary autonomous agents are robots or robot simulations whose controller is a dynamical neural network and whose evolution occurs autonomously under the guidance of a fitness function without the detailed or explicit direction of an external programmer. They are embodied agents with a simple neural network controller and as such they provide the optimal forum by which sensorimotor interactions in a specified environment can be studied without the computational assumptions inherent in standard neuroscience. Methods Evolutionary autonomous agents were evolved that were able to perform identical movements under two different contexts, one which represented an automatic movement and one which had a symbolic context. In an attempt to model the automatic-voluntary dissociation frequently seen in ideomotor apraxia, lesions were introduced into the neural network controllers resulting in a behavioral dissociation with loss of the ability to perform the movement which had a symbolic context and preservation of the simpler, automatic movement. Results Analysis of the changes in the hierarchical organization of the networks in the apractic EAAs demonstrated consistent changes in the network dynamics across all agents with loss of longer duration time scales in the network dynamics. Conclusion The concepts of determinate motor programs and perceptual representations that are implicit in the present day understanding of ideomotor apraxia are assumptions inherent in the computational understanding of brain function. The strength of the present study using EAAs to model one aspect of ideomotor apraxia is the absence of these assumptions and a grounding of all sensorimotor interactions in an embodied, autonomous agent. The consistency of the hierarchical changes in the network dynamics across all apractic agents demonstrates that this technique is tenable and will be a valuable adjunct to a computational formalism in the understanding

Drug-Induced Vasculitis: New Insights and a Changing Lineup of Suspects.

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Grau, Rafael G

2015-12-01

An increasing number of therapeutic agents have been associated with a vasculitic syndrome. This usually involves small vessels, primarily capillaries, venules, and arterioles in leukocytoclastic vasculitis, small-vessel disease similar to an antineutrophil cytoplasmic antibody-related vasculitis, or mid-sized muscular arteries in a polyarteritis-like picture. Antineutrophil cytoplasmic antibodies are present in many cases of vasculitis regardless of the size of the vessel involved. Monoclonal antibodies used to treat many autoimmune disorders have become the most common agents associated with drug-induced vasculitis. Important advances in epigenetics, genetics, and neutrophil apoptosis are providing new insights into the pathogenesis of both drug-induced vasculitis and idiopathic vasculitis. Although management has not changed significantly in the past few years where withdrawal of the offending agent is the primary intervention, increasing awareness of drug-induced vasculitis can lead to earlier diagnosis and prevention of severe organ damage and fatalities.

Urethral bulking agents versus other surgical procedures for the treatment of female stress urinary incontinence: a systematic review and meta-analysis.

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Leone Roberti Maggiore, Umberto; Bogani, Giorgio; Meschia, Michele; Sorice, Paola; Braga, Andrea; Salvatore, Stefano; Ghezzi, Fabio; Serati, Maurizio

2015-06-01

Bulking agents provide an alternative option in the management of women with stress urinary incontinence and they seem to have an important role in the management flow chart of SUI. However, evidence on this issue is scanty. The most important aspect is to understand whether bulking agents are comparable with the other first-line anti-incontinence surgical procedure (MUS, Burch colposuspension and pubovaginal slings). Hence, the primary aim of the current review was to assess the objective and subjective outcomes of bulking agents in comparison with the other surgical procedures for the treatment of SUI. PubMed and Medline were systematically searched and we included studies evaluating the use of bulking agents in comparison with other surgical approaches for either primary or recurrent treatment of female SUI. Three studies meeting the inclusion criteria were identified. Two of these studies were RCTs evaluating the use of bulking agents versus other surgical procedures for the treatment of primary female SUI; the remnant article was a retrospective cohort study that compared the effectiveness and safety of repeat midurethral sling with urethral bulking after failed midurethral sling. The combined results of all analyses showed that the objective recurrence rate of peri- or trans-urethral injections is significantly higher in comparison with the other surgical procedures. Similar findings were observed when considering separately the treatment for primary or recurrent SUI. Furthermore, lower subjective recurrence rate was observed among patients undergoing other surgical treatment in comparison with those undergoing bulking agents; however, this trend was not statistically significant. Moreover, patients undergoing injection of bulking agents experienced a lower rate of voiding dysfunctions in comparison to the control group. According to current evidence, bulking agents should not be proposed as first-line treatment in those women seeking permanent cure for both

Sensitivity Analysis of an Agent-Based Model of Culture's Consequences for Trade

NARCIS (Netherlands)

Burgers, S.L.G.E.; Jonker, C.M.; Hofstede, G.J.; Verwaart, D.

2010-01-01

This paper describes the analysis of an agent-based model’s sensitivity to changes in parameters that describe the agents’ cultural background, relational parameters, and parameters of the decision functions. As agent-based models may be very sensitive to small changes in parameter values, it is of

Coevolution of Artificial Agents Using Evolutionary Computation in Bargaining Game

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Sangwook Lee

2015-01-01

Full Text Available Analysis of bargaining game using evolutionary computation is essential issue in the field of game theory. This paper investigates the interaction and coevolutionary process among heterogeneous artificial agents using evolutionary computation (EC in the bargaining game. In particular, the game performance with regard to payoff through the interaction and coevolution of agents is studied. We present three kinds of EC based agents (EC-agent participating in the bargaining game: genetic algorithm (GA, particle swarm optimization (PSO, and differential evolution (DE. The agents’ performance with regard to changing condition is compared. From the simulation results it is found that the PSO-agent is superior to the other agents.

Evolutionary game theory using agent-based methods.

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Adami, Christoph; Schossau, Jory; Hintze, Arend

2016-12-01

Evolutionary game theory is a successful mathematical framework geared towards understanding the selective pressures that affect the evolution of the strategies of agents engaged in interactions with potential conflicts. While a mathematical treatment of the costs and benefits of decisions can predict the optimal strategy in simple settings, more realistic settings such as finite populations, non-vanishing mutations rates, stochastic decisions, communication between agents, and spatial interactions, require agent-based methods where each agent is modeled as an individual, carries its own genes that determine its decisions, and where the evolutionary outcome can only be ascertained by evolving the population of agents forward in time. While highlighting standard mathematical results, we compare those to agent-based methods that can go beyond the limitations of equations and simulate the complexity of heterogeneous populations and an ever-changing set of interactors. We conclude that agent-based methods can predict evolutionary outcomes where purely mathematical treatments cannot tread (for example in the weak selection-strong mutation limit), but that mathematics is crucial to validate the computational simulations. Copyright © 2016 Elsevier B.V. All rights reserved.

Metareasoning and Social Evaluations in Cognitive Agents

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Pinyol, Isaac; Sabater-Mir, Jordi

Reputation mechanisms have been recognized one of the key technologies when designing multi-agent systems. They are specially relevant in complex open environments, becoming a non-centralized mechanism to control interactions among agents. Cognitive agents tackling such complex societies must use reputation information not only for selecting partners to interact with, but also in metareasoning processes to change reasoning rules. This is the focus of this paper. We argue about the necessity to allow, as a cognitive systems designers, certain degree of freedom in the reasoning rules of the agents. We also describes cognitive approaches of agency that support this idea. Furthermore, taking as a base the computational reputation model Repage, and its integration in a BDI architecture, we use the previous ideas to specify metarules and processes to modify at run-time the reasoning paths of the agent. In concrete we propose a metarule to update the link between Repage and the belief base, and a metarule and a process to update an axiom incorporated in the belief logic of the agent. Regarding this last issue we also provide empirical results that show the evolution of agents that use it.

Intra-individual, randomised comparison of the MRI contrast agents gadobutrol versus gadoteridol in patients with primary and secondary brain tumours, evaluated in a blinded read

Energy Technology Data Exchange (ETDEWEB)

Koenig, M. [Klinikum Luenen St. Marien-Hospital, Department of Diagnostic and Interventional Radiology and Neuroradiology, Luenen (Germany); Schulte-Altedorneburg, G. [Staedtisches Klinikum Muenchen Harlaching, Department of Diagnostic and Interventional Radiology, Neuroradiology and Nuclear Medicine, Muenchen (Germany); Piontek, M.; Heuser, L. [Universitaetsklinikum Knappschaftskrankenhaus GmbH, Department of Diagnostic and Interventional Radiology, Neuroradiology and Nuclear Medicine, Bochum (Germany); Hentsch, A. [Radiologisches Institut Hohenzollernstrasse, Koblenz (Germany); Spangenberg, P. [Universitaetsklinikum Knappschaftskrankenhaus GmbH, Department of Neurosurgery, Bochum (Germany); Schwenke, C. [SCO:SSiS, Berlin (Germany); Harders, A. [Universitaetsklinikum Knappschaftskrankenhaus GmbH, Department of Neurosurgery Knappschaftskrankenhaus, Bochum (Germany)

2013-12-15

To prove that 1.0 M gadobutrol provides superior contrast enhancement and MRI image characteristics of primary and secondary brain tumours compared with 0.5 M gadoteridol, thereby providing superior diagnostic information. Brain MRI was performed in two separate examinations in patients scheduled for neurosurgery. Independent injections of 1.0 M gadobutrol and 0.5 M gadoteridol at doses of 0.1 mmol Gd/kg body weight were administered per patient in randomised order. Evaluation was performed in an off-site blinded read. Fifty-one patients in the full analysis set (FAS) were eligible for efficacy analysis and 44 for the per-protocol analysis. For the primary efficacy variable ''preference in contrast enhancement for one contrast agent or the other'', the rate of ''gadobutrol preferred'' was estimated at 0.73 (95 % confidence interval 0.61; 0.83), showing significant superiority of gadobutrol over gadoteridol. Calculated lesion-to-brain contrast and the results of all qualitative secondary efficacy variables were also in favour of gadobutrol. Keeping a sufficient time delay after contrast application proved to be essential to get optimal image quality. Compared with 0.5 M gadoteridol, 1.0 M gadobutrol was proven to have significantly superior contrast enhancement characteristics in a routine MRI protocol of primary and secondary brain tumours. (orig.)

Nash Equilibrium of Social-Learning Agents in a Restless Multiarmed Bandit Game.

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Nakayama, Kazuaki; Hisakado, Masato; Mori, Shintaro

2017-05-16

We study a simple model for social-learning agents in a restless multiarmed bandit (rMAB). The bandit has one good arm that changes to a bad one with a certain probability. Each agent stochastically selects one of the two methods, random search (individual learning) or copying information from other agents (social learning), using which he/she seeks the good arm. Fitness of an agent is the probability to know the good arm in the steady state of the agent system. In this model, we explicitly construct the unique Nash equilibrium state and show that the corresponding strategy for each agent is an evolutionarily stable strategy (ESS) in the sense of Thomas. It is shown that the fitness of an agent with ESS is superior to that of an asocial learner when the success probability of social learning is greater than a threshold determined from the probability of success of individual learning, the probability of change of state of the rMAB, and the number of agents. The ESS Nash equilibrium is a solution to Rogers' paradox.

Internal change agents' view of the management of change problem

NARCIS (Netherlands)

Saka, A

2003-01-01

The vital importance of change management in today's competitive climate has been widely investigated. While the need for successful change management is intensively proclaimed by "expert" consultants, the response for some time has been regarded as falling short of what is required The heavy

Advances in the use of biologic agents for the treatment of systemic vasculitis

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Chung, Sharon A.; Seo, Philip

2010-01-01

Purpose of review Due to the well-known toxicities of cyclophosphamide, substantial interest exists in finding other therapies to treat primary systemic vasculitis. Biologic agents have been proposed as an alternative to cyclophosphamide for these disorders because of their recent success in treating other rheumatic diseases. This article reviews the current state-of-the-art with regards to the use of biologic agents as a treatment for systemic vasculitis. Recent findings The greatest amount of experience with these agents for the treatment of systemic vasculitis is with anti-tumor necrosis factor agents, pooled intravenous immunoglobulin, and anti-B cell therapies such as rituximab. Intravenous immunoglobulin is already a standard therapy for Kawasaki's disease, but should also be considered for the treatment of ANCA-associated vasculitis when standard therapies are either ineffective or contraindicated. Early experience with tumor necrosis factor inhibitors indicates that they may be effective for the treatment of Takayasu's arteritis, but their role in the treatment of other forms of vasculitis remains controversial. Early experience with rituximab for the treatment of several forms of vasculitis has been quite promising, but must be confirmed by ongoing randomized clinical trials. Summary Biologic agents represent the next evolution in treatment for the primary systemic vasculitides. Greater understanding of these diseases has allowed use to move further away from non-specific, highly toxic therapies towards a more directed approach. As our experience with these agents increases, they will likely form the keystone of treatment in the near future. PMID:19077713

What makes virtual agents believable?

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Bogdanovych, Anton; Trescak, Tomas; Simoff, Simeon

2016-01-01

In this paper we investigate the concept of believability and make an attempt to isolate individual characteristics (features) that contribute to making virtual characters believable. As the result of this investigation we have produced a formalisation of believability and based on this formalisation built a computational framework focused on simulation of believable virtual agents that possess the identified features. In order to test whether the identified features are, in fact, responsible for agents being perceived as more believable, we have conducted a user study. In this study we tested user reactions towards the virtual characters that were created for a simulation of aboriginal inhabitants of a particular area of Sydney, Australia in 1770 A.D. The participants of our user study were exposed to short simulated scenes, in which virtual agents performed some behaviour in two different ways (while possessing a certain aspect of believability vs. not possessing it). The results of the study indicate that virtual agents that appear resource bounded, are aware of their environment, own interaction capabilities and their state in the world, agents that can adapt to changes in the environment and exist in correct social context are those that are being perceived as more believable. Further in the paper we discuss these and other believability features and provide a quantitative analysis of the level of contribution for each such feature to the overall perceived believability of a virtual agent.

Lack of change in glucose metabolism in eszopiclone-treated primary insomnia patients

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Buxton OM

2017-07-01

Full Text Available Orfeu M Buxton,1-4 Milena K Pavlova,1,5 Shawn P O’Connor,1 Wei Wang,1,2 John W Winkelman1,6 1Division of Sleep Medicine, Harvard Medical School, 2Department of Medicine, Brigham and Women’s Hospital, 3Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, 4Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, 5Department of Neurology, Brigham and Women’s Hospital, 6Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA Study objectives: Primary insomnia (PI may increase diabetes risk. We tested the hypothesis that the effects of PI on glucose metabolism could be improved by 2 months of pharmacological treatment.Methods: Adult men and women meeting clinical criteria for PI were studied (n=20, body mass index 25.1±2.7 kg/m2, age 39.7±7.9 in a randomized, double-blind, placebo-controlled clinical trial. The study consisted of two 1-day inpatient admissions to a General Clinical Research Center separated by 2 months of at-home treatment with 3 mg eszopiclone or placebo. During inpatient admissions, each subject underwent two intravenous glucose tolerance tests (IVGTTs pre- and post-treatment. Diet was controlled for micro- and macro-nutrient content and calories on the day prior to pre- and post-treatment IVGTTs. Subjects were randomized following completion of the initial IVGTT to take either placebo or eszopiclone 30 min prior to bedtime at home for 2 months.Results: Two-month eszopiclone treatment did not change insulin sensitivity, glucose tolerance, or any of the sleep measures significantly, compared with placebo. Changes in glycated hemoglobin (HbA1c, clinical measure of glycemic control were correlated with changes in diary-reported total sleep time in the eszopiclone group (r=0.66, p=0.0360, and in the combined groups’ data (r=0.55, p=0.0125. Changes in polysomnography-measured wake after sleep onset, a hallmark of PI, were positively related

How do small rural primary health care services sustain themselves in a constantly changing health system environment?

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Buykx Penny

2012-03-01

Full Text Available Abstract Background The ability to sustain comprehensive primary health care (PHC services in the face of change is crucial to the health of rural communities. This paper illustrates how one service has proactively managed change to remain sustainable. Methods A 6-year longitudinal evaluation of the Elmore Primary Health Service (EPHS located in rural Victoria, Australia, is currently underway, examining the performance, quality and sustainability of the service. Threats to, and enablers of, sustainability have been identified from evaluation data (audit of service indicators, community surveys, key stakeholder interviews and focus groups and our own observations. These are mapped against an overarching framework of service sustainability requirements: workforce organisation and supply; funding; governance, management and leadership; service linkages; and infrastructure. Results Four years into the evaluation, the evidence indicates EPHS has responded effectively to external and internal changes to ensure viability. The specific steps taken by the service to address risks and capitalise on opportunities are identified. Conclusions This evaluation highlights lessons for health service providers, policymakers, consumers and researchers about the importance of ongoing monitoring of sentinel service indicators; being attentive to changes that have an impact on sustainability; maintaining community involvement; and succession planning.

Studies on potassium chlorate as a primary oxidimetric reagent.

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Murty, C R; Rao, G G

1972-01-01

Conditions have been established for the use of potassium chlorate as a primary oxidizing agent in the direct titration of vanadium(III), tin(II) and titanium(III) with visual or potentiometric end-points.

Department Chairs as Change Agents: Leading Change in Resistant Environments

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Gaubatz, Julie A.; Ensminger, David C.

2017-01-01

Change process research often discusses barriers that impede organizational change (e.g., Banta, 1997; Cavacuiti and Locke, 2013; Mutchler, 1990; Stewart et al., 2012); however, no empirical research has addressed how behaviors established in leadership models counteract these barriers. This study explored these two interconnected constructs of…

An evaluation of the sonoporation potential of low-boiling point phase-change ultrasound contrast agents in vitro.

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Fix, Samantha M; Novell, Anthony; Yun, Yeoheung; Dayton, Paul A; Arena, Christopher B

2017-01-01

Phase-change ultrasound contrast agents (PCCAs) offer a solution to the inherent limitations associated with using microbubbles for sonoporation; they are characterized by prolonged circulation lifetimes, and their nanometer-scale sizes may allow for passive accumulation in solid tumors. As a first step towards the goal of extravascular cell permeabilization, we aim to characterize the sonoporation potential of a low-boiling point formulation of PCCAs in vitro. Parameters to induce acoustic droplet vaporization and subsequent microbubble cavitation were optimized in vitro using high-speed optical microscopy. Sonoporation of pancreatic cancer cells in suspension was then characterized at a range of pressures (125-600 kPa) and pulse lengths (5-50 cycles) using propidium iodide as an indicator molecule. We achieved sonoporation efficiencies ranging from 8 ± 1% to 36 ± 4% (percent of viable cells), as evidenced by flow cytometry. Increasing sonoporation efficiency trended with increasing pulse length and peak negative pressure. We conclude that PCCAs can be used to induce the sonoporation of cells in vitro, and our results warrant further investigation into the use of PCCAs as extravascular sonoporation agents in vivo.

Multi-agent agro-economic simulation of irrigation water demand with climate services for climate change adaptation

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Stefano Balbi

2013-09-01

Full Text Available Farmers’ irrigation practices play a crucial role in the sustainability of crop production and water consumption, and in the way they deal with the current and future effects of climate change. In this study, a system dynamic multi-agent model adopting the soil water balance provided by the Food and Agriculture Organization (FAO Irrigation and Drainage Paper 56 was developed to explore how farmers’ decision making may affect future water needs and use with a focus on the role of climate services, i.e. forecasts and insurance. A climatic projection record representing the down-scaled A1B market scenario (a balance across all sources of the assessment report of the Intergovernmental Panel on Climate Change (IPCC is used to produce future daily data about relative humidity, precipitation, temperature and wind speed. Two types of meteorological services are made available: i a bi-weekly bulletin; and ii seasonal forecasts. The precision of these services was altered to represent different conditions, from perfect knowledge to poor forecasts. Using the available forecasts, farming agents take adaptation decisions concerning crop allocation and irrigation management on the basis of their own risk attitudes. Farmers’ attitudes are characterized by fuzzy classifications depending on age, relative income and crop profitability. Farming agents’ adaptation decisions directly affect the crop and irrigation parameters, which in turn affect future water needs on a territorial level. By incorporating available and future meteorological services, the model allows the farmer’s decision making-process to be explored together with the consequent future irrigation water demand for the period 2015 to 2030. The model prototype is applied to a data set of the Venice Lagoon Watershed, an area of 2038 km2 in north-east Italy, for a preliminary test of its performance and to design future development objectives.

Environmental Education in Serbian Primary Schools: Challenges and Changes in Curriculum, Pedagogy, and Teacher Training

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Stanišic, Jelena; Maksic, Slavica

2014-01-01

The protection of human health and the preservation of the environment are topics that form an integral part of the primary school curriculum in Serbia. However, research studies have shown that students do not have enough knowledge to contribute to the development of a healthy lifestyle and environmental awareness. The latest changes in school…

Enzymes and other agents that enhance cell wall extensibility

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Cosgrove, D. J.

1999-01-01

Polysaccharides and proteins are secreted to the inner surface of the growing cell wall, where they assemble into a network that is mechanically strong, yet remains extensible until the cells cease growth. This review focuses on the agents that directly or indirectly enhance the extensibility properties of growing walls. The properties of expansins, endoglucanases, and xyloglucan transglycosylases are reviewed and their postulated roles in modulating wall extensibility are evaluated. A summary model for wall extension is presented, in which expansin is a primary agent of wall extension, whereas endoglucanases, xyloglucan endotransglycosylase, and other enzymes that alter wall structure act secondarily to modulate expansin action.

Responses of terrestrial ecosystems' net primary productivity to future regional climate change in China.

Science.gov (United States)

Zhao, Dongsheng; Wu, Shaohong; Yin, Yunhe

2013-01-01

The impact of regional climate change on net primary productivity (NPP) is an important aspect in the study of ecosystems' response to global climate change. China's ecosystems are very sensitive to climate change owing to the influence of the East Asian monsoon. The Lund-Potsdam-Jena Dynamic Global Vegetation Model for China (LPJ-CN), a global dynamical vegetation model developed for China's terrestrial ecosystems, was applied in this study to simulate the NPP changes affected by future climate change. As the LPJ-CN model is based on natural vegetation, the simulation in this study did not consider the influence of anthropogenic activities. Results suggest that future climate change would have adverse effects on natural ecosystems, with NPP tending to decrease in eastern China, particularly in the temperate and warm temperate regions. NPP would increase in western China, with a concentration in the Tibetan Plateau and the northwest arid regions. The increasing trend in NPP in western China and the decreasing trend in eastern China would be further enhanced by the warming climate. The spatial distribution of NPP, which declines from the southeast coast to the northwest inland, would have minimal variation under scenarios of climate change.

Responses of terrestrial ecosystems' net primary productivity to future regional climate change in China.

Directory of Open Access Journals (Sweden)

Dongsheng Zhao

Full Text Available The impact of regional climate change on net primary productivity (NPP is an important aspect in the study of ecosystems' response to global climate change. China's ecosystems are very sensitive to climate change owing to the influence of the East Asian monsoon. The Lund-Potsdam-Jena Dynamic Global Vegetation Model for China (LPJ-CN, a global dynamical vegetation model developed for China's terrestrial ecosystems, was applied in this study to simulate the NPP changes affected by future climate change. As the LPJ-CN model is based on natural vegetation, the simulation in this study did not consider the influence of anthropogenic activities. Results suggest that future climate change would have adverse effects on natural ecosystems, with NPP tending to decrease in eastern China, particularly in the temperate and warm temperate regions. NPP would increase in western China, with a concentration in the Tibetan Plateau and the northwest arid regions. The increasing trend in NPP in western China and the decreasing trend in eastern China would be further enhanced by the warming climate. The spatial distribution of NPP, which declines from the southeast coast to the northwest inland, would have minimal variation under scenarios of climate change.

