Sample records for providing ip quality

  1. Prevalence and Quality of Individual Placement and Support (IPS) Supported Employment in the United States. (United States)

    Johnson-Kwochka, Annalee; Bond, Gary R; Becker, Deborah R; Drake, Robert E; Greene, Mary Ann


    indicators. Nationally, most states provide IPS programs, but the within-state penetration rate and quality of implementation vary widely. While learning community and non-learning community states with IPS do not differ in the prevalence of IPS programs, learning community states are much more likely to report key quality indicators, which may enhance these states' potential for sustaining and expanding IPS. Olmstead settlements have not yet shown a direct impact on the penetration and quality of IPS, but as the Department of Justice continues to enforce the Supreme Court's Olmstead decision, their significance may increase.

  2. Data exploration, quality control and statistical analysis of ChIP-exo/nexus experiments. (United States)

    Welch, Rene; Chung, Dongjun; Grass, Jeffrey; Landick, Robert; Keles, Sündüz


    ChIP-exo/nexus experiments rely on innovative modifications of the commonly used ChIP-seq protocol for high resolution mapping of transcription factor binding sites. Although many aspects of the ChIP-exo data analysis are similar to those of ChIP-seq, these high throughput experiments pose a number of unique quality control and analysis challenges. We develop a novel statistical quality control pipeline and accompanying R/Bioconductor package, ChIPexoQual, to enable exploration and analysis of ChIP-exo and related experiments. ChIPexoQual evaluates a number of key issues including strand imbalance, library complexity, and signal enrichment of data. Assessment of these features are facilitated through diagnostic plots and summary statistics computed over regions of the genome with varying levels of coverage. We evaluated our QC pipeline with both large collections of public ChIP-exo/nexus data and multiple, new ChIP-exo datasets from Escherichia coli. ChIPexoQual analysis of these datasets resulted in guidelines for using these QC metrics across a wide range of sequencing depths and provided further insights for modelling ChIP-exo data. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.

  3. On-line Monitoring of VoIP Quality Using IPFIX

    Directory of Open Access Journals (Sweden)

    Petr Matousek


    Full Text Available The main goal of VoIP services is to provide a reliable and high-quality voice transmission over packet networks. In order to prove the quality of VoIP transmission, several approaches were designed. In our approach, we are concerned about on-line monitoring of RTP and RTCP traffic. Based on these data, we are able to compute main VoIP quality metrics including jitter, delay, packet loss, and finally R-factor and MOS values. This technique of VoIP quality measuring can be directly incorporated into IPFIX monitoring framework where an IPFIX probe analyses RTP/RTCP packets, computes VoIP quality metrics, and adds these metrics into extended IPFIX flow records. Then, these extended data are stored in a central IPFIX monitoring system called collector where can be used for monitoring purposes. This paper presents a functional implementation of IPFIX plugin for VoIP quality measurement and compares the results with results obtained by other tools.

  4. Impact of artefact removal on ChIP quality metrics in ChIP-seq and ChIP-exo data.

    Directory of Open Access Journals (Sweden)

    Thomas Samuel Carroll


    Full Text Available With the advent of ChIP-seq multiplexing technologies and the subsequent increase in ChIP-seq throughput, the development of working standards for the quality assessment of ChIP-seq studies has received significant attention. The ENCODE consortium’s large scale analysis of transcription factor binding and epigenetic marks as well as concordant work on ChIP-seq by other laboratories has established a new generation of ChIP-seq quality control measures. The use of these metrics alongside common processing steps has however not been evaluated. In this study, we investigate the effects of blacklisting and removal of duplicated reads on established metrics of ChIP-seq quality and show that the interpretation of these metrics is highly dependent on the ChIP-seq preprocessing steps applied. Further to this we perform the first investigation of the use of these metrics for ChIP-exo data and make recommendations for the adaptation of the NSC statistic to allow for the assessment of ChIP-exo efficiency.

  5. Impact of artifact removal on ChIP quality metrics in ChIP-seq and ChIP-exo data (United States)

    Carroll, Thomas S.; Liang, Ziwei; Salama, Rafik; Stark, Rory; de Santiago, Ines


    With the advent of ChIP-seq multiplexing technologies and the subsequent increase in ChIP-seq throughput, the development of working standards for the quality assessment of ChIP-seq studies has received significant attention. The ENCODE consortium's large scale analysis of transcription factor binding and epigenetic marks as well as concordant work on ChIP-seq by other laboratories has established a new generation of ChIP-seq quality control measures. The use of these metrics alongside common processing steps has however not been evaluated. In this study, we investigate the effects of blacklisting and removal of duplicated reads on established metrics of ChIP-seq quality and show that the interpretation of these metrics is highly dependent on the ChIP-seq preprocessing steps applied. Further to this we perform the first investigation of the use of these metrics for ChIP-exo data and make recommendations for the adaptation of the NSC statistic to allow for the assessment of ChIP-exo efficiency. PMID:24782889

  6. Fully automated high-throughput chromatin immunoprecipitation for ChIP-seq: identifying ChIP-quality p300 monoclonal antibodies. (United States)

    Gasper, William C; Marinov, Georgi K; Pauli-Behn, Florencia; Scott, Max T; Newberry, Kimberly; DeSalvo, Gilberto; Ou, Susan; Myers, Richard M; Vielmetter, Jost; Wold, Barbara J


    Chromatin immunoprecipitation coupled with DNA sequencing (ChIP-seq) is the major contemporary method for mapping in vivo protein-DNA interactions in the genome. It identifies sites of transcription factor, cofactor and RNA polymerase occupancy, as well as the distribution of histone marks. Consortia such as the ENCyclopedia Of DNA Elements (ENCODE) have produced large datasets using manual protocols. However, future measurements of hundreds of additional factors in many cell types and physiological states call for higher throughput and consistency afforded by automation. Such automation advances, when provided by multiuser facilities, could also improve the quality and efficiency of individual small-scale projects. The immunoprecipitation process has become rate-limiting, and is a source of substantial variability when performed manually. Here we report a fully automated robotic ChIP (R-ChIP) pipeline that allows up to 96 reactions. A second bottleneck is the dearth of renewable ChIP-validated immune reagents, which do not yet exist for most mammalian transcription factors. We used R-ChIP to screen new mouse monoclonal antibodies raised against p300, a histone acetylase, well-known as a marker of active enhancers, for which ChIP-competent monoclonal reagents have been lacking. We identified, validated for ChIP-seq, and made publicly available a monoclonal reagent called ENCITp300-1.

  7. The IPS Learning Community: A Longitudinal Study of Sustainment, Quality, and Outcome. (United States)

    Bond, Gary R; Drake, Robert E; Becker, Deborah R; Noel, Valerie A


    Implementations of evidence-based mental health practices often disappear quickly, and few studies have examined sustainment. Since 2001, the Individual Placement and Support (IPS) learning community has promoted dissemination, implementation, sustainment, and expansion of IPS by using multiple strategies: online training, in-person training and technical assistance, technical assistance teleconferences, annual meetings, stakeholder conference calls, fidelity assessments, and transparency of outcomes. This study examined sustainment of IPS over a two-year period among programs in the learning community in the United States. The authors interviewed IPS team leaders in 129 programs actively participating in the learning community in 2012 and 2014. The structured interview addressed questions about program status, funding, and quality improvement activities. Simultaneously, the learning community tracked program-level data on IPS fidelity and employment rates. The study examined two-year program sustainment and changes in employment rates, fidelity, funding, and quality improvement activities. In 2012, 129 participating sites had been active for an average of 4.5 years. At two-year follow-up, 124 (96%) sites were sustained. The sustaining sites maintained quality improvement activities, expanded funding sources, and increased employment rates (41% to 43%; p=.04) and fidelity scores (103.8 to 108.4; p=.002). Nearly all programs participating in a learning community in 2012 continued to provide IPS services over the next two years, exceeding sustainment rates for evidence-based practices reported in the literature. Quality indicators also improved, suggesting that learning community activities fostered sustainment and quality. Controlled studies must compare specific learning community approaches with usual methods of sustainment.

  8. Modular system for measuring a speech quality in the IP telephony infrastructures using autonomous probes (United States)

    Rezac, Filip; Safarik, Jakub; Macura, Lukas; Rozhon, Jan; Gresak, Erik


    The paper deals with a speech quality monitoring system using probes placed on the individual network nodes operating VoIP services. Information on speech quality is measured periodically and the results are then stored on the central server which provides visualization in a form of graph respecting a topology of the probes. Article provides overall description of the technology and algorithms used in the speech quality monitoring system and results achieved in this applied research are verified in real operation. Contribution of the work lies in a proposal of the new multi-agent system enabling speech quality monitoring and in own implementation and its verification in Czech academic network.

  9. KSR-based medium improves the generation of high-quality mouse iPS cells. (United States)

    Liu, Kai; Wang, Fang; Ye, Xiaoying; Wang, Lingling; Yang, Jiao; Zhang, Jingzhuo; Liu, Lin


    Induced pluripotent stem (iPS) cells from somatic cells have great potential for regenerative medicine. The efficiency in generation of iPS cells has been significantly improved in recent years. However, the generation of high-quality iPS cells remains of high interest. Consistently, we demonstrate that knockout serum replacement (KSR)-based medium accelerates iPS cell induction and improves the quality of iPS cells, as confirmed by generation of chimeras and all iPS cell-derived offspring with germline transmission competency. Both alkaline phosphatase (AP) activity assay and expression of Nanog have been used to evaluate the efficiency of iPS cell induction and formation of ES/iPS cell colonies; however, appropriate expression of Nanog frequently indicates the quality of ES/iPS cells. Interestingly, whereas foetal bovine serum (FBS)-based media increase iPS cell colony formation, as revealed by AP activity, KSR-based media increase the frequency of iPS cell colony formation with Nanog expression. Furthermore, inhibition of MAPK/ERK by a specific inhibitor, PD0325901, in KSR- but not in FBS-based media significantly increases Nanog-GFP+ iPS cells. In contrast, addition of bFGF in KSR-based media decreases proportion of Nanog-GFP+ iPS cells. Remarkably, PD can rescue Nanog-GFP+ deficiency caused by bFGF. These data suggest that MAPK/ERK pathway influences high quality mouse iPS cells and that KSR- and PD-based media could enrich homogeneous authentic pluripotent stem cells.

  10. CHANCE: comprehensive software for quality control and validation of ChIP-seq data.


    Song, Jun; Diaz, A; Nellore, A; Song, JS


    ChIP-seq is a powerful method for obtaining genome-wide maps of protein-DNA interactions and epigenetic modifications. CHANCE (CHip-seq ANalytics and Confidence Estimation) is a standalone package for ChIP-seq quality control and protocol optimization. Our

  11. 47 CFR 64.606 - VRS and IP Relay provider and TRS program certification. (United States)


    ... Services and Related Customer Premises Equipment for Persons With Disabilities § 64.606 VRS and IP Relay... establishes that its program in no way conflicts with federal law. (2)Requirements for VRS and IP Relay...

  12. Statistical Analysis and Quality Assessment of ChIP-seq Data with DROMPA. (United States)

    Nakato, Ryuichiro; Shirahige, Katsuhiko


    Chromatin immunoprecipitation followed by sequencing (ChIP-seq) analysis can detect protein/DNA-binding and histone-modification sites across an entire genome. As there are various factors during sample preparation that affect the obtained results, multilateral quality assessments are essential. Here, we describe a step-by-step protocol using DROMPA, a program for user-friendly ChIP-seq pipelining. DROMPA can be used for quality assessment, data normalization, visualization, peak calling, and multiple statistical analyses.

  13. ChiLin: a comprehensive ChIP-seq and DNase-seq quality control and analysis pipeline. (United States)

    Qin, Qian; Mei, Shenglin; Wu, Qiu; Sun, Hanfei; Li, Lewyn; Taing, Len; Chen, Sujun; Li, Fugen; Liu, Tao; Zang, Chongzhi; Xu, Han; Chen, Yiwen; Meyer, Clifford A; Zhang, Yong; Brown, Myles; Long, Henry W; Liu, X Shirley


    Transcription factor binding, histone modification, and chromatin accessibility studies are important approaches to understanding the biology of gene regulation. ChIP-seq and DNase-seq have become the standard techniques for studying protein-DNA interactions and chromatin accessibility respectively, and comprehensive quality control (QC) and analysis tools are critical to extracting the most value from these assay types. Although many analysis and QC tools have been reported, few combine ChIP-seq and DNase-seq data analysis and quality control in a unified framework with a comprehensive and unbiased reference of data quality metrics. ChiLin is a computational pipeline that automates the quality control and data analyses of ChIP-seq and DNase-seq data. It is developed using a flexible and modular software framework that can be easily extended and modified. ChiLin is ideal for batch processing of many datasets and is well suited for large collaborative projects involving ChIP-seq and DNase-seq from different designs. ChiLin generates comprehensive quality control reports that include comparisons with historical data derived from over 23,677 public ChIP-seq and DNase-seq samples (11,265 datasets) from eight literature-based classified categories. To the best of our knowledge, this atlas represents the most comprehensive ChIP-seq and DNase-seq related quality metric resource currently available. These historical metrics provide useful heuristic quality references for experiment across all commonly used assay types. Using representative datasets, we demonstrate the versatility of the pipeline by applying it to different assay types of ChIP-seq data. The pipeline software is available open source at . ChiLin is a scalable and powerful tool to process large batches of ChIP-seq and DNase-seq datasets. The analysis output and quality metrics have been structured into user-friendly directories and reports. We have successfully compiled 23

  14. 'Quality signposting': the role of online information prescription in providing patient information. (United States)

    Brewster, Liz; Sen, Barbara


      Information prescriptions (IPs) are part of a Department of Health (DH) initiative to improve patient care. IPs aim to meet health information needs by providing personalised, high quality patient information about conditions and treatment.   This paper identifies current online IP provision and evaluates a sample of IP websites against the original DH aims of IP provision; British Medical Association usability criteria; and information seeking vignettes.   Five UK and one international IP website were randomly selected as a sample. Two checklists designed to appraise the websites were used to review each IP provider. Two patient information seeking vignettes were developed to enable the websites to be assessed from a patient-centred perspective.   Information prescriptions currently vary in content, accessibility and quality. National IP websites score more highly than local IP websites, which are often weak on content for specific conditions and poorly designed but strong on signposting to local services.   Guidelines for IP provision need to be improved to ensure higher quality, more easily accessible information is available. A synthesis of expertise included in national and local websites would improve usability for patients. IP websites should conform to standards of web design and accessibility. © 2010 The authors. Health Information and Libraries Journal © 2010 Health Libraries Group.

  15. Performance Study of Objective Speech Quality Measurement for Modern Wireless-VoIP Communications

    Directory of Open Access Journals (Sweden)

    Chan Wai-Yip


    Full Text Available Wireless-VoIP communications introduce perceptual degradations that are not present with traditional VoIP communications. This paper investigates the effects of such degradations on the performance of three state-of-the-art standard objective quality measurement algorithms—PESQ, P.563, and an "extended" E-model. The comparative study suggests that measurement performance is significantly affected by acoustic background noise type and level as well as speech codec and packet loss concealment strategy. On our data, PESQ attains superior overall performance and P.563 and E-model attain comparable performance figures.

  16. A Video Quality Assessment Method for VoIP Applications Based on User Experience (United States)

    Wang, Zedong; Wang, Jing; Wang, Fei; Li, Chengcai; Fei, Zesong; Rahim, Tariq


    An objective video quality assessment method is proposed to evaluate the video quality in voice over internet protocol (VoIP) applications under network distortion. The fluency and the clarity of videos are two main parts of the factors that affect user experience, thus the method evaluates these two parts to assess the distortions of videos in VoIP applications caused by codec and packet loss. The clarity of the video is measured by calculating block artifacts and frame blurring. Video blocking artifacts are measured by splitting the picture into small blocks and calculating the difference of the pixels around each border while video blurring is measured by getting edge information through Sobel operator, and counting the gradient histogram. Then the video clarity can be measured by a weighted sum of block artifacts score and blurring score using linear regression. The scores are also normalized in order to eliminate the impact of different video contents. The video fluency is calculated by counting the wrong frame in the video. Finally, a weighted sum of video clarity score and video fluency score can represent the quality of the video. The experimental results show that the objective quality scores have a strong correlation with the subjective quality scores, and the algorithm concludes two parts of user experience other than just image quality, which is more comprehensive and it can be used in video quality assessment in VoIP applications.

  17. Recent advances in ChIP-seq analysis: from quality management to whole-genome annotation. (United States)

    Nakato, Ryuichiro; Shirahige, Katsuhiko


    Chromatin immunoprecipitation followed by sequencing (ChIP-seq) analysis can detect protein/DNA-binding and histone-modification sites across an entire genome. Recent advances in sequencing technologies and analyses enable us to compare hundreds of samples simultaneously; such large-scale analysis has potential to reveal the high-dimensional interrelationship level for regulatory elements and annotate novel functional genomic regions de novo. Because many experimental considerations are relevant to the choice of a method in a ChIP-seq analysis, the overall design and quality management of the experiment are of critical importance. This review offers guiding principles of computation and sample preparation for ChIP-seq analyses, highlighting the validity and limitations of the state-of-the-art procedures at each step. We also discuss the latest challenges of single-cell analysis that will encourage a new era in this field. © The Author 2016. Published by Oxford University Press.

  18. Zscan4 promotes genomic stability during reprogramming and dramatically improves the quality of iPS cells as demonstrated by tetraploid complementation. (United States)

    Jiang, Jing; Lv, Wenjian; Ye, Xiaoying; Wang, Lingbo; Zhang, Man; Yang, Hui; Okuka, Maja; Zhou, Chikai; Zhang, Xuan; Liu, Lin; Li, Jinsong


    Induced pluripotent stem (iPS) cells generated using Yamanaka factors have great potential for use in autologous cell therapy. However, genomic abnormalities exist in human iPS cells, and most mouse iPS cells are not fully pluripotent, as evaluated by the tetraploid complementation assay (TCA); this is most likely associated with the DNA damage response (DDR) occurred in early reprogramming induced by Yamanaka factors. In contrast, nuclear transfer can faithfully reprogram somatic cells into embryonic stem (ES) cells that satisfy the TCA. We thus hypothesized that factors involved in oocyte-induced reprogramming may stabilize the somatic genome during reprogramming, and improve the quality of the resultant iPS cells. To test this hypothesis, we screened for factors that could decrease DDR signals during iPS cell induction. We determined that Zscan4, in combination with the Yamanaka factors, not only remarkably reduced the DDR but also markedly promoted the efficiency of iPS cell generation. The inclusion of Zscan4 stabilized the genomic DNA, resulting in p53 downregulation. Furthermore, Zscan4 also enhanced telomere lengthening as early as 3 days post-infection through a telomere recombination-based mechanism. As a result, iPS cells generated with addition of Zscan4 exhibited longer telomeres than classical iPS cells. Strikingly, more than 50% of iPS cell lines (11/19) produced via this "Zscan4 protocol" gave rise to live-borne all-iPS cell mice as determined by TCA, compared to 1/12 for lines produced using the classical Yamanaka factors. Our findings provide the first demonstration that maintaining genomic stability during reprogramming promotes the generation of high quality iPS cells.

  19. 76 FR 1126 - Wireless E911 Location Accuracy Requirements; E911 Requirements for IP-Enabled Service Providers (United States)


    ... From the Federal Register Online via the Government Publishing Office FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 20 Wireless E911 Location Accuracy Requirements; E911 Requirements for IP-Enabled Service Providers AGENCY: Federal Communications Commission. ACTION: Proposed rule; extension of comment...

  20. Zerone: a ChIP-seq discretizer for multiple replicates with built-in quality control. (United States)

    Cuscó, Pol; Filion, Guillaume J


    Chromatin immunoprecipitation followed by high-throughput sequencing (ChIP-seq) is the standard method to investigate chromatin protein composition. As the number of community-available ChIP-seq profiles increases, it becomes more common to use data from different sources, which makes joint analysis challenging. Issues such as lack of reproducibility, heterogeneous quality and conflicts between replicates become evident when comparing datasets, especially when they are produced by different laboratories. Here, we present Zerone, a ChIP-seq discretizer with built-in quality control. Zerone is powered by a Hidden Markov Model with zero-inflated negative multinomial emissions, which allows it to merge several replicates into a single discretized profile. To identify low quality or irreproducible data, we trained a Support Vector Machine and integrated it as part of the discretization process. The result is a classifier reaching 95% accuracy in detecting low quality profiles. We also introduce a graphical representation to compare discretization quality and we show that Zerone achieves outstanding accuracy. Finally, on current hardware, Zerone discretizes a ChIP-seq experiment on mammalian genomes in about 5 min using less than 700 MB of memory. Zerone is available as a command line tool and as an R package. The C source code and R scripts can be downloaded from The information to reproduce the benchmark and the figures is stored in a public Docker image that can be downloaded from : Supplementary data are available at Bioinformatics online. © The Author 2016. Published by Oxford University Press.

  1. Voice Quality Estimation in Combined Radio-VoIP Networks for Dispatching Systems

    Directory of Open Access Journals (Sweden)

    Jiri Vodrazka


    Full Text Available The voice quality modelling assessment and planning field is deeply and widely theoretically and practically mastered for common voice communication systems, especially for the public fixed and mobile telephone networks including Next Generation Networks (NGN - internet protocol based networks. This article seeks to contribute voice quality modelling assessment and planning for dispatching communication systems based on Internet Protocol (IP and private radio networks. The network plan, correction in E-model calculation and default values for the model are presented and discussed.

  2. Health Provider Networks, Quality and Costs

    NARCIS (Netherlands)

    Boone, J.; Schottmuller, C.


    We provide a modeling framework to think about selective contracting in the health care sector. Two health care providers differ in quality and costs. When buying health insurance, consumers observe neither provider quality nor costs. We derive an equilibrium where health insurers signal provider

  3. Health provider networks, quality and costs

    NARCIS (Netherlands)

    Boone, Jan; Schottmuller, C.


    We provide a modeling framework to think about selective contracting in the health care sector. Two health care providers differ in quality and costs. When buying health insurance, consumers observe neither provider quality nor costs. We derive an equilibrium where health insurers signal provider

  4. High-quality ChIP-seq analysis of MBD3 in human breast cancer cells. (United States)

    Shimbo, Takashi; Takaku, Motoki; Wade, Paul A


    Chromatin accessibility is tightly regulated by multiple factors/mechanisms to establish different cell type-specific gene expression programs from a single genome. Dysregulation of this process can lead to diseases including cancer. The Mi-2/nucleosome remodeling and deacetylase (NuRD) complex is thought to orchestrate chromatin structure using its intrinsic nucleosome remodeling and histone deacetylase activities. However, the detailed mechanisms by which the NuRD complex regulates chromatin structure in vivo are not yet known. To explore the regulatory mechanisms of the NuRD complex, we mapped genome-wide localization of MBD3, a structural component of NuRD, in a human breast cancer cell line (MDA-MB-231) using a modified ChIP-seq protocol. Our data showed high quality localization information (i.e., high mapping efficiency and low PCR duplication rate) and excellent consistency between biological replicates. The data are deposited in the Gene Expression Omnibus (GSE76116).

  5. 76 FR 47114 - Wireless E911 Location Accuracy Requirements; E911 Requirements for IP-Enabled Service Providers (United States)


    ... of the `smart phone', it has been observed that the location reported by the device is enormously... calls. Vonage states that it has worked with public safety to adapt Vonage's 911 service to the... commercial mobile smartphones running VoIP applications, Wi-Fi enabled VoIP handsets, portable terminal...

  6. VoIP Quality Measurements in a Multilevel Secure (MLS) Environment

    National Research Council Canada - National Science Library

    Adams, Jr, Coy M


    Voice over Internet Protocol (VoIP) is growing in popularity in the civilian and military communities due to its low cost and the management advantages it offers over traditional Public Switched Telephone Networks (PSTN) phone systems...

  7. 75 FR 67321 - Wireless E911 Location Accuracy Requirements; E911 Requirements for IP-Enabled Service Providers (United States)


    ...; or via the Internet to [email protected] . SUPPLEMENTARY INFORMATION: I. Introduction 1. As... with the surge in wireless usage, encompassing additional voice over Internet Protocol (VoIP) and... evolution in the use of wireless devices and the development of location technologies. As recommended in the...

  8. Impact of different ChIP-Seq protocols on DNA integrity and quality of bioinformatics analysis results. (United States)

    Felsani, Armando; Gudmundsson, Bjarki; Nanni, Simona; Brini, Elena; Moles, Anna; Thormar, Hans Guttormur; Estibeiro, Peter; Gaetano, Carlo; Capogrossi, Maurizio; Farsetti, Antonella; Jonsson, Jon Johannes; Guffanti, Alessandro


    Different ChIP-Seq protocols may have a significant impact on the final outcome in terms of quality, number and distribution of called peaks. Sample DNA undergoes a long procedure before the final sequencing step, and damaged DNA can result in excessive mismatches in the alignment with reference genome. In this letter, we present the effect of well-defined modifications (timing of formaldehyde crosslink reversal, brand of the sonicator) of standard ChIP-Seq protocol on parallel samples derived from the same cell line correlating the initial DNA quality control metrics to the final bioinformatics analysis results. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email:

  9. Analisa Perbandingan Quality of Service Voice Over IP dengan Pengujian Codec Menggunakan Algoritma Low Latency Queuing

    Directory of Open Access Journals (Sweden)

    Darmawan Darmawan


    Full Text Available Voice over IP (VoIP adalah solusi komunikasi suara yang murah karena menggunakan jaringan IP dibanding penggunaan telephone analog yang banyak memakan biaya. Dalam penerapannya, VoIP mengalami permasalahan karena menggunakan teknologi packet switching yang mana penggunaannya bersamaan dengan paket data sehingga timbul delay, jitter, dan packet loss.  Pada penelitian ini, algoritma Low Latency Queuing (LLQ diterapkan pada router cisco. Algoritma LLQ merupakan gabungan dari algoritma Priority Queuing (PQ dan Class Based Weight Fair Queuing (CBWFQ sehingga dapat memprioritaskan paket suara disamping paket data. Algoritma LLQ ini diujikan menggunakan codec GSM FR, G722, dan G711 A-law. Hasil pengujian didapatkan nilai parameter yang tidak jauh berbeda dan memenuhi standar ITU-T.G1010. Nilai delay rata - rata terendah yaitu ketika menggunakan codec G722 sebesar 20,019 ms tetapi G722 memiliki rata - rata jitter yang terbesar yaitu 0,986 ms.  Codec dengan jitter rata – rata terkecil adalah G711 A-law sebesar 0,838 ms. Packet loss untuk semua codec yang diujikan adalah 0%.  Throughput pada paket data terbesar saat menggunakan codec GSM FR yaitu 18,139 kbps. Codec yang direkomendasikan adalah G711 A-law karena lebih stabil dari segi jitter dan codec GSM FR cocok diimplementasikan pada jaringan yang memiliki bandwitdh kecil.

  10. A Comparative Survey of Adaptive Codec Solutions for VoIP over Multirate WLANs: A Capacity versus Quality Performance Trade-Off

    Directory of Open Access Journals (Sweden)

    Sfairopoulou A


    Full Text Available In multi-rate WLANs, users can suffer transmission rate changes due to the link adaptation mechanism. This results in a variable capacity channel, which is very hostile for VoIP and can cause serious quality of service (QoS degradation in all active calls. Various codec adaptation mechanisms have been proposed as a solution to this, as well as to solve congestion problems on WLAN environments. Here, these solutions are presented, categorized according to the adaptation policy and scenario they implement, and evaluated at call-level in terms of the resulting blocking and dropping probabilities, as well as the perceived voice quality. To define a common performance metric, a new index named VGoS-factor is presented, which, by combining these capacity and quality indicators, can provide an overall view of the capacity versus quality trade-off of the proposed mechanisms and consequently help in choosing the adequate policy for each scenario.

  11. Providing better indoor environmental quality brings economicbenefits

    Energy Technology Data Exchange (ETDEWEB)

    Fisk, William; Seppanen, Olli


    This paper summarizes the current scientific evidence that improved indoor environmental quality can improve work performance and health. The review indicates that work and school work performance is affected by indoor temperature and ventilation rate. Pollutant source removal can sometimes improve work performance. Based on formal statistical analyses of existing research results, quantitative relationships are provided for the linkages of work performance with indoor temperature and outdoor air ventilation rate. The review also indicates that improved health and related financial savings are obtainable from reduced indoor tobacco smoking, prevention and remediation of building dampness, and increased ventilation. Example cost-benefit analyses indicate that many measures to improve indoor temperature control and increase ventilation rates will be highly cost effective, with benefit-cost ratios as high as 80 and annual economic benefits as high as $700 per person.

  12. Sierra platinum: a fast and robust peak-caller for replicated ChIP-seq experiments with visual quality-control and -steering. (United States)

    Müller, Lydia; Gerighausen, Daniel; Farman, Mariam; Zeckzer, Dirk


    Histone modifications play an important role in gene regulation. Their genomic locations are of great interest. Usually, the location is measured by ChIP-seq and analyzed with a peak-caller. Replicated ChIP-seq experiments become more and more available. However, their analysis is based on single-experiment peak-calling or on tools like PePr which allows peak-calling of replicates but whose underlying model might not be suitable for the conditions under which the experiments are performed. We propose a new peak-caller called 'Sierra Platinum' that allows peak-calling of replicated ChIP-seq experiments. Moreover, it provides a variety of quality measures together with integrated visualizations supporting the assessment of the replicates and the resulting peaks, as well as steering the peak-calling process. We show that Sierra Platinum outperforms currently available methods using a newly generated benchmark data set and using real data from the NIH Roadmap Epigenomics Project. It is robust against noisy replicates.

  13. Assessing quality standards for ChIP-seq and related massive parallel sequencing-generated datasets: When rating goes beyond avoiding the crisis

    Directory of Open Access Journals (Sweden)

    Marco Antonio Mendoza-Parra


    Full Text Available Massive parallel DNA sequencing combined with chromatin immunoprecipitation and a large variety of DNA/RNA-enrichment methodologies is at the origin of data resources of major importance. Indeed these resources, available for multiple genomes, represent the most comprehensive catalogue of (i cell, development and signal transduction-specified patterns of binding sites for transcription factors (‘cistromes’ and for transcription and chromatin modifying machineries and (ii the patterns of specific local post-translational modifications of histones and DNA (‘epigenome’ or of regulatory chromatin binding factors. In addition, (iii the resources specifying chromatin structure alterations are emerging. Importantly, these types of “omics” datasets populate increasingly public repositories and provide highly valuable resources for the exploration of general principles of cell function in a multi-dimensional genome–transcriptome–epigenome–chromatin structure context. However, data mining is critically dependent on the data quality, an issue that, surprisingly, is still largely ignored by scientists and well-financed consortia, data repositories and scientific journals. So what determines the quality of ChIP-seq experiments and the datasets generated therefrom and what refrains scientists from associating quality criteria to their data? In this ‘opinion’ we trace the various parameters that influence the quality of this type of datasets, as well as the computational efforts that were made until now to qualify them. Moreover, we describe a universal quality control (QC certification approach that provides a quality rating for ChIP-seq and enrichment-related assays. The corresponding QC tool and a regularly updated database, from which at present the quality parameters of more than 8000 datasets can be retrieved, are freely accessible at

  14. Antibody performance in ChIP-sequencing assays: From quality scores of public data sets to quantitative certification [version 2; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Marco-Antonio Mendoza-Parra


    Full Text Available We have established a certification system for antibodies to be used in chromatin immunoprecipitation assays coupled to massive parallel sequencing (ChIP-seq. This certification comprises a standardized ChIP procedure and the attribution of a numerical quality control indicator (QCi to biological replicate experiments. The QCi computation is based on a universally applicable quality assessment that quantitates the global deviation of randomly sampled subsets of ChIP-seq dataset with the original genome-aligned sequence reads. Comparison with a QCi database for >28,000 ChIP-seq assays were used to attribute quality grades (ranging from ‘AAA’ to ‘DDD’ to a given dataset. In the present report we used the numerical QC system to assess the factors influencing the quality of ChIP-seq assays, including the nature of the target, the sequencing depth and the commercial source of the antibody.  We have used this approach specifically to certify mono and polyclonal antibodies obtained from Active Motif directed against the histone modification marks H3K4me3, H3K27ac and H3K9ac for ChIP-seq. The antibodies received the grades AAA to BBC ( We propose to attribute such quantitative grading of all antibodies attributed with the label “ChIP-seq grade”.

  15. A study of artificial speech quality assessors of VoIP calls subject to limited bursty packet losses

    Directory of Open Access Journals (Sweden)

    Jelassi Sofiene


    Full Text Available Abstract A revolutionary feature of emerging media services over the Internet is their ability to account for human perception during service delivery processes, which surely increases their popularity and incomes. In such a situation, it is necessary to understand the users' perception, what should obviously be done using standardized subjective experiences. However, it is also important to develop artificial quality assessors that enable to automatically quantify the perceived quality. This efficiently helps performing optimal network and service management at the core and edges of the delivery systems. In our article, we explore the behavior rating of new emerging artificial speech quality assessors of VoIP calls subject to moderately bursty packet loss processes. The examined Speech Quality Assessment (SQA algorithms are able to estimate speech quality of live VoIP calls at run-time using control information extracted from header content of received packets. They are especially designed to be sensitive to packet loss burstiness. The performance evaluation study is performed using a dedicated set-up software-based SQA framework. It offers a specialized packet killer and includes the implementation of four SQA algorithms. A speech quality database, which covers a wide range of bursty packet loss conditions, has been created and then thoroughly analyzed. Our main findings are the following: (1 all examined automatic bursty-loss aware speech quality assessors achieve a satisfactory correlation under upper (> 20% and lower (< 10% ranges of packet loss processes; (2 they exhibit a clear weakness to assess speech quality under a moderated packet loss process; (3 the accuracy of sequence-by-sequence basis of examined SQA algorithms should be addressed in detail for further precision.

  16. A study on the impact of AL-FEC techniques on TV over IP Quality of Experience

    Directory of Open Access Journals (Sweden)

    Mammi Elena


    Full Text Available Abstract In this contribution, an evaluation of the effectiveness of Application Layer-Forward Error Correction (AL-FEC scheme in video communications over unreliable channels is presented. In literature, several AL-FEC techniques for reducing the effect of noisy transmission on multimedia communication have been adopted. Recently, their use has been proposed for inclusion in TV over IP broadcasting international standards. The objective of the analysis performed in this paper is to verify the effectiveness of AL-FEC techniques in terms of perceived Quality of Service (QoS and more in general of Quality of Experience (QoE, and to evaluate the trade-off between AL-FEC redundancy and video quality degradation for a given packet loss ratio. To this goal, several channel error models are investigated (random i.i.d. losses, burst losses, and network congestions on test sequences encoded at 2 and 4 Mbps. The perceived quality is evaluated by means of three quality metrics: the full-reference objective quality metric NTIA-VQM combined with the ITU-T Rec. G.1070, the full-reference DMOS-KPN metric, and the pixel-wise error comparison performed by using the PSNR distortion measure. A post-processing synchronization between the original and the reconstructed stream has also been designed for improving the fidelity of the performed quality measures. The experimental results show the effectiveness and the limits of the Application Layer protection schemes.

  17. A study on the impact of AL-FEC techniques on TV over IP Quality of Experience (United States)

    Battisti, Federica; Carli, Marco; Mammi, Elena; Neri, Alessandro


    In this contribution, an evaluation of the effectiveness of Application Layer-Forward Error Correction (AL-FEC) scheme in video communications over unreliable channels is presented. In literature, several AL-FEC techniques for reducing the effect of noisy transmission on multimedia communication have been adopted. Recently, their use has been proposed for inclusion in TV over IP broadcasting international standards. The objective of the analysis performed in this paper is to verify the effectiveness of AL-FEC techniques in terms of perceived Quality of Service (QoS) and more in general of Quality of Experience (QoE), and to evaluate the trade-off between AL-FEC redundancy and video quality degradation for a given packet loss ratio. To this goal, several channel error models are investigated (random i.i.d. losses, burst losses, and network congestions) on test sequences encoded at 2 and 4 Mbps. The perceived quality is evaluated by means of three quality metrics: the full-reference objective quality metric NTIA-VQM combined with the ITU-T Rec. G.1070, the full-reference DMOS-KPN metric, and the pixel-wise error comparison performed by using the PSNR distortion measure. A post-processing synchronization between the original and the reconstructed stream has also been designed for improving the fidelity of the performed quality measures. The experimental results show the effectiveness and the limits of the Application Layer protection schemes.

  18. Rotating electrical machines - Part 5: Degrees of protection provided by the integral design of rotating electrical machines (IP code) - Classification

    CERN Document Server

    International Electrotechnical Commission. Geneva


    Gives definitions for standard degrees of protection provided by enclosures; protection of machines against harmful effects due to the ingress of water; protection of machines against ingress of solid foreign objects; Protection of persons against contact with or approach to live parts and against contact with moving parts. Gives designations for these protective degrees and tests to verify that the machines meet the requirements.

  19. COPAR: A ChIP-Seq Optimal Peak Analyzer. (United States)

    Tang, Binhua; Wang, Xihan; Jin, Victor X


    Sequencing data quality and peak alignment efficiency of ChIP-sequencing profiles are directly related to the reliability and reproducibility of NGS experiments. Till now, there is no tool specifically designed for optimal peak alignment estimation and quality-related genomic feature extraction for ChIP-sequencing profiles. We developed open-sourced COPAR, a user-friendly package, to statistically investigate, quantify, and visualize the optimal peak alignment and inherent genomic features using ChIP-seq data from NGS experiments. It provides a versatile perspective for biologists to perform quality-check for high-throughput experiments and optimize their experiment design. The package COPAR can process mapped ChIP-seq read file in BED format and output statistically sound results for multiple high-throughput experiments. Together with three public ChIP-seq data sets verified with the developed package, we have deposited COPAR on GitHub under a GNU GPL license.