Investigating the influence of social exclusion on persuasion by a virtual agent

NARCIS (Netherlands)

Ruijten, P.A.M.; Ham, J.R.C.; Midden, C.J.H.; Spagnolli, A.; Chittaro, L.; Gamberini, L.

2014-01-01

Persuasive agents may function as a tool to induce changes in human behavior. Research has shown that human-likeness of such agents influences their effectiveness. Besides characteristics of the agent, other characteristics may also have strong influences on persuasive agents’ effectiveness. One

Why Do Extension Agents Resign?

Science.gov (United States)

Manton, Linda Nunes; van Es, J. C.

1985-01-01

Past and current Illinois extension agents were surveyed via mail questionnaires as to reasons for staying or leaving extension programs. Reasons for leaving included family changes, family moves, opportunity to advance, better salary/benefits, dissatisfaction with administration, and too much time away from family. (CT)

Effects of contrast agents on the fallopian tube in a rabbit model

International Nuclear Information System (INIS)

Moore, D.E.

1989-01-01

Selection of the optimal contrast agent for hysterosalpingography was the focus of this study. The authors have evaluated the effect of different iodinated contrast agents on the fallopian tube of a rabbit. Ethiodol (oil-soluble contrast agent), methylglucamine iothalomate (water-soluble ionic agent) 30% and 60%, and Ioxilan (water-soluble monionic contrast agent) were compared. The agents were introduced by fallopian tube catheterization. Findings suggested that nonionic water-soluble contrast agents were the least detrimental to the fallopian tube and surrounding tissue. Iothalomate 60% resulted in mild inflammatory changes. Oil-soluble contrast agents caused granulomatous reaction and fibrinous adhesions

Start-up and incremental practice expenses for behavior change interventions in primary care.

Science.gov (United States)

Dodoo, Martey S; Krist, Alex H; Cifuentes, Maribel; Green, Larry A

2008-11-01

If behavior-change services are to be offered routinely in primary care practices, providers must be appropriately compensated. Estimating what is spent by practices in providing such services is a critical component of establishing appropriate payment and was the objective of this study. In-practice expenditure data were collected for ten different interventions, using a standardized instrument in 29 practices nested in ten practice-based research networks across the U.S. during 2006-2007. The data were analyzed using standard templates to create credible estimates of the expenses incurred for both the start-up period and the implementation phase of the interventions. Average monthly start-up expenses were $1860 per practice (SE=$455). Most start-up expenditures were for staff training. Average monthly incremental costs were $58 ($15 for provision of direct care [SE=$5]; $43 in overhead [SE=$17]) per patient participant. The bulk of the intervention expenditures was spent on the recruitment and screening of patient participants. Primary care practices must spend money to address their patients' unhealthy behaviors--at least $1860 to initiate systematic approaches and $58 monthly per participating patient to implement the approaches routinely. Until primary care payment systems incorporate these expenses, it is unlikely that these services will be readily available.

Putative neuroprotective agents in neuropsychiatric disorders.

Science.gov (United States)

Dodd, Seetal; Maes, Michael; Anderson, George; Dean, Olivia M; Moylan, Steven; Berk, Michael

2013-04-05

In many individuals with major neuropsychiatric disorders including depression, bipolar disorder and schizophrenia, their disease characteristics are consistent with a neuroprogressive illness. This includes progressive structural brain changes, cognitive and functional decline, poorer treatment response and an increasing vulnerability to relapse with chronicity. The underlying molecular mechanisms of neuroprogression are thought to include neurotrophins and regulation of neurogenesis and apoptosis, neurotransmitters, inflammatory, oxidative and nitrosative stress, mitochondrial dysfunction, cortisol and the hypothalamic-pituitary-adrenal axis, and epigenetic influences. Knowledge of the involvement of each of these pathways implies that specific agents that act on some or multiple of these pathways may thus block this cascade and have neuroprotective properties. This paper reviews the potential of the most promising of these agents, including lithium and other known psychotropics, aspirin, minocycline, statins, N-acetylcysteine, leptin and melatonin. These agents are putative neuroprotective agents for schizophrenia and mood disorders. Copyright © 2012 Elsevier Inc. All rights reserved.

Contrast-enhanced ultrasound imaging and in vivo circulatory kinetics with low-boiling-point nanoscale phase-change perfluorocarbon agents.

Science.gov (United States)

Sheeran, Paul S; Rojas, Juan D; Puett, Connor; Hjelmquist, Jordan; Arena, Christopher B; Dayton, Paul A

2015-03-01

Many studies have explored phase-change contrast agents (PCCAs) that can be vaporized by an ultrasonic pulse to form microbubbles for ultrasound imaging and therapy. However, few investigations have been published on the utility and characteristics of PCCAs as contrast agents in vivo. In this study, we examine the properties of low-boiling-point nanoscale PCCAs evaluated in vivo and compare data with those for conventional microbubbles with respect to contrast generation and circulation properties. To do this, we develop a custom pulse sequence to vaporize and image PCCAs using the Verasonics research platform and a clinical array transducer. Results indicate that droplets can produce contrast enhancement similar to that of microbubbles (7.29 to 18.24 dB over baseline, depending on formulation) and can be designed to circulate for as much as 3.3 times longer than microbubbles. This study also reports for the first time the ability to capture contrast washout kinetics of the target organ as a measure of vascular perfusion. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Emergency managers as change agents: recognizing the value of management, leadership, and strategic management in the disaster profession.

Science.gov (United States)

Urby, Heriberto; McEntire, David A

2015-01-01

This article discusses the influence of management theory, some principles of leadership, four strategic management considerations, that are applied to emergency management, allow emergency managers to transform their followers, organizations, and communities at large. The authors argue that in the past there has been little recognition of the value, or application, of these three areas of emphasis in the disaster profession. Using more of these principles, emergency managers may transform into transformational change agents who make a difference in their followers' lives, who themselves transform other people and improve emergency management.

Hybrid POMDP-BDI Agent Architecture with Online Stochastic Planning and Desires with Changing Intensity Levels

CSIR Research Space (South Africa)

Rens, GB

2015-01-01

Full Text Available The authors propose an agent architecture which combines Partially observable Markov decision processes (POMDPs) and the belief-desire-intention (BDI) framework have several complementary strengths. The authors propose an agent architecture, which...

[Near infrared reflectance spectroscopy (NIRS): a novel approach to reconstructing historical changes of primary productivity in Antarctic lake].

Science.gov (United States)

Chen, Qian-Qian; Liu, Xiao-Dong; Liu, Wen-Qi; Jiang, Shan

2011-10-01

Compared with traditional chemical analysis methods, reflectance spectroscopy has the advantages of speed, minimal or no sample preparation, non-destruction, and low cost. In order to explore the potential application of spectroscopy technology in the paleolimnological study on Antarctic lakes, we took a lake sediment core in Mochou Lake at Zhongshan Station of Antarctic, and analyzed the near infrared reflectance spectroscopy (NIRS) data in the sedimentary samples. The results showed that the factor loadings of principal component analysis (PCA) displayed very similar depth-profile change pattern with the S2 index, a reliable proxy for the change in historical lake primary productivity. The correlation analysis showed that the values of PCA factor loading and S2 were correlated significantly, suggesting that it is feasible to infer paleoproductivity changes recorded in Antarctic lakes using NIRS technology. Compared to the traditional method of the trough area between 650 and 700 nm, the authors found that the PCA statistical approach was more accurate for reconstructing the change in historical lake primary productivity. The results reported here demonstrate that reflectance spectroscopy can provide a rapid method for the reconstruction of lake palaeoenviro nmental change in the remote Antarctic regions.

SHIFTING THE FUTURE? TEACHERS AS AGENTS OF SOCIAL CHANGE IN SOUTH AFRICAN SECONDARY SCHOOLS

Directory of Open Access Journals (Sweden)

Christina Lane Cappy

2016-12-01

Full Text Available South Africa has risen to the forefront of educational debates that claim schooling can promote social justice and social cohesion. By drawing on Freire’s (1970 theory of critical pedagogy, this paper examines how South African teachers in rural and township schools encourage students to reflect critically upon their own lives and take action to improve issues of inequality, violence, and insecurity. It argues that teachers understand their roles as agents of social change primarily as encouraging respect, morality, and racial reconciliation among learners. The ways in which the youth take up the teachers’ efforts to promote change depends upon how the teachers’ practices speak to the students’ own life circumstances. When the youth relate to the teachers’ life stories and course material, they engage in the process of moral translation. In other words, the youth rework their lessons into ideas of how they should behave as moral human beings. Yet, frequently young South Africans do not learn a morality based on a Freirean notion of social justice – a seemingly central component to the national curriculum – but instead a morality based on individualised notions of personal responsibility and hope for a better future. The paper concludes with several suggestions to improve educational practices for social justice.

The role of antiseptic agents in atopic dermatitis.

Science.gov (United States)

Lee, Melissa; Van Bever, Hugo

2014-10-01

The skin of individuals with atopic dermatitis has a susceptibility to be colonized with Staphylococcus aureus. This has been associated with increased frequency and severity of exacerbations of atopic dermatitis. Therefore, there is a growing interest in the use of antiseptic agents to target primary bacterial colonization and infection. Antiseptic agents have been found to be better tolerated and less likely to induce bacterial resistance as compared to antibiotics. There is also a wide variety of antiseptic agents available. The efficacy of antiseptic agents has yet to be established as the studies reviewed previously have been small and of suboptimal quality. This review discusses the rationale behind targeting S. aureus with antiseptic agents and presents findings from a review of studies assessing the efficacy of antiseptics in atopic dermatitis in the last five years. Four studies were found, including a bleach bath study which has already been reviewed elsewhere. The remaining 3 studies assessed the efficacy of sodium hypochlorite containing cleansing body wash, sodium hypochlorite baths and 1% triclosan in leave on emollient. These studies suggested some benefit for the inclusion of antiseptic use with the mainstay management of atopic dermatitis, including a potential steroid sparring effect. However, there are many limitations to these studies which therefore warrant further investigation on the impact of antiseptic use in atopic dermatitis.

MULTI AGENT-BASED ENVIRONMENTAL LANDSCAPE (MABEL) - AN ARTIFICIAL INTELLIGENCE SIMULATION MODEL: SOME EARLY ASSESSMENTS

OpenAIRE

Alexandridis, Konstantinos T.; Pijanowski, Bryan C.

2002-01-01

The Multi Agent-Based Environmental Landscape model (MABEL) introduces a Distributed Artificial Intelligence (DAI) systemic methodology, to simulate land use and transformation changes over time and space. Computational agents represent abstract relations among geographic, environmental, human and socio-economic variables, with respect to land transformation pattern changes. A multi-agent environment is developed providing task-nonspecific problem-solving abilities, flexibility on achieving g...

A Multi-Agent Traffic Control Model Based on Distributed System

Directory of Open Access Journals (Sweden)

Qian WU

2014-06-01

Full Text Available With the development of urbanization construction, urban travel has become a quite thorny and imminent problem. Some previous researches on the large urban traffic systems easily change into NPC problems. We purpose a multi-agent inductive control model based on the distributed approach. To describe the real traffic scene, this model designs four different types of intelligent agents, i.e. we regard each lane, route, intersection and traffic region as different types of intelligent agents. Each agent can achieve the real-time traffic data from its neighbor agents, and decision-making agents establish real-time traffic signal plans through the communication between local agents and their neighbor agents. To evaluate the traffic system, this paper takes the average delay, the stopped time and the average speed as performance parameters. Finally, the distributed multi-agent is simulated on the VISSIM simulation platform, the simulation results show that the multi-agent system is more effective than the adaptive control system in solving the traffic congestion.

Effects of precipitation changes on aboveground net primary production and soil respiration in a switchgrass field

Science.gov (United States)

This study attempted to test whether switchgrass aboveground net primary production (ANPP) responds to precipitation (PPT) changes in a double asymmetry pattern as framed by Knapp et al. (2016), and whether it is held true for other ecosystem processes such as soil respiration (SR). Data were colle...

The influence of bone graft procedures on primary stability and bone change of implants placed in fresh extraction sockets.

Science.gov (United States)

Jun, Sang Ho; Park, Chang-Joo; Hwang, Suk-Hyun; Lee, Youn Ki; Zhou, Cong; Jang, Hyon-Seok; Ryu, Jae-Jun

2018-12-01

This study was to evaluate the effect of bone graft procedure on the primary stability of implants installed in fresh sockets and assess the vertical alteration of peri-implant bone radiographically. Twenty-three implants were inserted in 18 patients immediately after tooth extraction. The horizontal gap between the implant and bony walls of the extraction socket was grafted with xenografts. The implant stability before and after graft procedure was measured by Osstell Mentor as implant stability quotient before bone graft (ISQ bbg) and implant stability quotient after bone graft (ISQ abg). Peri-apical radiographs were taken to measure peri-implant bone change immediately after implant surgery and 12 months after implant placement. Data were analyzed by independent t test; the relationships between stability parameters (insertion torque value (ITV), ISQ abg, and ISQ bbg) and peri-implant bone changes were analyzed according to Pearson correlation coefficients. The increase of ISQ in low primary stability group (LPSG) was 6.87 ± 3.62, which was significantly higher than the increase in high primary stability group (HPSG). A significant correlation between ITV and ISQ bbg ( R  = 0.606, P  = 0.002) was found; however, age and peri-implant bone change were not found significantly related to implant stability parameters. It was presented that there were no significant peri-implant bone changes at 1 year after bone graft surgery. Bone graft procedure is beneficial for increasing the primary stability of immediately placed implants, especially when the ISQ of implants is below 65 and that bone grafts have some effects on peri-implant bone maintenance.

A Potential Adjuvant Agent of Chemotherapy: Sepia Ink Polysaccharides

Directory of Open Access Journals (Sweden)

Fangping Li

2018-03-01

Full Text Available Sepia ink polysaccharide (SIP isolated from squid and cuttlefish ink is a kind of acid mucopolysaccharide that has been identified in three types of primary structures from squid (Illex argentinus and Ommastrephes bartrami, cuttlefish Sepiella maindroni, and cuttlefish Sepia esculenta ink. Although SIP has been proved to be multifaceted, most of the reported evidence has illuminated its chemopreventive and antineoplastic activities. As a natural product playing a role in cancer treatment, SIP may be used as chemotherapeutic ancillary agent or functional food. Based on the current findings on SIP, we have summarized four topics in this review, including: chemopreventive, antineoplastic, chemosensitive, and procoagulant and anticoagulant activities, which are correlative closely with the actions of anticancer agents on cancer patients, such as anticancer, toxicity and thrombogenesis, with the latter two actions being common causes of death in cancer cases exposed to chemotherapeutic agents.

Agent Programming Languages and Logics in Agent-Based Simulation

DEFF Research Database (Denmark)

Larsen, John

2018-01-01

and social behavior, and work on verification. Agent-based simulation is an approach for simulation that also uses the notion of agents. Although agent programming languages and logics are much less used in agent-based simulation, there are successful examples with agents designed according to the BDI...

Impact of iso-osmolar versus low-osmolar contrast agents on contrast-induced nephropathy and tissue reperfusion in unselected patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention (from the Contrast Media and Nephrotoxicity Following Primary Angioplasty for Acute Myocardial Infarction [CONTRAST-AMI] Trial).

Science.gov (United States)

Bolognese, Leonardo; Falsini, Giovanni; Schwenke, Carsten; Grotti, Simone; Limbruno, Ugo; Liistro, Francesco; Carrera, Arcangelo; Angioli, Paolo; Picchi, Andrea; Ducci, Kenneth; Pierli, Carlo

2012-01-01

Conflicting data have been reported on the effects of low-osmolar and iso-osmolar contrast media on contrast-induced acute kidney injury (CI-AKI). In particular, no clinical trial has yet focused on the effect of contemporary contrast media on CI-AKI, epicardial flow, and microcirculatory function in patients with ST-segment elevation acute myocardial infarction who undergo primary percutaneous coronary intervention. The Contrast Media and Nephrotoxicity Following Coronary Revascularization by Angioplasty for Acute Myocardial Infarction (CONTRAST-AMI) trial is a prospective, randomized, single-blind, parallel-group, noninferiority study aiming to evaluate the effects of the low-osmolar contrast medium iopromide compared to the iso-osmolar agent iodixanol on CI-AKI and tissue-level perfusion in patients with ST-segment elevation acute myocardial infarction. Four hundred seventy-five consecutive, unselected patients who underwent primary percutaneous coronary intervention were randomized to iopromide (n = 239) or iodixanol (n = 236). All patients received high-dose N-acetylcysteine and hydration. The primary end point was the proportion of patients with serum creatinine (sCr) increases ≥25% from baseline to 72 hours. Secondary end points were Thrombolysis In Myocardial Infarction (TIMI) myocardial perfusion grade, increase in sCr ≥50%, increase in sCr ≥0.5 or ≥1 mg/dl, and 1-month major adverse cardiac events. The primary end point occurred in 10% of the iopromide group and in 13% of the iodixanol group (95% confidence interval -9% to 3%, p for noninferiority = 0.0002). A TIMI myocardial perfusion grade of 0 or 1 was present in 14% of patients in the 2 groups. No differences between the 2 groups were found in any of the secondary analyses of sCr increase. No significant difference in 1-month major adverse cardiac events was found (8% vs 6%, p = 0.37). In conclusion, in a population of unselected patients with ST-segment elevation acute myocardial infarction

Productive vegetation: relationships between net primary productivity, vegetation types and climate change in the Wet Tropics bioregion

International Nuclear Information System (INIS)

Ramirez, Vanessa Valdez; Williams, Stephen E.; VanDerWal, Jeremy

2007-01-01

Full text: Full text: There is now ample evidence demonstrating the impacts of climate change on biodiversity and human society (Walther ef a/. 2002). Numerous studies have shown climate change is one of the most significant threats to tropical forests, such as the Wet Tropics Heritage Area, due to their high biodiversity and endemism (Pounds ef al. 1999; Hughes 2000; Parmesan and Yohe 2003). Williams ef al. (2003) suggested that small shifts in net primary productivity (NPP) as a result of climate change could lead to potentially massive follow-on effects for the extremely diverse and vulnerable rainforest flora and fauna. It is therefore crucial to explore the relationships between NPP and local biodiversity, especially to create models for different climate change scenarios. Nevertheless, NPP in the Wet Tropics has yet to be estimated. This is the first study to provide a general NPP estimate for the Wet Tropics bioregion using climate surrogates (Schuur 2003). This technique estimates NPP in an accurate, repeatable, and cost-effective way. NPP values were linked to vegetation types and examined under various climatic and environmental conditions. Results show a significant difference in productivity according to vegetation types and climatic variables, with temperature and rainfall seasonality as the most important determining variables. Additionally, lowland and upland vegetations showed a significant difference in productivity patterns throughout the year. Vegetation types located above 1000 metres in altitude had the lowest values of mean annual productivity due to their high rainfall and low temperatures; vegetation types located below 600 metres showed increased productivity values during the wet season (December-March). Net primary productivity will certainly be impacted by changes in temperature and rainfall, due to climate change. Although an increase in NPP values can be predicted for upland areas, the more widely distributed lowlands will drastically

Cisplatin impairs rat liver mitochondrial functions by inducing changes on membrane ion permeability: Prevention by thiol group protecting agents

International Nuclear Information System (INIS)

Custodio, Jose B.A.; Cardoso, Carla M.P.; Santos, Maria S.; Almeida, Leonor M.; Vicente, Joaquim A.F.; Fernandes, Maria A.S.

2009-01-01

Cisplatin (CisPt) is the most important platinum anticancer drug widely used in the treatment of head, neck, ovarian and testicular cancers. However, the mechanisms by which CisPt induces cytotoxicity, namely hepatotoxicity, are not completely understood. The goal of this study was to investigate the influence of CisPt on rat liver mitochondrial functions (Ca 2+ -induced mitochondrial permeability transition (MPT), mitochondrial bioenergetics, and mitochondrial oxidative stress) to better understand the mechanism underlying its hepatotoxicity. The effect of thiol group protecting agents and some antioxidants against CisPt-induced mitochondrial damage was also investigated. Treatment of rat liver mitochondria with CisPt (20 nmol/mg protein) induced Ca 2+ -dependent mitochondrial swelling, depolarization of membrane potential (ΔΨ), Ca 2+ release, and NAD(P)H fluorescence intensity decay. These effects were prevented by cyclosporine A (CyA), a potent and specific inhibitor of the MPT. In the concentration range of up to 40 nmol/mg protein, CisPt slightly inhibited state 3 and stimulated state 2 and state 4 respiration rates using succinate as respiratory substrate. The respiratory indexes, respiratory control ratio (RCR) and ADP/O ratios, the ΔΨ, and the ADP phosphorylation rate were also depressed. CisPt induced mitochondrial inner membrane permeabilization to protons (proton leak) but did not induce significant changes on mitochondrial H 2 O 2 generation. All the effects induced by CisPt on rat liver mitochondria were prevented by thiol group protecting agents namely, glutathione (GSH), dithiothreitol (DTT), N-acetyl-L-cysteine (NAC) and cysteine (CYS), whereas superoxide-dismutase (SOD), catalase (CAT) and ascorbate (ASC) were without effect. In conclusion, the anticancer drug CisPt: (1) increases the sensitivity of mitochondria to Ca 2+ -induced MPT; (2) interferes with mitochondrial bioenergetics by increasing mitochondrial inner membrane permeabilization to

Agents unleashed a public domain look at agent technology

CERN Document Server

Wayner, Peter

1995-01-01

Agents Unleashed: A Public Domain Look at Agent Technology covers details of building a secure agent realm. The book discusses the technology for creating seamlessly integrated networks that allow programs to move from machine to machine without leaving a trail of havoc; as well as the technical details of how an agent will move through the network, prove its identity, and execute its code without endangering the host. The text also describes the organization of the host's work processing an agent; error messages, bad agent expulsion, and errors in XLISP-agents; and the simulators of errors, f

How Sensitive is the Demand for Primary Education to Changes in Economic Factors

DEFF Research Database (Denmark)

Nielsen, Helena Skyt

2001-01-01

During the recession in the seventies and the eighties in LDCs in general and in Zambia in specific, private costs of schooling have increased and school quality has deteriorated. Combined with poverty, these changes may have damaged the demand for primary education. This observation motivates a ...... in school are reflected in household income, educational expenses and quality indicators, and the results show that they all affect school enrollment as would be expected, even though the magnitudes of the effects are relatively moderate. Udgivelsesdato: JUL...

Secondary Science Teachers' and Students' Involvement in a Primary School Community of Science Practice: How It Changed Their Practices and Interest in Science

Science.gov (United States)

Forbes, Anne; Skamp, Keith

2016-02-01

MyScience is a primary science education initiative in which being in a community of practice is integral to the learning process. In this initiative, stakeholder groups—primary teachers, primary students and mentors—interact around the `domain' of `investigating scientifically'. This paper builds on three earlier publications and interprets the findings of the views of four secondary science teachers and five year 9 secondary science students who were first-timer participants—as mentors—in MyScience. Perceptions of these mentors' interactions with primary students were analysed using attributes associated with both `communities of practice' and the `nature of science'. Findings reveal that participation in MyScience changed secondary science teachers' views and practices about how to approach the teaching of science in secondary school and fostered primary-secondary links. Year 9 students positively changed their views about secondary school science and confidence in science through participation as mentors. Implications for secondary science teaching and learning through participation in primary school community of science practice settings are discussed.

The economics of optimal adaptation to climate change

Energy Technology Data Exchange (ETDEWEB)

Callaway, J.M.; Ringius, L.

2002-07-01

This paper has set out to provide a consistent theoretical framework for understanding how consumers, producers and factor agents respond to the impacts of climate change, with a primary focus on the production and consumption of, and investment in, market goods and services under competitive conditions. However, we have also pointed out that this theory can be extended to economies where individuals and groups pursue other well-defined objectives, and we have provided some examples that show the consistency in adaptation behaviour between economic terms and those who maximise the objective of household nutrition. We have defined adaptation as the changes that economic agents make in the allocation of resources to consumption, production and investment to offset the effects of weather variability or climate change on their welfare. This definition is broad enough to encompass almost every conceivable kind of adaptation behaviour. Further, we have followed the distinction between adaptation that is autonomous and adaptation actions that are undertaken by governments in the form of adaptation strategies. Autonomous adaptation is adaptation that economic agents will undertake to change, without the assistance of government, to improve their welfare due to incentives that are built into the political economy of a country. Adaptation strategies involve conscious decisions by governments to undertake actions and implement projects to avoid (or benefit from) weather variability and climate change. We show how the extent to which economic activities are adapted to existing climate variability will affect how much autonomous adaptation will need to occur once the pure effect of climate change is taken into account. In this paper we argue that the ability of economic activities to adapt once the pure effect of climate change can be accounted for by the following factors: Presence of well-developed markets for inputs and outputs; Ability and competitiveness to produce

An agent-based intelligent environmental monitoring system

OpenAIRE

Athanasiadis, Ioannis N; Mitkas, Pericles A

2004-01-01

Fairly rapid environmental changes call for continuous surveillance and on-line decision making. There are two main areas where IT technologies can be valuable. In this paper we present a multi-agent system for monitoring and assessing air-quality attributes, which uses data coming from a meteorological station. A community of software agents is assigned to monitor and validate measurements coming from several sensors, to assess air-quality, and, finally, to fire alarms to appropriate recipie...

Regional homogeneity changes in patients with primary insomnia

Energy Technology Data Exchange (ETDEWEB)

Wang, Tianyue [Guangdong No. 2 Provincial People' s Hospital of Southern Medical University, The Third Clinical Medical College of Southern Medical University, Guangzhou (China); Li, Shumei; Jiang, Guihua; Lin, Chulan; Li, Meng; Ma, Xiaofen; Zhan, Wenfeng; Fang, Jin; Li, Liming; Li, Cheng; Tian, Junzhang [Guangdong No. 2 Provincial People' s Hospital of Southern Medical University, Guangzhou (China)

2016-05-15

The study aimed to explore the regional spontaneous activity changes in primary insomnia (PI) patients. Based on the resting-state fMRI datasets acquired from 59 PI patients and 47 healthy controls, a two-sample t-test was performed on individual normalized regional homogeneity (ReHo) maps. Relationships between abnormal ReHo values and the Pittsburgh Sleep Quality Index (PSQI), the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS) were investigated with Pearson correlation analysis. In PI patients, we found increased ReHo in the left insula, right anterior cingulate gyrus, bilateral precentral gyrus and left cuneus, as well as decreased ReHo in the right middle cingulate cortex and left fusiform (p < 0.05, AlphaSim-corrected). We also found a significant positive correlation between increased ReHo in the left insula and SAS scores, decreased ReHo in the right middle cingulated cortex and SDS, SAS scores as well as a negative correlation between increased ReHo in the right precentral gyrus and SDS scores (p < 0.05). Our study found abnormal spontaneous activities in multiple brain regions, especially in emotion-related areas in PI patients. Alterative activities in these regions might contribute to an understanding the intrinsic functional architecture of insomnia and its clinical features. (orig.)

Regional homogeneity changes in patients with primary insomnia

International Nuclear Information System (INIS)

Wang, Tianyue; Li, Shumei; Jiang, Guihua; Lin, Chulan; Li, Meng; Ma, Xiaofen; Zhan, Wenfeng; Fang, Jin; Li, Liming; Li, Cheng; Tian, Junzhang

2016-01-01

The study aimed to explore the regional spontaneous activity changes in primary insomnia (PI) patients. Based on the resting-state fMRI datasets acquired from 59 PI patients and 47 healthy controls, a two-sample t-test was performed on individual normalized regional homogeneity (ReHo) maps. Relationships between abnormal ReHo values and the Pittsburgh Sleep Quality Index (PSQI), the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS) were investigated with Pearson correlation analysis. In PI patients, we found increased ReHo in the left insula, right anterior cingulate gyrus, bilateral precentral gyrus and left cuneus, as well as decreased ReHo in the right middle cingulate cortex and left fusiform (p < 0.05, AlphaSim-corrected). We also found a significant positive correlation between increased ReHo in the left insula and SAS scores, decreased ReHo in the right middle cingulated cortex and SDS, SAS scores as well as a negative correlation between increased ReHo in the right precentral gyrus and SDS scores (p < 0.05). Our study found abnormal spontaneous activities in multiple brain regions, especially in emotion-related areas in PI patients. Alterative activities in these regions might contribute to an understanding the intrinsic functional architecture of insomnia and its clinical features. (orig.)

Primary Meningococcal Polyarthritis in an Adult Woman

Directory of Open Access Journals (Sweden)

José Celso Giordan Cavalcanti Sarinho

2015-01-01

Full Text Available Primary joint infection caused by the Gram-negative bacteria Neisseria meningitidis is rare. Normally, joint involvement comes secondary to meningitis or severe sepsis caused by this agent. When primary arthritis is seen, monoarthritis is the most common presentation. A meningococcal polyarthritis is described in less than 10 case reports according to current literature. This case report aims to briefly review this rare clinical event in an adult woman with no previous history of rheumatological disease. Early diagnosis of polyarthritis caused by meningococcal bacteria usually present a good prognosis when properly treated.

Mobile Agent Data Integrity Using Multi-Agent Architecture

National Research Council Canada - National Science Library

McDonald, Jeffrey

2004-01-01

.... Security issues for mobile agents continue to produce research interest, particularly in developing mechanisms that guarantee protection of agent data and agent computations in the presence of malicious hosts...

Responses of Terrestrial Ecosystems’ Net Primary Productivity to Future Regional Climate Change in China

Science.gov (United States)

Zhao, Dongsheng; Wu, Shaohong; Yin, Yunhe

2013-01-01

The impact of regional climate change on net primary productivity (NPP) is an important aspect in the study of ecosystems’ response to global climate change. China’s ecosystems are very sensitive to climate change owing to the influence of the East Asian monsoon. The Lund–Potsdam–Jena Dynamic Global Vegetation Model for China (LPJ-CN), a global dynamical vegetation model developed for China’s terrestrial ecosystems, was applied in this study to simulate the NPP changes affected by future climate change. As the LPJ-CN model is based on natural vegetation, the simulation in this study did not consider the influence of anthropogenic activities. Results suggest that future climate change would have adverse effects on natural ecosystems, with NPP tending to decrease in eastern China, particularly in the temperate and warm temperate regions. NPP would increase in western China, with a concentration in the Tibetan Plateau and the northwest arid regions. The increasing trend in NPP in western China and the decreasing trend in eastern China would be further enhanced by the warming climate. The spatial distribution of NPP, which declines from the southeast coast to the northwest inland, would have minimal variation under scenarios of climate change. PMID:23593325

Longitudinal Changes of Angle Configuration in Primary Angle-Closure Suspects

Science.gov (United States)

Jiang, Yuzhen; Chang, Dolly S.; Zhu, Haogang; Khawaja, Anthony P.; Aung, Tin; Huang, Shengsong; Chen, Qianyun; Munoz, Beatriz; Grossi, Carlota M.

2015-01-01

Objective To determine longitudinal changes in angle configuration in the eyes of primary angle-closure suspects (PACS) treated by laser peripheral iridotomy (LPI) and in untreated fellow eyes. Design Longitudinal cohort study. Participants Primary angle-closure suspects aged 50 to 70 years were enrolled in a randomized, controlled clinical trial. Methods Each participant was treated by LPI in 1 randomly selected eye, with the fellow eye serving as a control. Angle width was assessed in a masked fashion using gonioscopy and anterior segment optical coherence tomography (AS-OCT) before and at 2 weeks, 6 months, and 18 months after LPI. Main Outcome Measures Angle width in degrees was calculated from Shaffer grades assessed under static gonioscopy. Angle configuration was also evaluated using angle opening distance (AOD250, AOD500, AOD750), trabecular-iris space area (TISA500, TISA750), and angle recess area (ARA) measured in AS-OCT images. Results No significant difference was found in baseline measures of angle configuration between treated and untreated eyes. At 2 weeks after LPI, the drainage angle on gonioscopy widened from a mean of 13.5° at baseline to a mean of 25.7° in treated eyes, which was also confirmed by significant increases in all AS-OCT angle width measures (Pgonioscopy (P = 0.18), AOD250 (P = 0.167) and ARA (P = 0.83). In untreated eyes, angle width consistently decreased across all follow-up visits after LPI, with a more rapid longitudinal decrease compared with treated eyes (P values for all variables ≤0.003). The annual rate of change in angle width was equivalent to 1.2°/year (95% confidence interval [CI], 0.8–1.6) in treated eyes and 1.6°/year (95% CI, 1.3–2.0) in untreated eyes (P<0.001). Conclusions Angle width of treated eyes increased markedly after LPI, remained stable for 6 months, and then decreased significantly by 18 months after LPI. Untreated eyes experienced a more consistent and rapid decrease in angle width over the

Sulfur polymer cement, a solidification and stabilization agent for hazardous and radioactive wastes

International Nuclear Information System (INIS)

Darnell, G.R.

1992-01-01

Hydraulic cements have been the primary radioactive waste stabilization agents in the United States for 50 years. Twelve years ago, Brookhaven National Laboratory was funded by the Department of Energy's Defense Low-Level Waste Management Program to test and develop sulfur polymer cement (SPC). It has stabilized routine wastes as well as some troublesome wastes with high waste-to-agent ratios. The Department of Energy's Hazardous Waste Remedial Action Program joined the effort by providing funding for testing and developing sulfur polymer cement as a hazardous-waste stabilization agent. Sulfur polymer cement has passed all the laboratory scale tests required by the US Environmental Protection Agency and US Nuclear Regulatory Commission. Two decades of tests by the US Bureau of Mines and private concrete contractors indicate this agent is likely to exceed other agents in longevity. This bulletin provides technical data from pertinent tests conducted by these various entities

Development of Virtual Traveller: A behaviour change intervention to increase physical activity during primary school lessons

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Emma Norris

2015-09-01

Three sources of data were used to inform the intervention development process: the existing research literature on school-based physical activity interventions, teacher interviews (N=12 and pupil focus groups (N=18 and an experimental feasibility study (N=85; Norris, Shelton, Dunsmuir, Duke-Williams, & Stamatakis, 2015b. The Behaviour Change Wheel was used as a framework to guide synthesis of evidence into the resulting intervention. Potential appropriate Behaviour Change Techniques were reviewed and embedded within the intervention. Conclusions The resulting 6-week Virtual Traveller programme with a 3-month follow-up period is currently in its final stages of evaluation in ten Greater London primary schools. Using the Behaviour Change Wheel and Behaviour Change Techniques allows development of replicable health interventions in applied settings such as schools.

Bone mineral changes in primary hyperparathyroidism

International Nuclear Information System (INIS)

Richardson, M.L.; Harborview Medical Center, Seattle, WA; Pozzi-Mucelli, R.S.; Trieste Univ.; Kanter, A.S.; Genant, H.K.; Kolb, F.O.; Ettinger, B.

1986-01-01

We studied 34 patients with primary hyperparathyroidism in order to assess their bone mineral status, to determine its relationship to biochemical parameters (serum calcium and parathyroid hormone) and surgical status, and to determine the relationship between peripheral cortical bone and spinal trabecular bone in this disease. These patients were studied with radiogrammetry of the metacarpals, Norland-Cameron photon absorptiometry of the radius, quantitative computed tomography (QCT) of the spine, industrial radiography of the hands, and conventional radiography of the thoracolumbar spine. We also calculated a spinal fracture index from thoracolumbar spine films. We found that the appendicular measurements correlated well together, but less well with spinal QCT. The spinal fracture index correlated best with QCT (r = 0.55), although significant dispersion was noted. We found that, in general, these hyperparathyroid patients had statistically significant decrements in bone mineral content in both the appendicular and the axial portions of the skeleton. However, the decrement in the appendicular skeleton did not correlate well with that in the axial skeleton. Therefore we conclude that it is necessary to measure both peripheral and central bone mineral content in order to reliably assess the skeletal demineralizing effects of primary hyperparathyroidism in an individual patient. (orig.)

Agent-based modeling in ecological economics.

Science.gov (United States)

Heckbert, Scott; Baynes, Tim; Reeson, Andrew

2010-01-01

Interconnected social and environmental systems are the domain of ecological economics, and models can be used to explore feedbacks and adaptations inherent in these systems. Agent-based modeling (ABM) represents autonomous entities, each with dynamic behavior and heterogeneous characteristics. Agents interact with each other and their environment, resulting in emergent outcomes at the macroscale that can be used to quantitatively analyze complex systems. ABM is contributing to research questions in ecological economics in the areas of natural resource management and land-use change, urban systems modeling, market dynamics, changes in consumer attitudes, innovation, and diffusion of technology and management practices, commons dilemmas and self-governance, and psychological aspects to human decision making and behavior change. Frontiers for ABM research in ecological economics involve advancing the empirical calibration and validation of models through mixed methods, including surveys, interviews, participatory modeling, and, notably, experimental economics to test specific decision-making hypotheses. Linking ABM with other modeling techniques at the level of emergent properties will further advance efforts to understand dynamics of social-environmental systems.

Travel Agent. Occupational Simulation Kit.

Science.gov (United States)

Peterson, Wayne

This career exploration instructional booklet on the travel agent's occupation is one of several resulting from the rural southwestern Colorado CEPAC Project (Career Education Process of Attitude Change). Based on a job analysis and utilizing a programed instructional format, the following content is included: A brief description of what a travel…

Morphological and chemical changes in dentin after using endodontic agents: Fourier transform Raman spectroscopy, energy-dispersive x-ray fluorescence spectrometry, and scanning electron microscopy study

Science.gov (United States)

Pascon, Fernanda Miori; Kantovitz, Kamila Rosamilia; Soares, Luís Eduardo Silva; Santo, Ana Maria do Espírito; Martin, Airton Abraha~o.; Puppin-Rontani, Regina Maria

2012-07-01

We examine the morphological and chemical changes in the pulp chamber dentin after using endodontic agents by scanning electron microscopy (SEM), Fourier transform Raman spectroscopy (FT-Raman), and micro energy-dispersive x-ray fluorescence spectrometry (μEDXRF). Thirty teeth were sectioned exposing the pulp chamber and divided by six groups (n=5): NT-no treatment; CHX-2% chlorhexidine; CHXE-2% chlorhexidine+17% EDTA E-17% EDTA; SH5-5.25% NaOCl; SH5E-5.25% NaOCl+17% EDTA. The inorganic and organic content was analyzed by FT-Raman. μEDXRF examined calcium (Ca) and phosphorus (P) content as well as Ca/P ratio. Impressions of specimens were evaluated by SEM. Data were submitted to Kruskal-Wallis and Dunn tests (pNT=SH5E>CHX>E>CHXE). CHXE and E presented the highest Ca/P ratio values compared to the other groups (p<0.05). The SEM images in the EDTA-treated groups had the highest number of open tubules. Erosion in the tubules was observed in CHX and SH5E groups. Endodontic agents change the inorganic and organic content of pulp chamber dentin. NaOCl used alone, or in association with EDTA, was the most effective agent considering chemical and morphological approaches.

A Participatory Model of the Paradox of Primary Care

Science.gov (United States)

Homa, Laura; Rose, Johnie; Hovmand, Peter S.; Cherng, Sarah T.; Riolo, Rick L.; Kraus, Alison; Biswas, Anindita; Burgess, Kelly; Aungst, Heide; Stange, Kurt C.; Brown, Kalanthe; Brooks-Terry, Margaret; Dec, Ellen; Jackson, Brigid; Gilliam, Jules; Kikano, George E.; Reichsman, Ann; Schaadt, Debbie; Hilfer, Jamie; Ticknor, Christine; Tyler, Carl V.; Van der Meulen, Anna; Ways, Heather; Weinberger, Richard F.; Williams, Christine

2015-01-01

PURPOSE The paradox of primary care is the observation that primary care is associated with apparently low levels of evidence-based care for individual diseases, but systems based on primary care have healthier populations, use fewer resources, and have less health inequality. The purpose of this article is to explore, from a complex systems perspective, mechanisms that might account for the effects of primary care beyond disease-specific care. METHODS In an 8-session, participatory group model-building process, patient, caregiver, and primary care clinician community stakeholders worked with academic investigators to develop and refine an agent-based computer simulation model to test hypotheses about mechanisms by which features of primary care could affect health and health equity. RESULTS In the resulting model, patients are at risk for acute illness, acute life-changing illness, chronic illness, and mental illness. Patients have changeable health behaviors and care-seeking tendencies that relate to their living in advantaged or disadvantaged neighborhoods. There are 2 types of care available to patients: primary and specialty. Primary care in the model is less effective than specialty care in treating single diseases, but it has the ability to treat multiple diseases at once. Primary care also can provide disease prevention visits, help patients improve their health behaviors, refer to specialty care, and develop relationships with patients that cause them to lower their threshold for seeking care. In a model run with primary care features turned off, primary care patients have poorer health. In a model run with all primary care features turned on, their conjoint effect leads to better population health for patients who seek primary care, with the primary care effect being particularly pronounced for patients who are disadvantaged and patients with multiple chronic conditions. Primary care leads to more total health care visits that are due to more disease

Maintaining the Identify of Dynamically Embodied Agents

OpenAIRE

Martin, Alan; O'Hare, Gregory; Duffy, Brian; Schoen-Phelan, Bianca; Bradley, John

2005-01-01

Virtual agents are traditionally constrained in their embod- iment, as they are restricted to one form of body. We propose allowing them to change their embodiment in order to expand their capabili- ties. This presents users with a number of di±culties in maintaining the identity of the agents, but these can be overcome by using identity cues, certain features that remain constant across embodiment forms. This pa- per outlines an experiment that examines these identity cues, and shows that th...

CLINICAL IMPLICATION OF FATTY ACID CHANGES IN PATIENTS WITH PRIMARY GOUT ASSOCIATED WITH ARTERIAL HYPERTENSION

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N. N. Kushnarenko

2015-12-01

Full Text Available Aim. To study blood levels of non-esterified fatty acids (NEFAs and adenyl nucleotides, and fatty acids levels in lipids of erythrocyte membranes in patients with primary gout associated with arterial hypertension (HT. Material and methods. 175 male patients with primary gout were included in the study. According to 24-hour blood pressure (BP monitoring results patients were split into two groups: 74 patients with normal BP (group 1 and 101 patients with HT (group 2. 29 healthy age-comparable subjects were included into control group. Uric acid, total NEFAs and glycerol blood levels were studied in all patients. Adenyl nucleotides (ATP , ADP and AMP levels were determined in erythrocytes. Higher fatty acid levels were specified in lipids of erythrocyte membranes, including the following acids: myristinic (С14:0, palmitinic (С16:0, stearic (С18:0, pentadecanic (С15:0, heptadecanic (С17:0, pentadecenic (С15:1, heptadecenic (С17:1, palmitooleic (С16:1, oleic (С18:1, linoleic (С18:2ω6, α-linolenic (С18:3ω3, γ-linolenic (С18:3ω6, dihomo-γ-linolenic (С20:3ω6, arachidonic (С20:4ω6, eicosapentaenoic (С20:5ω3, and docosapentaenoic (С22:5ω3. Results and discussion. Hypertensive patients with gout demonstrated higher NEFAs blood level and greater changes in ATP-ADP-AMP system than normotensive gout patients and healthy subjects as well as 2.2 and 3.7 times higher NEFAs/ATP ratio, respectively. In hypertensive patients with primary gout the composition of fatty acids in erythrocyte membranes lipids changed due to increase in saturated fatty acids amount and decrease in unsaturated fatty acids amount, at that monoenic acid levels increased while polyenic acid levels decreased in unsaturated acids composition. Hypertensive patients with gout shown 1.3 and 2.5 times less levels of ω-3 poly-unsaturated fatty acids (PUFA than normotensive gout patients and healthy subjects, respectively. At the same time ω-6 PUFA levels changed in

[Alkylating agents].

Science.gov (United States)

Pourquier, Philippe

2011-11-01

With the approval of mechlorethamine by the FDA in 1949 for the treatment of hematologic malignancies, alkylating agents are the oldest class of anticancer agents. Even though their clinical use is far beyond the use of new targeted therapies, they still occupy a major place in specific indications and sometimes represent the unique option for the treatment of refractory diseases. Here, we are reviewing the major classes of alkylating agents and their mechanism of action, with a particular emphasis for the new generations of alkylating agents. As for most of the chemotherapeutic agents used in the clinic, these compounds are derived from natural sources. With a complex but original mechanism of action, they represent new interesting alternatives for the clinicians, especially for tumors that are resistant to conventional DNA damaging agents. We also briefly describe the different strategies that have been or are currently developed to potentiate the use of classical alkylating agents, especially the inhibition of pathways that are involved in the repair of DNA lesions induced by these agents. In this line, the development of PARP inhibitors is a striking example of the recent regain of interest towards the "old" alkylating agents.

Efficacy of the chelating agent CaEDTA in reversing lead-induced changes in behavior.

Science.gov (United States)

Cory-Slechta, D A; Weiss, B

1989-01-01

The chelating agent CaEDTA has been reported to reverse the deficits in intellectual function and performance associated with Pb (lead) exposure in children. However, such studies have not included rigorous controls for the intervention procedures per se. The experiments reported here examined reversibility of performance changes in a rat model based on behavior sensitive to low-level Pb exposure. Rats were exposed to 50 ppm sodium or Pb acetate in drinking water from weaning. Performance maintained under a Fixed-Interval schedule of food reinforcement began at 55 days of age. Following the onset of the characteristic increase in short interresponse times (IRTs) associated with low-level Pb exposure after 35 experimental sessions, Pb treatment was terminated. Animals within both the control and Pb groups were then matched on the basis of performance indices and injected daily for 5 days with either saline, 75 mg/kg or 150 mg/kg CaEDTA. Subsequent changes in F1 performance were monitored for 35-60 sessions. No consistent effects of CaEDTA were detected in control animals. CaEDTA treatment failed to reverse the behavioral effects in Pb-exposed animals. If anything, it tended to further increase the proportion of short IRTs. These data suggest that better controlled clinical studies are warranted to evaluate the efficacy of CaEDTA in reversing Pb-induced behavioral effects before its application for these purposes becomes widespread.

Using the Agent-Based Modeling in Economic Field

Directory of Open Access Journals (Sweden)

Nora Mihail

2006-10-01

For ABM, a complex system is a system of individual agents who have the freedom to act in ways that are not always totally predictable, and whose actions are interconnected such that one agent’s actions changes the context (environment for other agents. These are many examples of such complex systems: the stock market, the human body immune system, a business organization, an institution, a work-team, a family etc.