  20. Quality Perception within Corporate E-Learning Providers in Catalonia (United States)

    Sangra, Albert; Fernandez-Michels, Pedro


    Purpose: The paper seeks to describe the Catalan corporate e-learning providers from the perspective of quality perception, quality assessment and quality control. Design/methodology/approach: A literature review reveals key aspects of the definition of quality in e-learning. The results of the review constitute the basis for exploratory research…

  1. Offloading IP Flows onto Lambda-Connections

    NARCIS (Netherlands)

    Fioreze, Tiago; Oude Wolbers, Mattijs; van de Meent, R.; Pras, Aiko


    Optical networks are capable of switching IP traffic via lambda connections. In this way, big IP flows that overload the regular IP routing level may be moved to the optical level, where they get better Quality of Service (QoS). At the same time, the IP routing level is off-loaded and can serve

  2. Ogbuewu, IP

    African Journals Online (AJOL)

    Ogbuewu, IP. Vol 13 (2011) - Articles Egg Production Potentials of Muscovy Ducks (Cairina moschata) Raised Under Three Management Systems in the Humid Tropics Abstract. ISSN: 1119-4308. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

  3. Mobile IP

    NARCIS (Netherlands)

    Heijenk, Geert; Sallent, S.; Pras, Aiko


    The Internet is growing exponentially, both in the amount of traffic carried, and in the amount of hosts connected. IP technology is becoming more and more important, in company networks (Intranets), and also in the core networks for the next generation mobile networks. Further, wireless access to

  4. Privately Provided Accommodation Service Quality and Customer Satisfaction

    National Research Council Canada - National Science Library

    Joshua Mugambwa; George William Mugerwa; Wilson Williams Mutumba; Claire Muganzi; Bridget Namubiru; Yusuf Waswa; Isaac Newton Kayongo


    .... This research took a case study of Nsamizi Training Institute of Social Development (NTISD) to determine the relationship between privately provided accommodation service quality and customer satisfaction...

  5. Healthcare quality management in Switzerland--a survey among providers. (United States)

    Kaderli, Reto; Pfortmueller, Carmen A; Businger, Adrian P


    In the last decade assessing the quality of healthcare has become increasingly important across the world. Switzerland lacks a detailed overview of how quality management is implemented and of its effects on medical procedures and patients' concerns. This study aimed to examine the systematics of quality management in Switzerland by assessing the providers and collected parameters of current quality initiatives. In summer 2011 we contacted all of the medical societies in Switzerland, the Federal Office of Public Health, the Swiss Medical Association (FMH) and the head of Swiss medical insurance providers, to obtain detailed information on current quality initiatives. All quality initiatives featuring standardised parameter assessment were included. Of the current 45 initiatives, 19 were powered by medical societies, five by hospitals, 11 by non-medical societies, two by the government, two by insurance companies or related institutions and six by unspecified institutions. In all, 24 medical registers, five seals of quality, five circles of quality, two self-assessment tools, seven superior entities, one checklist and one combined project existed. The cost of treatment was evaluated by four initiatives. A data report was released by 24 quality initiatives. The wide variety and the large number of 45 recorded quality initiatives provides a promising basis for effective healthcare quality management in Switzerland. However, an independent national supervisory authority should be appointed to provide an effective review of all quality initiatives and their transparency and coordination.

  6. Evaluation of patients ' satisfaction with quality of care provided at ...

    African Journals Online (AJOL)

    Background: The umpteenth threats to change of healthcare provider by dissatisfied patients on formal sector health insurance are well known and can be a proxy indicator for the need for quality improvement in service delivery. Objective: This study was aimed at evaluating patientsf satisfaction with quality of care provided ...

  7. Provide good air quality for people and improve their productivity

    DEFF Research Database (Denmark)

    Fanger, Povl Ole


    Three recent independent studies have documented that the quality of indoor air has a significant and positive influence on the productivity of office workers. A combined analysis of the results of the three studies shows a significant relationship between productivity and perceived indoor air...... quality. The impact on productivity justifies a much higher indoor air quality than the minimum levels prescribed in present standards and guidelines. One way of providing air of high quality for people to breathe, without involving excessive ventilation rates and energy use, is to provide "personalized...

  8. Foundations of hardware IP protection

    CERN Document Server

    Torres, Lionel


    This book provides a comprehensive and up-to-date guide to the design of security-hardened, hardware intellectual property (IP). Readers will learn how IP can be threatened, as well as protected, by using means such as hardware obfuscation/camouflaging, watermarking, fingerprinting (PUF), functional locking, remote activation, hidden transmission of data, hardware Trojan detection, protection against hardware Trojan, use of secure element, ultra-lightweight cryptography, and digital rights management. This book serves as a single-source reference to design space exploration of hardware security and IP protection. · Provides readers with a comprehensive overview of hardware intellectual property (IP) security, describing threat models and presenting means of protection, from integrated circuit layout to digital rights management of IP; · Enables readers to transpose techniques fundamental to digital rights management (DRM) to the realm of hardware IP security; · Introduce designers to the concept of salutar...

  9. Computational methodology for ChIP-seq analysis (United States)

    Shin, Hyunjin; Liu, Tao; Duan, Xikun; Zhang, Yong; Liu, X. Shirley


    Chromatin immunoprecipitation coupled with massive parallel sequencing (ChIP-seq) is a powerful technology to identify the genome-wide locations of DNA binding proteins such as transcription factors or modified histones. As more and more experimental laboratories are adopting ChIP-seq to unravel the transcriptional and epigenetic regulatory mechanisms, computational analyses of ChIP-seq also become increasingly comprehensive and sophisticated. In this article, we review current computational methodology for ChIP-seq analysis, recommend useful algorithms and workflows, and introduce quality control measures at different analytical steps. We also discuss how ChIP-seq could be integrated with other types of genomic assays, such as gene expression profiling and genome-wide association studies, to provide a more comprehensive view of gene regulatory mechanisms in important physiological and pathological processes. PMID:25741452

  10. Provider communication and HPV vaccination: The impact of recommendation quality (United States)

    Gilkey, Melissa B.; Calo, William A.; Moss, Jennifer L.; Shah, Parth D.; Marciniak, Macary W.; Brewer, Noel T.


    Background Receiving a healthcare provider’s recommendation is a strong predictor of HPV vaccination, but little is known empirically about which types of recommendation are most influential. Thus, we sought to investigate the relationship between recommendation quality and HPV vaccination among U.S. adolescents. Methods In 2014, we conducted a national, online survey of 1,495 parents of 11- to 17-year-old adolescents. Parents reported whether providers endorsed HPV vaccination strongly, encouraged same-day vaccination, and discussed cancer prevention. Using an index of these quality indicators, we categorized parents as having received no, low-quality, or high-quality recommendations for HPV vaccination. Separate multivariable logistic regression models assessed associations between recommendation quality and HPV vaccine initiation (≥1 dose), follow through (3 doses, among initiators), refusal, and delay. Results Almost half (48%) of parents reported no provider recommendation for HPV vaccination, while 16% received low-quality recommendations and 36% received high-quality recommendations. Compared to no recommendation, high-quality recommendations were associated with over nine times the odds of HPV vaccine initiation (23% vs. 74%, OR=9.31, 95% CI, 7.10–12.22) and over three times the odds of follow through (17% vs. 44%, OR=3.82, 95% CI, 2.39–6.11). Low-quality recommendations were more modestly associated with initiation (OR=4.13, 95% CI, 2.99–5.70), but not follow through. Parents who received high-versus low-quality recommendations less often reported HPV vaccine refusal or delay. Conclusions High-quality recommendations were strongly associated with HPV vaccination behavior, but only about one-third of parents received them. Interventions are needed to improve not only whether, but how providers recommend HPV vaccination for adolescents. PMID:26812078

  11. Do public nursing home care providers deliver higher quality than private providers? Evidence from Sweden. (United States)

    Winblad, Ulrika; Blomqvist, Paula; Karlsson, Andreas


    Swedish nursing home care has undergone a transformation, where the previous virtual public monopoly on providing such services has been replaced by a system of mixed provision. This has led to a rapidly growing share of private actors, the majority of which are large, for-profit firms. In the wake of this development, concerns have been voiced regarding the implications for care quality. In this article, we investigate the relationship between ownership and care quality in nursing homes for the elderly by comparing quality levels between public, for-profit, and non-profit nursing home care providers. We also look at a special category of for-profit providers; private equity companies. The source of data is a national survey conducted by the Swedish National Board of Health and Welfare in 2011 at 2710 nursing homes. Data from 14 quality indicators are analyzed, including structure and process measures such as staff levels, staff competence, resident participation, and screening for pressure ulcers, nutrition status, and risk of falling. The main statistical method employed is multiple OLS regression analysis. We differentiate in the analysis between structural and processual quality measures. The results indicate that public nursing homes have higher quality than privately operated homes with regard to two structural quality measures: staffing levels and individual accommodation. Privately operated nursing homes, on the other hand, tend to score higher on process-based quality indicators such as medication review and screening for falls and malnutrition. No significant differences were found between different ownership categories of privately operated nursing homes. Ownership does appear to be related to quality outcomes in Swedish nursing home care, but the results are mixed and inconclusive. That staffing levels, which has been regarded as a key quality indicator in previous research, are higher in publicly operated homes than private is consistent with earlier

  12. Providing quality palliative care in end-stage Alzheimer disease. (United States)

    Yeaman, Paul A; Ford, James L; Kim, Kye Y


    Providing quality palliative care is a daunting task profoundly impacted by diminished patient capacity at the end of life. Alzheimer disease (AD) is a disorder that erases our memories and is projected to increase dramatically for decades to come. By the time the patients with AD reach the end stage of the disease, the ability of patients to provide pertinent subjective complaints of pain and discomfort would have vanished. Historical perspectives of palliative care, exploration of the AD process, ethical issues, and crucial clinical considerations are provided to improve the understanding of disease progression and quality of care for patients with end-stage AD.

  13. Privately Provided Accommodation Service Quality and Customer Satisfaction

    Directory of Open Access Journals (Sweden)

    Joshua Mugambwa


    Full Text Available Privately provided accommodation is a growing service in Uganda’s higher education sector due to education liberalization and demand for education. This research took a case study of Nsamizi Training Institute of Social Development (NTISD to determine the relationship between privately provided accommodation service quality and customer satisfaction. Specifically, the objectives of the study were (a to find out the relationship between security and NTISD students’ satisfaction with privately provided accommodation, and (b to find out the hierarchical level of importance of NTISD student satisfaction of the three service quality dimensions (reliability, security, and tangibles with privately provided accommodation. Using quantitative and qualitative modes of data analysis and a sample of 300 students from 20 private hostels, this study established a strong positive significant relationship between security and satisfaction regarding privately provided accommodation. This implies that accommodation service providers should increase the quality of security so as to increase the satisfaction of students regarding privately provided accommodation. The study established the hierarchical order of importance from the most important service quality dimension, respectively, as follows: reliability, security, and tangibles. Therefore, private accommodation service managers should pay extra attention to the dimensions in the same order.

  14. Provider diversity in the NHS: impact on quality and innovation


    Bartlett, Will; Allen, Pauline; Pérotin, Virginie; Turner, Simon; Zamora, Bernarda; Matchaya, Greenwell; Roberts, Jennifer


    The overall objective of the research project has been to assess the impact of provider diversity on quality and innovation in the NHS. The specific research aims were to identify the differences in performance between non-profit Third Sector organisations, for-profit private enterprises, and incumbent public sector institutions within the NHS as providers of health care services, as well as the factors that affect the entry and growth of new private and Third Sector providers.\\ud The study u...

  15. Telomere reprogramming and maintenance in porcine iPS cells.

    Directory of Open Access Journals (Sweden)

    Guangzhen Ji

    Full Text Available Telomere reprogramming and silencing of exogenous genes have been demonstrated in mouse and human induced pluripotent stem cells (iPS cells. Pigs have the potential to provide xenotransplant for humans, and to model and test human diseases. We investigated the telomere length and maintenance in porcine iPS cells generated and cultured under various conditions. Telomere lengths vary among different porcine iPS cell lines, some with telomere elongation and maintenance, and others telomere shortening. Porcine iPS cells with sufficient telomere length maintenance show the ability to differentiate in vivo by teratoma formation test. IPS cells with short or dysfunctional telomeres exhibit reduced ability to form teratomas. Moreover, insufficient telomerase and incomplete telomere reprogramming and/or maintenance link to sustained activation of exogenous genes in porcine iPS cells. In contrast, porcine iPS cells with reduced expression of exogenous genes or partial exogene silencing exhibit insufficient activation of endogenous pluripotent genes and telomerase genes, accompanied by telomere shortening with increasing passages. Moreover, telomere doublets, telomere sister chromatid exchanges and t-circles that presumably are involved in telomere lengthening by recombination also are found in porcine iPS cells. These data suggest that both telomerase-dependent and telomerase-independent mechanisms are involved in telomere reprogramming during induction and passages of porcine iPS cells, but these are insufficient, resulting in increased telomere damage and shortening, and chromosomal instability. Active exogenes might compensate for insufficient activation of endogenous genes and incomplete telomere reprogramming and maintenance of porcine iPS cells. Further understanding of telomere reprogramming and maintenance may help improve the quality of porcine iPS cells.

  16. Telomere reprogramming and maintenance in porcine iPS cells. (United States)

    Ji, Guangzhen; Ruan, Weimin; Liu, Kai; Wang, Fang; Sakellariou, Despoina; Chen, Jijun; Yang, Yang; Okuka, Maja; Han, Jianyong; Liu, Zhonghua; Lai, Liangxue; Gagos, Sarantis; Xiao, Lei; Deng, Hongkui; Li, Ning; Liu, Lin


    Telomere reprogramming and silencing of exogenous genes have been demonstrated in mouse and human induced pluripotent stem cells (iPS cells). Pigs have the potential to provide xenotransplant for humans, and to model and test human diseases. We investigated the telomere length and maintenance in porcine iPS cells generated and cultured under various conditions. Telomere lengths vary among different porcine iPS cell lines, some with telomere elongation and maintenance, and others telomere shortening. Porcine iPS cells with sufficient telomere length maintenance show the ability to differentiate in vivo by teratoma formation test. IPS cells with short or dysfunctional telomeres exhibit reduced ability to form teratomas. Moreover, insufficient telomerase and incomplete telomere reprogramming and/or maintenance link to sustained activation of exogenous genes in porcine iPS cells. In contrast, porcine iPS cells with reduced expression of exogenous genes or partial exogene silencing exhibit insufficient activation of endogenous pluripotent genes and telomerase genes, accompanied by telomere shortening with increasing passages. Moreover, telomere doublets, telomere sister chromatid exchanges and t-circles that presumably are involved in telomere lengthening by recombination also are found in porcine iPS cells. These data suggest that both telomerase-dependent and telomerase-independent mechanisms are involved in telomere reprogramming during induction and passages of porcine iPS cells, but these are insufficient, resulting in increased telomere damage and shortening, and chromosomal instability. Active exogenes might compensate for insufficient activation of endogenous genes and incomplete telomere reprogramming and maintenance of porcine iPS cells. Further understanding of telomere reprogramming and maintenance may help improve the quality of porcine iPS cells.

  17. Evaluation and Investigation of the Delay in VoIP Networks

    Directory of Open Access Journals (Sweden)

    V. Janata


    Full Text Available The paper is focused mainly on the delay problems, which considerably influence the final quality of connections in VoIP (Voice over IP networks. The paper provides a detailed exploration of the nature and mechanisms of the delay. The main purpose of the investigation was an attempt to formulate a mathematical model of delay in the VoIP network and its subsequent analysis by laboratory data.

  18. IP over DWDM Technologies


    Qiong Wang


    This study has discussed some shortages of IP over SDH used currently, and has proposed the necessities of IP over DWDM. It has given the structure of IP over DWDM, and has explained why it can increase its bandwidth when transiting IP packets over DWDM. The study has also discussed the two methods of realizing IP over DWDM transmission network.

  19. The Roots of Quality Care: Strengths of Master Providers. (United States)

    Weaver, Ruth Harding


    Reviews research on characteristics and resources of family child caregivers providing high quality care. Focuses on regulation, lifelong learning in early childhood education, psychological well-being, commitment to child care, supportive child care connections, and a solid financial foundation. Maintains that consumer education can help parents…

  20. Provider communication quality: influence of patients' weight and race. (United States)

    Wong, Michelle S; Gudzune, Kimberly A; Bleich, Sara N


    To examine the relationship between patient weight and provider communication quality and determine whether patient race/ethnicity modifies this association. We conducted a cross-sectional analysis with 2009-2010 medical expenditures panel survey-household component (N=25,971). Our dependent variables were patient report of providers explaining well, listening, showing respect, and spending time. Our independent variables were patient weight status and patient weight-race/ethnicity groups. Using survey weights, we performed multivariate logistic regression to examine the adjusted association between patient weight and patient-provider communication measures, and whether patient race/ethnicity modifies this relationship. Compared to healthy weight whites, obese blacks were less likely to report that their providers explained things well (OR 0.78; p=0.02) or spent enough time with them (OR 0.81; p=0.04), and overweight blacks were also less likely to report that providers spent enough time with them (OR 0.78; p=0.02). Healthy weight Hispanics were also less likely to report adequate provider explanations (OR 0.74; p=0.04). Our study provides preliminary evidence that overweight/obese black and healthy weight Hispanic patients experience disparities in provider communication quality. Curricula on weight bias and cultural competency might improve communication between providers and their overweight/obese black and healthy weight Hispanic patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. Agents for change: nonphysician medical providers and health care quality. (United States)

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


    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.

  2. Abortion providers, stigma and professional quality of life. (United States)

    Martin, Lisa A; Debbink, Michelle; Hassinger, Jane; Youatt, Emily; Harris, Lisa H


    The Providers Share Workshop (PSW) provides abortion providers safe space to discuss their work experiences. Our objectives were to assess changes in abortion stigma over time and explore how stigma is related to aspects of professional quality of life, including compassion satisfaction, burnout and compassion fatigue for providers participating in the workshops. Seventy-nine providers were recruited to the PSW study. Surveys were completed prior to, immediately following and 1 year after the workshops. The outcome measures were the Abortion Provider Stigma Survey and the Professional Quality of Life (ProQOL) survey. Baseline ProQOL scores were compared to published averages using t tests. Changes in abortion stigma and aspects of professional quality of life were assessed by fitting a two-level random-effects model with repeated measures at level 1 (period-level) and static measures (e.g., demographic data) at level 2 (person-level). Potential covariates included age, parenting status, education, organizational tenure, job type and clinic type (stand-alone vs. hospital-based clinics). Compared to other healthcare workers, abortion providers reported higher compassion satisfaction (t=2.65, p=.009) and lower burnout (t=5.13, pabortion stigma as a significant predictor of lower compassion satisfaction, higher burnout and higher compassion fatigue. Participants in PSW reported a reduction in abortion stigma over time. Further, stigma is an important predictor of compassion satisfaction, burnout and compassion fatigue, suggesting that interventions aimed at supporting the abortion providing workforce should likely assess abortion stigma. Stigma is an important predictor of compassion satisfaction, burnout and compassion fatigue among abortion care providers. Therefore, strengthening human resources for abortion care requires stigma reduction efforts. Participants in the PSWs show reductions in stigma over time. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Voice over Internet Protocol (VoIP) Technology as a Global Learning Tool: Information Systems Success and Control Belief Perspectives (United States)

    Chen, Charlie C.; Vannoy, Sandra


    Voice over Internet Protocol- (VoIP) enabled online learning service providers struggling with high attrition rates and low customer loyalty issues despite VoIP's high degree of system fit for online global learning applications. Effective solutions to this prevalent problem rely on the understanding of system quality, information quality, and…

  4. Voice over IP in Wireless Heterogeneous Networks

    DEFF Research Database (Denmark)

    Fathi, Hanane; Chakraborty, Shyam; Prasad, Ramjee

    with the deployment of wireless heterogeneous systems, both speech and data traffic are carrried over wireless links by the same IP-based packet-switched infrastructure. However, this combination faces some challenges due to the inherent properties of the wireless network. The requirements for good quality VoIP...... communications are difficult to achieve in a time-varying environment due to channel errors and traffic congestion and across different systems. The provision of VoIP in wireless heterogeneous networks requires a set of time-efficient control mechanisms to support a VoIP session with acceptable quality....... The focus of Voice over IP in Wierless Heterogeneous Networks is on mechanisms that affect the VoIP user satisfaction  while not explicitly involved in the media session. This relates to the extra delays introduced by the security and the signaling protocols used to set up an authorized VoIP session...