Evaluation of oral abdominal contrast agent containing ferric ammonium citrate

International Nuclear Information System (INIS)

Shiga, Toshiko; Kawamura, Yasutaka; Iwasaki, Toshiko

1991-01-01

We evaluated the effectiveness of oral MRI contrast agent containing ferric ammonium citrate. Twenty patients were arbitrarily divided into 2 groups according to the given dose of 100 and 200 mg Fe of oral MRI contrast agent. MRI was performed before and immediately after ingesting 300 ml solution of oral MRI contrast agent using a 1.5 T superconducting system (GE: Signa). Each dose of 100 and 200 mg Fe of oral MRI contrast agent produced sufficient enhancement of gastrointestinal tract, enough to make clear the pancreatic contour and porta hepatis. There was no significant change in blood and urine analysis observed after taking oral MRI contrast agent. The use of ferric ammonium citrate as an oral MRI contrast agent seems to add valuable information in performing upper abdominal MRI imaging. (author)

Evaluating Water Demand Using Agent-Based Modeling

Science.gov (United States)

Lowry, T. S.

2004-12-01

The supply and demand of water resources are functions of complex, inter-related systems including hydrology, climate, demographics, economics, and policy. To assess the safety and sustainability of water resources, planners often rely on complex numerical models that relate some or all of these systems using mathematical abstractions. The accuracy of these models relies on how well the abstractions capture the true nature of the systems interactions. Typically, these abstractions are based on analyses of observations and/or experiments that account only for the statistical mean behavior of each system. This limits the approach in two important ways: 1) It cannot capture cross-system disruptive events, such as major drought, significant policy change, or terrorist attack, and 2) it cannot resolve sub-system level responses. To overcome these limitations, we are developing an agent-based water resources model that includes the systems of hydrology, climate, demographics, economics, and policy, to examine water demand during normal and extraordinary conditions. Agent-based modeling (ABM) develops functional relationships between systems by modeling the interaction between individuals (agents), who behave according to a probabilistic set of rules. ABM is a "bottom-up" modeling approach in that it defines macro-system behavior by modeling the micro-behavior of individual agents. While each agent's behavior is often simple and predictable, the aggregate behavior of all agents in each system can be complex, unpredictable, and different than behaviors observed in mean-behavior models. Furthermore, the ABM approach creates a virtual laboratory where the effects of policy changes and/or extraordinary events can be simulated. Our model, which is based on the demographics and hydrology of the Middle Rio Grande Basin in the state of New Mexico, includes agent groups of residential, agricultural, and industrial users. Each agent within each group determines its water usage

A Culture-Sensitive Agent in Kirman's Ant Model

Science.gov (United States)

Chen, Shu-Heng; Liou, Wen-Ching; Chen, Ting-Yu

The global financial crisis brought a serious collapse involving a "systemic" meltdown. Internet technology and globalization have increased the chances for interaction between countries and people. The global economy has become more complex than ever before. Mark Buchanan [12] indicated that agent-based computer models will prevent another financial crisis and has been particularly influential in contributing insights. There are two reasons why culture-sensitive agent on the financial market has become so important. Therefore, the aim of this article is to establish a culture-sensitive agent and forecast the process of change regarding herding behavior in the financial market. We based our study on the Kirman's Ant Model[4,5] and Hofstede's Natational Culture[11] to establish our culture-sensitive agent based model. Kirman's Ant Model is quite famous and describes financial market herding behavior from the expectations of the future of financial investors. Hofstede's cultural consequence used the staff of IBM in 72 different countries to understand the cultural difference. As a result, this paper focuses on one of the five dimensions of culture from Hofstede: individualism versus collectivism and creates a culture-sensitive agent and predicts the process of change regarding herding behavior in the financial market. To conclude, this study will be of importance in explaining the herding behavior with cultural factors, as well as in providing researchers with a clearer understanding of how herding beliefs of people about different cultures relate to their finance market strategies.

A technology path to tactical agent-based modeling

Science.gov (United States)

James, Alex; Hanratty, Timothy P.

2017-05-01

Wargaming is a process of thinking through and visualizing events that could occur during a possible course of action. Over the past 200 years, wargaming has matured into a set of formalized processes. One area of growing interest is the application of agent-based modeling. Agent-based modeling and its additional supporting technologies has potential to introduce a third-generation wargaming capability to the Army, creating a positive overmatch decision-making capability. In its simplest form, agent-based modeling is a computational technique that helps the modeler understand and simulate how the "whole of a system" responds to change over time. It provides a decentralized method of looking at situations where individual agents are instantiated within an environment, interact with each other, and empowered to make their own decisions. However, this technology is not without its own risks and limitations. This paper explores a technology roadmap, identifying research topics that could realize agent-based modeling within a tactical wargaming context.

Detection of temporal changes in insect body reflectance in response to killing agents.

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Christian Nansen

Full Text Available Computer vision and reflectance-based analyses are becoming increasingly important methods to quantify and characterize phenotypic responses by whole organisms to environmental factors. Here, we present the first study of how a non-destructive and completely non-invasive method, body reflectance profiling, can be used to detect and time stress responses in adult beetles. Based on high-resolution hyperspectral imaging, we acquired time series of average reflectance profiles (70 spectral bands from 434-876 nm from adults in two beetle species, maize weevils (Sitophilus zeamais and larger black flour beetles (Cynaus angustus. For each species, we acquired reflectance data from untreated controls and from individuals exposed continuously to killing agents (an insecticidal plant extract applied to maize kernels or entomopathogenic nematodes applied to soil applied at levels leading to ≈100% mortality. In maize weevils (exposed to hexanic plant extract, there was no significant effect of the on reflectance profiles acquired from adult beetles after 0 and 12 hours of exposure, but a significant treatment response in spectral bands from 434 to 550 nm was detected after 36 to 144 hours of exposure. In larger black flour beetles, there was no significant effect of exposure to entomopathogenic nematodes after 0 to 26 hours of exposure, but a significant response in spectral bands from 434-480 nm was detected after 45 and 69 hours of exposure. Spectral bands were used to develop reflectance-based classification models for each species, and independent validation of classification algorithms showed sensitivity (ability to positively detect terminal stress in beetles and specificity (ability to positively detect healthy beetles of about 90%. Significant changes in body reflectance occurred at exposure times, which coincided with published exposure times and known physiological responses to each killing agent. The results from this study underscore the

A human capital predictive model for agent performance in contact centres

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Chris Jacobs

2011-10-01

Research purpose: The primary focus of this article was to develop a theoretically derived human capital predictive model for agent performance in contact centres and Business Process Outsourcing (BPO based on a review of current empirical research literature. Motivation for the study: The study was motivated by the need for a human capital predictive model that can predict agent and overall business performance. Research design: A nonempirical (theoretical research paradigm was adopted for this study and more specifically a theory or model-building approach was followed. A systematic review of published empirical research articles (for the period 2000–2009 in scholarly search portals was performed. Main findings: Eight building blocks of the human capital predictive model for agent performance in contact centres were identified. Forty-two of the human capital contact centre related articles are detailed in this study. Key empirical findings suggest that person– environment fit, job demands-resources, human resources management practices, engagement, agent well-being, agent competence; turnover intention; and agent performance are related to contact centre performance. Practical/managerial implications: The human capital predictive model serves as an operational management model that has performance implications for agents and ultimately influences the contact centre’s overall business performance. Contribution/value-add: This research can contribute to the fields of human resource management (HRM, human capital and performance management within the contact centre and BPO environment.

Rituximab treatment in primary angiitis of the central nervous system.

Science.gov (United States)

Patel, Shreeya; Ross, Laura; Oon, Shereen; Nikpour, Mandana

2018-06-01

Primary angiitis of the central nervous system (PACNS) is a rare autoimmune vasculitis affecting the brain and spinal cord. Treatment with biological agents has revolutionised the treatment of many rheumatic conditions but there is scant literature regarding the use of biological agents in PACNS. We present three cases of PACNS treated with rituximab, including two cases of relapsed disease, and a literature review suggesting a role for rituximab in this condition. © 2018 Royal Australasian College of Physicians.

Agent-based autonomous systems and abstraction engines: Theory meets practice

OpenAIRE

Dennis, L.A.; Aitken, J.M.; Collenette, J.; Cucco, E.; Kamali, M.; McAree, O.; Shaukat, A.; Atkinson, K.; Gao, Y.; Veres, S.M.; Fisher, M.

2016-01-01

We report on experiences in the development of hybrid autonomous systems where high-level decisions are made by a rational agent. This rational agent interacts with other sub-systems via an abstraction engine. We describe three systems we have developed using the EASS BDI agent programming language and framework which supports this architecture. As a result of these experiences we recommend changes to the theoretical operational semantics that underpins the EASS framework and present a fourth...

Supervision Vs Education Quality in Primary Education

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Jhoel Ruber Mota Fonseca

2016-11-01

Full Text Available This article has as objective to interpret the voices of teachers supervising vs quality of education in primary education, as today, supervision entails progress and improvement in the performance of the duties of teachers in the learning environment is therefore, that through this content conflicts present information to achieve changes within educational institutions towards organizational efficiency and under supplied. In it, a qualitative paradigmatic approach as a methodological foundation that allows us to interpret educational supervision through delos social actors which is made up of managers, teachers and supervisors in the context of primary education, established likewise was necessary to collect the information through direct observation technique using as an interview script whose implementation was key informants comprised of a primary teacher education, a supervisor and from this the researcher, thus achieving the corresponding analysis according to the information provided for each, which allowed the development of argumentative skills teachers, establishing rules and procedures that provide guidelines for creating answers to the problem. For with following aims determined in the investigation, vital agents that help teachers to be highly competent in their daily practice, using teaching strategies that will enable success in the classroom, whose purpose is the achievement orientation and optimization in the process of teaching and student learning. In this sense, a reflection about the role it should play the supervisor to achieve educational quality is performed, demonstrating spaces mediation, integration, participation and collaboration with respect to the performance of the master whose aim is to be efficient and effective in its educational work of the educational system.

EFFECTS OF OUTSCHOOL BODY ACTIVITIES ON QUALITATIVE CHANGES OF MOTORICAL STATUS PUPILS OF PRIMARY SCHOOL STRATURE

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Izudin Tanović

2011-09-01

Full Text Available Population of pupil high classes primary school present one of cariks in chain of complex education and systematic social influence in body and health education, which are used a new generations (Mikić,1991. Including that we have a very sensibility population in way of strature and development in phase of adolescental period, it is necessary that throw the classes body education and extra outschool activities, give enough quantity of motorical activities, which will completly satisfied necessy of children this strature and also completly give them normal biopsychosocial growth. Explorations of effects extra outschool activities in frame of school sport sections pupils of primary school tell us that with a correct planning and programming work, which understand correctly choice adequate methods and operators of work could been very significant transformations of anthropological status of pupils (Malacko 2002. The basic target of this explorations was that confirm influence of outschool body activities on level qualitative changes of structure motorical space of pupils primary school strature, under influence applying programme of outschool activities. With help of factory analise, but also of method of congruation, it was explored structure of motorical space in the start but also at the end of this applying experimental programme of outschool body activities , and we concluded that changes which was appear in structure of explored motorical space, tell us on positive influence outschool body activities in sense transformation and progressing of motorical status of explorated sample.

Organization of the secure distributed computing based on multi-agent system

Science.gov (United States)

Khovanskov, Sergey; Rumyantsev, Konstantin; Khovanskova, Vera

2018-04-01

Nowadays developing methods for distributed computing is received much attention. One of the methods of distributed computing is using of multi-agent systems. The organization of distributed computing based on the conventional network computers can experience security threats performed by computational processes. Authors have developed the unified agent algorithm of control system of computing network nodes operation. Network PCs is used as computing nodes. The proposed multi-agent control system for the implementation of distributed computing allows in a short time to organize using of the processing power of computers any existing network to solve large-task by creating a distributed computing. Agents based on a computer network can: configure a distributed computing system; to distribute the computational load among computers operated agents; perform optimization distributed computing system according to the computing power of computers on the network. The number of computers connected to the network can be increased by connecting computers to the new computer system, which leads to an increase in overall processing power. Adding multi-agent system in the central agent increases the security of distributed computing. This organization of the distributed computing system reduces the problem solving time and increase fault tolerance (vitality) of computing processes in a changing computing environment (dynamic change of the number of computers on the network). Developed a multi-agent system detects cases of falsification of the results of a distributed system, which may lead to wrong decisions. In addition, the system checks and corrects wrong results.

Immediate and six-month space changes after premature loss of a primary maxillary first molar.

Science.gov (United States)

Lin, Yai-Tin; Lin, Wen-Hsien; Lin, Yng-Tzer J

2007-03-01

Premature loss of primary maxillary first molars has been associated with a number of consequences (such as tipping of the first permanent molar). The aim of the authors' study was to investigate dental-arch space problems arising as a result of premature loss of a primary maxillary first molar. This study was composed of 19 children who experienced unilateral premature loss of a primary maxillary first molar. The authors used each patient's intact contralateral arch segment as a control. The authors obtained maxillary dental study casts two or three days after the tooth was extracted, as well as six months later. The D + E space from the extraction side six months after removal of the tooth (mean +/- standard deviation, 15.62 +/- 1.13 millimeters) was significantly smaller than the space on the control side (16.88 +/- 1.12 mm) and the initial D + E space (16.70 +/- 0.69 mm). The authors found a significantly shorter arch length (25.47 +/- 1.58 mm) and larger intercanine width (31.29 +/- 2.49 mm) six months after the tooth was extracted compared with the initial arch length (25.66 +/- 1.64 mm) and intercanine width (30.42 +/- 2.64 mm). The early space changes to the maxillary arch subsequent to premature loss of a primary maxillary first molar are primarily distal drift of the primary canines toward the extraction space and palatal migration of the maxillary incisors. Although 1 mm of space was lost, which is statistically significant, this is not likely to be of sufficient clinical significance to warrant use of a space maintainer. If palatal movement appears to be needed, the dentist should consider use of a palatal arch rather than a band-and-loop maintainer. The effects of space maintainers need to be re-evaluated in cases of unilateral premature loss of a primary maxillary first molar.

Towards an environment interface standard for agent platforms

OpenAIRE

Behrens, T.M.; Hindriks, K.V.; Dix, J.

2010-01-01

We introduce an interface for connecting agent platforms to environments. This interface provides generic functionality for executing actions and for perceiving changes in an agent’s environment. It also provides support for managing an environment, e.g., for starting, pausing and terminating it. Among the benefits of such an interface are (1) standard functionality is provided by the interface implementation itself, and (2) agent platforms that support the interface can connect to any enviro...

Screen for agents that induce autolysis in Bacillus subtilis.

Science.gov (United States)

Lacriola, Christopher J; Falk, Shaun P; Weisblum, Bernard

2013-01-01

The growing prevalence of antibiotic-resistant infections underscores the need to discover new antibiotics and to use them with maximum effectiveness. In response to these needs, we describe a screening protocol for the discovery of autolysis-inducing agents that uses two Bacillus subtilis reporter strains, SH-536 and BAU-102. To screen chemical libraries, autolysis-inducing agents were first identified with a BAU-102-based screen and then subdivided with SH-536 into two major groups: those that induce autolysis by their direct action on the cell membrane and those that induce autolysis secondary to inhibition of cell wall synthesis. SH-536 distinguishes between the two groups of autolysis-inducing agents by synthesizing and then releasing β-galactosidase (β-Gal) in late stationary phase at a time that cells have nearly stopped growing and are therefore tolerant of cell wall synthesis inhibitors. Four hits, named compound 2, compound 3, compound 5, and compound 24, obtained previously as inducers of autolysis by screening a 10,080-compound discovery library with BAU-102, were probed with SH-536 and found to release β-Gal, indicating that their mode of action was to permeabilize the B. subtilis cell membrane. The four primary hits inhibited growth in Staphylococcus aureus, Enterococcus faecium, Bacillus subtilis, and Bacillus anthracis, with MICs in the 12.5- to 25-μg/ml (20 to 60 μM) range. The four primary hits were further used to probe B. subtilis, and their action was partially characterized with respect to the dependence of induced autolysis on specific autolysins.

Incorporating BDI Agents into Human-Agent Decision Making Research

Science.gov (United States)

Kamphorst, Bart; van Wissen, Arlette; Dignum, Virginia

Artificial agents, people, institutes and societies all have the ability to make decisions. Decision making as a research area therefore involves a broad spectrum of sciences, ranging from Artificial Intelligence to economics to psychology. The Colored Trails (CT) framework is designed to aid researchers in all fields in examining decision making processes. It is developed both to study interaction between multiple actors (humans or software agents) in a dynamic environment, and to study and model the decision making of these actors. However, agents in the current implementation of CT lack the explanatory power to help understand the reasoning processes involved in decision making. The BDI paradigm that has been proposed in the agent research area to describe rational agents, enables the specification of agents that reason in abstract concepts such as beliefs, goals, plans and events. In this paper, we present CTAPL: an extension to CT that allows BDI software agents that are written in the practical agent programming language 2APL to reason about and interact with a CT environment.

Chemical warfare agents.

Science.gov (United States)

Kuca, Kamil; Pohanka, Miroslav

2010-01-01

Chemical warfare agents are compounds of different chemical structures. Simple molecules such as chlorine as well as complex structures such as ricin belong to this group. Nerve agents, vesicants, incapacitating agents, blood agents, lung-damaging agents, riot-control agents and several toxins are among chemical warfare agents. Although the use of these compounds is strictly prohibited, the possible misuse by terrorist groups is a reality nowadays. Owing to this fact, knowledge of the basic properties of these substances is of a high importance. This chapter briefly introduces the separate groups of chemical warfare agents together with their members and the potential therapy that should be applied in case someone is intoxicated by these agents.

Logics for Intelligent Agents and Multi-Agent Systems

NARCIS (Netherlands)

Meyer, John-Jules Charles

2014-01-01

This chapter presents the history of the application of logic in a quite popular paradigm in contemporary computer science and artificial intelligence, viz. the area of intelligent agents and multi-agent systems. In particular we discuss the logics that have been used to specify single agents, the

The interaction of MRI contrast agents with phospholipids

International Nuclear Information System (INIS)

Jendrasiak, Gordon L.; Smith, Ralph L.; Ribeiro, Anthony A.

2000-01-01

The molecular interactions of three clinically used MRI contrast agents with lipid vesicles, consisting of egg phosphatidylcholine (EPC), have been studied using high-field NMR techniques. At a molar ratio of one contrast agent molecule to five phospholipid molecules, a significant increase in the proton resonance line width occurred for certain lipid head group moieties. A large decrease in the T 1 relaxation times for the head group moieties was also observed. These two effects occurred regardless of the ionic status and the chelate structure of the three contrast agents. The structure of the contrast agents did, however, affect the magnitude of the two NMR parameter changes. These NMR effects also differed in magnitude amongst the various head group entities. The NMR effects were greatest for the head group moieties at or near the vesicle-water interface. The results are discussed in terms of the structure of the phospholipid-water interface. Since the use of contrast agents has become routine in clinical MRI, our results are of importance in terms of the interaction of the agents with physiological surfaces, many of which contain phospholipids. The understanding of such interactions should be of value not only for improved diagnostics, but also in the development of new contrast agents. (author)

Modeling collective emotions: a stochastic approach based on Brownian agents

International Nuclear Information System (INIS)

Schweitzer, F.

2010-01-01

We develop a agent-based framework to model the emergence of collective emotions, which is applied to online communities. Agents individual emotions are described by their valence and arousal. Using the concept of Brownian agents, these variables change according to a stochastic dynamics, which also considers the feedback from online communication. Agents generate emotional information, which is stored and distributed in a field modeling the online medium. This field affects the emotional states of agents in a non-linear manner. We derive conditions for the emergence of collective emotions, observable in a bimodal valence distribution. Dependent on a saturated or a super linear feedback between the information field and the agent's arousal, we further identify scenarios where collective emotions only appear once or in a repeated manner. The analytical results are illustrated by agent-based computer simulations. Our framework provides testable hypotheses about the emergence of collective emotions, which can be verified by data from online communities. (author)

A study of work changes due to cancer in tumor-free primary-treated cancer patients. A NOCWO study.

Science.gov (United States)

Gudbergsson, Saevar Berg; Fosså, Sophie D; Dahl, Alv A

2008-10-01

The goal of this study is to explore the characteristics of tumor-free cancer survivors (CSs) who after their primary treatment were still working but made work changes due to cancer and compare them to survivors who did not. The sample consisted of 431 CSs (219 females with breast cancer, 212 males with testicular (N = 150) or prostate cancer (N = 62)) diagnosed 2-6 years prior to the study. All CSs had good prognosis and had returned to work after primary treatment. All CSs filled in a mailed questionnaire covering demography, morbidity, life style, mental distress, fatigue, quality of life and job strain. Seventy-two CSs (17%) had made work changes due to cancer during the observation period, and 359 (83%) had not. Among CSs who made work changes, significantly more were females; they showed significantly poorer physical and mental work ability, worked fewer hours per week, reported more comorbidity, and had lower physical and mental quality of life and more neuroticism, compared to the nonchange group. Work changes were moderately correlated with current work ability. The majority of CSs did not report any work changes due to cancer during the 2-6-year observation period, which is an encouraging finding. A minority had done work changes, and this group consisted mainly of women and was also characterized by poorer physical and mental quality of life and poorer mental work ability due to cancer. The issue of work changes and work ability should be considered in the follow-up of cancer survivors.

Fate of IIT B52 Antiform Agent Across the Small Tank Tetraphenylborate Process

International Nuclear Information System (INIS)

Calloway, T.B.

2001-01-01

The primary objective of these experiments was to determine the fate (partitioning) of the antifoam agent across the precipitation, concentration and washing cycles. A secondary objective of this experiment was to determine if insoluble aluminum formed during the STTP process

Biological Agents

Science.gov (United States)

... E-Tools Safety and Health Topics / Biological Agents Biological Agents This page requires that javascript be enabled ... 202) 693-2300 if additional assistance is required. Biological Agents Menu Overview In Focus: Ebola Frederick A. ...

Locoregional Recurrent or Second Primary Head and Neck Cancer: Management Strategies and Challenges.

Science.gov (United States)

Wong, Stuart J; Heron, Dwight E; Stenson, Kerstin; Ling, Diane C; Vargo, John A

2016-01-01

Treatment of patients with locoregional recurrent or second primary head and neck squamous cell cancer (HNSCC) has been guided by well-reasoned principles and informed by carefully tested chemotherapy and radiation regimens. However, clinical decision making for this population is complicated by many factors. Although surgery is generally considered the treatment of choice for patients with HNSCC with recurrent disease or new second primary disease in a previously irradiated field, operability of cases is not always straightforward. Postoperative treatment is frequently warranted but carries significant risk. In addition, the rapid rise in the incidence of HPV-associated HNSCC raises the question of whether established treatment paradigms should be re-examined in this population of patients with a much better prognosis than the non-HPV population. Furthermore, new radiation techniques and new systemic agents show early promising results in recent clinical studies, suggesting potential for practice-changing effects in the future management of this disease. This article examines each of the treatment modalities used in the care of patients with HNSCC with recurrent or new second primary disease and provides a perspective to aid clinicians in the management of this disease.

Multi-Agent Cooperative Target Search

Directory of Open Access Journals (Sweden)

Jinwen Hu

2014-05-01

Full Text Available This paper addresses a vision-based cooperative search for multiple mobile ground targets by a group of unmanned aerial vehicles (UAVs with limited sensing and communication capabilities. The airborne camera on each UAV has a limited field of view and its target discriminability varies as a function of altitude. First, by dividing the whole surveillance region into cells, a probability map can be formed for each UAV indicating the probability of target existence within each cell. Then, we propose a distributed probability map updating model which includes the fusion of measurement information, information sharing among neighboring agents, information decay and transmission due to environmental changes such as the target movement. Furthermore, we formulate the target search problem as a multi-agent cooperative coverage control problem by optimizing the collective coverage area and the detection performance. The proposed map updating model and the cooperative control scheme are distributed, i.e., assuming that each agent only communicates with its neighbors within its communication range. Finally, the effectiveness of the proposed algorithms is illustrated by simulation.

Neuroimaging: do we really need new contrast agents for MRI?

International Nuclear Information System (INIS)

Roberts, T.P.L.; Chuang, N.; Roberts, H.C.

2000-01-01

The use of exogenous contrast media in magnetic resonance imaging of the brain has brought dramatic improvement in the sensitivity of detection and delineation of pathological structures, such as primary and metastatic brain tumors, inflammation and ischemia. Disruption of the blood brain barrier leads to accumulation of the intravenously injected contrast material in the extravascular space, leading to signal enhancement. Magnetic resonance angiography benefits from T 1 -shortening effects of contrast agent, improving small vessel depiction and providing vascular visualization even in situations of slow flow. High speed dynamic MRI after bolus injection of contrast media allows tracer kinetic modeling of cerebral perfusion. Progressive enhancement over serial post-contrast imaging allows modeling of vascular permeability and thus quantitative estimation of the severity of blood brain barrier disruption. With such an array of capabilities and ever improving technical abilities, it seems that the role of contrast agents in MR neuroimaging is established and the development of new agents may be superfluous. However, new agents are being developed with prolonged intravascular residence times, and with in-vivo binding of ever-increasing specificity. Intravascular, or blood pool, agents are likely to benefit magnetic resonance angiography of the carotid and cerebral vessels; future agents may allow the visualization of therapeutic drug delivery, the monitoring of, for example, gene expression, and the imaging evaluation of treatment efficacy. So while there is a substantial body of work that can be performed with currently available contrast agents, especially in conjunction with optimized image acquisition strategies, post processing, and mathematical analysis, there are still unrealized opportunities for novel contrast agent introduction, particularly those exploiting biological specificity. This article reviews the current use of contrast media in magnetic resonance

Progressive changes in arch width from primary to early mixed dentition period: a longitudinal study.

Science.gov (United States)

Sangwan, S; Chawla, H S; Goyal, A; Gauba, K; Mohanty, U

2011-01-01

The present study was conducted to evaluate, on a longitudinal basis, the changes in intercanine and intermolar widths form the primary to the early mixed dentition periods. A total of 38 children aged 4-5 years, with normal occlusion without any proximal caries or any dental anomalies, were selected. The impressions were recorded and casts were prepared. Intercanine and intermolar widths were measured on these dental casts with the help of a digital vernier calliper. After 3 years follow-up, the impressions were recorded again and dental casts were prepared. Intercanine and intermolar widths were measured again at this stage and were compared with the baseline data using the paired t-test and the chi square test. There is a significant increase in the intercanine (3.93 + 1.70 mm) and intermolar width (1.49 + 1.77 mm) during the transition period from primary to early mixed dentition in both the arches and both the sexes. The gender-wise comparison showed a greater increase in males than in females, but this was not statistically significant. A thorough knowledge of growth changes during various stages of the mixed dentition period are important for a pediatric dentist to make an accurate diagnosis and treatment planning during preventive and interceptive orthodontics.

Sensitivity Analysis of a Land-Use Change Model with and without Agents to Assess Land Abandonment and Long-Term Re-Forestation in a Swiss Mountain Region

NARCIS (Netherlands)

Brandle, M.; Langendijk, G.; Peter, S.; Brunner, S.H.

2015-01-01

Land abandonment and the subsequent re-forestation are important drivers behind the loss of ecosystem services in mountain regions. Agent-based models can help to identify global change impacts on farmland abandonment and can test policy and management options to counteract this development.

In vivo imaging agents: an international market report

International Nuclear Information System (INIS)

1990-01-01

The purpose of this study is to provide a global perspective of the in vivo imaging agents business to market planning executives who are working for companies that develop, produce and distribute various types of in vivo imaging agents. Others that could find this study useful include investment bankers, regulatory and governmental authorities and purchasers of these products. The study attempts to diligently provide market data by type for important geographic markets - Western Europe, the U.S.A., and Japan. A competitive intelligence section which discusses companies involved in these markets constitutes the last part of this study. These profiles are not intended to extensively evaluate each company's marketing strengths or strategies but to provide a general idea of the market presence and prospects. A combination of primary and secondary research is used for all findings. (author)

Historical changes of the Mediterranean Sea ecosystem: modelling the role and impact of primary productivity and fisheries changes over time

Science.gov (United States)

Piroddi, Chiara; Coll, Marta; Liquete, Camino; Macias, Diego; Greer, Krista; Buszowski, Joe; Steenbeek, Jeroen; Danovaro, Roberto; Christensen, Villy

2017-03-01

The Mediterranean Sea has been defined “under siege” because of intense pressures from multiple human activities; yet there is still insufficient information on the cumulative impact of these stressors on the ecosystem and its resources. We evaluate how the historical (1950-2011) trends of various ecosystems groups/species have been impacted by changes in primary productivity (PP) combined with fishing pressure. We investigate the whole Mediterranean Sea using a food web modelling approach. Results indicate that both changes in PP and fishing pressure played an important role in driving species dynamics. Yet, PP was the strongest driver upon the Mediterranean Sea ecosystem. This highlights the importance of bottom-up processes in controlling the biological characteristics of the region. We observe a reduction in abundance of important fish species (~34%, including commercial and non-commercial) and top predators (~41%), and increases of the organisms at the bottom of the food web (~23%). Ecological indicators, such as community biomass, trophic levels, catch and diversity indicators, reflect such changes and show overall ecosystem degradation over time. Since climate change and fishing pressure are expected to intensify in the Mediterranean Sea, this study constitutes a baseline reference for stepping forward in assessing the future management of the basin.

Resistance profiles to antimicrobial agents in bacteria isolated from acute endodontic infections: systematic review and meta-analysis.

Science.gov (United States)

Lang, Pauline M; Jacinto, Rogério C; Dal Pizzol, Tatiane S; Ferreira, Maria Beatriz C; Montagner, Francisco

2016-11-01

Infected root canal or acute apical abscess exudates can harbour several species, including Fusobacterium, Porphyromonas, Prevotella, Parvimonas, Streptococcus, Treponema, Olsenella and not-yet cultivable species. A systematic review and meta-analysis was performed to assess resistance rates to antimicrobial agents in clinical studies that isolated bacteria from acute endodontic infections. Electronic databases and the grey literature were searched up to May 2015. Clinical studies in humans evaluating the antimicrobial resistance of primary acute endodontic infection isolates were included. PRISMA guidelines were followed. A random-effect meta-analysis was employed. The outcome was described as the pooled resistance rates for each antimicrobial agent. Heterogeneity and sensitivity analyses were performed. Subgroup analyses were conducted based upon report or not of the use of antibiotics prior to sampling as an exclusion factor (subgroups A and B, respectively). Data from seven studies were extracted. Resistance rates for 15 different antimicrobial agents were evaluated (range, 3.5-40.0%). Lower resistance rates were observed for amoxicillin/clavulanic acid and amoxicillin; higher resistance rates were detected for tetracycline. Resistance rates varied according to previous use of an antimicrobial agent as demonstrated by the subgroup analyses. Heterogeneity was observed for the resistance profiles of penicillin G in subgroup A and for amoxicillin, clindamycin, metronidazole and tetracycline in subgroup B. Sensitivity analyses demonstrated that resistance rates changed for metronidazole, clindamycin, tetracycline and amoxicillin. These findings suggest that clinical isolates had low resistance to β-lactams. Further well-designed studies are needed to clarify whether the differences in susceptibility among the antimicrobial agents may influence clinical responses to treatment. Copyright © 2016 Elsevier B.V. and International Society of Chemotherapy. All rights

Network flow of mobile agents enhances the evolution of cooperation

Science.gov (United States)

Ichinose, G.; Satotani, Y.; Nagatani, T.

2018-01-01

We study the effect of contingent movement on the persistence of cooperation on complex networks with empty nodes. Each agent plays the Prisoner's Dilemma game with its neighbors and then it either updates the strategy depending on the payoff difference with neighbors or it moves to another empty node if not satisfied with its own payoff. If no neighboring node is empty, each agent stays at the same site. By extensive evolutionary simulations, we show that the medium density of agents enhances cooperation where the network flow of mobile agents is also medium. Moreover, if the movements of agents are more frequent than the strategy updating, cooperation is further promoted. In scale-free networks, the optimal density for cooperation is lower than other networks because agents get stuck at hubs. Our study suggests that keeping a smooth network flow is significant for the persistence of cooperation in ever-changing societies.

Using systems science for population health management in primary care.

Science.gov (United States)

Li, Yan; Kong, Nan; Lawley, Mark A; Pagán, José A

2014-10-01

Population health management is becoming increasingly important to organizations managing and providing primary care services given ongoing changes in health care delivery and payment systems. The objective of this study is to show how systems science methodologies could be incorporated into population health management to compare different interventions and improve health outcomes. The New York Academy of Medicine Cardiovascular Health Simulation model (an agent-based model) and data from the Behavioral Risk Factor Surveillance System were used to evaluate a lifestyle program that could be implemented in primary care practice settings. The program targeted Medicare-age adults and focused on improving diet and exercise and reducing weight. The simulation results suggest that there would be significant reductions projected in the proportion of the Medicare-age population with diabetes after the implementation of the proposed lifestyle program for a relatively long term (3 and 5 years). Similar results were found for the subpopulations with high cholesterol, but the proposed intervention would not have a significant effect in the proportion of the population with hypertension over a time period of Systems science methodologies can be useful to compare the health outcomes of different interventions. These tools can become an important component of population health management because they can help managers and other decision makers evaluate alternative programs in primary care settings. © The Author(s) 2014.

Opinion dynamics of learning agents: does seeking consensus lead to disagreement?

International Nuclear Information System (INIS)

Vicente, Renato; Martins, André C R; Caticha, Nestor

2009-01-01

We study opinion dynamics in a population of interacting adaptive agents voting on a set of issues represented by vectors. We consider agents who can classify issues into one of two categories and can arrive at their opinions using an adaptive algorithm. Adaptation comes from learning and the information for the learning process comes from interacting with other neighboring agents and trying to change the internal state in order to concur with their opinions. The change in the internal state is driven by the information contained in the issue and in the opinion of the other agent. We present results in a simple yet rich context where each agent uses a Boolean perceptron to state their opinion. If the update occurs with information asynchronously exchanged among pairs of agents, then the typical case, if the number of issues is kept small, is the evolution into a society torn by the emergence of factions with extreme opposite beliefs. This occurs even when seeking consensus with agents with opposite opinions. If the number of issues is large, the dynamics becomes trapped, the society does not evolve into factions and a distribution of moderate opinions is observed. The synchronous case is technically simpler and is studied by formulating the problem in terms of differential equations that describe the evolution of order parameters that measure the consensus between pairs of agents. We show that for a large number of issues and unidirectional information flow, global consensus is a fixed point; however, the approach to this consensus is glassy for large societies

Opinion dynamics of learning agents: does seeking consensus lead to disagreement?

Science.gov (United States)

Vicente, Renato; Martins, André C. R.; Caticha, Nestor

2009-03-01

We study opinion dynamics in a population of interacting adaptive agents voting on a set of issues represented by vectors. We consider agents who can classify issues into one of two categories and can arrive at their opinions using an adaptive algorithm. Adaptation comes from learning and the information for the learning process comes from interacting with other neighboring agents and trying to change the internal state in order to concur with their opinions. The change in the internal state is driven by the information contained in the issue and in the opinion of the other agent. We present results in a simple yet rich context where each agent uses a Boolean perceptron to state their opinion. If the update occurs with information asynchronously exchanged among pairs of agents, then the typical case, if the number of issues is kept small, is the evolution into a society torn by the emergence of factions with extreme opposite beliefs. This occurs even when seeking consensus with agents with opposite opinions. If the number of issues is large, the dynamics becomes trapped, the society does not evolve into factions and a distribution of moderate opinions is observed. The synchronous case is technically simpler and is studied by formulating the problem in terms of differential equations that describe the evolution of order parameters that measure the consensus between pairs of agents. We show that for a large number of issues and unidirectional information flow, global consensus is a fixed point; however, the approach to this consensus is glassy for large societies.

Exploring long-term trends in land use change and aboveground human appropriation of net primary production in nine European countries

DEFF Research Database (Denmark)

Gingrich, Simone; Niedertscheider, Maria; Kastner, Thomas

2015-01-01

Profound changes in land use occurred during the last century in Europe, driven by growing population, changes in affluence, and technological innovation. To capture and understand these changes, we compiled a consistent dataset on the distribution of land-use types and biomass extraction for nine...... primary production" (HANPP) framework for the nine countries and for the sum of all countries on a yearly basis from 1902 to 2003. We find that cropland and grazing land contracted in all countries except Albania in the observed period, while forestland increased. Crop yields increased in all countries......, most strongly during the second half of the 20th century. In some countries, biomass extraction on grazing lands increased to a similar extent. Overall, HANPP was high but declined slightly from 63% of the net primary production of potential vegetation in 1902 to 55% in 2003. This is the result...

Data feedback and behavioural change intervention to improve primary care prescribing safety (EFIPPS): multicentre, three arm, cluster randomised controlled trial.

Science.gov (United States)

Guthrie, Bruce; Kavanagh, Kimberley; Robertson, Chris; Barnett, Karen; Treweek, Shaun; Petrie, Dennis; Ritchie, Lewis; Bennie, Marion

2016-08-18

 To evaluate the effectiveness of feedback on safety of prescribing compared with moderately enhanced usual care.  Three arm, highly pragmatic cluster randomised trial.  262/278 (94%) primary care practices in three Scottish health boards.  Practices were randomised to: "usual care," consisting of emailed educational material with support for searching to identify patients (88 practices at baseline, 86 analysed); usual care plus feedback on practice's high risk prescribing sent quarterly on five occasions (87 practices, 86 analysed); or usual care plus the same feedback incorporating a behavioural change component (87 practices, 86 analysed).  The primary outcome was a patient level composite of six prescribing measures relating to high risk use of antipsychotics, non-steroidal anti-inflammatories, and antiplatelets. Secondary outcomes were the six individual measures. The primary analysis compared high risk prescribing in the two feedback arms against usual care at 15 months. Secondary analyses examined immediate change and change in trend of high risk prescribing associated with implementation of the intervention within each arm.  In the primary analysis, high risk prescribing as measured by the primary outcome fell from 6.0% (3332/55 896) to 5.1% (2845/55 872) in the usual care arm, compared with 5.9% (3341/56 194) to 4.6% (2587/56 478) in the feedback only arm (odds ratio 0.88 (95% confidence interval 0.80 to 0.96) compared with usual care; P=0.007) and 6.2% (3634/58 569) to 4.6% (2686/58 582) in the feedback plus behavioural change component arm (0.86 (0.78 to 0.95); P=0.002). In the pre-specified secondary analysis of change in trend within each arm, the usual care educational intervention had no effect on the existing declining trend in high risk prescribing. Both types of feedback were associated with significantly more rapid decline in high risk prescribing after the intervention compared with before.  Feedback of prescribing safety data

Integrating semantic web and software agents : Exchanging RIF and BDI rules

NARCIS (Netherlands)

Gong, Y.; Overbeek, S.J.

2011-01-01

Software agents and rules are both used for creating flexibility. Exchanging rules between Semantic Web and agents can ensure consistency in rules and support easy updating and changing of rules. The Rule Interchange Format (RIF) is a new W3C recommendation Semantic Web standard for exchanging rules

The roles and training of primary care doctors: China, India, Brazil and South Africa.

Science.gov (United States)

Mash, Robert; Almeida, Magda; Wong, William C W; Kumar, Raman; von Pressentin, Klaus B

2015-12-04

China, India, Brazil and South Africa contain 40% of the global population and are key emerging economies. All these countries have a policy commitment to universal health coverage with an emphasis on primary health care. The primary care doctor is a key part of the health workforce, and this article, which is based on two workshops at the 2014 Towards Unity For Health Conference in Fortaleza, Brazil, compares and reflects on the roles and training of primary care doctors in these four countries. Key themes to emerge were the need for the primary care doctor to function in support of a primary care team that provides community-orientated and first-contact care. This necessitates task-shifting and an openness to adapt one's role in line with the needs of the team and community. Beyond clinical competence, the primary care doctor may need to be a change agent, critical thinker, capability builder, collaborator and community advocate. Postgraduate training is important as well as up-skilling the existing workforce. There is a tension between training doctors to be community-orientated versus filling the procedural skills gaps at the facility level. In training, there is a need to plan postgraduate education at scale and reform the system to provide suitable incentives for doctors to choose this as a career path. Exposure should start at the undergraduate level. Learning outcomes should be socially accountable to the needs of the country and local communities, and graduates should be person-centred comprehensive generalists.

An agent-based approach with collaboration among agents. Estimation of wholesale electricity price on PJM and artificial data generated by a mean reverting model

International Nuclear Information System (INIS)

Sueyoshi, Toshiyuki

2010-01-01

This study examines the performance of MAIS (Multi-Agent Intelligent Simulator) equipped with various learning capabilities. In addition to the learning capabilities, the proposed MAIS incorporates collaboration among agents. The proposed MAIS is applied to estimate a dynamic change of wholesale electricity price in PJM (Pennsylvania-New Jersey-Mainland) and an artificial data set generated by a mean reverting model. Using such different types of data sets, the methodological validity of MAIS is confirmed by comparing it with other well-known alternatives in computer science. This study finds that the MAIS needs to incorporate both the mean reverting model and the collaboration behavior among agents in order to enhance its estimation capability. The MAIS discussed in this study will provide research on energy economics with a new numerical capability that can investigate a dynamic change of not only wholesale electricity price but also speculation and learning process of traders. (author)

Potential impacts of climate change on the primary production of regional seas: A comparative analysis of five European seas

Science.gov (United States)

Holt, Jason; Schrum, Corinna; Cannaby, Heather; Daewel, Ute; Allen, Icarus; Artioli, Yuri; Bopp, Laurent; Butenschon, Momme; Fach, Bettina A.; Harle, James; Pushpadas, Dhanya; Salihoglu, Baris; Wakelin, Sarah

2016-01-01

Regional seas are potentially highly vulnerable to climate change, yet are the most directly societally important regions of the marine environment. The combination of widely varying conditions of mixing, forcing, geography (coastline and bathymetry) and exposure to the open-ocean makes these seas subject to a wide range of physical processes that mediates how large scale climate change impacts on these seas' ecosystems. In this paper we explore the response of five regional sea areas to potential future climate change, acting via atmospheric, oceanic and terrestrial vectors. These include the Barents Sea, Black Sea, Baltic Sea, North Sea, Celtic Seas, and are contrasted with a region of the Northeast Atlantic. Our aim is to elucidate the controlling dynamical processes and how these vary between and within these seas. We focus on primary production and consider the potential climatic impacts on: long term changes in elemental budgets, seasonal and mesoscale processes that control phytoplankton's exposure to light and nutrients, and briefly direct temperature response. We draw examples from the MEECE FP7 project and five regional model systems each using a common global Earth System Model as forcing. We consider a common analysis approach, and additional sensitivity experiments. Comparing projections for the end of the 21st century with mean present day conditions, these simulations generally show an increase in seasonal and permanent stratification (where present). However, the first order (low- and mid-latitude) effect in the open ocean projections of increased permanent stratification leading to reduced nutrient levels, and so to reduced primary production, is largely absent, except in the NE Atlantic. Even in the two highly stratified, deep water seas we consider (Black and Baltic Seas) the increase in stratification is not seen as a first order control on primary production. Instead, results show a highly heterogeneous picture of positive and negative change

Changes in grouping practices over primary and secondary school

OpenAIRE

Baines, Ed; Blatchford, Peter; Kutnick, P.

2003-01-01

The research detailed in this paper provides a systematic description and analysis of grouping practices in primary and secondary schools in England. Practices are compared to main findings in developmental and educational literature with regard to effective contexts for learning and recent ideas about pedagogy. The research is based on an analysis of 4924 groupings from 672 Reception, Year 2 and Year 5 classes in 331 primary schools and 248 Year 7 and Year 10 classes in 47 secondary schools....

Tissue-specific MR contrast agents. Impact on imaging diagnosis and future prospects

International Nuclear Information System (INIS)

Yoshimitsu, Kengo; Nakayama, Tomohiro; Kakihara, Daisuke; Irie, Hiroyuki; Tajima, Tsuyoshi; Asayama, Yoshiki; Hirakawa, Masakazu; Ishigami, Kousei; Honda, Hiroshi

2005-01-01

Superparamagnetic iron oxide (SPIO) is the only tissue-specific MR agent currently available in Japan. It is quickly taken up by Kupffer cells at the first pass (either arterial or portal) and becomes clustered in the lysosome, providing characteristic T2 * and T2 shortening effects that suppresses the signal of normal or non-tumorous liver tissue. SPIO has dramatically changed the diagnostic algorithm of liver metastasis in clinical practice, now serving as the gold standard instead of CT during arterial portography (CTAP). Its role in the diagnosis of hepatocellular carcinoma (HCC), however, is somewhat complicated, owing to its heterogeneous uptake by the background cirrhotic liver, as well as by some of the HCCs themselves. It has been shown to be useful in the diagnosis of pseudolesions (arterioportal shunts) and some benign hepatocellular lesions (focal nodular hyperplasia or adenoma) by their complete or partial uptake of SPIO, in contrast to an absence of uptake by true liver lesions. It has also been suggested that the histological grade of HCC affects the degree of SPIO uptake. Thus, SPIO serves as a complementary tool to the primary modalities of vascular survey, namely, dynamic CT/MR and CT during hepatic arteriography (CTHA)/CTAP, in the diagnosis of HCC. Gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) is a novel hepatobiliary contrast agent that is not yet available but is supposed to be approved by the Ministry of Health, Labour, and Welfare of Japan in the near future. It is taken up by hepatocytes and excreted into the bile, providing a T1-shortening effect that enhances the normal or non-tumorous liver tissue. It has also been shown to have the effect of positive enhancement of hypervascular liver tumors on the arterial phase, just like the usual extracellular contrast agent (gadopentetate dimeglumine: Gd-DTPA). Thus, Gd-EOB-DTPA was once thought to be an ideal contrast agent for liver tumors, providing information on both

A Software Product Line Process to Develop Agents for the IoT

Directory of Open Access Journals (Sweden)

Inmaculada Ayala

2015-07-01

Full Text Available One of the most important challenges of this decade is the Internet of Things (IoT, which aims to enable things to be connected anytime, anyplace, with anything and anyone, ideally using any path/network and any service. IoT systems are usually composed of heterogeneous and interconnected lightweight devices that support applications that are subject to change in their external environment and in the functioning of these devices. The management of the variability of these changes, autonomously, is a challenge in the development of these systems. Agents are a good option for developing self-managed IoT systems due to their distributed nature, context-awareness and self-adaptation. Our goal is to enhance the development of IoT applications using agents and software product lines (SPL. Specifically, we propose to use Self-StarMASMAS, multi-agent system agents and to define an SPL process using the Common Variability Language. In this contribution, we propose an SPL process for Self-StarMAS, paying particular attention to agents embedded in sensor motes.

A Software Product Line Process to Develop Agents for the IoT.

Science.gov (United States)

Ayala, Inmaculada; Amor, Mercedes; Fuentes, Lidia; Troya, José M

2015-07-01

One of the most important challenges of this decade is the Internet of Things (IoT), which aims to enable things to be connected anytime, anyplace, with anything and anyone, ideally using any path/network and any service. IoT systems are usually composed of heterogeneous and interconnected lightweight devices that support applications that are subject to change in their external environment and in the functioning of these devices. The management of the variability of these changes, autonomously, is a challenge in the development of these systems. Agents are a good option for developing self-managed IoT systems due to their distributed nature, context-awareness and self-adaptation. Our goal is to enhance the development of IoT applications using agents and software product lines (SPL). Specifically, we propose to use Self-StarMASMAS, multi-agent system) agents and to define an SPL process using the Common Variability Language. In this contribution, we propose an SPL process for Self-StarMAS, paying particular attention to agents embedded in sensor motes.