  5. Should bus commuting be subsidized for providing quality transport ...

    Indian Academy of Sciences (India)

    e-mail: Abstract. Urban transport has ... (ii) Should bus prices be subsidized in order to provide a quality public transport system? (iii) How large is the modal shift in favour ..... been derived through a speed-flow relationship function, with a car free flow speed of 45 km/h, peak traffic speed of 24 km/h and ...

  6. PVM and IP multicast

    Energy Technology Data Exchange (ETDEWEB)

    Dunigan, T.H.; Hall, K.A.


    This report describes a 1994 demonstration implementation of PVM that uses IP multicast. PVM`s one-to-many unicast implementation of its pvm{_}mcast() function is replaced with reliable IP multicast. Performance of PVM using IP multicast over local and wide-area networks is measured and compared with the original unicast implementation. Current limitations of IP multicast are noted.

  7. Capturing value from Intellectual Property (IP) in a global environment

    DEFF Research Database (Denmark)

    Alcácer, Juan; Beukel, Karin; Cassiman, Bruno


    in patents, trademarks, and industrial designs used by firms to protect their IP globally. We then show that IP protection remains fragmented; the quality of IP applications might be questionable; and developing a comprehensive IP footprint worldwide is very costly. Growing numbers of applications...

  8. Quality of Services and Quality of Life from Service Providers' Perspectives: Analysis with Focus Groups (United States)

    Jenaro, C.; Vega, V.; Flores, N.; Cruz, M.


    Background: Concepts such as support, quality of life and quality of services are customary in services for people with intellectual disabilities. The identification of the different ways of conceiving, prioritising and implementing these concepts by service providers can help to drive changes to achieve better personal outcomes for this…

  9. Recent history provides sustainable African water quality project insight. (United States)

    Holm, Rochelle H


    Small-scale projects to provide clean drinking water undertaken in the developing world can contribute to significantly improving the livelihood of rural communities. There has been a historical tendency to poorly plan such projects leading to an unsustainable future. Recent history indicates three simple steps to ensuring successful and enduring clean water projects. First, identification of need by the indigenous community provides ownership in the project. Second, a partnership between key individuals in the indigenous community with the donor provides for ambassadors on both sides of the project. Finally, an exit strategy by the donors for the indigenous communities ensures local sustainability for the future. The study site is the village of Geisha in northern Malawi, Africa. Sustainable implementation approaches are discussed in this case study as well as the various lessons learned. Improved project processes ensure sustainable small-scale water quality projects by donor organizations in developing countries. © 2011, The Author(s). Ground Water © 2011, National Ground Water Association.

  10. Hardware IP security and trust

    CERN Document Server

    Bhunia, Swarup; Tehranipoor, Mark


    This book provides an overview of current Intellectual Property (IP) based System-on-Chip (SoC) design methodology and highlights how security of IP can be compromised at various stages in the overall SoC design-fabrication-deployment cycle. Readers will gain a comprehensive understanding of the security vulnerabilities of different types of IPs. This book would enable readers to overcome these vulnerabilities through an efficient combination of proactive countermeasures and design-for-security solutions, as well as a wide variety of IP security and trust assessment and validation techniques. This book serves as a single-source of reference for system designers and practitioners for designing secure, reliable and trustworthy SoCs.

  11. Credibility and validation of simulation models for tactical IP networks

    NARCIS (Netherlands)

    Boltjes, B.; Thiele, F.; Diaz, I.F.


    The task of TNO is to provide predictions of the scalability and performance of the new all-IP tactical networks of the Royal Netherlands Army (RNLA) that are likely to be fielded. The inherent properties of fielded tactical networks, such as low bandwidth and Quality of Service (QoS) policies

  12. Cultural competency: providing quality care to diverse populations. (United States)

    Betancourt, Joseph R


    The goal of this paper is to define cultural competence and present a practical framework to address crosscultural challenges that emerge in the clinical encounter, with a particular focus on the issue of nonadherence. English-language literature, both primary and reports from various agencies, and the author's personal experiences in clinical practice. Relevant literature on patient-centered care and cultural competence. There is a growing literature that delineates the impact of sociocultural factors, race, ethnicity, and limited-English proficiency on health and clinical care. The field of cultural competence focuses on addressing these issues. Health care providers need a practical set of tools and skills that will enable them to provide quality care to patients during a brief encounter, whatever differences in background that may exist. Cultural competence has evolved from the gathering of information and making of assumptions about patients on the basis of their sociocultural background to the development of skills to implement the principles of patient-centered care. This patient-based approach to cross-cultural care consists of first, assessing core cross-cultural issues; second, exploring the meaning of the illness to the patient; third, determining the social context in which the patient lives; and fourth, engaging in negotiation with the patient to encourage adherence. Addressing adherence is a particularly challenging issue, the determinants of which are multifactorial, and the ESFT (explanatory/social/fears/treatment) model--derived from the patient-based approach--is a tool that identifies barriers to adherence and provides strategies to address them. It obviously is impossible to learn everything about every culture and that should not be expected. Instead, we should learn about the communities we care for. More important, we should have a framework that allows us to provide appropriate care for any patient--one that deals with issues of adherence

  13. Mobile IP: Security & application

    NARCIS (Netherlands)

    Tuquerres, G.; Salvador, M.R.; Sprenkels, Ron


    As required in the TGS Mobile IP Advanced Module, this paper presents a survey of common security threats which mobile IP networks are exposed to as well as some proposed solutions to deal with such threats.

  14. Impact of quality assurance program: providing practice assessment. (United States)

    Saporito, R A; Feldman, C A; Stewart, D C; Echoldt, H; Buchanan, R N


    Participation in a self-administered quality assessment (SAQA) program led to changes in New Jersey dentists' perceptions of practice quality. Ninety-four percent indicated they discovered practice deficiencies. This study suggests that using a self-administered quality assessment program, such as the SAQA program, can lead to a better understanding of a practice's strengths and weaknesses.

  15. Measuring parental satisfaction of care quality provided in hospitalized children

    Directory of Open Access Journals (Sweden)

    Spyridoula Tsironi


    Full Text Available Introduction: Measuring parental satisfaction is of major importance for pediatric hospitals and the key component of evaluating the quality of services provided to health services. Aim: To assess the degree of parental satisfaction from the care provided to their hospitalized children.Methodology: A descriptive study conducted using a convenience sample of parents of hospitalized children in two public pediatric hospitals in Athens. Data collection was completed in a period of 3 months. 352 questionnaires were collected (response rate 88%. The Pyramid Questionnaire for parents of hospitalized children was used which estimates the degree of parental satisfaction from the care provided to their hospitalized child.Results: More parents were satisfied with health care professionals’ behavior (81,9%, the supplied care (78,2% and the information provision to parents regarding the hospitalized child’s disease (71,9%. In contrast, less parents were satisfied with their hospitalized child’s involvement in care (52,3% and the accessibility to the hospital (39,5%. The overall parental satisfaction ranged in very good level (76,8% and it was higher on hospital A (78,8%, among married parents (77,4% and those not al all concerned or concerned less for child’s illness (83,1%. Logistic regression model showed that hospitalization in hospital B and the great concern for child’s illness and its complications decreased ovewrall satisfaction by 24% and 17% respectively. Conclusions: The assessment of the degree of parental satisfaction is the most important indicator of hospitals’ proper functioning. From our study certain areas need improvement, such as: the parental involvement in child’s care, information provision, the accessibility to the hospital, the communication and the interpersonal health care in order greater satisfaction to be achieved.

  16. Ensuring Software IP Cleanliness

    Directory of Open Access Journals (Sweden)

    Mahshad Koohgoli


    Full Text Available At many points in the life of a software enterprise, determination of intellectual property (IP cleanliness becomes critical. The value of an enterprise that develops and sells software may depend on how clean the software is from the IP perspective. This article examines various methods of ensuring software IP cleanliness and discusses some of the benefits and shortcomings of current solutions.

  17. Quality in Family Child Care Networks: An Evaluation of All Our Kin Provider Quality (United States)

    Porter, Toni; Reiman, Kayla; Nelson, Christina; Sager, Jessica; Wagner, Janna


    This article presents findings from a quasi-experimental evaluation of quality with a sample of 28 family child care providers in the All Our Kin Family Child Care Network, a staffed family child care network which offers a range of services including relationship-based intensive consultation, and 20 family child care providers who had no…

  18. IP voice over ATM satellite: experimental results over satellite channels (United States)

    Saraf, Koroush A.; Butts, Norman P.


    IP telephony, a new technology to provide voice communication over traditional data networks, has the potential to revolutionize telephone communication within the modern enterprise. This innovation uses packetization techniques to carry voice conversations over IP networks. This packet switched technology promises new integrated services, and lower cost long-distance communication compared to traditional circuit switched telephone networks. Future satellites will need to carry IP traffic efficiently in order to stay competitive in servicing the global data- networking and global telephony infrastructure. However, the effects of Voice over IP over switched satellite channels have not been investigated in detail. To fully understand the effects of satellite channels on Voice over IP quality; several experiments were conducted at Lockheed Martin Telecommunications' Satellite Integration Lab. The result of those experiments along with suggested improvements for voice communication over satellite are presented in this document. First, a detailed introduction of IP telephony as a suitable technology for voice communication over future satellites is presented. This is followed by procedures for the experiments, along with results and strategies. In conclusion we hope that these capability demonstrations will alleviate any uncertainty regarding the applicability of this technology to satellite networks.

  19. Comparing genome-wide chromatin profiles using ChIP-chip or ChIP-seq

    NARCIS (Netherlands)

    Johannes, Frank; Wardenaar, Rene; Colomé Tatché, Maria; Mousson, Florence; de Graaf, Petra; Mokry, Michal; Guryev, Victor; Timmers, H. Th. Marc; Cuppen, Edwin; Jansen, Ritsert C.; Bateman, Alex


    Motivation: ChIP-chip and ChIP-seq technologies provide genomewide measurements of various types of chromatin marks at an unprecedented resolution. With ChIP samples collected from different tissue types and/ or individuals, we can now begin to characterize stochastic or systematic changes in

  20. Comparing genome-wide chromatin profiles using ChIP-chip or ChIP-seq

    NARCIS (Netherlands)

    Johannes, F.; Wardenaar, R.; Colome-Tatche, M.; Mousson, F.; de Graaf, P.; Mokry, M.; Guryev, V.; Timmers, H.T.; Cuppen, E.; Jansen, R.


    MOTIVATION: ChIP-chip and ChIP-seq technologies provide genome-wide measurements of various types of chromatin marks at an unprecedented resolution. With ChIP samples collected from different tissue types and/or individuals, we can now begin to characterize stochastic or systematic changes in

  1. A Comparison of SERVQUAL and I-P Analysis: Measuring and Improving Service Quality in Egyptian Private Universities (United States)

    Mostafa, Mohamed M.


    The overall purpose of this research is to further our understanding of how students perceive service quality in Egypt's private universities. The paper also tests the SERVQUAL dimensions in higher education within an Arab, non-Western context. A sample of 508 students from four private universities in Egypt participated in the study. Student…

  2. Policy-Based Quality of Service and Security Management for Multimedia Services on IP networks in the RTIPA project

    NARCIS (Netherlands)

    Gay, V.C.J.; Almeroth, K.C.; Duflos, Sandrine; Hasan, M.; Kervella, Brigitte; Diaz, Gladys; Horlait, Eric


    This paper summarizes the research work that has been conducted in the context of the RTIPA project on policy-based QoS (Quality of Service) and security management for distributed multimedia services. It presents an architecture allowing the derivation of policies from the service level down to the

  3. Implementasi Sistem IP PBX menggunakan Briker

    Directory of Open Access Journals (Sweden)



    Full Text Available Abstrak VoIP (Voice over Internet Protocol adalah komunikasi suara jarak jauh yang digunakan melalui jaringan IP. Pada penelitian ini dirancang sistem IP PBX dengan menggunakan teknologi berbasis VoIP. IP PBX adalah perangkat switching komunikasi telepon dan data berbasis teknologi Internet Protocol (IP yang mengendalikan ekstension telepon analog maupun ekstension IP Phone. Software VirtualBox digunakan dengan tujuan agar lebih memudahkan dalam sistem pengoperasian Linux yang dimana program untuk membuat IP PBX adalah menggunakan Briker yang bekerja pada Operating System Linux 2.6. Setelah proses penginstalan Briker pada Virtualbox dilakukan implementasi jaringan IP PBX. Setelah mengimplementasikan jaringan IP PBX sesuai dengan topologi, kemudian melakukan pengujian success call rate dan analisis Quality of Service (QoS. Pengukuran QoS menggunakan parameter jitter, delay, dan packet loss yang dihasilkan dalam sistem IP PBX ini. Nilai jitter sesama user Briker (baik pada smartphone maupun komputer mempunyai rata-rata berada pada nilai 16,77 ms. Sedangkan nilai packetloss yang didapat pada saat terdapat pada saat user 1 sebagai pemanggil telepon adalah 0%. Sedangkan persentase packet loss pada saat user 1 sebagai penerima telepon adalah 0,01%. Nilai delay pada saat berkomunikasi antar user berada pada 11,75 ms. Secara keseluruhan nilai yang didapatkan melalui penelitian ini, dimana hasil pengujian parameter-parameter QOS sesuai dengan standar yang telah direkomendasikan oleh ITU dan didapatkan nilai QoS dengan hasil “baik”. Kata Kunci : Briker, VoIP, QoS, IP PBX, Smartphone. Abstract VoIP (Voice over Internet Protocol is a long-distance voice communications over IP networks are used. In this study, IP PBX systems designed using VoIP -based technologies. IP PBX is a telephone switching device and data communication technology-based Internet Protocol (IP which controls the analog phone extensions and IP Phone extensions. VirtualBox software is

  4. Applying a gaming approach to IP strategy. (United States)

    Gasnier, Arnaud; Vandamme, Luc


    Adopting an appropriate IP strategy is an important but complex area, particularly in the pharmaceutical and biotechnology sectors, in which aspects such as regulatory submissions, high competitive activity, and public health and safety information requirements limit the amount of information that can be protected effectively through secrecy. As a result, and considering the existing time limits for patent protection, decisions on how to approach IP in these sectors must be made with knowledge of the options and consequences of IP positioning. Because of the specialized nature of IP, it is necessary to impart knowledge regarding the options and impact of IP to decision-makers, whether at the level of inventors, marketers or strategic business managers. This feature review provides some insight on IP strategy, with a focus on the use of a new 'gaming' approach for transferring the skills and understanding needed to make informed IP-related decisions; the game Patentopolis is discussed as an example of such an approach. Patentopolis involves interactive activities with IP-related business decisions, including the exploitation and enforcement of IP rights, and can be used to gain knowledge on the impact of adopting different IP strategies.

  5. Vaccines and IP Rights: A Multifaceted Relationship. (United States)

    Durell, Karen


    Just as there are many forms of vaccines and components to vaccines-particular compositions, delivery systems, components, and distribution networks-there are a variety of intellectual property (IP) protections applicable for vaccines. IP rights such as patent, copyright, trademarks, plant breeders' rights, and trade secrets may all be applicable to vaccines. Thus, discussion of IP rights and vaccines should not begin and end with the application of one IP right to a vaccine. The discussion should engage considerations of multiple IP rights applicable to a vaccine and how these can be utilized in an integrated manner in a strategy aimed at supporting the development and distribution of the vaccine. Such an approach to IP rights to vaccines allows for the integrated rights to be considered in light of the justifications for protecting vaccines with IP rights, as well as the issues relating to specific IP rights for vaccines, such as compulsory license regimes, available humanitarian purpose IP credits, etc. To view vaccines as the subject of multiple IP protections involves a refocusing, but the outcome can provide significant benefits for vaccine development and distribution.

  6. The Quality of Care Provided to Patients with Chronic Non ...

    African Journals Online (AJOL)

    BACKGROUND: Chronic Non-Communicable Diseases are among the major causes of morbidity and mortality worldwide. However, access to and quality of health care for patients is very low in developing countries including Ethiopia. Hospitals and Health Centers are the main sources of health care for such patients in ...

  7. Securing VoIP keeping your VoIP network safe

    CERN Document Server

    (Bud) Bates, Regis J Jr


    Securing VoIP: Keeping Your VoIP Network Safe will show you how to take the initiative to prevent hackers from recording and exploiting your company's secrets. Drawing upon years of practical experience and using numerous examples and case studies, technology guru Bud Bates discusses the business realities that necessitate VoIP system security and the threats to VoIP over both wire and wireless networks. He also provides essential guidance on how to conduct system security audits and how to integrate your existing IT security plan with your VoIP system and security plans, helping you prevent

  8. Performance of VoIP on HSDPA

    DEFF Research Database (Denmark)

    Wang, Bang; Pedersen, Klaus I.; Kolding, Troels E.


    This paper provides packet scheduler design and performance simulations for running VoIP services over high-speed downlink packet access (HSDPA) in WCDMA. The main challenge of supporting VoIP service on HSDPA is the tight delay requirement combined with the small VoIP packet size. A packet...... scheduler design incorporating VoIP packet aggregation and user multiplexing is proposed and the VoIP capacity is studied for a macro-cellular environment. Results are obtained for different delay budgets and packet scheduling settings, using either blind round robin or a slightly modified version...... of proportional fair scheduling. For proportional fair scheduling with code-multiplexing of 4-users, the downlink VoIP cell capacity on HSDPA is found to be in the range 72-104 users depending on whether the delay budget for the Node-B scheduling and user reception equals 80 ms or 150 ms, respectively....