Primary care training and the evolving healthcare system.

Science.gov (United States)

Peccoralo, Lauren A; Callahan, Kathryn; Stark, Rachel; DeCherrie, Linda V

2012-01-01

With growing numbers of patient-centered medical homes and accountable care organizations, and the potential implementation of the Patient Protection and Affordable Care Act, the provision of primary care in the United States is expanding and changing. Therefore, there is an urgent need to create more primary-care physicians and to train physicians to practice in this environment. In this article, we review the impact that the changing US healthcare system has on trainees, strategies to recruit and retain medical students and residents into primary-care internal medicine, and the preparation of trainees to work in the changing healthcare system. Recruitment methods for medical students include early preclinical exposure to patients in the primary-care setting, enhanced longitudinal patient experiences in clinical clerkships, and primary-care tracks. Recruitment methods for residents include enhanced ambulatory-care training and primary-care programs. Financial-incentive programs such as loan forgiveness may encourage trainees to enter primary care. Retaining residents in primary-care careers may be encouraged via focused postgraduate fellowships or continuing medical education to prepare primary-care physicians as both teachers and practitioners in the changing environment. Finally, to prepare primary-care trainees to effectively and efficiently practice within the changing system, educators should consider shifting ambulatory training to community-based practices, encouraging resident participation in team-based care, providing interprofessional educational experiences, and involving trainees in quality-improvement initiatives. Medical educators in primary care must think innovatively and collaboratively to effectively recruit and train the future generation of primary-care physicians. © 2012 Mount Sinai School of Medicine.

Influence of radiographic contrast agents on quantitative coronary angiography

International Nuclear Information System (INIS)

Jost, Stefan; Hausmann, Dirk; Lippolt, Peter; Gerhardt, Uwe; Lichtlen, Paul R.

1997-01-01

Purpose. Quantitative angiographic studies on the vasomotility of epicardial coronary arteries are gaining increasing relevance. We investigated whether radiographic contrast agents might influence coronary vasomotor tone and thereby the results of such studies. Methods. Coronary angiograms were taken in 12 patients with coronary artery disease at intervals of 5, 3, 2, and 1 min with the low-osmolar, nonionic contrast agent iopamidol 300, and were repeated at identical intervals with the high-osmolar, ionic agent diatrizoate 76%. Results. Quantitative cine film analysis demonstrated no significant diameter changes in angiographically normal and stenotic coronary arteries with iopamidol. With diatrizoate, however, normal segments were dilated 2%±2% (p<0.01) after 2 min and 10%±3% after the 1 min interval (p<0.001). Stenoses showed no uniform responses to diatrizoate. Conclusion. Low-osmolar, nonionic contrast agents should be preferred for quantitative angiographic studies on epicardial coronary vasomotility. When using ionic contrast agents, injection intervals of at least 3 min are required

Developmental pathways of change in fitness and motor competence are related to overweight and obesity status at the end of primary school.

Science.gov (United States)

Rodrigues, Luis P; Stodden, David F; Lopes, Vítor P

2016-01-01

To test how different developmental pathways of health-related physical fitness and motor competence tests relate to weight status (overweight and obesity) at the end of primary school. Longitudinal study on growth, health-related physical fitness, and motor competence of 472 primary school children assessed yearly throughout 1st to 4th grade, with an average age of 6.3±0.7 years of age at 1st grade. Children's pathways of change on each of the fitness and motor competence tests were determined along the four years of the study. Participants were divided into three groups according to their rate of change in each test over time: Low Rate of Change, Average Rate of Change, and High Rate of Change. A logistic regression was used to predict the odds ratio of becoming overweight or obese, depending on the developmental pathway of change in fitness and motor competence across childhood. Children with a low or average rate of change in their developmental pathways of fitness and motor competence were several times more prone to become overweight or obese at the end of primary school (OR 2.0 to 6.3), independent of sex and body mass index at baseline. Specifically, a negative developmental pathway (Low Rate of Change) in cardiorespiratory fitness demonstrated over a six-fold elevated risk of being overweight or obese, compared to peers with a positive pathway. Not all children improve their motor competence and fitness levels over time and many actually regress over time. Developing positive fitness and motor competence pathways during childhood protects from obesity and overweight. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Progressive changes in arch width from primary to early mixed dentition period: A longitudinal study

OpenAIRE

S Sangwan; H S Chawla; A Goyal; K Gauba; U Mohanty

2011-01-01

Objective: The present study was conducted to evaluate, on a longitudinal basis, the changes in intercanine and intermolar widths form the primary to the early mixed dentition periods. Materials and Methods: A total of 38 children aged 4-5 years, with normal occlusion without any proximal caries or any dental anomalies, were selected. The impressions were recorded and casts were prepared. Intercanine and intermolar widths were measured on these dental casts with the help of a digital vernier ...

Alkoxyl- and carbon-centered radicals as primary agents for degrading non-phenolic lignin-substructure model compounds.

Science.gov (United States)

Ohashi, Yasunori; Uno, Yukiko; Amirta, Rudianto; Watanabe, Takahito; Honda, Yoichi; Watanabe, Takashi

2011-04-07

Lignin degradation by white-rot fungi proceeds via free radical reaction catalyzed by oxidative enzymes and metabolites. Basidiomycetes called selective white-rot fungi degrade both phenolic and non-phenolic lignin substructures without penetration of extracellular enzymes into the cell wall. Extracellular lipid peroxidation has been proposed as a possible ligninolytic mechanism, and radical species degrading the recalcitrant non-phenolic lignin substructures have been discussed. Reactions between the non-phenolic lignin model compounds and radicals produced from azo compounds in air have previously been analysed, and peroxyl radical (PR) is postulated to be responsible for lignin degradation (Kapich et al., FEBS Lett., 1999, 461, 115-119). However, because the thermolysis of azo compounds in air generates both a carbon-centred radical (CR) and a peroxyl radical (PR), we re-examined the reactivity of the three radicals alkoxyl radical (AR), CR and PR towards non-phenolic monomeric and dimeric lignin model compounds. The dimeric lignin model compound is degraded by CR produced by reaction of 2,2'-azobis(2-amidinopropane) dihydrochloride (AAPH), which under N(2) atmosphere cleaves the α-β bond in 1-(4-ethoxy-3-methoxyphenyl)-2-(2-methoxyphenoxy)-1,3-propanediol to yield 4-ethoxy-3-methoxybenzaldehyde. However, it is not degraded by the PR produced by reaction of Ce(4+)/tert-BuOOH. In addition, it is degraded by AR produced by reaction of Ti(3+)/tert-BuOOH. PR and AR are generated in the presence and absence of veratryl alcohol, respectively. Rapid-flow ESR analysis of the radical species demonstrates that AR but not PR reacts with the lignin model compound. Thus, AR and CR are primary agents for the degradation of non-phenolic lignin substructures.

Clinical Pharmacology of Chemotherapy Agents in Older People with Cancer

Directory of Open Access Journals (Sweden)

Xiaoye He

2011-01-01

Full Text Available Populations around the world are aging, and the associated increase in cancer incidence has led to the recognition of the importance of geriatric oncology. Chronological age is a poor determinant of pharmacological response to cancer chemotherapy agents. Age-associated changes in physiology and organ function have a significant impact on the clinical pharmacology of cancer chemotherapy agents used in cancer treatment. Altered response to medicines in older people is a consequence of changes in body composition, organ function, concomitant pathophysiology, multiple medications, genetic determinants of drug response, and patient's clinical status. These issues highlight the need to individualize the management of cancer in the older people with consideration of age-related changes in the clinical pharmacology of cancer drugs, analgesics, and adjunctive therapies.

A MULTI-AGENT SYSTEM FOR FOREST TRANSPORT ACTIVITY PLANNING

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Carlos Alberto Araújo Júnior

2017-09-01

Full Text Available This study aims to propose and implement a conceptual model of an intelligent system in a georeferenced environment to determine the design of forest transport fleets. For this, we used a multi-agent systems based tool, which is the subject of studies of distributed artificial intelligence. The proposed model considers the use of plantation mapping (stands and forest roads, as well as information about the different vehicle transport capacities. The system was designed to adapt itself to changes that occur during the forest transport operation process, such as the modification of demanded volume or the inclusion of route restrictions used by the vehicles. For its development, we used the Java programming language associated with the LPSolve library for the optimization calculation, the JADE platform to develop agents, and the ArcGis Runtime to determine the optimal transport routes. Five agents were modelled: the transporter, controller, router, loader and unloader agents. The model is able to determine the amount of trucks among the different vehicles available that meet the demand and availability of routes, with a focus on minimizing the total costs of timber transport. The system can also rearrange itself after the transportation routes change during the process.

Design criteria of primary coolant chemistry in SMART-P

International Nuclear Information System (INIS)

Choi, Byung Seon; Kim, Ah Young; Kim, Seong Hoon; Yoon, Ju Hyeon; Zee, Sung Qunn

2005-01-01

SMART-P differs significantly from commercially designed PWRs. Materials inventories used in SMART-P differ from that at PWRs. All surfaces of the primary circuit with the primary coolant are either made from or plated with stainless steel. The material of steam generator (SG) is also different from that of the standard material of the commercially operating PWRs: titanium alloy for the steam generator tubes. Also, SMART-P primary coolant technology differs from that in PWRs: ammonia is used as a pH raising agent and hydrogen formed due to radiolytic processes is kept in specific range by ammonia dosing. Nevertheless, main objectives of the SMART-P primary coolant are the same as at PWRs: to assure primary system pressure boundary integrity, fuel cladding integrity and to minimize out-of-core radiation buildup. The objective of this work is to introduce the design criteria for the primary water chemistry for SMART-P from the viewpoint of the system characteristics and the chemical design concept

Corroborating the Land Use Change as Primary Determinant of Air Quality Degradation in a Concentric City

Directory of Open Access Journals (Sweden)

Ariva Sugandi Permana

2015-05-01

Full Text Available Bandung City is characterized by concentric land use pattern as found in many naturally grown cities. It radiates from mixed commercial areas in the center to low density residential areas in the periphery. This pattern generates significant traffic volume towards city center. The gener-ated traffic releases emissions and degrades urban air quality since fossil fuel is predominantly used by vehicles in Bandung. In the absence of air polluting industries as well as construction and demolition activities, traffic load generated by land use changes is the only major contribu-tor to air quality degradation in the city. The land use change can therefore be seen as primary determinant of air pollution in Bandung. This study analyses land use changes and its impacts on traffic pattern and air quality. Multivariate correlation between traffic load and land use changes is employed as tool to substantiate the proposition. Relationships between the degree of chang-es in land use, as reflected in traffic loads, and the quantity of two principal air pollutants, namely SO2 and HC are also established to validate the argument. The result of analysis sub-stantiates the correlation between land use changes and air quality degradation.

Improving value in primary total joint arthroplasty care pathways: changes in inpatient physical therapy staffing.

Science.gov (United States)

Pelt, Christopher E; Anderson, Mike B; Pendleton, Robert; Foulks, Matthew; Peters, Christopher L; Gililland, Jeremy M

2017-03-01

An early physical therapy (PT) care pathway was implemented to provide same-day ambulation after total joint arthroplasty by changing PT staffing hours. After receiving an exemption from our institutional review board, we performed a secondary data analysis on a cohort of patients that underwent primary TJA of the hip or knee 6 months before and 12 months after implementation of the change. Data on same-day ambulation rates, length of stay (LOS), and in-hospital costs were reviewed. Early evaluation and mobilization of patients by PT improved on postoperative day (POD) 0 from 64% to 85% after the change ( P ≤ .001). The median LOS before the change was 3.27 days compared to 3.23 days after the change ( P  = .014). Patients with higher American Society of Anesthesiologists scores were less likely to ambulate on POD 0 ( P  = .038) and had longer hospital stays ( P < .001). Early mobilization in the entire cohort was associated with a greater cost savings ( P < .001). A relatively simple change to staffing hours, using resources currently available to us, and little additional financial or institutional investment resulted in a significant improvement in the number of patients ambulating on POD 0, with a modest reduction in both LOS and inpatient costs.

Projected US timber and primary forest product market impacts of climate change mitigation through timber set-asides

Science.gov (United States)

Prakash Nepal; Peter J. Ince; Kenneth E. Skog; Sun J. Chang

2013-01-01

Whereas climate change mitigation involving payments to forest landowners for accumulating carbon on their land may increase carbon stored in forests, it will also affect timber supply and prices. This study estimated the effect on US timber and primary forest product markets of hypothetical timber set-aside scenarios where US forest landowners would be paid to forego...

Propagation of the state change induced by external forces in local interactions

Science.gov (United States)

Lu, Jianjun; Tokinaga, Shozo

2016-10-01

This paper analyses the propagation of the state changes of agents that are induced by external forces applied to a plane. In addition, we propose two models for the behavior of the agents placed on a lattice plane, both of which are affected by local interactions. We first assume that agents are allowed to move to another site to maximise their satisfaction. Second, we utilise a model in which the agents choose activities on each site. The results show that the migration (activity) patterns of agents in both models achieve stability without any external forces. However, when we apply an impulsive external force to the state of the agents, we then observe the propagation of the changes in the agents' states. Using simulation studies, we show the conditions for the propagation of the state changes of the agents. We also show the propagation of the state changes of the agents allocated in scale-free networks and discuss the estimation of the agents' decisions in real state changes. Finally, we discuss the estimation of the agents' decisions in real state temporal changes using economic and social data from Japan and the United States.

[Variation trends of natural vegetation net primary productivity in China under climate change scenario].

Science.gov (United States)

Zhao, Dong-sheng; Wu, Shao-hong; Yin, Yun-he

2011-04-01

Based on the widely used Lund-Potsdam-Jena Dynamic Global Vegetation Model (LPJ) for climate change study, and according to the features of natural environment in China, the operation mechanism of the model was adjusted, and the parameters were modified. With the modified LPJ model and taking 1961-1990 as baseline period, the responses of natural vegetation net primary productivity (NPP) in China to climate change in 1991-2080 were simulated under the Special Report on Emissions Scenarios (SRES) B2 scenario. In 1961-1990, the total NPP of natural vegetation in China was about 3.06 Pg C a(-1); in 1961-2080, the total NPP showed a fluctuant decreasing trend, with an accelerated decreasing rate. Under the condition of slight precipitation change, the increase of mean air temperature would have definite adverse impact on the NPP. Spatially, the NPP decreased from southeast coast to northwest inland, and this pattern would have less variation under climate change. In eastern China with higher NPP, especially in Northeast China, east of North China, and Loess Plateau, the NPP would mainly have a decreasing trend; while in western China with lower NPP, especially in the Tibetan Plateau and Tarim Basin, the NPP would be increased. With the intensive climate change, such a variation trend of NPP would be more obvious.

Progressive changes in arch width from primary to early mixed dentition period: A longitudinal study

Directory of Open Access Journals (Sweden)

S Sangwan

2011-01-01

Full Text Available Objective: The present study was conducted to evaluate, on a longitudinal basis, the changes in intercanine and intermolar widths form the primary to the early mixed dentition periods. Materials and Methods: A total of 38 children aged 4-5 years, with normal occlusion without any proximal caries or any dental anomalies, were selected. The impressions were recorded and casts were prepared. Intercanine and intermolar widths were measured on these dental casts with the help of a digital vernier calliper. After 3 years follow-up, the impressions were recorded again and dental casts were prepared. Intercanine and intermolar widths were measured again at this stage and were compared with the baseline data using the paired t-test and the chi square test. Results: There is a significant increase in the intercanine (3.93 + 1.70 mm and intermolar width (1.49 + 1.77 mm during the transition period from primary to early mixed dentition in both the arches and both the sexes. The gender-wise comparison showed a greater increase in males than in females, but this was not statistically significant. Conclusion: A thorough knowledge of growth changes during various stages of the mixed dentition period are important for a pediatric dentist to make an accurate diagnosis and treatment planning during preventive and interceptive orthodontics.

A Composite Agent Architecture for Multi-Agent Simulations

OpenAIRE

VanPutte, Michael; Osborn, Brian; Hiles, John

2002-01-01

CGF Computer Generated Forces and Behavioral Representation The MOVES Institute’s Computer-Generated Autonomy Group has focused on a research goal of modeling complex and adaptive behavior while at the same time making the behavior easier to create and control. This research has led to several techniques for agent construction, that includes a social and organization relationship management engine, a composite agent architecture, an agent goal apparatus, a structure for capturi...

TACtic- A Multi Behavioral Agent for Trading Agent Competition

Science.gov (United States)

Khosravi, Hassan; Shiri, Mohammad E.; Khosravi, Hamid; Iranmanesh, Ehsan; Davoodi, Alireza

Software agents are increasingly being used to represent humans in online auctions. Such agents have the advantages of being able to systematically monitor a wide variety of auctions and then make rapid decisions about what bids to place in what auctions. They can do this continuously and repetitively without losing concentration. To provide a means of evaluating and comparing (benchmarking) research methods in this area the trading agent competition (TAC) was established. This paper describes the design, of TACtic. Our agent uses multi behavioral techniques at the heart of its decision making to make bidding decisions in the face of uncertainty, to make predictions about the likely outcomes of auctions, and to alter the agent's bidding strategy in response to the prevailing market conditions.

Agent-Based Modeling of China's Rural-Urban Migration and Social Network Structure.

Science.gov (United States)

Fu, Zhaohao; Hao, Lingxin

2018-01-15

We analyze China's rural-urban migration and endogenous social network structures using agent-based modeling. The agents from census micro data are located in their rural origin with an empirical-estimated prior propensity to move. The population-scale social network is a hybrid one, combining observed family ties and locations of the origin with a parameter space calibrated from census, survey and aggregate data and sampled using a stepwise Latin Hypercube Sampling method. At monthly intervals, some agents migrate and these migratory acts change the social network by turning within-nonmigrant connections to between-migrant-nonmigrant connections, turning local connections to nonlocal connections, and adding among-migrant connections. In turn, the changing social network structure updates migratory propensities of those well-connected nonmigrants who become more likely to move. These two processes iterate over time. Using a core-periphery method developed from the k -core decomposition method, we identify and quantify the network structural changes and map these changes with the migration acceleration patterns. We conclude that network structural changes are essential for explaining migration acceleration observed in China during the 1995-2000 period.

Agent-based modeling of China's rural-urban migration and social network structure

Science.gov (United States)

Fu, Zhaohao; Hao, Lingxin

2018-01-01

We analyze China's rural-urban migration and endogenous social network structures using agent-based modeling. The agents from census micro data are located in their rural origin with an empirical-estimated prior propensity to move. The population-scale social network is a hybrid one, combining observed family ties and locations of the origin with a parameter space calibrated from census, survey and aggregate data and sampled using a stepwise Latin Hypercube Sampling method. At monthly intervals, some agents migrate and these migratory acts change the social network by turning within-nonmigrant connections to between-migrant-nonmigrant connections, turning local connections to nonlocal connections, and adding among-migrant connections. In turn, the changing social network structure updates migratory propensities of those well-connected nonmigrants who become more likely to move. These two processes iterate over time. Using a core-periphery method developed from the k-core decomposition method, we identify and quantify the network structural changes and map these changes with the migration acceleration patterns. We conclude that network structural changes are essential for explaining migration acceleration observed in China during the 1995-2000 period.

DEPRESSION IN PRIMARY CARE. PART 2: MANAGEMENT

Directory of Open Access Journals (Sweden)

XV Pereira

2007-01-01

Full Text Available The management of depression in the primary care setting should ideally take a biological, psychological, and sociologicalapproach. Antidepressants are the most commonly used biological agents in the treatment of depression. Psychologicaltherapies and psychosocial interventions improve the outcome of treatment when combined with pharmacotherapy.Clinical depression is treatable and thus efforts should be made to alleviate the suffering of patients with depression.

Geometry of behavioral spaces: A computational approach to analysis and understanding of agent based models and agent behaviors

Science.gov (United States)

Cenek, Martin; Dahl, Spencer K.

2016-11-01

Systems with non-linear dynamics frequently exhibit emergent system behavior, which is important to find and specify rigorously to understand the nature of the modeled phenomena. Through this analysis, it is possible to characterize phenomena such as how systems assemble or dissipate and what behaviors lead to specific final system configurations. Agent Based Modeling (ABM) is one of the modeling techniques used to study the interaction dynamics between a system's agents and its environment. Although the methodology of ABM construction is well understood and practiced, there are no computational, statistically rigorous, comprehensive tools to evaluate an ABM's execution. Often, a human has to observe an ABM's execution in order to analyze how the ABM functions, identify the emergent processes in the agent's behavior, or study a parameter's effect on the system-wide behavior. This paper introduces a new statistically based framework to automatically analyze agents' behavior, identify common system-wide patterns, and record the probability of agents changing their behavior from one pattern of behavior to another. We use network based techniques to analyze the landscape of common behaviors in an ABM's execution. Finally, we test the proposed framework with a series of experiments featuring increasingly emergent behavior. The proposed framework will allow computational comparison of ABM executions, exploration of a model's parameter configuration space, and identification of the behavioral building blocks in a model's dynamics.

3-bromopyruvate: a new targeted antiglycolytic agent and a promise for cancer therapy.

Science.gov (United States)

Ganapathy-Kanniappan, S; Vali, M; Kunjithapatham, R; Buijs, M; Syed, L H; Rao, P P; Ota, S; Kwak, B K; Loffroy, R; Geschwind, J F

2010-08-01

The pyruvate analog, 3-bromopyruvate, is an alkylating agent and a potent inhibitor of glycolysis. This antiglycolytic property of 3-bromopyruvate has recently been exploited to target cancer cells, as most tumors depend on glycolysis for their energy requirements. The anticancer effect of 3-bromopyruvate is achieved by depleting intracellular energy (ATP) resulting in tumor cell death. In this review, we will discuss the principal mechanism of action and primary targets of 3-bromopyruvate, and report the impressive antitumor effects of 3-bromopyruvate in multiple animal tumor models. We describe that the primary mechanism of 3-bromopyruvate is via preferential alkylation of GAPDH and that 3-bromopyruvate mediated cell death is linked to generation of free radicals. Research in our laboratory also revealed that 3-bromopyruvate induces endoplasmic reticulum stress, inhibits global protein synthesis further contributing to cancer cell death. Therefore, these and other studies reveal the tremendous potential of 3-bromopyruvate as an anticancer agent.

Reducing Change Management Complexity: Aligning Change Recipient Sensemaking to Change Agent Sensegiving

Science.gov (United States)

Kumar; Payal; Singhal, Manish

2012-01-01

Implementation of change in an organisation through culture can elicit a wide array of reactions from organisational members, spanning from acceptance to resistance. Drawing on Hatch's cultural dynamics model and on Wegner's social theory of learning, this paper dwells on an underdeveloped area in the extant literature, namely understanding change…

Tacrolimus versus cyclosporin as primary immunosuppression for lung transplant recipients

DEFF Research Database (Denmark)

Penninga, Luit; Penninga, Ida Elisabeth Irene; Møller, Christian H

2013-01-01

Lung transplantation is a well-accepted treatment for people with most end-stage lung diseases. Although both tacrolimus and cyclosporin are used as primary immunosuppressive agents in lung transplant recipients, it is unclear which of these drugs is better in reducing rejection and death without...