  9. On Tuning the Knobs of Distribution-Based Methods for Detecting VoIP Covert Channels (United States)


    for use, because of the high bandwidth provided by the channels. However, Huang et al. [16] present a VoIP covert channel using steganography that...these protocols to deliver good voice audio quality. The combination of these circumstances makes abusing VoIP protocols an effective way for a malicious...calls in this manner. For the audio input in the call, we play a French language training audio program on both ends of the call. We save packet capture

  10. Identification of Candidate Functional Elements in the Genome from ChIP-seq Data. (United States)

    Marinov, Georgi K


    ChIP-seq datasets provide a wealth of information for the identification of candidate regulatory elements in the genome. For this potential to be fully realized, methods for evaluating data quality and for distinguishing reproducible signal from technical and biological noise are necessary. Here, the computational methods for addressing these challenges developed by the ENCODE Consortium are described and the key considerations for analyzing and interpreting ChIP-seq data are discussed.

  11. Metabolomics Provides Quality Characterization of Commercial Gochujang (Fermented Pepper Paste

    Directory of Open Access Journals (Sweden)

    Gyu Min Lee


    Full Text Available To identify the major factors contributing to the quality of commercial gochujang (fermented red pepper paste, metabolites were profiled by mass spectrometry. In principal component analysis, cereal type (wheat, brown rice, and white rice and species of hot pepper (Capsicum annuum, C. annuum cv. Chung-yang, and C. frutescens affected clustering patterns. Relative amino acid and citric acid levels were significantly higher in wheat gochujang than in rice gochujang. Sucrose, linoleic acid, oleic acid, and lysophospholipid levels were high in brown-rice gochujang, whereas glucose, maltose, and γ-aminobutyric acid levels were high in white-rice gochujang. The relative capsaicinoid and luteolin derivative contents in gochujang were affected by the hot pepper species used. Gochujang containing C. annuum cv. Chung-yang and C. frutescens showed high capsaicinoid levels. The luteolin derivative level was high in gochujang containing C. frutescens. These metabolite variations in commercial gochujang may be related to different physicochemical phenotypes and antioxidant activity.

  12. Beyond iPS!

    Directory of Open Access Journals (Sweden)



    Full Text Available It’s undoubtedly a jubilant moment for scientists and clinicians working in the stem cell arena as Prof. Gurdon and Prof. Shinya Yamanaka have been chosen for the Nobel Prize in Physiology & Medicine this year. The mystery of cell biology is something unfathomable and probably the work of this duo as well as the other scientists, who have put their hands on in- vitro de-differentiation have opened our eyes to a new window or a new paradigm in cell biology. The iPS invention has brought a lot of hope in terms of potential direct benefits to treat several diseases, which have no definite options at the moment. But, we envisage that several spin-offs could come out of this invention and one very significant spin-off finding recently witnessed is the finding by Prof. Masaharu Seno and his team of researchers at the Okayama University, Japan (Chen L, et al. 2012, PLoS ONE 7(4:e33544.doi:10.1371/journal.pone.0033544. According to Prof. Seno, mouse iPS cells (miPS when cultured in the conditioned medium derived from cancer cell lines, differentiate into cancer stem cells (CSCs. While differentiating into CSCs, they do retain the potential to develop endothelial progenitor cells. Several questions arise here: 1.Are these miPS derived CSCs really pluripotent, even if the terminal differentiation destined to specific phenotypes? 2.Shouldn’t the Cancer Stem Cells be termed as cancer progenitor cells, as till date they are considered to be producing only cancer cells but not pluripotent to yield other types of normal tissues? The spin-offs could be infinite as the process of differentiation and de-differentiation happening due to trillions of signals and pathways, most still remaining not-so-well understood. A special mention should be made to Prof. Shinya Yamanaka as he has several sterling qualities to be a role-model for budding scientists. Apart from his passion for science, which made him shift his career from orthopedics to a cell biologist, his

  13. Opportunities for IP  in Communications Beyond 3G

    DEFF Research Database (Denmark)

    Nielsen, Thomas Toftegaard; Jacobsen, Rune H.


    Future communication will be based on TCP/IP as common network and transport layers to provide global connectivity to users and applications. IP is used to provide ubiquitous access across different access networks and exploits the benefits of a common connectivity layer while reducing the cost...... of operation and maintenance of the network. This paper discusses the opportunities for IP in the evolution towards a future broadband, all-IP mobile communication network. In particular, we argue for three opportunities for the future: Interworking access technologies over IP, IP layer transparency...

  14. Evaluation of IP Portfolios

    DEFF Research Database (Denmark)

    Søberg, Peder Veng


    As a result of an inquiry concerning how to evaluate IP (intellectual property) portfolios in order to enable the best possible use of IP resources within organizations, an IP evaluation approach primarily applicable for patents and utility models is developed. The developed approach is useful...... in order to discuss, visualize and align IPR issues with different management functions within the organization. Unlike existing approaches the present approach takes into account such value indicators as remaining lifetime, geographical range, broadness of scope and product strategic considerations...

  15. Continuously Connected With Mobile IP (United States)


    Cisco Systems developed Cisco Mobile Networks, making IP devices mobile. With this innovation, a Cisco router and its connected IP devices can roam across network boundaries and connection types. Because a mobile user is able to keep the same IP address while roaming, a live IP connection can be maintained without interruption. Glenn Research Center jointly tested the technology with Cisco, and is working to use it on low-earth-orbiting research craft. With Cisco's Mobile Networks functionality now available in Cisco IOS Software release 12.2(4)T, the commercial advantages and benefits are numerous. The technology can be applied to public safety, military/homeland security, emergency management services, railroad and shipping systems, and the automotive industry. It will allow ambulances, police, firemen, and the U.S. Coast Guard to stay connected to their networks while on the move. In the wireless battlefield, the technology will provide rapid infrastructure deployment for U.S. national defense. Airline, train, and cruise passengers utilizing Cisco Mobile Networks can fly all around the world with a continuous Internet connection. Cisco IOS(R) Software is a registered trademark of Cisco Systems.

  16. Agency IP Data (United States)

    National Aeronautics and Space Administration — Public data set for NASA Agency Intellectual Property (IP). The distribution contains both Patent information as well as General Release of Open Source Software.

  17. Impact of genome assembly status on ChIP-Seq and ChIP-PET data mapping

    Directory of Open Access Journals (Sweden)

    Sachs Laurent


    Full Text Available Abstract Background ChIP-Seq and ChIP-PET can potentially be used with any genome for genome wide profiling of protein-DNA interaction sites. Unfortunately, it is probable that most genome assemblies will never reach the quality of the human genome assembly. Therefore, it remains to be determined whether ChIP-Seq and ChIP-PET are practicable with genome sequences other than a few (e.g. human and mouse. Findings Here, we used in silico simulations to assess the impact of completeness or fragmentation of genome assemblies on ChIP-Seq and ChIP-PET data mapping. Conclusions Most currently published genome assemblies are suitable for mapping the short sequence tags produced by ChIP-Seq or ChIP-PET.

  18. Endorsing good quality assurance practices in molecular pathology: risks and recommendations for diagnostic laboratories and external quality assessment providers. (United States)

    Tembuyser, Lien; Dequeker, Elisabeth M C


    Quality assurance is an indispensable element in a molecular diagnostic laboratory. The ultimate goal is to warrant patient safety. Several risks that can compromise high quality procedures are at stake, from sample collection to the test performed by the laboratory, the reporting of test results to clinicians, and the organization of effective external quality assessment schemes. Quality assurance should therefore be safeguarded at each level and should imply a holistic multidisciplinary approach. This review aims to provide an overview of good quality assurance practices and discusses certain risks and recommendations to promote and improve quality assurance for both diagnostic laboratories and for external quality assessment providers. The number of molecular targets is continuously rising, and new technologies are evolving. As this poses challenges for clinical implementation and increases the demand for external quality assessment, the formation of an international association for improving quality assurance in molecular pathology is called for.

  19. Customized power quality service provided by converter interfaced microgrids — Voltage harmonics as a study case

    DEFF Research Database (Denmark)

    Meng, Lexuan; Chaudhary, Sanjay K.; Guerrero, Josep M.


    Customers may have different power quality requirements, thus, the economic operational strategy can try to provide them with distinctive quality levels as customized service. An optimization based method is proposed in this paper to realize this functionality, offering the possibility...

  20. A Survey of Voice over IP Security Research (United States)

    Keromytis, Angelos D.

    We present a survey of Voice over IP security research. Our goal is to provide a roadmap for researchers seeking to understand existing capabilities and, and to identify gaps in addressing the numerous threats and vulnerabilities present in VoIP systems. We also briefly discuss the implications of our findings with respect to actual vulnerabilities reported in a variety VoIP products.

  1. Optimal use of tandem biotin and V5 tags in ChIP assays (United States)

    Kolodziej, Katarzyna E; Pourfarzad, Farzin; de Boer, Ernie; Krpic, Sanja; Grosveld, Frank; Strouboulis, John


    Background Chromatin immunoprecipitation (ChIP) assays coupled to genome arrays (Chip-on-chip) or massive parallel sequencing (ChIP-seq) lead to the genome wide identification of binding sites of chromatin associated proteins. However, the highly variable quality of antibodies and the availability of epitopes in crosslinked chromatin can compromise genomic ChIP outcomes. Epitope tags have often been used as more reliable alternatives. In addition, we have employed protein in vivo biotinylation tagging as a very high affinity alternative to antibodies. In this paper we describe the optimization of biotinylation tagging for ChIP and its coupling to a known epitope tag in providing a reliable and efficient alternative to antibodies. Results Using the biotin tagged erythroid transcription factor GATA-1 as example, we describe several optimization steps for the application of the high affinity biotin streptavidin system in ChIP. We find that the omission of SDS during sonication, the use of fish skin gelatin as blocking agent and choice of streptavidin beads can lead to significantly improved ChIP enrichments and lower background compared to antibodies. We also show that the V5 epitope tag performs equally well under the conditions worked out for streptavidin ChIP and that it may suffer less from the effects of formaldehyde crosslinking. Conclusion The combined use of the very high affinity biotin tag with the less sensitive to crosslinking V5 tag provides for a flexible ChIP platform with potential implications in ChIP sequencing outcomes. PMID:19196479

  2. Optimal use of tandem biotin and V5 tags in ChIP assays

    Directory of Open Access Journals (Sweden)

    Krpic Sanja


    Full Text Available Abstract Background Chromatin immunoprecipitation (ChIP assays coupled to genome arrays (Chip-on-chip or massive parallel sequencing (ChIP-seq lead to the genome wide identification of binding sites of chromatin associated proteins. However, the highly variable quality of antibodies and the availability of epitopes in crosslinked chromatin can compromise genomic ChIP outcomes. Epitope tags have often been used as more reliable alternatives. In addition, we have employed protein in vivo biotinylation tagging as a very high affinity alternative to antibodies. In this paper we describe the optimization of biotinylation tagging for ChIP and its coupling to a known epitope tag in providing a reliable and efficient alternative to antibodies. Results Using the biotin tagged erythroid transcription factor GATA-1 as example, we describe several optimization steps for the application of the high affinity biotin streptavidin system in ChIP. We find that the omission of SDS during sonication, the use of fish skin gelatin as blocking agent and choice of streptavidin beads can lead to significantly improved ChIP enrichments and lower background compared to antibodies. We also show that the V5 epitope tag performs equally well under the conditions worked out for streptavidin ChIP and that it may suffer less from the effects of formaldehyde crosslinking. Conclusion The combined use of the very high affinity biotin tag with the less sensitive to crosslinking V5 tag provides for a flexible ChIP platform with potential implications in ChIP sequencing outcomes.

  3. IPS - a vision aided navigation system (United States)

    Börner, Anko; Baumbach, Dirk; Buder, Maximilian; Choinowski, Andre; Ernst, Ines; Funk, Eugen; Grießbach, Denis; Schischmanow, Adrian; Wohlfeil, Jürgen; Zuev, Sergey


    Ego localization is an important prerequisite for several scientific, commercial, and statutory tasks. Only by knowing one's own position, can guidance be provided, inspections be executed, and autonomous vehicles be operated. Localization becomes challenging if satellite-based navigation systems are not available, or data quality is not sufficient. To overcome this problem, a team of the German Aerospace Center (DLR) developed a multi-sensor system based on the human head and its navigation sensors - the eyes and the vestibular system. This system is called integrated positioning system (IPS) and contains a stereo camera and an inertial measurement unit for determining an ego pose in six degrees of freedom in a local coordinate system. IPS is able to operate in real time and can be applied for indoor and outdoor scenarios without any external reference or prior knowledge. In this paper, the system and its key hardware and software components are introduced. The main issues during the development of such complex multi-sensor measurement systems are identified and discussed, and the performance of this technology is demonstrated. The developer team started from scratch and transfers this technology into a commercial product right now. The paper finishes with an outlook.

  4. Biobjective VoIP Service Management in Cloud Infrastructure

    Directory of Open Access Journals (Sweden)

    Jorge M. Cortés-Mendoza


    Full Text Available Voice over Internet Protocol (VoIP allows communication of voice and/or data over the internet in less expensive and reliable manner than traditional ISDN systems. This solution typically allows flexible interconnection between organization and companies on any domains. Cloud VoIP solutions can offer even cheaper and scalable service when virtualized telephone infrastructure is used in the most efficient way. Scheduling and load balancing algorithms are fundamental parts of this approach. Unfortunately, VoIP scheduling techniques do not take into account uncertainty in dynamic and unpredictable cloud environments. In this paper, we formulate the problem of scheduling of VoIP services in distributed cloud environments and propose a new model for biobjective optimization. We consider the special case of the on-line nonclairvoyant dynamic bin-packing problem and discuss solutions for provider cost and quality of service optimization. We propose twenty call allocation strategies and evaluate their performance by comprehensive simulation analysis on real workload considering six months of the MIXvoip company service.

  5. Provider perspectives on barriers to family planning quality in Uganda: a qualitative study. (United States)

    Mugisha, John Frank; Reynolds, Heidi


    Provider perspectives on the quality of family planning services have been overlooked in quality of care research and interventions. This qualitative study was carried out in four districts in Uganda, a country where lack of access to quality family planning services remains a challenge. Using four focus group discussions, 16 provider in-depth interviews and nine manager in-depth interviews, this study documented providers' perceptions of quality of care and of barriers to quality services at the organisational and societal levels. To guide study development, analysis and interpretation, the authors relied on an ecological framework where providers' abilities are shaped by the larger organisational and societal environments in which providers live and work. Providers felt that organisational factors, such as supply availability, workload and their own knowledge and skills, affected their abilities to offer quality care. At the same time, providers were challenged by societal factors such as male partner participation, financial constraints, misconceptions and leadership support. While making changes to the elements of quality care that clients experience is important, it is not sufficient in view of the organisational and social barriers. Across the different levels of the ecological framework, providers face barriers to providing quality family planning services that are synergistic. Solutions to improve quality of care must address also limitations at the organisational and societal levels since efforts to overcome a particular constraint are less likely to be successful if this interdependence is not taken into account.

  6. Mobile IP and protocol authentication extension


    Nguyen, Phuc V.


    Mobile IP is an open standard, defined by the Internet Engineering Task Force (IETF) RFC 3220. By using Mobile IP, you can keep the same IP address, stay connected, and maintain ongoing applications while roaming between IP networks. Mobile IP is scalable for the Internet because it is based on IP - any media that can support IP can support Mobile IP.

  7. Quality of reproductive healthcare for adolescents: A nationally representative survey of providers in Mexico.

    Directory of Open Access Journals (Sweden)

    Aremis Villalobos

    Full Text Available Adolescents need sexual and reproductive health services but little is known about quality-of-care in lower- and middle-income countries where most of the world's adolescents reside. Quality-of-care has important implications as lower quality may be linked to higher unplanned pregnancy and sexually transmitted infection rates. This study sought to generate evidence about quality-of-care in public sexual and reproductive health services for adolescents.This cross-sectional study had a complex, probabilistic, stratified sampling design, representative at the national, regional and rural/urban level in Mexico, collecting provider questionnaires at 505 primary care units in 2012. A sexual and reproductive quality-of-healthcare index was defined and multinomial logistic regression was utilized in 2015.At the national level 13.9% (95%CI: 6.9-26.0 of healthcare units provide low quality, 68.6% (95%CI: 58.4-77.3 medium quality and 17.5% (95%CI: 11.9-25.0 high quality reproductive healthcare services to adolescents. Urban or metropolitan primary care units were at least 10 times more likely to provide high quality care than those in rural areas. Units with a space specifically for counseling adolescents were at least 8 times more likely to provide high quality care. Ministry of Health clinics provided the lowest quality of service, while those from Social Security for the Underserved provided the best.The study indicates higher quality sexual and reproductive healthcare services are needed. In Mexico and other middle- to low-income countries where quality-of-care has been shown to be a problem, incorporating adolescent-friendly, gender-equity and rights-based perspectives could contribute to improvement. Setting and disseminating standards for care in guidelines and providing tools such as algorithms could help healthcare personnel provide higher quality care.

  8. ChIP-chip versus ChIP-seq: Lessons for experimental design and data analysis (United States)


    Background Chromatin immunoprecipitation (ChIP) followed by microarray hybridization (ChIP-chip) or high-throughput sequencing (ChIP-seq) allows genome-wide discovery of protein-DNA interactions such as transcription factor bindings and histone modifications. Previous reports only compared a small number of profiles, and little has been done to compare histone modification profiles generated by the two technologies or to assess the impact of input DNA libraries in ChIP-seq analysis. Here, we performed a systematic analysis of a modENCODE dataset consisting of 31 pairs of ChIP-chip/ChIP-seq profiles of the coactivator CBP, RNA polymerase II (RNA PolII), and six histone modifications across four developmental stages of Drosophila melanogaster. Results Both technologies produce highly reproducible profiles within each platform, ChIP-seq generally produces profiles with a better signal-to-noise ratio, and allows detection of more peaks and narrower peaks. The set of peaks identified by the two technologies can be significantly different, but the extent to which they differ varies depending on the factor and the analysis algorithm. Importantly, we found that there is a significant variation among multiple sequencing profiles of input DNA libraries and that this variation most likely arises from both differences in experimental condition and sequencing depth. We further show that using an inappropriate input DNA profile can impact the average signal profiles around genomic features and peak calling results, highlighting the importance of having high quality input DNA data for normalization in ChIP-seq analysis. Conclusions Our findings highlight the biases present in each of the platforms, show the variability that can arise from both technology and analysis methods, and emphasize the importance of obtaining high quality and deeply sequenced input DNA libraries for ChIP-seq analysis. PMID:21356108

  9. Glaucoma patient-provider communication about vision quality-of-life. (United States)

    Sleath, Betsy; Sayner, Robyn; Vitko, Michelle; Carpenter, Delesha M; Blalock, Susan J; Muir, Kelly W; Giangiacomo, Annette L; Hartnett, Mary Elizabeth; Robin, Alan L


    The purpose of this study was to: (a) describe the extent to which ophthalmologists and glaucoma patients discuss vision quality-of-life during office visits, and (b) examine the association between patient and ophthalmologist characteristics and provider-patient communication about vision quality-of-life. Patients with glaucoma who were newly prescribed or on glaucoma medications were recruited at six ophthalmology clinics. Patients' visits were video-tape recorded and quality-of-life communication variables were coded. Generalized estimating equations were used to analyze the data. Two hundred and seventy-nine patients participated. Specific glaucoma quality-of-life domains were discussed during only 13% of visits. Older patients were significantly more likely to discuss one or more vision quality-of-life domains than younger patients. African American patients were significantly less likely to make statements about their vision quality-of-life and providers were less likely to ask them one or more vision quality-of-life questions than non-African American patients. Eye care providers and patients infrequently discussed the patient's vision quality-of-life during glaucoma visits. African American patients were less likely to communicate about vision quality-of-life than non-African American patients. Eye care providers should make sure to discuss vision quality-of-life with glaucoma patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Stud.IP


    Stockmann, Ralf; Berg, Alexander


    Dieser Beitrag beschreibt die Konzeption, den Funktionsumfang und Erfahrungswerte der Open-Source-eLearning-Plattform Stud.IP. Der Funktionsumfang umfasst für jede einzelne Veranstaltung Ablaufpläne, das Hochladen von Hausarbeiten, Diskussionsforen, persönliche Homepages, Chaträume u.v.a. Ziel ist es hierbei, eine Infrastruktur des Lehrens und Lernens anzubieten, die dem Stand der Technik entspricht. Wissenschaftliche Einrichtungen finden zudem eine leistungsstarke Umgebung zur Verwaltung ihr...