Changes of postoperative macular structure in primary angle closure disease complicated with cataract

Directory of Open Access Journals (Sweden)

Wen-long Liu

2018-02-01

Full Text Available AIM: To explore the change of postoperative macular structure in primary angle closure disease(PACDcomplicated with cataract. METHODS: The clinical data of 200 cases of PACD patients complicated with cataract treated in our hospital were analyzed retrospectively. The patients were divided into the Group A(n=60, 60 eyes, treated with trabeculectomy, the Group B(n=72, 72 eyes, given the phacoemulsification combined with intraocular lens implantationand the Group C(n=68, 68 eyes, given the trabeculectomy and phacoemulsification combined with intraocular lens implantation. The vision changes before and after treatment and the changes of intraocular pressure and macular thickness(foveal area, near central area, foveal surrounding areabefore operation and at 1wk, 1 and 3mo after operation were compared and observed, and the incidence of complications was compared between the two groups. RESULTS: There were significant differences in the improvement rate and reduction rate of visual acuity among three groups at 3mo after operation(PPPPPPPPPCONCLUSION: Phacoemulsification combined with intraocular lens implantation can relieve angle closure caused by pupillary block and lens factors, and can significantly improve the vision and reduce intraocular pressure of PACD patients with cataract, and it has small effects on postoperative macular edema with few complications.

Co-creating value through agents interaction within service network

International Nuclear Information System (INIS)

Okdinawati, L.; Simatupang, T.M.; Sunitiyoso, Y.

2017-01-01

The purpose of this paper is to gives further understanding on value co-creation mechanisms in B-to-B service network by reinforcing the processes, the relationships, and influences of other agents where Collaborative Transportation Management (CTM) forms might be best employed. Design/methodology/approach: In order to model the interactions among agents in the collaboration processes and the value co-creation processes, this research used three collaboration cases in Indonesia. Then, the agent-based simulation was used to capture both the collaboration process and the value co-creation process of the three collaboration cases. Findings: The interactions among the agents both inside and outside their collaboration environment determined agent’s role as a value co-creator. The willingness of an agent to accept the opinion of another agent determined the degree of their willingness to co-operate and to change their strategies, and perceptions. Therefore, influenced the size of the value obtained by them in each collaboration process. Research limitations/implications: The findings of the simulations subject to assumptions based on the collaboration cases. Further research is related to how to encourage agents to co-operate and adjust their perceptions. Practical implications: It is crucial for the practitioners to interact with another agent both inside and outside their collaboration environment. The opinions of another agent inside the collaboration environment also need to be considered. Originality/value: This research is derived from its emphasis on how a value is co-created by reinforcing both the collaborative processes and the interactions among agents as well as on how CTM might be best employed.

Co-creating value through agents interaction within service network

Energy Technology Data Exchange (ETDEWEB)

Okdinawati, L.; Simatupang, T.M.; Sunitiyoso, Y.

2017-07-01

The purpose of this paper is to gives further understanding on value co-creation mechanisms in B-to-B service network by reinforcing the processes, the relationships, and influences of other agents where Collaborative Transportation Management (CTM) forms might be best employed. Design/methodology/approach: In order to model the interactions among agents in the collaboration processes and the value co-creation processes, this research used three collaboration cases in Indonesia. Then, the agent-based simulation was used to capture both the collaboration process and the value co-creation process of the three collaboration cases. Findings: The interactions among the agents both inside and outside their collaboration environment determined agent’s role as a value co-creator. The willingness of an agent to accept the opinion of another agent determined the degree of their willingness to co-operate and to change their strategies, and perceptions. Therefore, influenced the size of the value obtained by them in each collaboration process. Research limitations/implications: The findings of the simulations subject to assumptions based on the collaboration cases. Further research is related to how to encourage agents to co-operate and adjust their perceptions. Practical implications: It is crucial for the practitioners to interact with another agent both inside and outside their collaboration environment. The opinions of another agent inside the collaboration environment also need to be considered. Originality/value: This research is derived from its emphasis on how a value is co-created by reinforcing both the collaborative processes and the interactions among agents as well as on how CTM might be best employed.

Inter-generational change in African elephant range use is associated with poaching risk, primary productivity and adult mortality.

Science.gov (United States)

Goldenberg, Shifra Z; Douglas-Hamilton, Iain; Wittemyer, George

2018-05-30

Repeated use of the same areas may benefit animals as they exploit familiar sites, leading to consistent home ranges over time that can span generations. Changing risk landscapes may reduce benefits associated with home range fidelity, however, and philopatric animals may alter movement in response to new pressures. Despite the importance of range changes to ecological and evolutionary processes, little tracking data have been collected over the long-term nor has range change been recorded in response to human pressures across generations. Here, we investigate the relationships between ecological, demographic and human variables and elephant ranging behaviour across generations using 16 years of tracking data from nine distinct female social groups in a population of elephants in northern Kenya that was heavily affected by ivory poaching during the latter half of the study. Nearly all groups-including those that did not experience loss of mature adults-exhibited a shift north over time, apparently in response to increased poaching in the southern extent of the study area. However, loss of mature adults appeared to be the primary indicator of range shifts and expansions, as generational turnover was a significant predictor of range size increases and range centroid shifts. Range expansions and northward shifts were associated with higher primary productivity and lower poached carcass densities, while westward shifts exhibited a trend to areas with higher values of primary productivity and higher poached carcass densities relative to former ranges. Together these results suggest a trade-off between resource access, mobility and safety. We discuss the relevance of these results to elephant conservation efforts and directions meriting further exploration in this disrupted society of a keystone species. © 2018 The Author(s).

Primary gastric Hodgkin's lymphoma: favourable outcome following multi-agent chemotherapy without surgical intervention.

LENUS (Irish Health Repository)

Quintyne, K I

2011-02-01

The authors report the case of a 51-year-old man who presented with left-sided abdominal pain and weight loss associated with drenching night sweats. Preliminary blood tests yielded no specific cause for his symptoms, but abdominal ultrasound revealed multiple hepatic lesions and peripancreatic lymphadenopathy. Further imaging, including positron emission tomography (PET)\\/CT, revealed fludeoxyglucose 18F (FDG) avid uptake within lymphadenopathy above and below the diaphragm and also noted gastric thickening. Diagnosis was established with gastric biopsy and revealed gastric Hodgkin\\'s lymphoma. He was started on and tolerated multi-agent chemotherapy. Repeated PET\\/CT and gastric biopsy showed complete metabolic and pathologic response to treatment.

Contrasts agents in magnetic resonance imaging

International Nuclear Information System (INIS)

Bonnet, P.A.; Fernandez, J.P.; Milhavet, J.C.; Chapat, J.P.; Almes, C.; Bruel, J.M.; Rouanet, J.P.; Lamarque, J.L.

1984-01-01

Changing different parameters involved in imaging procedures, paramagnetic substances provide contrast enhancement in MRI. Contrast agents presently studied in animals and clinical trials, are either salts or complexes of mineral ions either nitroxide stable free radicals. Their development should extend the possibilities of tissular characterization and fonctional or metabolic evaluation of the MRI [fr

Teachers as Agents of Social Change

Science.gov (United States)

Bourn, Douglas

2016-01-01

Teachers are seen as key actors of change within programmes and projects on global learning. But all too often they are regarded in an instrumental way or as promoters of some form of ideal global teacher. Evidence from the UK and elsewhere suggests that if a pedagogical approach is taken to the role of teachers within the process of learning,…

A pilot study of a Community Health Agent-led type 2 diabetes self-management program using Motivational Interviewing-based approaches in a public primary care center in São Paulo, Brazil.

Science.gov (United States)

do Valle Nascimento, Thais Moura Ribeiro; Resnicow, Ken; Nery, Marcia; Brentani, Alexandra; Kaselitz, Elizabeth; Agrawal, Pooja; Mand, Simanjit; Heisler, Michele

2017-01-13

Rates of noncommunicable diseases (NCDs) such as type 2 diabetes are escalating in low and middle-income countries such as Brazil. Scalable primary care-based interventions are needed to improve self-management and clinical outcomes of adults with diabetes. This pilot study examines the feasibility, acceptability, and outcomes of training community health agents (CHAs) in Motivational Interviewing (MI)-based counseling for patients with poorly controlled diabetes in a primary care center in São Paulo, Brazil. Nineteen salaried CHAs participated in 32 h of training in MI and behavioral action planning. With support from booster training sessions, they used these skills in their regular monthly home visits over a 6 month period with 57 diabetes patients with baseline HbA1cs > 7.0%. The primary outcome was patients' reports of the quality of diabetes care as measured by the Portuguese version of the Patient Assessment of Chronic Illness Care (PACIC) scale. Secondary outcomes included changes in patients' reported diabetes self-management behaviors and in A1c, blood pressure, cholesterol and triglycerides. We also examined CHAs' fidelity to and experiences with the intervention. Patients reported improvements over the 6 month period in quality of diabetes care received (PACIC score improved 33 (+/-19) to 68 (+/-21) (p < .001)). They reported increases in physical activity (p = .001), consumption of fruits and vegetables (p < .001) and medication adherence (p = .002), but no decreases in consumption of high-fat foods (p = .402) or sweets (p = .436). Participants had mean 6-month A1c levels 0.34% points lower than at baseline (p = .08) and improved mean LDL (-16.1 mg/dL, p = .005) and triglyceride levels (-38.725 mg/dL, p = .002). Of the 16 CHAs observed in fidelity assessments, 13 were categorized as medium- or high-performing on MI skills, while 3 were low-performing. CHAs expressed enthusiasm about learning new skills, and many

Temporal association between changes in primary sensory cortex and corticomotor output during muscle pain.

Science.gov (United States)

Schabrun, S M; Jones, E; Kloster, J; Hodges, P W

2013-04-03

Integration of information between multiple cortical regions is thought to underpin the experience of pain. Yet studies tend to focus on pain related changes in discrete cortical regions. Although altered processing in the primary motor (M1) and sensory cortex (S1) is implicated in pain, the temporal relationship between these regions is unknown and may provide insight into the interaction between them. We used recordings of somatosensory-evoked potentials (SEPs) and transcranial magnetic stimulation to investigate the temporal relationship between altered excitability of the primary sensory cortex and corticomotor output during and after muscle pain induced by hypertonic saline infusion into the right first dorsal interosseous. SEPs and motor-evoked potentials (MEPs) were recorded in 12 healthy individuals. Participants reported an average pain intensity of 5.4 (0.5) on a 10-cm visual analogue scale. The area of the N20-P25-N33 complex of the SEP was reduced during and after pain, but MEP amplitudes were suppressed only after pain had resolved. Our data show that pain reduces sensory processing before motor output is altered. This temporal dispersion, coupled with the lack of correlation between pain-induced changes in S1 and M1 excitability, imply either that independent processes are involved, or that reduced excitability of S1 during acute experimental muscle pain mediates latent reductions in motor output via processes that are non-linear and potentially involve activation of a wider brain network. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Infections and exposure to anti-infective agents and the risk of severe mental disorders

DEFF Research Database (Denmark)

Köhler, Ole; Petersen, Liselotte; Mors, O

2017-01-01

OBJECTIVE: Severe infections are associated with increased risks of mental disorders; however, this is the first large-scale study investigating whether infections treated with anti-infective agents in the primary care setting increase the risks of schizophrenia and affective disorders. METHOD: We...

Primary evaluation of a nickel-chlorophyll derivative as a multimodality agent for tumor imaging and photodynamic therapy

International Nuclear Information System (INIS)

Ozge Er; Fatma Yurt Lambrecht; Kasim Ocakoglu; Cagla Kayabasi; Cumhur Gunduz

2015-01-01

In this study, the biological potential of a nickel chlorophyll derivative (Ni-PH-A) as a multimodal agent for tumor imaging and photodynamic therapy (PDT) was investigated. Optimum conditions of labeling with 131 I were investigated and determined as pH 10 and 1 mg amount of iodogen. Biodistribution results of 131 I labeled Ni-PH-A in female rats indicated that radiolabeled Ni-PH-A maximum uptake in the liver, spleen and ovary was observed at 30 min. Intercellular uptake and PDT efficacy of Ni-PH-A were better in MDAH-2774 (human ovarian endometrioid adenocarcinoma) than in MCF-7 (human breast adenocarcinoma) cells. Ni-PH-A might be a promising multimodal agent for lung, ovary and liver tumor imaging and PDT. (author)

Evolution of natural agents: preservation, advance, and emergence of functional information.

Science.gov (United States)

Sharov, Alexei A

2016-04-01

Biological evolution is often viewed narrowly as a change of morphology or allele frequency in a sequence of generations. Here I pursue an alternative informational concept of evolution, as preservation, advance, and emergence of functional information in natural agents. Functional information is a network of signs (e.g., memory, transient messengers, and external signs) that are used by agents to preserve and regulate their functions. Functional information is preserved in evolution via complex interplay of copying and construction processes: the digital components are copied, whereas interpreting subagents together with scaffolds, tools, and resources, are constructed. Some of these processes are simple and invariant, whereas others are complex and contextual. Advance of functional information includes improvement and modification of already existing functions. Although the genome information may change passively and randomly, the interpretation is active and guided by the logic of agent behavior and embryonic development. Emergence of new functions is based on the reinterpretation of already existing information, when old tools, resources, and control algorithms are adopted for novel functions. Evolution of functional information progressed from protosemiosis, where signs correspond directly to actions, to eusemiosis, where agents associate signs with objects. Language is the most advanced form of eusemiosis, where the knowledge of objects and models is communicated between agents.

Quantitation of MRI sensitivity to quasi-monodisperse microbubble contrast agents for spatially resolved manometry.

Science.gov (United States)

Bencsik, Martin; Al-Rwaili, Amgad; Morris, Robert; Fairhurst, David J; Mundell, Victoria; Cave, Gareth; McKendry, Jonathan; Evans, Stephen

2013-11-01

The direct in-vivo measurement of fluid pressure cannot be achieved with MRI unless it is done with the contribution of a contrast agent. No such contrast agents are currently available commercially, whilst those demonstrated previously only produced qualitative results due to their broad size distribution. Our aim is to quantitate then model the MR sensitivity to the presence of quasi-monodisperse microbubble populations. Lipid stabilised microbubble populations with mean radius 1.2 ± 0.8 μm have been produced by mechanical agitation. Contrast agents with increasing volume fraction of bubbles up to 4% were formed and the contribution the bubbles bring to the relaxation rate was quantitated. A periodic pressure change was also continuously applied to the same contrast agent, until MR signal changes were only due to bubble radius change and not due to a change in bubble density. The MR data compared favourably with the prediction of an improved numerical simulation. An excellent MR sensitivity of 23 % bar(-1) has been demonstrated. This work opens up the possibility of generating microbubble preparations tailored to specific applications with optimised MR sensitivity, in particular MRI based in-vivo manometry. Copyright © 2012 Wiley Periodicals, Inc.

Transforming stand-alone expert system into a community of cooperating agents

CERN Document Server

Jennings, N R; Aarnts, R P; Fuchs, J; Skarek, Paul

1993-01-01

Distributed Artificial Intelligence (DAI) systems in which multiple problem solving agents cooperate to achieve a common objective is a rapidly emerging and promising technology. However, as yet, there have been relatively few reported cases of such systems being employed to tackle real-world problems in realistic domains. One of the reasons for this is that DAI researchers have given virtually no consideration to the process of incorporating pre-existing systems into a community of cooperating agents. Yet reuse is a primary consideration for any organisation with a large software base. To redress the balance, this paper reports on an experiment undertaken at the CERN laboratories, in which two pre-existing and standalone expert systems for diagnosing faults in a particle accelerator were transformed into a community of cooperating agents. The experiences and insights gained during this process provide a valuable first step towards satisfying the needs of potential users of DAI technology - identifying the ty...

Dynamic aggregation evolution of competitive societies of cooperative and noncooperative agents

International Nuclear Information System (INIS)

Lin Zhen-Quan; Ye Gao-Xiang

2013-01-01

We propose an evolution model of cooperative agent and noncooperative agent aggregates to investigate the dynamic evolution behaviors of the system and the effects of the competing microscopic reactions on the dynamic evolution. In this model, each cooperative agent and noncooperative agent are endowed with integer values of cooperative spirits and noncooperative spirits, respectively. The cooperative spirits of a cooperative agent aggregate and the noncooperative spirits of a noncooperative agent aggregate change via four competing microscopic reaction schemes: the win-win reaction between two cooperative agents, the lose-lose reaction between two noncooperative agents, the win-lose reaction between a cooperative agent and a noncooperative agent (equivalent to the migration of spirits from cooperative agents to noncooperative agents), and the cooperative agent catalyzed decline of noncooperative spirits. Based on the generalized Smoluchowski's rate equation approach, we investigate the dynamic evolution behaviors such as the total cooperative spirits of all cooperative agents and the total noncooperative spirits of all noncooperative agents. The effects of the three main groups of competition on the dynamic evolution are revealed. These include: (i) the competition between the lose-lose reaction and the win-lose reaction, which gives rise to respectively the decrease and increase in the noncooperative agent spirits; (ii) the competition between the win-win reaction and the win-lose reaction, which gives rise to respectively the increase and decrease in the cooperative agent spirits; (iii) the competition between the win-lose reaction and the catalyzed-decline reaction, which gives rise to respectively the increase and decrease in the noncooperative agent spirits. (interdisciplinary physics and related areas of science and technology)

Multi-Agent Pathfinding with n Agents on Graphs with n Vertices

DEFF Research Database (Denmark)

Förster, Klaus-Tycho; Groner, Linus; Hoefler, Torsten

2017-01-01

We investigate the multi-agent pathfinding (MAPF) problem with $n$ agents on graphs with $n$ vertices: Each agent has a unique start and goal vertex, with the objective of moving all agents in parallel movements to their goal s.t.~each vertex and each edge may only be used by one agent at a time....... We give a combinatorial classification of all graphs where this problem is solvable in general, including cases where the solvability depends on the initial agent placement. Furthermore, we present an algorithm solving the MAPF problem in our setting, requiring O(n²) rounds, or O(n³) moves...... of individual agents. Complementing these results, we show that there are graphs where Omega(n²) rounds and Omega(n³) moves are required for any algorithm....

Bridging the gap in ageing: Translating policies into practice in Malaysian Primary Care

Directory of Open Access Journals (Sweden)

Ambigga Krishnapillai S

2011-03-01

Full Text Available Abstract Population ageing is poised to become a major challenge to the health system as Malaysia progresses to becoming a developed nation by 2020. This article aims to review the various ageing policy frameworks available globally; compare aged care policies and health services in Malaysia with Australia; and discuss various issues and challenges in translating these policies into practice in the Malaysian primary care system. Fundamental solutions identified to bridge the gap include restructuring of the health care system, development of comprehensive benefit packages for older people under the national health financing scheme, training of the primary care workforce, effective use of electronic medical records and clinical guidelines; and empowering older people and their caregivers with knowledge, skills and positive attitudes to ageing and self care. Ultimately, family medicine specialists must become the agents for change to lead multidisciplinary teams and work with various agencies to ensure that better coordination, continuity and quality of care are eventually delivered to older patients across time and settings.

Exploring complex dynamics in multi agent-based intelligent systems: Theoretical and experimental approaches using the Multi Agent-based Behavioral Economic Landscape (MABEL) model

Science.gov (United States)

Alexandridis, Konstantinos T.

This dissertation adopts a holistic and detailed approach to modeling spatially explicit agent-based artificial intelligent systems, using the Multi Agent-based Behavioral Economic Landscape (MABEL) model. The research questions that addresses stem from the need to understand and analyze the real-world patterns and dynamics of land use change from a coupled human-environmental systems perspective. Describes the systemic, mathematical, statistical, socio-economic and spatial dynamics of the MABEL modeling framework, and provides a wide array of cross-disciplinary modeling applications within the research, decision-making and policy domains. Establishes the symbolic properties of the MABEL model as a Markov decision process, analyzes the decision-theoretic utility and optimization attributes of agents towards comprising statistically and spatially optimal policies and actions, and explores the probabilogic character of the agents' decision-making and inference mechanisms via the use of Bayesian belief and decision networks. Develops and describes a Monte Carlo methodology for experimental replications of agent's decisions regarding complex spatial parcel acquisition and learning. Recognizes the gap on spatially-explicit accuracy assessment techniques for complex spatial models, and proposes an ensemble of statistical tools designed to address this problem. Advanced information assessment techniques such as the Receiver-Operator Characteristic curve, the impurity entropy and Gini functions, and the Bayesian classification functions are proposed. The theoretical foundation for modular Bayesian inference in spatially-explicit multi-agent artificial intelligent systems, and the ensembles of cognitive and scenario assessment modular tools build for the MABEL model are provided. Emphasizes the modularity and robustness as valuable qualitative modeling attributes, and examines the role of robust intelligent modeling as a tool for improving policy-decisions related to land

Use of 2,5-dimethyl-2,5-hexane diamine as a curing agent for epoxy resins. [Patent application

Science.gov (United States)

Rinde, J.A.; Newey, H.A.

Primary diamines are prepared for use as a curing agent for epoxy resins. These curing agents can be used to form epoxy resin mixtures useful in filament winding and preimpregnated fiber molding and in formulating film adhesives, powder coatings and molding powders. The epoxy mixtures form for such uses a room temperature non-reacting, intermediate stable state which has a latent cross-linking capability.

Nature of chromosome gaps induced by alkylating agents and γ-rays as revealed by caffeine treatment

International Nuclear Information System (INIS)

Dimitrov, B.

1981-01-01

In the cells of primary roots of Crepis capillaris, post-treatment with caffeine increased the frequency of gaps and chromosomal aberrations induced by the alkylating agents ethyleneimine and N-nitroso-N-methylurethane and γ-rays. The increase in the frequency of gaps was considerably lower than that observed in chromosomal aberrations, this being more strongly expressed in the case fo the alkylating agents. The potentiating effect of caffeine on the γ-ray-induced chromosomal gaps was a little higher in S as compared in G 2 . These results lead to the conclusion that the alkylating agents and the γ-rays might induce 2 types of chromosomal gap. (orig.)

9th KES Conference on Agent and Multi-Agent Systems : Technologies and Applications

CERN Document Server

Howlett, Robert; Jain, Lakhmi

2015-01-01

Agents and multi-agent systems are related to a modern software paradigm which has long been recognized as a promising technology for constructing autonomous, complex and intelligent systems. The topics covered in this volume include agent-oriented software engineering, agent co-operation, co-ordination, negotiation, organization and communication, distributed problem solving, specification of agent communication languages, agent privacy, safety and security, formalization of ontologies and conversational agents. The volume highlights new trends and challenges in agent and multi-agent research and includes 38 papers classified in the following specific topics: learning paradigms, agent-based modeling and simulation, business model innovation and disruptive technologies, anthropic-oriented computing, serious games and business intelligence, design and implementation of intelligent agents and multi-agent systems, digital economy, and advances in networked virtual enterprises. Published p...

Surface Modification of Gd Nanoparticles with pH-Responsive Block Copolymers for Use As Smart MRI Contrast Agents.