  11. Provider category and quality of care in the Norwegian nursing home industry

    Directory of Open Access Journals (Sweden)

    Astri Drange Hole


    Full Text Available This paper examines empirically if there is a link between quality of care in the Norwegian nursing home industry and exposure of the industry to competition. Exposing public care to competition implies that the responsibility for providing care services is shared between public authorities and private actors. In Norway, exposure to competition means tender competition. Suppliers bid for a contract issued by the Norwegian authorities for a limited number of years. Quality of care in an institution is the major competitive factor. The provider categories of elderly care are: 1 care provided by institutions run by municipalities, 2 care provided by institutions run by private companies, which have won a tender competition, 3 care provided by institutions run by private companies owned by private families, voluntary religious or idealistic organizations. Nurse-to-patient ratio is used as a proxy for quality of care. The regression analysis indicates a relationship between quality of care and exposure to competition. The quality of care in provider category 2 is significantly lower than in provider category 1, but there are more variations in the quality of care in provider category 1 than in provider category 2. We find the lowest quality of care in provider category 1. There is also a relationship between the quality of care in an institution and the educational level of the staff, the location, the workforce, and the size of an institution. Finally, there is a relationship between the quality of care in an institution and the real and the required capacity, and the financial status in a region.

  12. Large performance incentives had the greatest impact on providers whose quality metrics were lowest at baseline. (United States)

    Greene, Jessica; Hibbard, Judith H; Overton, Valerie


    This study examined the impact of Fairview Health Services' primary care provider compensation model, in which 40 percent of compensation was based on clinic-level quality outcomes. Fairview Health Services is a Pioneer accountable care organization in Minnesota. Using publicly reported performance data from 2010 and 2012, we found that Fairview's improvement in quality metrics was not greater than the improvement in other comparable Minnesota medical groups. An analysis of Fairview's administrative data found that the largest predictor of improvement over the first two years of the compensation model was primary care providers' baseline quality performance. Providers whose baseline performance was in the lowest tertile improved three times more, on average, across the three quality metrics studied than those in the middle tertile, and almost six times more than those in the top tertile. As a result, there was a narrowing of variation in performance across all primary care providers at Fairview and a narrowing of the gap in quality between providers who treated the highest-income patient panels and those who treated the lowest-income panels. The large quality incentive fell short of its overall quality improvement aim. However, the results suggest that payment reform may help narrow variation in primary care provider performance, which can translate into narrowing socioeconomic disparities. Project HOPE—The People-to-People Health Foundation, Inc.

  13. The Association of Perceived Provider-Patient Communication and Relationship Quality with Colorectal Cancer Screening (United States)

    Underhill, Meghan L.; Kiviniemi, Marc T.


    Background: Two-thirds of adults aged 50 years and older are adherent to recommendations for colorectal cancer screening. Provider-patient communication and characteristics of the patient-provider relationship may relate to screening behavior. Methods: The association of provider communication quality, relationship, and colorectal cancer screening…

  14. Adopting Quality Criteria for Websites Providing Medical Information About Rare Diseases. (United States)

    Pauer, Frédéric; Göbel, Jens; Storf, Holger; Litzkendorf, Svenja; Babac, Ana; Frank, Martin; Lührs, Verena; Schauer, Franziska; Schmidtke, Jörg; Biehl, Lisa; Wagner, Thomas Of; Ückert, Frank; Graf von der Schulenburg, Johann-Matthias; Hartz, Tobias


    The European Union considers diseases to be rare when they affect less than 5 in 10,000 people. It is estimated that there are between 5000 and 8000 different rare diseases. Consistent with this diversity, the quality of information available on the Web varies considerably. Thus, quality criteria for websites about rare diseases are needed. The objective of this study was to generate a catalog of quality criteria suitable for rare diseases. First, relevant certificates and quality recommendations for health information websites were identified through a comprehensive Web search. Second, all considered quality criteria of each certification program and catalog were examined, extracted into an overview table, and analyzed by thematic content. Finally, an interdisciplinary expert group verified the relevant quality criteria. We identified 9 quality certificates and criteria catalogs for health information websites with 304 single criteria items. Through this, we aggregated 163 various quality criteria, each assigned to one of the following categories: thematic, technical, service, content, and legal. Finally, a consensus about 13 quality criteria for websites offering medical information on rare diseases was determined. Of these categories, 4 (data protection concept, imprint, creation and updating date, and possibility to contact the website provider) were identified as being the most important for publishing medical information about rare diseases. The large number of different quality criteria appearing within a relatively small number of criteria catalogs shows that the opinion of what is important in the quality of health information differs. In addition, to define useful quality criteria for websites about rare diseases, which are an essential source of information for many patients, a trade-off is necessary between the high standard of quality criteria for health information websites in general and the limited provision of information about some rare diseases

  15. A survey of IP over ATM architectures

    Energy Technology Data Exchange (ETDEWEB)

    Chen, H.; Tsang, R.; Brandt, J.; Hutchins, J.


    Over the past decade, the Internet has burgeoned into a worldwide information highway consisting of approximately 5 million hosts on over 45,000 interconnected networks. This unprecedented growth, together with the introduction of multimedia workstations, has spurred the development of innovative applications that require high speed, low latency, and real-time transport. Today`s Internet can neither scale in its bandwidth nor guarantee the Quality of Services (QoS) necessary to meet these performance requirements. Many network researchers propose to use the Asynchronous Transfer Mode (ATM) technology as the underlying infrastructure for the next generation of workgroup, campus, and enterprise IP networks. Since ATM is significantly different from today`s legacy network technologies, efficient implementation of IP over ATM is especially challenging. This tutorial paper covers several existing proposals that integrate IP over ATM.

  16. The Spacelab IPS Star Simulator (United States)

    Wessling, Francis C., III

    The cost of doing business in space is very high. If errors occur while in orbit the costs grow and desired scientific data may be corrupted or even lost. The Spacelab Instrument Pointing System (IPS) Star Simulator is a unique test bed that allows star trackers to interface with simulated stars in a laboratory before going into orbit. This hardware-in-the loop testing of equipment on earth increases the probability of success while in space. The IPS Star Simulator provides three fields of view 2.55 x 2.55 degrees each for input into star trackers. The fields of view are produced on three separate monitors. Each monitor has 4096 x 4096 addressable points and can display 50 stars (pixels) maximum at a given time. The pixel refresh rate is 1000 Hz. The spectral output is approximately 550 nm. The available relative visual magnitude range is 2 to 8 visual magnitudes. The star size is less than 100 arc seconds. The minimum star movement is less than 5 arc seconds and the relative position accuracy is approximately 40 arc seconds. The purpose of this paper is to describe the LPS Star Simulator design and to provide an operational scenario so others may gain from the approach and possible use of the system.

  17. Effectiveness of UK provider financial incentives on quality of care: a systematic review. (United States)

    Mandavia, Rishi; Mehta, Nishchay; Schilder, Anne; Mossialos, Elias


    Provider financial incentives are being increasingly adopted to help improve standards of care while promoting efficiency. To review the UK evidence on whether provider financial incentives are an effective way of improving the quality of health care. Systematic review of UK evidence, undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. MEDLINE and Embase databases were searched in August 2016. Original articles that assessed the relationship between UK provider financial incentives and a quantitative measure of quality of health care were included. Studies showing improvement for all measures of quality of care were defined as 'positive', those that were 'intermediate' showed improvement in some measures, and those classified as 'negative' showed a worsening of measures. Studies showing no effect were documented as such. Quality was assessed using the Downs and Black quality checklist. Of the 232 published articles identified by the systematic search, 28 were included. Of these, nine reported positive effects of incentives on quality of care, 16 reported intermediate effects, two reported no effect, and one reported a negative effect. Quality assessment scores for included articles ranged from 15 to 19, out of a maximum of 22 points. The effects of UK provider financial incentives on healthcare quality are unclear. Owing to this uncertainty and their significant costs, use of them may be counterproductive to their goal of improving healthcare quality and efficiency. UK policymakers should be cautious when implementing these incentives - if used, they should be subject to careful long-term monitoring and evaluation. Further research is needed to assess whether provider financial incentives represent a cost-effective intervention to improve the quality of care delivered in the UK. © British Journal of General Practice 2017.

  18. Distinct iPS Cells Show Different Cardiac Differentiation Efficiency. (United States)

    Ohno, Yohei; Yuasa, Shinsuke; Egashira, Toru; Seki, Tomohisa; Hashimoto, Hisayuki; Tohyama, Shugo; Saito, Yuki; Kunitomi, Akira; Shimoji, Kenichiro; Onizuka, Takeshi; Kageyama, Toshimi; Yae, Kojiro; Tanaka, Tomofumi; Kaneda, Ruri; Hattori, Fumiyuki; Murata, Mitsushige; Kimura, Kensuke; Fukuda, Keiichi


    Patient-specific induced pluripotent stem (iPS) cells can be generated by introducing transcription factors that are highly expressed in embryonic stem (ES) cells into somatic cells. This opens up new possibilities for cell transplantation-based regenerative medicine by overcoming the ethical issues and immunological problems associated with ES cells. Despite the development of various methods for the generation of iPS cells that have resulted in increased efficiency, safety, and general versatility, it remains unknown which types of iPS cells are suitable for clinical use. Therefore, the aims of the present study were to assess (1) the differentiation potential, time course, and efficiency of different types of iPS cell lines to differentiate into cardiomyocytes in vitro and (2) the properties of the iPS cell-derived cardiomyocytes. We found that high-quality iPS cells exhibited better cardiomyocyte differentiation in terms of the time course and efficiency of differentiation than low-quality iPS cells, which hardly ever differentiated into cardiomyocytes. Because of the different properties of the various iPS cell lines such as cardiac differentiation efficiency and potential safety hazards, newly established iPS cell lines must be characterized prior to their use in cardiac regenerative medicine.

  19. Key Factors of Quality in the Sector of Tourism Services Providers: Case Study: Czech Republic

    Directory of Open Access Journals (Sweden)

    Ida Vajčnerová


    Full Text Available The paper summarizes main results of partial research aimed at detection of the key factors affecting quality in the sector of tourism services providers, namely tour operators and travel agencies. A primary questionnaire survey was conducted; the researched factors were distributed in the context of service quality dimensions (Grönroos model; the dimensions were tested in relation to sex, age and education of the respondents (ANOVA; Brown-Forsythe test. Assurance was identified as the most important dimension. The output of the study is determining the significance of individual quality factors from the perspective of a potential customer when selecting a service provider.

  20. iTAR: a web server for identifying target genes of transcription factors using ChIP-seq or ChIP-chip data. (United States)

    Yang, Chia-Chun; Andrews, Erik H; Chen, Min-Hsuan; Wang, Wan-Yu; Chen, Jeremy J W; Gerstein, Mark; Liu, Chun-Chi; Cheng, Chao


    Chromatin immunoprecipitation followed by massively parallel DNA sequencing (ChIP-seq) or microarray hybridization (ChIP-chip) has been widely used to determine the genomic occupation of transcription factors (TFs). We have previously developed a probabilistic method, called TIP (Target Identification from Profiles), to identify TF target genes using ChIP-seq/ChIP-chip data. To achieve high specificity, TIP applies a conservative method to estimate significance of target genes, with the trade-off being a relatively low sensitivity of target gene identification compared to other methods. Additionally, TIP's output does not render binding-peak locations or intensity, information highly useful for visualization and general experimental biological use, while the variability of ChIP-seq/ChIP-chip file formats has made input into TIP more difficult than desired. To improve upon these facets, here we present are fined TIP with key extensions. First, it implements a Gaussian mixture model for p-value estimation, increasing target gene identification sensitivity and more accurately capturing the shape of TF binding profile distributions. Second, it enables the incorporation of TF binding-peak data by identifying their locations in significant target gene promoter regions and quantifies their strengths. Finally, for full ease of implementation we have incorporated it into a web server ( ) that enables flexibility of input file format, can be used across multiple species and genome assembly versions, and is freely available for public use. The web server additionally performs GO enrichment analysis for the identified target genes to reveal the potential function of the corresponding TF. The iTAR web server provides a user-friendly interface and supports target gene identification in seven species, ranging from yeast to human. To facilitate investigating the quality of ChIP-seq/ChIP-chip data, the web server generates the chart of the


    Directory of Open Access Journals (Sweden)

    Dita Puruwita


    Full Text Available This research aims are to find out how well the service quality of PT Indosat Jakarta, how loyal are the customers, and how far the effect of the service quality toward the customers loyalty Indosat in Jakarta. The category of this research are descriptive and verification with surveys method by using a convenience sampling. The sample sizes is 120 respondents of Indosat customers. Therefore, the data collecting technique used are from secondary data, interview, observation and questionnaires. The result of this research based on hypothetical test indicates that there is a effect between the service quality and the customer loyalty. The conclusion of this research is that the performance of the service quality provided by Indosat is still under the customer expectation. It is suggested to the management of PT. Indosat, to improve and maintain their service quality in the dimension that is regard as important, as well the customer’s loyalty level.

  2. Value-added strategy models to provide quality services in senior health business. (United States)

    Yang, Ya-Ting; Lin, Neng-Pai; Su, Shyi; Chen, Ya-Mei; Chang, Yao-Mao; Handa, Yujiro; Khan, Hafsah Arshed Ali; Elsa Hsu, Yi-Hsin


    The rapid population aging is now a global issue. The increase in the elderly population will impact the health care industry and health enterprises; various senior needs will promote the growth of the senior health industry. Most senior health studies are focused on the demand side and scarcely on supply. Our study selected quality enterprises focused on aging health and analyzed different strategies to provide excellent quality services to senior health enterprises. We selected 33 quality senior health enterprises in Taiwan and investigated their excellent quality services strategies by face-to-face semi-structured in-depth interviews with CEO and managers of each enterprise in 2013. A total of 33 senior health enterprises in Taiwan. Overall, 65 CEOs and managers of 33 enterprises were interviewed individually. None. Core values and vision, organization structure, quality services provided, strategies for quality services. This study's results indicated four type of value-added strategy models adopted by senior enterprises to offer quality services: (i) residential care and co-residence model, (ii) home care and living in place model, (iii) community e-business experience model and (iv) virtual and physical portable device model. The common part in these four strategy models is that the services provided are elderly centered. These models offer virtual and physical integrations, and also offer total solutions for the elderly and their caregivers. Through investigation of successful strategy models for providing quality services to seniors, we identified opportunities to develop innovative service models and successful characteristics, also policy implications were summarized. The observations from this study will serve as a primary evidenced base for enterprises developing their senior market and, also for promoting the value co-creation possibility through dialogue between customers and those that deliver service.

  3. Evaluation of the Quality of Health Service Providers: The Iranian People Perspective 2014. (United States)

    Asefzadeh, Saeed; Gholami, Soheyla; Rajaee, Roya; Najafi, Marziye; Alijanzadeh, Mehran


    Quality is the center of attention in all service providing organizations that are effective in promoting satisfaction of patients who are referred to medical centers. The aim of this study was to investigate the quality of health service providers in a case study of Qazvin, Iran, in 2014. This descriptive study was conducted on 1,002 people who were residents of Qazvin Province (Iran) in 2014. The people were selected randomly from the population of the study area. The main variables studied were education, perceptions, expectations, and gaps in service quality. The data collection tool was the standard Servequal questionnaire. To determine the reliability of the research tool, we used Cronbach's Alpha coefficient and the test-retest method. Statistical analyses were conducted using SPSS and the ANOVA test. The mean age of people included in the study was 32 ± 9.9 years, and the average waiting time to receive services was 73 ± 47 minutes. Hospitals and doctors' offices had the highest quality gap of -1.420 ± 0.82 and -1.01 ± 0.75, respectively. The service quality gaps in medical centers, health providers of rural area, and health providers of urban area were -0.883 ± 0.67, -0.882 ± 0.83, and -0.804 ± 0.62, respectively. There was a significant relationship between peoples' perceptions and expectations concerning the quality of health services and their educational levels. The higher gaps in quality in hospitals and in doctors' offices require more attention. Managers and policy makers should consider developing and implementing plans to reduce these gaps in quality and to promote better health services in these two sectors.

  4. Quality of language intervention provided to primary-grade students with language impairment. (United States)

    Biancone, Tricia L; Farquharson, Kelly; Justice, Laura M; Schmitt, Mary Beth; Logan, Jessica A R


    This study had two aims: (a) to describe the quality of language intervention provided by school-based speech-language pathologists (SLPs) to children with language impairment in the primary grades with respect to the quality of emotional support, instructional support, and proactive management during SLP-child interactions, and (b) to determine if key characteristics of the SLPs are predictors of variance in intervention quality. Participants were 174 children nested within 40 SLPs' caseloads from various districts in two Midwestern states involved in a larger study of speech-language therapy practices in the public schools. A total of 208 videotaped language intervention sessions were coded for emotional support, instructional support, and proactive management using the Classroom Assessment Scoring System (CLASS; Pianta, La Paro, & Hamre, 2008). The quality of language intervention varied widely and was generally mid-range to high with respect to emotional support and proactive management, and low to mid-range in terms of instructional support. The quality of interactions varied and a large percentage of the observed variance in quality was attributed to SLPs. Time pressure was a strong predictor of the quality of emotional support, instructional support, and proactive management, and job satisfaction was a significant predictor of instructional support and proactive management. This descriptive information about school-based language intervention highlights the impact of the individual SLP in terms of the quality of the interactions taking place and the potential need to ease job pressures and promote job satisfaction. Readers will be able to: (1) identify and define three aspects of SLP-child interaction quality during intervention as framed in this study using the CLASS observation tool (Pianta, La Paro, et al., 2008); (2) discuss the relevance of those three aspects of quality to children with LI; and (3) identify SLP-level factors that significantly predict

  5. Vertical displacement of Ips Latidens and Ips Pini (United States)

    Daniel R. Miller


    The effect of semiochemical interruptants was examined for Ips latidens (LeConte) and Ips pini (Say) using artificial trees (tall-traps) consisting of an array of seven Lindgren multiple-funnel traps suspended vertically on a rope ladder. S-(+)- Ipsdienol reduced the numbers of I. latidens captured in (±)-ipsenol...