Science.gov (United States)

Zhu, Liping; Yang, Yuan; Farquhar, Kirsten; Wang, Jingjing; Tian, Chixia; Ranville, James; Boyes, Stephen G

2016-02-01

Despite recent advances in the understanding of fundamental cancer biology, cancer remains the second most common cause of death in the United States. One of the primary factors indicative of high cancer morbidity and mortality and aggressive cancer phenotypes is tumors with a low extracellular pH (pHe). Thus, the ability to measure tumor pHe in vivo using noninvasive and accurate techniques that also provide high spatiotemporal resolution has become increasingly important and is of great interest to researchers and clinicians. In an effort to develop a pH-responsive magnetic resonance imaging (MRI) contrast agent (CA) that has the potential to be used to measure tumor pHe, well-defined pH-responsive polymers, synthesized via reversible addition-fragmentation chain transfer polymerization, were attached to the surface of gadolinium-based nanoparticles (GdNPs) via a "grafting to" method after reduction of the thiocarbonylthio end groups. The successful modification of the GdNPs was verified by transmission electron microscopy, Fourier transform infrared spectroscopy, thermogravimetric analysis and dynamic light scattering. The performance of the pH-responsive polymer modified GdNPs was then evaluated for potential use as smart MRI CAs via monitoring the relaxivity changes with changing environmental pH. The results suggested that the pH-responsive polymers can be used to effectively modify the GdNPs surface to prepare a smart contrast agent for MRI.

Can We Predict the Efficacy of Anti-TNF-α Agents?

Science.gov (United States)

Lopetuso, Loris Riccardo; Gerardi, Viviana; Papa, Valerio; Scaldaferri, Franco; Rapaccini, Gian Lodovico; Gasbarrini, Antonio; Papa, Alfredo

2017-09-14

The use of biologic agents, particularly anti-tumor necrosis factor (TNF)-α, has revolutionized the treatment of inflammatory bowel diseases (IBD), modifying their natural history. Several data on the efficacy of these agents in inducing and maintaining clinical remission have been accumulated over the past two decades: their use avoid the need for steroids therapy, promote mucosal healing, reduce hospitalizations and surgeries and therefore dramatically improve the quality of life of IBD patients. However, primary non-response to these agents or loss of response over time mainly due to immunogenicity or treatment-related side-effects are a frequent concern in IBD patients. Thus, the identification of predicting factors of efficacy is crucial to allow clinicians to efficiently use these therapies, avoiding them when they are ineffective and eventually shifting towards alternative biological therapies with the end goal of optimizing the cost-effectiveness ratio. In this review, we aim to identify the predictive factors of short- and long-term benefits of anti-TNF-α therapy in IBD patients. In particular, multiple patient-, disease- and treatment-related factors have been evaluated.

Analysis of health behaviour change interventions for preventing dental caries delivered in primary schools.

Science.gov (United States)

Adair, P M; Burnside, G; Pine, C M

2013-01-01

To improve oral health in children, the key behaviours (tooth brushing and sugar control) responsible for development of dental caries need to be better understood, as well as how to promote these behaviours effectively so they become habitual; and, the specific, optimal techniques to use in interventions. The aim of this paper is to describe and analyse the behaviour change techniques that have been used in primary school-based interventions to prevent dental caries (utilizing a Cochrane systematic review that we have undertaken) and to identify opportunities for improving future interventions by incorporating a comprehensive range of behaviour change techniques. Papers of five interventions were reviewed and data were independently extracted. Results indicate that behaviour change techniques were limited to information-behaviour links, information on consequences, instruction and demonstration of behaviours. None of the interventions were based on behaviour change theory. We conclude that behaviour change techniques used in school interventions to reduce dental caries were limited and focused around providing information about how behaviour impacts on health and the consequences of not developing the correct health behaviours as well as providing oral hygiene instruction. Establishing which techniques are effective is difficult due to poor reporting of interventions in studies. Future design of oral health promotion interventions using behaviour change theory for development and evaluation (and reporting results in academic journals) could strengthen the potential for efficacy and provide a framework to use a much wider range of behaviour change techniques. Future studies should include development and publication of intervention manuals which is becoming standard practice in other health promoting programmes. © 2013 S. Karger AG, Basel.

10th International Conference on Practical Applications of Agents and Multi-Agent Systems

CERN Document Server

Pérez, Javier; Golinska, Paulina; Giroux, Sylvain; Corchuelo, Rafael; Trends in Practical Applications of Agents and Multiagent Systems

2012-01-01

PAAMS, the International Conference on Practical Applications of Agents and Multi-Agent Systems is an evolution of the International Workshop on Practical Applications of Agents and Multi-Agent Systems. PAAMS is an international yearly tribune to present, to discuss, and to disseminate the latest developments and the most important outcomes related to real-world applications. It provides a unique opportunity to bring multi-disciplinary experts, academics and practitioners together to exchange their experience in the development of Agents and Multi-Agent Systems.   This volume presents the papers that have been accepted for the 2012 in the workshops: Workshop on Agents for Ambient Assisted Living, Workshop on Agent-Based Solutions for Manufacturing and Supply Chain and Workshop on Agents and Multi-agent systems for Enterprise Integration.

Riot Control Agents

Science.gov (United States)

... Submit What's this? Submit Button Facts About Riot Control Agents Interim document Recommend on Facebook Tweet Share Compartir What riot control agents are Riot control agents (sometimes referred to ...

iCrowd: agent-based behavior modeling and crowd simulator

Science.gov (United States)

Kountouriotis, Vassilios I.; Paterakis, Manolis; Thomopoulos, Stelios C. A.

2016-05-01

Initially designed in the context of the TASS (Total Airport Security System) FP-7 project, the Crowd Simulation platform developed by the Integrated Systems Lab of the Institute of Informatics and Telecommunications at N.C.S.R. Demokritos, has evolved into a complete domain-independent agent-based behavior simulator with an emphasis on crowd behavior and building evacuation simulation. Under continuous development, it reflects an effort to implement a modern, multithreaded, data-oriented simulation engine employing latest state-of-the-art programming technologies and paradigms. It is based on an extensible architecture that separates core services from the individual layers of agent behavior, offering a concrete simulation kernel designed for high-performance and stability. Its primary goal is to deliver an abstract platform to facilitate implementation of several Agent-Based Simulation solutions with applicability in several domains of knowledge, such as: (i) Crowd behavior simulation during [in/out] door evacuation. (ii) Non-Player Character AI for Game-oriented applications and Gamification activities. (iii) Vessel traffic modeling and simulation for Maritime Security and Surveillance applications. (iv) Urban and Highway Traffic and Transportation Simulations. (v) Social Behavior Simulation and Modeling.

Organizational Change

OpenAIRE

Davis, MC; Coan, P

2015-01-01

This chapter examines how organizational change principles may be applied to promote organizational greening and employee pro-environmental behaviour. Four key areas of change management are focused upon: organizational culture; leadership and change agents; employee engagement; and the differing forms that change may take. The role of each factor in supporting environmental change is discussed, together with relevant research evidence drawn from the corporate sustainability; WPEB; management...

Primary Blast-Induced Changes in Akt and GSK3β Phosphorylation in Rat Hippocampus

Directory of Open Access Journals (Sweden)

Yushan Wang

2017-08-01

Full Text Available Traumatic brain injury (TBI due to blast from improvised explosive devices has been a leading cause of morbidity and mortality in recent conflicts in Iraq and Afghanistan. However, the mechanisms of primary blast-induced TBI are not well understood. The Akt signal transduction pathway has been implicated in various brain pathologies including TBI. In the present study, the effects of simulated primary blast waves on the phosphorylation status of Akt and its downstream effector kinase, glycogen synthase kinase 3β (GSK3β, in rat hippocampus, were investigated. Male Sprague-Dawley (SD rats (350–400 g were exposed to a single pulse shock wave (25 psi; ~7 ms duration and sacrificed 1 day, 1 week, or 6 weeks after exposure. Total and phosphorylated Akt, as well as phosphorylation of its downstream effector kinase GSK3β (at serine 9, were detected with western blot analysis and immunohistochemistry. Results showed that Akt phosphorylation at both serine 473 and threonine 308 was increased 1 day after blast on the ipsilateral side of the hippocampus, and this elevation persisted until at least 6 weeks postexposure. Similarly, phosphorylation of GSK3β at serine 9, which inhibits GSK3β activity, was also increased starting at 1 day and persisted until at least 6 weeks after primary blast on the ipsilateral side. In contrast, p-Akt was increased at 1 and 6 weeks on the contralateral side, while p-GSK3β was increased 1 day and 1 week after primary blast exposure. No significant changes in total protein levels of Akt and GSK were observed on either side of the hippocampus at any time points. Immunohistochemical results showed that increased p-Akt was mainly of neuronal origin in the CA1 region of the hippocampus and once phosphorylated, the majority was translocated to the dendritic and plasma membranes. Finally, electrophysiological data showed that evoked synaptic N-methyl-d-aspartate (NMDA receptor activity was

Assessing surface water flood risk and management strategies under future climate change: Insights from an Agent-Based Model.

Science.gov (United States)

Jenkins, K; Surminski, S; Hall, J; Crick, F

2017-10-01

Climate change and increasing urbanization are projected to result in an increase in surface water flooding and consequential damages in the future. In this paper, we present insights from a novel Agent Based Model (ABM), applied to a London case study of surface water flood risk, designed to assess the interplay between different adaptation options; how risk reduction could be achieved by homeowners and government; and the role of flood insurance and the new flood insurance pool, Flood Re, in the context of climate change. The analysis highlights that while combined investment in property-level flood protection and sustainable urban drainage systems reduce surface water flood risk, the benefits can be outweighed by continued development in high risk areas and the effects of climate change. In our simulations, Flood Re is beneficial in its function to provide affordable insurance, even under climate change. However, the scheme does face increasing financial pressure due to rising surface water flood damages. If the intended transition to risk-based pricing is to take place then a determined and coordinated strategy will be needed to manage flood risk, which utilises insurance incentives, limits new development, and supports resilience measures. Our modelling approach and findings are highly relevant for the ongoing regulatory and political approval process for Flood Re as well as for wider discussions on the potential of insurance schemes to incentivise flood risk management and climate adaptation in the UK and internationally. Copyright © 2017 Elsevier B.V. All rights reserved.

'I wouldn't push that further because I don't want to lose her': a multiperspective qualitative study of behaviour change for long-term conditions in primary care.

Science.gov (United States)

Hunter, Cheryl; Chew-Graham, Carolyn A; Langer, Susanne; Drinkwater, Jessica; Stenhoff, Alexandra; Guthrie, Elspeth A; Salmon, Peter

2015-12-01

Health outcomes for long-term conditions (LTCs) can be improved by lifestyle, dietary and condition management-related behaviour change. Primary care is an important setting for behaviour change work. Practitioners have identified barriers to this work, but there is little evidence examining practices of behaviour change in primary care consultations and how patients and practitioners perceive these practices. To examine how behaviour change is engaged with in primary care consultations for LTCs and investigate how behaviour change is perceived by patients and practitioners. Multiperspective, longitudinal qualitative research involving six primary health-care practices in England. Consultations between patients with LTCs and health-care practitioners were audio-recorded. Semi-structured interviews were completed with patients and practitioners, using stimulated recall. Patients were re-interviewed 3 months later. Framework analysis was applied to all data. Thirty-two people with at least one LTC (chronic obstructive pulmonary disease, diabetes, asthma and coronary heart disease) and 10 practitioners. Behaviour change talk in consultations was rare and, when it occurred, was characterized by deflection and diffidence on the part of practitioners. Patient motivation tended to be unaddressed. While practitioners positioned behaviour change work as outside their remit, patients felt uncertain about, yet responsible for, this work. Practitioners raised concerns that this work could damage other aspects of care, particularly the patient-practitioner relationship. Behaviour change work is often deflected or deferred by practitioners in consultations, who nevertheless vocalize support for its importance in interviews. This discrepancy between practitioners' accounts and behaviours needs to be addressed within primary health-care organizations. © 2014 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Constructing Secure Mobile Agent Systems Using the Agent Operating System

NARCIS (Netherlands)

van t Noordende, G.J.; Overeinder, B.J.; Timmer, R.J.; Brazier, F.M.; Tanenbaum, A.S.

2009-01-01

Designing a secure and reliable mobile agent system is a difficult task. The agent operating system (AOS) is a building block that simplifies this task. AOS provides common primitives required by most mobile agent middleware systems, such as primitives for secure communication, secure and

Nondestructive Intervention to Multi-Agent Systems through an Intelligent Agent

Science.gov (United States)

Han, Jing; Wang, Lin

2013-01-01

For a given multi-agent system where the local interaction rule of the existing agents can not be re-designed, one way to intervene the collective behavior of the system is to add one or a few special agents into the group which are still treated as normal agents by the existing ones. We study how to lead a Vicsek-like flocking model to reach synchronization by adding special agents. A popular method is to add some simple leaders (fixed-headings agents). However, we add one intelligent agent, called ‘shill’, which uses online feedback information of the group to decide the shill's moving direction at each step. A novel strategy for the shill to coordinate the group is proposed. It is strictly proved that a shill with this strategy and a limited speed can synchronize every agent in the group. The computer simulations show the effectiveness of this strategy in different scenarios, including different group sizes, shill speed, and with or without noise. Compared to the method of adding some fixed-heading leaders, our method can guarantee synchronization for any initial configuration in the deterministic scenario and improve the synchronization level significantly in low density groups, or model with noise. This suggests the advantage and power of feedback information in intervention of collective behavior. PMID:23658695

Nondestructive intervention to multi-agent systems through an intelligent agent.

Directory of Open Access Journals (Sweden)

Jing Han

Full Text Available For a given multi-agent system where the local interaction rule of the existing agents can not be re-designed, one way to intervene the collective behavior of the system is to add one or a few special agents into the group which are still treated as normal agents by the existing ones. We study how to lead a Vicsek-like flocking model to reach synchronization by adding special agents. A popular method is to add some simple leaders (fixed-headings agents. However, we add one intelligent agent, called 'shill', which uses online feedback information of the group to decide the shill's moving direction at each step. A novel strategy for the shill to coordinate the group is proposed. It is strictly proved that a shill with this strategy and a limited speed can synchronize every agent in the group. The computer simulations show the effectiveness of this strategy in different scenarios, including different group sizes, shill speed, and with or without noise. Compared to the method of adding some fixed-heading leaders, our method can guarantee synchronization for any initial configuration in the deterministic scenario and improve the synchronization level significantly in low density groups, or model with noise. This suggests the advantage and power of feedback information in intervention of collective behavior.

The effects of water soluble contrast agents on the respiratory tract

International Nuclear Information System (INIS)

Lovett, I.; Donchey, S.; Doust, B.; Branson, J.; Munro, V.

1989-01-01

The water soluble contrast agents Gastrografin R (Sodium diatrizoate and meglumine diatrizoate, Schering, Berlin), Iopamiro 300 R (Iopamidol, Schering, Berlin), and Dionosil Aqueous R (propyliodone BP, Glaxo, England) were instilled into the tracheobronchial tree of rats in doses of either 0.1 ml and 0.25 ml. Rats being used as controls, underwent sham operations with the instillation of air instead of contrast agent. In all, 85 rats were used. All rats that had not already died from the effects of contrast agent were sacrificed 30 minutes after instillation. The relative effects of the contrast agents were measured by comparing: survival time; radiographic effects of the contrast agents on the lungs; and pathological changes as estimated by post mortem lung section and microscopy. The least toxic agent was the one with the lowest osmotic activity, namely Aqueous Dionosil. It is therefore recommended that Aqueous Dionosil be used in preference to Gastrografin or Iopamidol for studies of the oesophagus whenever there is a danger of aspiration of contrast agent into the tracheobronchial tree. 11 refs., 3 figs., 5 tabs

Organizations as Socially Constructed Agents in the Agent Oriented Paradigm

NARCIS (Netherlands)

G. Boella (Guido); L.W.N. van der Torre (Leon)

2005-01-01

htmlabstractIn this paper we propose a new role for the agent metaphor in the definition of the organizational structure of multiagent systems. The agent metaphor is extended to consider as agents also social entities like organizations, groups and normative systems, so that mental attitudes can

The Role of Conversation Policy in Carrying Out Agent Conversations

International Nuclear Information System (INIS)

Link, Hamilton E.; Phillips, Laurence R.

1999-01-01

Structured conversation diagrams, or conversation specifications, allow agents to have predictable interactions and achieve predefined information-based goals, but they lack the flexibility needed to function robustly in an unpredictable environment. We propose a mechanism that combines a typical conversation structure with a separately established policy to generate an actual conversation. The word ''policy'' connotes a high-level direction external to a specific planned interaction with the environment. Policies, which describe acceptable procedures and influence decisions, can be applied to broad sets of activity. Based on their observation of issues related to a policy, agents may dynamically adjust their communication patterns. The policy object describes limitations, constraints, and requirements that may affect the conversation in certain circumstances. Using this new mechanism of interaction simplifies the description of individual conversations and allows domain-specific issues to be brought to bear more easily during agent communication. By following the behavior of the conversation specification when possible and deferring to the policy to derive behavior in exceptional circumstances, an agent is able to function predictably under normal situations and still act rationally in abnormal situations. Different conversation policies applied to a given conversation specification can change the nature of the interaction without changing the specification

Neuroprotective "agents" in surgery. Secret "agent" man, or common "agent" machine?

Science.gov (United States)

Andrews, R. J.

1999-01-01

The search for clinically-effective neuroprotective agents has received enormous support in recent years--an estimated $200 million by pharmaceutical companies on clinical trials for traumatic brain injury alone. At the same time, the pathophysiology of brain injury has proved increasingly complex, rendering the likelihood of a single agent "magic bullet" even more remote. On the other hand, great progress continues with technology that makes surgery less invasive and less risky. One example is the application of endovascular techniques to treat coronary artery stenosis, where both the invasiveness of sternotomy and the significant neurological complication rate (due to microemboli showering the cerebral vasculature) can be eliminated. In this paper we review aspects of intraoperative neuroprotection both present and future. Explanations for the slow progress on pharmacologic neuroprotection during surgery are presented. Examples of technical advances that have had great impact on neuroprotection during surgery are given both from coronary artery stenosis surgery and from surgery for Parkinson's disease. To date, the progress in neuroprotection resulting from such technical advances is an order of magnitude greater than that resulting from pharmacologic agents used during surgery. The progress over the last 20 years in guidance during surgery (CT and MRI image-guidance) and in surgical access (endoscopic and endovascular techniques) will soon be complemented by advances in our ability to evaluate biological tissue intraoperatively in real-time. As an example of such technology, the NASA Smart Probe project is considered. In the long run (i.e., in 10 years or more), pharmacologic "agents" aimed at the complex pathophysiology of nervous system injury in man will be the key to true intraoperative neuroprotection. In the near term, however, it is more likely that mundane "agents" based on computers, microsensors, and microeffectors will be the major impetus to improved

Measuring psychological change during cognitive behaviour therapy in primary care: a Polish study using 'PSYCHLOPS' (Psychological Outcome Profiles.

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Slawomir Czachowski

Full Text Available BACKGROUND: Psychological outcome measures are evolving into measures that depict progress over time. Interval measurement during therapy has not previously been reported for a patient-generated measure in primary care. We aimed to determine the sensitivity to change throughout therapy, using 'PSYCHLOPS' (Psychological Outcome Profiles, and to determine if new problems appearing during therapy diminish overall improvement. METHODS: Responses to PSYCHLOPS, pre-, during- and post-therapy were compared. SETTING: patients offered brief cognitive behaviour therapy in primary care in Poland. RESULTS: 238 patients completed the pre-therapy questionnaire, 194 (81.5% the during-therapy questionnaire and 142 the post-therapy questionnaire (59.7%. For those completing all three questionnaires (n = 135, improvement in total scores produced an overall Effect Size of 3.1 (2.7 to 3.4. We estimated change using three methods for dealing with missing values. Single and multiple imputation did not significantly change the Effect Size; 'Last Value Carried Forward', the most conservative method, produced an overall Effect Size of 2.3 (1.9 to 2.6. New problems during therapy were reported by 81 patients (60.0%: new problem and original problem scores were of similar magnitude and change scores were not significantly different when compared to patients who did not report new problems. CONCLUSION: A large proportion of outcome data is lost when outcome measures depend upon completed end of therapy questionnaires. The use of a during-therapy measure increases data capture. Missing data still produce difficulties in interpreting overall effect sizes for change. We found no evidence that new problems appearing during therapy hampered overall recovery.

Altered primary production during mass-extinction events

NARCIS (Netherlands)

van de Schootbrugge, B.; Gollner, S.

2013-01-01

The Big Five mass-extinction events are characterized by dramatic changes in primary producers. Initial disturbance to primary producers is usually followed by a succession of pioneers that represent qualitative and quantitative changes in standing crops of land plants and/or phytoplankton. On land,

A multi-agent system architecture for sensor networks.

Science.gov (United States)

Fuentes-Fernández, Rubén; Guijarro, María; Pajares, Gonzalo

2009-01-01

The design of the control systems for sensor networks presents important challenges. Besides the traditional problems about how to process the sensor data to obtain the target information, engineers need to consider additional aspects such as the heterogeneity and high number of sensors, and the flexibility of these networks regarding topologies and the sensors in them. Although there are partial approaches for resolving these issues, their integration relies on ad hoc solutions requiring important development efforts. In order to provide an effective approach for this integration, this paper proposes an architecture based on the multi-agent system paradigm with a clear separation of concerns. The architecture considers sensors as devices used by an upper layer of manager agents. These agents are able to communicate and negotiate services to achieve the required functionality. Activities are organized according to roles related with the different aspects to integrate, mainly sensor management, data processing, communication and adaptation to changes in the available devices and their capabilities. This organization largely isolates and decouples the data management from the changing network, while encouraging reuse of solutions. The use of the architecture is facilitated by a specific modelling language developed through metamodelling. A case study concerning a generic distributed system for fire fighting illustrates the approach and the comparison with related work.

International consensus report on the investigation and management of primary immune thrombocytopenia

NARCIS (Netherlands)

Provan, Drew; Stasi, Roberto; Newland, Adrian C.; Blanchette, Victor S.; Bolton-Maggs, Paula; Bussel, James B.; Chong, Beng H.; Cines, Douglas B.; Gernsheimer, Terry B.; Godeau, Bertrand; Grainger, John; Greer, Ian; Hunt, Beverley J.; Imbach, Paul A.; Lyons, Gordon; McMillan, Robert; Rodeghiero, Francesco; Sanz, Miguel A.; Tarantino, Michael; Watson, Shirley; Young, Joan; Kuter, David J.

2010-01-01

Previously published guidelines for the diagnosis and management of primary immune thrombocytopenia (ITP) require updating largely due to the introduction of new classes of therapeutic agents, and a greater understanding of the disease pathophysiology. However, treatment-related decisions still

The influence of active vision on the exoskeleton of intelligent agents

Science.gov (United States)

Smith, Patrice; Terry, Theodore B.

2016-04-01

Chameleonization occurs when a self-learning autonomous mobile system's (SLAMR) active vision scans the surface of which it is perched causing the exoskeleton to changes colors exhibiting a chameleon effect. Intelligent agents having the ability to adapt to their environment and exhibit key survivability characteristics of its environments would largely be due in part to the use of active vision. Active vision would allow the intelligent agent to scan its environment and adapt as needed in order to avoid detection. The SLAMR system would have an exoskeleton, which would change, based on the surface it was perched on; this is known as the "chameleon effect." Not in the common sense of the term, but from the techno-bio inspired meaning as addressed in our previous paper. Active vision, utilizing stereoscopic color sensing functionality would enable the intelligent agent to scan an object within its close proximity, determine the color scheme, and match it; allowing the agent to blend with its environment. Through the use of its' optical capabilities, the SLAMR system would be able to further determine its position, taking into account spatial and temporal correlation and spatial frequency content of neighboring structures further ensuring successful background blending. The complex visual tasks of identifying objects, using edge detection, image filtering, and feature extraction are essential for an intelligent agent to gain additional knowledge about its environmental surroundings.