  6. A ChIP-Seq Data Analysis Pipeline Based on Bioconductor Packages. (United States)

    Park, Seung-Jin; Kim, Jong-Hwan; Yoon, Byung-Ha; Kim, Seon-Young


    Nowadays, huge volumes of chromatin immunoprecipitation-sequencing (ChIP-Seq) data are generated to increase the knowledge on DNA-protein interactions in the cell, and accordingly, many tools have been developed for ChIP-Seq analysis. Here, we provide an example of a streamlined workflow for ChIP-Seq data analysis composed of only four packages in Bioconductor: dada2, QuasR, mosaics, and ChIPseeker. 'dada2' performs trimming of the high-throughput sequencing data. 'QuasR' and 'mosaics' perform quality control and mapping of the input reads to the reference genome and peak calling, respectively. Finally, 'ChIPseeker' performs annotation and visualization of the called peaks. This workflow runs well independently of operating systems (e.g., Windows, Mac, or Linux) and processes the input fastq files into various results in one run. R code is available at github:

  7. Identification of a major IP5 kinase in Cryptococcus neoformans confirms that PP-IP5/IP7, not IP6, is essential for virulence


    Cecilia Li; Sophie Lev; Adolfo Saiardi; Desmarini Desmarini; Sorrell, Tania C.; Djordjevic, Julianne T.


    Fungal inositol polyphosphate (IP) kinases catalyse phosphorylation of IP3 to inositol pyrophosphate, PP-IP5/IP7, which is essential for virulence of Cryptococcus neoformans. Cryptococcal Kcs1 converts IP6 to PP-IP5/IP7, but the kinase converting IP5 to IP6 is unknown. Deletion of a putative IP5 kinase-encoding gene (IPK1) alone (ipk1Δ), and in combination with KCS1 (ipk1Δkcs1Δ), profoundly reduced virulence in mice. However, deletion of KCS1 and IPK1 had a greater impact on virulence attenua...

  8. Overview of the Moral Status of iPS Cells. (United States)

    Martinho, Andreia Martins


    The production of induced pluripotent stem (iPS) cells in 2006 by Takahashi and Yamanaka was a major breakthrough in stem cell research. IPS cells technology holds great promise for cell therapy, disease modelling, and drug testing, but it poses ethical questions concerning the moral status of somatic cells, which can re-gain pluripotency (iPS cells). This article provides an overview of the arguments that substantiate the debate on the moral assessment of iPS cells: potentiality argument; relational properties/standard view; and genetic basis for moral status.

  9. Quality and use of consumer information provided with home test kits: room for improvement. (United States)

    Grispen, Janaica E J; Ickenroth, Martine H P; de Vries, Nanne K; van der Weijden, Trudy; Ronda, Gaby


    Diagnostic self-tests (tests on body materials that are initiated by consumers with the aim of diagnosing a disorder or risk factor) are becoming increasingly available. Although the pros and cons of self-testing are currently not clear, it is an existing phenomenon that is likely to gain further popularity. To examine consumers' use of and needs for information about self-testing, and to assess the quality of consumer information provided with home test kits, as perceived by consumers and as assessed using a checklist of quality criteria. A cross-sectional Internet survey among 305 self-testers assessed their use of and needs for information and their perception of the quality of consumer information provided with self-test kits. A meta-search engine was used to identify Dutch and English consumer information for home diagnostic tests available online at the time of the study. The quality of this consumer information was evaluated using a checklist of quality criteria. The consumers' information needs were in line with the most frequently used information, and the information was perceived as being of moderate to good quality. The information was mostly in agreement with clinical practice guidelines, although information on reliability and follow-up behaviour was limited. Approximately half of the instruction leaflets did not include information on the target group of the test. Although generally of moderate to good quality, some aspects of the information provided were in many cases insufficient. European legislation concerning self-tests and accompanying information needs to be adapted and adhered to more closely. © 2012 John Wiley & Sons Ltd.

  10. Predictors of Quality and Commitment in Family Child Care: Provider Education, Personal Resources, and Support. (United States)

    Weaver, Ruth Harding


    Examined the personal characteristics and resources in 65 licensed family child care providers' lives that influence developmentally enhancing caregiving and professional commitment. Unique predictors to higher quality of care were higher levels of formal education and training, college coursework in early childhood education, higher psychological…

  11. Considerations of Administrative Licensure, Provider Type, and Leadership Quality: Recommendations for Research, Policy, and Practice (United States)

    Hackmann, Donald G.


    This article reviews U.S. administrative licensure regulations, focusing on type of school leader licensure, provider types, and leadership quality. Licensure obtained through university-based and alternative routes is examined. Due to limited research on alternative school administrative licensure, regulations in medicine, psychology,…

  12. Providing high-quality HIV care in a deeply rural setting – the ...

    African Journals Online (AJOL)

    Providing high-quality HIV care in a deeply rural setting – the Zithulele experience. C Young, B Gaunt. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · · AJOL African Journals Online. HOW TO ...

  13. Qualities of care managers in chronic disease management: patients and providers' expectations. (United States)

    Dejesus, Ramona S; Vickers, Kristin S; Howell, Lisa A; Stroebel, Robert J


    The collaborative care model has been shown in studies to be effective in achieving sustained treatment outcomes in chronic disease management. Its success is highly dependent on active patient engagement, provider endorsement and effective care management. This study sought to ask patients and providers what qualities they look for in a care manager. A questionnaire with 3 open ended questions was mailed out randomly to 1000 patients residing in Olmsted County, MN identified through the registry to have type 2 diabetes mellitus. Forty-two primary care providers received similar questionnaire with 2 open ended questions. Answers were qualitatively analyzed using coding and identification of major themes. One hundred seventy-five patients and 22 providers responded. Both groups listed being knowledgeable, having good communication skills and certain personality traits as common themes on what are desirable qualities in a care manager. Patients felt that a care manager would be most helpful by being accessible. Providers listed undesirable qualities to include not being a team player and not knowing practice limitations. Both patients and providers have clear expectations of a care manager which carry significant implications in recruiting and training care managers for chronic disease management. Copyright © 2012 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  14. Pairs of cooperating cleaner fish provide better service quality than singletons. (United States)

    Bshary, Redouan; Grutter, Alexandra S; Willener, Astrid S T; Leimar, Olof


    Service providers may vary service quality depending on whether they work alone or provide the service simultaneously with a partner. The latter case resembles a prisoner's dilemma, in which one provider may try to reap the benefits of the interaction without providing the service. Here we present a game-theory model based on the marginal value theorem, which predicts that as long as the client determines the duration, and the providers cooperate towards mutual gain, service quality will increase in the pair situation. This prediction is consistent with field observations and with an experiment on cleaning mutualism, in which stable male-female pairs of the cleaner wrasse Labroides dimidiatus repeatedly inspect client fish jointly. Cleaners cooperate by eating ectoparasites off clients but actually prefer to cheat and eat client mucus. Because clients often leave in response to such cheating, the benefits of cheating can be gained by only one cleaner during a pair inspection. In both data sets, the increased service quality during pair inspection was mainly due to the smaller females behaving significantly more cooperatively than their larger male partners. In contrast, during solitary inspections, cleaning behaviour was very similar between the sexes. Our study highlights the importance of incorporating interactions between service providers to make more quantitative predictions about cooperation between species.

  15. Identification of a major IP5 kinase in Cryptococcus neoformans confirms that PP-IP5/IP7, not IP6, is essential for virulence. (United States)

    Li, Cecilia; Lev, Sophie; Saiardi, Adolfo; Desmarini, Desmarini; Sorrell, Tania C; Djordjevic, Julianne T


    Fungal inositol polyphosphate (IP) kinases catalyse phosphorylation of IP3 to inositol pyrophosphate, PP-IP5/IP7, which is essential for virulence of Cryptococcus neoformans. Cryptococcal Kcs1 converts IP6 to PP-IP5/IP7, but the kinase converting IP5 to IP6 is unknown. Deletion of a putative IP5 kinase-encoding gene (IPK1) alone (ipk1Δ), and in combination with KCS1 (ipk1Δkcs1Δ), profoundly reduced virulence in mice. However, deletion of KCS1 and IPK1 had a greater impact on virulence attenuation than that of IPK1 alone. ipk1Δkcs1Δ and kcs1Δ lung burdens were also lower than those of ipk1Δ. Unlike ipk1Δ, ipk1Δkcs1Δ and kcs1Δ failed to disseminate to the brain. IP profiling confirmed Ipk1 as the major IP5 kinase in C. neoformans: ipk1Δ produced no IP6 or PP-IP5/IP7 and, in contrast to ipk1Δkcs1Δ, accumulated IP5 and its pyrophosphorylated PP-IP4 derivative. Kcs1 is therefore a dual specificity (IP5 and IP6) kinase producing PP-IP4 and PP-IP5/IP7. All mutants were similarly attenuated in virulence phenotypes including laccase, urease and growth under oxidative/nitrosative stress. Alternative carbon source utilisation was also reduced significantly in all mutants except ipk1Δ, suggesting that PP-IP4 partially compensates for absent PP-IP5/IP7 in ipk1Δ grown under this condition. In conclusion, PP-IP5/IP7, not IP6, is essential for fungal virulence.

  16. Unjuk Kerja IP PBX Asterisk dan FreeSWITCH pada Topologi Bertingkat di Jaringan Kampus

    Directory of Open Access Journals (Sweden)

    Iwan Setiawan


    Full Text Available Internet Protocol-based Private Branch Exchange (IP PBX diperlukan untuk menghubungkan panggilan antar perangkat komunikasi Voice over Internet Protocol (VoIP di sebuah jaringan lokal (LAN. Dengan adanya IP PBX, layanan VoIP dapat disediakan di atas jaringan data/IP yang sudah tergelar. Penelitian ini kami lakukan untuk mengetahui unjuk kerja VoIP pada dua IP PBX yang menggunakan perangkat lunak server Asterisk dan FreeSWITCH. Kami merancang sebuah arsitektur jaringan eksperimen yang diadaptasi dari topologi bertingkat pada jaringan kampus (CAN di lokasi penelitian dengan hierarki perangkat yang terdiri dari core switch, distribution switch, dan access switch. Kedua IP PBX ditempatkan pada hierarki yang berbeda pada topologi jaringan tersebut agar dapat diketahui pengaruhnya terhadap unjuk kerja VoIP. Konsep eksperimen ini diharapkan dapat menjadi salah satu dasar untuk mendesain arsitektur IP PBX secara terpusat dan tersebar pada jaringan kampus. Unjuk kerja VoIP kami ukur dengan parameter-parameter Quality of Service (QoS dan Quality of Experience (QoE. Selain itu, kami juga mengukur konsumsi prosesor dan memori yang dipakai oleh perangkat lunak server VoIP pada saat komunikasi terjadi. Pengukuran dilakukan dengan skenario phone-to-phone pada jaringan eksperimen yang terhubung ke jaringan kampus aktif. Hasil penelitian menunjukkan bahwa penempatan IP PBX di hierarki yang berbeda pada topologi jaringan berpengaruh terhadap unjuk kerja VoIP khususnya pada IP PBX Asterisk. Ketika dibandingkan, unjuk kerja IP PBX FreeSWITCH dalam hal QoS dan QoE sedikit lebih baik daripada Asterisk pada rerata latensi/delay, jitter, Mean Opinion Score (MOS, dan konsumsi memori yaitu 41,012 ms, 0,060 ms, 5, dan 1 % untuk IP PBX 1 serta 41,016 ms, 0,066 ms, 5, dan 0,5 % untuk IP PBX 2

  17. Providing Total Quality Fundamentals: 1995 Workshops for the NASA Lewis Research Center's Technical Services Directorate (United States)

    Antczak, Paul; Jacinto,Gilda; Simek, Jimmy


    The National Aeronautics and Space Administration's (NASA) agency-wide movement to cultivate a quality workplace is the basis for Lewis Research Center to implement Total Quality Fundamentals (TQF) initiatives. The Lewis Technical Services Directorate (TSD) introduced the Total Quality Fundamentals (TQF) workshops to its work force as an opportunity to introduce the concepts and principles of TQF. These workshops also provided the participants with the opportunity to dialogue with fellow TSD employees and managers. This report describes, through the perspective of the Lewis TSD TQF Coaches, how the TQF work- shop process was accomplished in TSD. It describes the structure for addressing the need, implementation process, input the TSD Coaches provided, common themes and concerns raised, conclusions, and recommendations. The Coaches concluded that these types of workshops could be the key to open the communication channels that are necessary to help everyone at Lewis understand where they fit in the organization. TQF workshops can strengthen the participant's connection with the Mission, Vision of the Center, and Vision of the Agency. Reconunendations are given based on these conclusions that can help the TSD Quality Board develop attainable measures towards a quality workplace.

  18. Protection against cancer by dietary IP6 and inositol. (United States)

    Vucenik, Ivana; Shamsuddin, AbulKalam M


    Inositol hexaphosphate (IP(6)) is a naturally occurring polyphosphorylated carbohydrate, abundantly present in many plant sources and in certain high-fiber diets, such as cereals and legumes. In addition to being found in plants, IP(6) is contained in almost all mammalian cells, although in much smaller amounts, where it is important in regulating vital cellular functions such as signal transduction, cell proliferation, and differentiation. For a long time IP(6) has been recognized as a natural antioxidant. Recently IP(6) has received much attention for its role in cancer prevention and control of experimental tumor growth, progression, and metastasis. In addition, IP(6) possesses other significant benefits for human health, such as the ability to enhance immune system, prevent pathological calcification and kidney stone formation, lower elevated serum cholesterol, and reduce pathological platelet activity. In this review we show the efficacy and discuss some of the molecular mechanisms that govern the action of this dietary agent. Exogenously administered IP(6) is rapidly taken up into cells and dephosphorylated to lower inositol phosphates, which further affect signal transduction pathways resulting in cell cycle arrest. A striking anticancer action of IP(6) was demonstrated in different experimental models. In addition to reducing cell proliferation, IP(6) also induces differentiation of malignant cells. Enhanced immunity and antioxidant properties also contribute to tumor cell destruction. Preliminary studies in humans show that IP(6) and inositol, the precursor molecule of IP(6), appear to enhance the anticancer effect of conventional chemotherapy, control cancer metastases, and improve quality of life. Because it is abundantly present in regular diet, efficiently absorbed from the gastrointestinal tract, and safe, IP(6) + inositol holds great promise in our strategies for cancer prevention and therapy. There is clearly enough evidence to justify the

  19. Quality dementia care: Prerequisites and relational ethics among multicultural healthcare providers. (United States)

    Sellevold, Gerd Sylvi; Egede-Nissen, Veslemøy; Jakobsen, Rita; Sørlie, Venke


    Many nursing homes appear as multicultural workplaces where the majority of healthcare providers have an ethnic minority background. This environment creates challenges linked to communication, interaction and cultural differences. Furthermore, the healthcare providers have varied experiences and understanding of what quality care of patients with dementia involves. The aim of this study is to illuminate multi-ethnic healthcare providers' lived experiences of their own working relationship, and its importance to quality care for people with dementia. The study is part of a greater participatory action research project: 'Hospice values in the care for persons with dementia'. The data material consists of extensive notes from seminars, project meetings and dialogue-based teaching. The text material was subjected to phenomenological-hermeneutical interpretation. Participants and research context: Participants in the project were healthcare providers working in a nursing home unit. The participants came from 15 different countries, had different formal qualifications, varied backgrounds and ethnic origins. Ethical considerations: The study is approved by the Norwegian Regional Ethics Committee and the Norwegian Social Science Data Services. The results show that good working relationships, characterized by understanding each other's vulnerability and willingness to learn from each other through shared experiences, are prerequisites for quality care. The healthcare providers further described ethical challenges as uncertainty and different understandings. The results are discussed in the light of Lögstrup's relational philosophy of ethics and the concepts of vulnerability, ethic responsibility, trust and openness of speech. The prerequisite for quality care for persons with dementia in a multicultural working environment is to create arenas for open discussions between the healthcare providers. Leadership is of great importance.

  20. [Do nursing homes with higher quality ratings provide a better quality of care? : Empirical study based on administrative data]. (United States)

    Przylog, Adam; Stroka, Magdalena A; Engel, Susanne; Linder, Roland


    In 2009 a new system for the objective evaluation of nursing homes was introduced in Germany. The so-called nursing transparency agreement (Pflege-Transparenzvereinbarungen) was introduced to provide a reliable tool for an objective comparison of inpatient (PTVS) and outpatient (PTVA) care; however, the new regulations have been the subject of a broad discussion regarding reliability, efficiency and objectivity. To overcome the lack of objective health outcomes, this study used administrative data from Germany's largest health insurance fund, the Techniker Krankenkasse, in order to analyze the association between the quality ratings and objective quality measures on an individual level. This is the first study that provides empirical evidence on this topic using administrative data. The administrative dataset contained information on several individual characteristics as well as data on injuries, poisoning and other extrinsic effects on care-dependent individuals over the age of 64 years who were living in a nursing home in 2009. Based on these data an objective measure was constructed to test whether higher quality ratings of nursing homes led to a better quality of care of the respective patients using non-linear regression models. The results of the estimated models showed no significant evidence of such a relationship, neither considering the probability nor the number of injuries, poisoning and other extrinsic effects. Significant effects were only observed for gender and specific diseases. The results of this study support the argument that the current rating procedure for nursing homes has to be refined. Using quality indicators in combination with the administrative data could possibly contribute to such an enhancement.

  1. Measuring the quality of provided services for patients with chronic kidney disease. (United States)

    Bahadori, Mohammadkarim; Raadabadi, Mehdi; Heidari Jamebozorgi, Majid; Salesi, Mahmood; Ravangard, Ramin


    The healthcare organizations need to develop and implement quality improvement plans for their survival and success. Measuring quality in the healthcare competitive environment is an undeniable necessity for these organizations and will lead to improved patient satisfaction. This study aimed to measure the quality of provided services for patients with chronic kidney disease in Kerman in 2014. This cross-sectional, descriptive-analytic study was performed from 23 January 2014 to 14 February 2014 in four hemodialysis centers in Kerman. All of the patients on chronic hemodialysis (n = 195) who were referred to these four centers were selected and studied using census method. The required data were collected using the SERVQUAL questionnaire, consisting of two parts: questions related to the patients' demographic characteristics, and 28 items to measure the patients' expectations and perceptions of the five dimensions of service quality, including tangibility, reliability, responsiveness, assurance, and empathy. The collected data were analyzed using SPSS 21.0 through some statistical tests, including independent-samples t test, one-way ANOVA, and paired-samples t test. The results showed that the means of patients' expectations were more than their perceptions of the quality of provided services in all dimensions, which indicated that there were gaps in all dimensions. The highest and lowest means of negative gaps were related to empathy (-0.52 ± 0.48) and tangibility (-0.29 ± 0.51). In addition, among the studied patients' demographic characteristics and the five dimensions of service quality, only the difference between the patients' income levels and the gap in assurance were statistically significant (P < 0.001). Overall, the results of the present study showed that the expectations of patients on hemodialysis were more than their perceptions of provided services. The healthcare providers and employees should pay more attention to the patients' opinions and

  2. Analysis of ChIP-seq Data in R/Bioconductor. (United States)

    de Santiago, Ines; Carroll, Thomas


    The development of novel high-throughput sequencing methods for ChIP (chromatin immunoprecipitation) has provided a very powerful tool to study gene regulation in multiple conditions at unprecedented resolution and scale. Proactive quality-control and appropriate data analysis techniques are of critical importance to extract the most meaningful results from the data. Over the last years, an array of R/Bioconductor tools has been developed allowing researchers to process and analyze ChIP-seq data. This chapter provides an overview of the methods available to analyze ChIP-seq data based primarily on software packages from the open-source Bioconductor project. Protocols described in this chapter cover basic steps including data alignment, peak calling, quality control and data visualization, as well as more complex methods such as the identification of differentially bound regions and functional analyses to annotate regulatory regions. The steps in the data analysis process were demonstrated on publicly available data sets and will serve as a demonstration of the computational procedures routinely used for the analysis of ChIP-seq data in R/Bioconductor, from which readers can construct their own analysis pipelines.

  3. [Induced pluripotent stem (iPS) cell - issues for clinical application - ]. (United States)

    Aoi, Takashi


    Induced pluripotent stem (iPS) cells are generated from somatic cells by introducing small sets of transcription factors. iPS cells demonstrate pluripotency and the ability to self-renew. In addition, iPS cells can be generated from donor individuals with particular characteristics. Based on these features, iPS cells are expected to be applicable in drug discovery, the study of disease mechanisms and cell therapy. From a technical point of view, "diversity" is the key word. At present, iPS cells can be derived using various techniques, resulting in diversity in the quality of iPS cells generated. Therefore, optimization of the derivation technology is one of the most important issues. Another "diversity" is in the propensities amongst iPS cell lines derived using similar techniques. Thus, strategies for selecting good quality lines remain to be established. Considering such technical hurdles, establishment of an iPS cell bank consisting of high quality and versatile iPS lines is a promising idea because of the merits of cost and quality control. Now, we are exploring relevant parameters for the quality control of banked cells. The challenges facing clinical application of iPS cells are new but not unprecedented. To realize clinical applications of iPS cells, we need to make these challenges clear and overcome them through partnership not only with industry, governments and universities, but also patients and society at large.

  4. Providing quality nutrition care in acute care hospitals: perspectives of nutrition care personnel. (United States)

    Keller, H H; Vesnaver, E; Davidson, B; Allard, J; Laporte, M; Bernier, P; Payette, H; Jeejeebhoy, K; Duerksen, D; Gramlich, L


    Malnutrition is common in acute care hospitals worldwide and nutritional status can deteriorate during hospitalisation. The aim of the present qualitative study was to identify enablers and challenges and, specifically, the activities, processes and resources, from the perspective of nutrition care personnel, required to provide quality nutrition care. Eight hospitals participating in the Nutrition Care in Canadian Hospitals study provided focus group data (n = 8 focus groups; 91 participants; dietitians, dietetic interns, diet technicians and menu clerks), which were analysed thematically. Five themes emerged from the data: (i) developing a nutrition culture, where nutrition practice is considered important to recovery of patients and teams work together to achieve nutrition goals; (ii) using effective tools, such as screening, evidence-based protocols, quality, timely and accurate patient information, and appropriate and quality food; (iii) creating effective systems to support delivery of care, such as communications, food production and delivery; (iv) being responsive to care needs, via flexible food systems, appropriate menus and meal supplements, up to date clinical care and including patient and family in the care processes; and (v) uniting the right person with the right task, by delineating roles, training staff, providing sufficient time to undertake these important tasks and holding staff accountable for their care. The findings of the present study are consistent with other work and provide guidance towards improving the nutrition culture in hospitals. Further empirical work on how to support successful implementation of nutrition care processes is needed. © 2013 The British Dietetic Association Ltd.

  5. Gevaar VoIP voor telecomsector overdreven

    NARCIS (Netherlands)

    Deventer, M.O. van; Wegberg, M. van


    Het is een hype Voice-over-IP (VoIP) voor te stellen als een ontwrichtende technologie die de telecomindustrie ingrijpend zal veranderen. Maar hoe ontwrichtend is VoIP eigenlijk? Oskar van Deventer en Marc van Wegberg analyseren drie vormen van VoIP en laten zien dat alleen ‘VoIP-chat’ potentieel

  6. Development and Validation of Quality Criteria for Providing Patient- and Family-centered Injury Care. (United States)

    Boyd, Jamie M; Burton, Rachael; Butler, Barb L; Dyer, Dianne; Evans, David C; Felteau, Melissa; Gruen, Russell L; Jaffe, Kenneth M; Kortbeek, John; Lang, Eddy; Lougheed, Val; Moore, Lynne; Narciso, Michelle; Oxland, Peter; Rivara, Frederick P; Roberts, Derek; Sarakbi, Diana; Vine, Karen; Stelfox, Henry T


    The aim of this study was to develop and evaluate the content validity of quality criteria for providing patient- and family-centered injury care. Quality criteria have been developed for clinical injury care, but not patient- and family-centered injury care. Using a modified Research AND Development Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Methodology, a panel of 16 patients, family members, injury and quality of care experts serially rated and revised criteria for patient- and family-centered injury care identified from patient and family focus groups. The criteria were then sent to 384 verified trauma centers in the United States, Canada, Australia, and New Zealand for evaluation. A total of 46 criteria were rated and revised by the panel over 4 rounds of review producing 14 criteria related to clinical care (n = 4; transitions of care, pain management, patient safety, provider competence), communication (n = 3; information for patients/families; communication of discharge plans to patients/families, communication between hospital and community providers), holistic care (n = 4; patient hygiene, kindness and respect, family access to patient, social and spiritual support) and end-of-life care (n = 3; decision making, end-of-life care, family follow-up). Medical directors, managers, or coordinators representing 254 trauma centers (66% response rate) rated 12 criteria to be important (95% of responses) for patient- and family-centered injury care. Fewer centers rated family access to the patient (80%) and family follow-up after patient death (65%) to be important criteria. Fourteen-candidate quality criteria for patient- and family-centered injury care were developed and shown to have content validity. These may be used to guide quality improvement practices.

  7. Developing Indicators of Service Quality Provided for Cardiovascular Patients Hospitalized in Cardiac Care Unit

    Directory of Open Access Journals (Sweden)

    Saber Azami-Aghdash


    Full Text Available Introduction: Cardiovascular diseases are among the most prevalent chronic diseases leading to high degrees of mortality and morbidity worldwide and in Iran. The aim of the current study was to determine and develop appropriate indicators for evaluating provided service quality for cardiovascular patients admitted to Cardiac Care Units (CCU in Iran. Methods: In order to determine the indicators for evaluating provided service quality, a four-stage process including reviewing systematic review articles in premier bibliographic databases, interview, performing two rounds of Delphi technique, and holding experts panel by attendance of experts in different fields was adopted. Finally, after recognizing relevant indicators in resources, these indicators were finalized during various stages using ideas of 27 experts in different fields. Results: Among 2800 found articles in the text reviewing phase, 21 articles, which had completely mentioned relevant indicators, were studied and 48 related indicators were extracted. After two interviews with a cardiologist and an epidemiologist, 32 items of the indicators were omitted and replaced by 27 indicators coping with the conditions of Iranian hospitals. Finally, 43 indicators were added into the Delphi phase and after 2 rounds of Delphi with 18 specialists, 7 cases were excluded due to their low scores of applicability. In the experts’ panel stage, 6 items were also omitted and 10 new indicators were developed to replace them. Eventually, 40 indicators were finalized. Conclusion: In this study, some proper indicators for evaluating provided service quality for CCU admissions in Iran were determined. Considering the informative richness of these indicators, they can be used by managers, policy makers, health service providers, and also insurance agencies in order to improve the quality of services, decisions, and policies.

  8. Health-related quality of life and working conditions among nursing providers


    Amanda Aparecida Silva; José Maria Pacheco de Souza; Flávio Notarnicola da Silva Borges; Frida Marina Fischer


    OBJECTIVE: To evaluate working conditions associated with health-related quality of life (HRQL) among nursing providers. METHODS: Cross-sectional study conducted in a university hospital in the city of São Paulo, Southeastern Brazil, during 2004-2005. The study sample comprised 696 registered nurses, nurse technicians and nurse assistants, predominantly females (87.8%), who worked day and/or night shifts. Data on sociodemographic information, working and living conditions, lifestyles, and hea...

  9. Women's and care providers' perspectives of quality prenatal care: a qualitative descriptive study

    Directory of Open Access Journals (Sweden)

    Sword Wendy


    Full Text Available Abstract Background Much attention has been given to the adequacy of prenatal care use in promoting healthy outcomes for women and their infants. Adequacy of use takes into account the timing of initiation of prenatal care and the number of visits. However, there is emerging evidence that the quality of prenatal care may be more important than adequacy of use. The purpose of our study was to explore women's and care providers' perspectives of quality prenatal care to inform the development of items for a new instrument, the Quality of Prenatal Care Questionnaire. We report on the derivation of themes resulting from this first step of questionnaire development. Methods A qualitative descriptive approach was used. Semi-structured interviews were conducted with 40 pregnant women and 40 prenatal care providers recruited from five urban centres across Canada. Data were analyzed using inductive open and then pattern coding. The final step of analysis used a deductive approach to assign the emergent themes to broader categories reflective of the study's conceptual framework. Results The three main categories informed by Donabedian's model of quality health care were structure of care, clinical care processes, and interpersonal care processes. Structure of care themes included access, physical setting, and staff and care provider characteristics. Themes under clinical care processes were health promotion and illness prevention, screening and assessment, information sharing, continuity of care, non-medicalization of pregnancy, and women-centredness. Interpersonal care processes themes were respectful attitude, emotional support, approachable interaction style, and taking time. A recurrent theme woven throughout the data reflected the importance of a meaningful relationship between a woman and her prenatal care provider that was characterized by trust. Conclusions While certain aspects of structure of care were identified as being key dimensions of

  10. Information provided for ecological quality management of production on microeconomic level under conditions of sustainable development

    Directory of Open Access Journals (Sweden)

    Zamula I.V.


    Full Text Available Nowadays, economic development is characterized by increasing of contradictions between ecological and economic systems. As a result, the necessity of unity achievement is growing in the existence of ecological and economic values as one of the main conditions of the concept of sustainable development. For this purpose it is important to implement and create an ecological and economic management system at the enterprise to ensure ecological and economic efficiency. There is a need to improve accounting as a system of measuring economic phenomena and processes for a high level of ecological and economic management. The research is aimed at the development of theoretical and methodological approaches to accounting management for ecological quality of products based on the definition of the essence of the concept as an object of management under conditions of sustainable development, identification and systematization of factors of increasing the ecological quality of products and their management features, accounting identification of costs for ecological quality of products. According to the results of the research, it is established that the ecological quality of products is a combination of properties, which ensure excellent performance of assigned functions and the presence in products of those properties and characteristics that promote the maximum satisfaction of consumer needs and inquiries. The existing order of organization of accounting in Ukraine does not provide the provision of necessary information for the management of the ecological quality of products. The proposed directions of development of elements of the expense accounting method for the ecological quality of products will promote the expansion of information support for the adoption of substantiated and effective management decisions regarding the activities of business entities in accordance with the provisions of the concept of sustainable development.

  11. Providing high-quality care in primary care settings: how to make trade-offs. (United States)

    Beaulieu, Marie-Dominique; Geneau, Robert; Del Grande, Claudio; Denis, Jean-Louis; Hudon, Eveline; Haggerty, Jeannie L; Bonin, Lucie; Duplain, Réjean; Goudreau, Johanne; Hogg, William


    To gain a deeper understanding of how primary care (PC) practices belonging to different models manage resources to provide high-quality care. Multiple-case study embedded in a cross-sectional study of a random sample of 37 practices. Three regions of Quebec. Health care professionals and staff of 5 PC practices. Five cases showing above-average results on quality-of-care indicators were purposefully selected to contrast on region, practice size, and PC model. Data were collected using an organizational questionnaire; the Team Climate Inventory, which was completed by health care professionals and staff; and 33 individual interviews. Detailed case histories were written and thematic analysis was performed. The core common feature of these practices was their ongoing effort to make trade-offs to deliver services that met their vision of high-quality care. These compromises involved the same 3 areas, but to varying degrees depending on clinic characteristics: developing a shared vision of high-quality care; aligning resource use with that vision; and balancing professional aspirations and population needs. The leadership of the physician lead was crucial. The external environment was perceived as a source of pressure and dilemmas rather than as a source of support in these matters. Irrespective of their models, PC practices' pursuit of high-quality care is based on a vision in which accessibility is a key component, balanced by appropriate management of available resources and of external environment expectations. Current PC reforms often create tensions rather than support PC practices in their pursuit of high-quality care. Copyright© the College of Family Physicians of Canada.

  12. Do water quality criteria based on nonnative species provide appropriate protection for native species? (United States)

    Jin, Xiaowei; Wang, Zijian; Wang, Yeyao; Lv, Yibing; Rao, Kaifeng; Jin, Wei; Giesy, John P; Leung, Kenneth M Y


    The potential use of toxicity data for nonnative species to derive water quality criteria is controversial because it is sometimes questioned whether criteria based on species from one geographical region provide appropriate protection for species in a different region. However, this is an important concept for the development of Chinese water quality criteria or standards. Data were assembled on 38 chemicals for which values were available for both native and nonnative species. Sensitivities of these organisms were compared based on the 5% hazardous concentration values and the species sensitivity distribution from a literature review. Results of the present study's analysis showed that there is approximately 74% certainty that use of nonnative species to generate water quality criteria would be sufficiently protective of aquatic ecosystems in China. Without applying any assessment factor to the water quality criteria generated from nonnative species, the uncertainty would be 26% when the native Chinese species might be under protection. Applying an assessment factor of 10 would offer adequate protection to native Chinese species for approximately 90% of tested chemicals and thus reduce the uncertainty from 26% to 10%. © 2015 SETAC.

  13. The Impact of Quality Service Provided by SRM Hospital on Outpatients

    Directory of Open Access Journals (Sweden)

    Kenneth Amoah-Binfoh


    Full Text Available Consumer’s perceptions about the health care services play an important role when choosing a hospital. The quality of service is crucial to both the outpatients and the service providers. The dimensions of the service quality are reliability, responsiveness, assurance, empathy, and tangibles. Customer’s expectations and experiences vary with services. When there is a shortfall between expectation of service level and perception of actual service delivery, it is called customer gap. The causes of customer gap include; not knowing what customers expect, not selecting the right service designs and standards, not delivering to service standards and not matching performance to promises. This paper focuses on the level of service quality rendered by SRM’s hospital, the patient-physicians’ relationship and to examine the pre and post service of outpatients in the SRM’s hospital. A structured questionnaires and interviews were constructed to provide answers to the research questions using a sample size of 50 [employees and outpatients]. It was found out that some outpatients were satisfied with the services rendered by the hospital with reservations for more improvement. It was also found out that, there were gaps between the outpatients’ expectation and perception about the service rendered by the hospital. It was recommended that a competent marketing executive should be employed since marketing is the voice of the healthcare industry.

  14. Association of mandated language access programming and quality of care provided by mental health agencies. (United States)

    McClellan, Sean R; Snowden, Lonnie


    This study examined the association between language access programming and quality of psychiatric care received by persons with limited English proficiency (LEP). In 1999, the California Department of Mental Health required county Medicaid agencies to implement a "threshold language access policy" to meet the state's Title VI obligations. This policy required Medi-Cal agencies to provide language access programming, including access to interpreters and translated written material, to speakers of languages other than English if the language was spoken by at least 3,000, or 5%, of the county's Medicaid population. Using a longitudinal study design with a nonequivalent control group, this study examined the quality of care provided to Spanish speakers with LEP and a severe mental illness before and after implementation of mandatory language access programming. Quality was measured by receipt of at least two follow-up medication visits within 90 days or three visits within 180 days of an initial medication visit over a period of 38 quarter-years. On average, only 40% of Spanish-speaking clients received at least three medication follow-up visits within 180 days. In multivariate analyses, language access programming was not associated with receipt of at least two medication follow-up visits within 90 days or at least three visits within 180 days. This study found no evidence that language access programming led to increased rates of follow-up medication visits for clients with LEP.

  15. Impact of Provider Incentives on Quality and Value of Health Care. (United States)

    Doran, Tim; Maurer, Kristin A; Ryan, Andrew M


    The use of financial incentives to improve quality in health care has become widespread. Yet evidence on the effectiveness of incentives suggests that they have generally had limited impact on the value of care and have not led to better patient outcomes. Lessons from social psychology and behavioral economics indicate that incentive programs in health care have not been effectively designed to achieve their intended impact. In the United States, Medicare's Hospital Readmission Reduction Program and Hospital Value-Based Purchasing Program, created under the Affordable Care Act (ACA), provide evidence on how variations in the design of incentive programs correspond with differences in effect. As financial incentives continue to be used as a tool to increase the value and quality of health care, improving the design of programs will be crucial to ensure their success.

  16. Defining bacterial regulons using ChIP-seq. (United States)

    Myers, Kevin S; Park, Dan M; Beauchene, Nicole A; Kiley, Patricia J


    Chromatin immunoprecipitation followed by high-throughput sequencing (ChIP-seq) is a powerful method that identifies protein-DNA binding sites in vivo. Recent studies have illustrated the value of ChIP-seq in studying transcription factor binding in various bacterial species under a variety of growth conditions. These results show that in addition to identifying binding sites, correlation of ChIP-seq data with expression data can reveal important information about bacterial regulons and regulatory networks. In this chapter, we provide an overview of the current state of knowledge about ChIP-seq methodology in bacteria, from sample preparation to raw data analysis. We also describe visualization and various bioinformatic analyses of processed ChIP-seq data. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Defining Bacterial Regulons Using ChIP-seq Methods (United States)

    Myers, Kevin S.; Park, Dan M.; Beauchene, Nicole A.; Kiley, Patricia J.


    Chromatin immunoprecitation followed by high-throughput sequencing (ChIP-seq) is a powerful method that identifies protein-DNA binding sites in vivo. Recent studies have illustrated the value of ChIP-seq in studying transcription factor binding in various bacterial species under a variety of growth conditions. These results show that in addition to identifying binding sites, correlation of ChIP-seq data with expression data can reveal important information about bacterial regulons and regulatory networks. In this chapter, we provide an overview of the current state of knowledge about ChIP-seq methodology in bacteria, from sample preparation to raw data analysis. We also describe visualization and various bioinformatic analyses of processed ChIP-seq data. PMID:26032817

  18. Cloud infrastructure for providing tools as a service: quality attributes and potential solutions

    DEFF Research Database (Denmark)

    Chauhan, Muhammad Aufeef; Ali Babar, Muhammad


    Cloud computing is being increasingly adopted in various domains for providing on-demand infrastructure and Software as a service (SaaS) by leveraging the utility computing model and virtualization technologies. One of the domains, where cloud computing is expected to gain huge traction is Global...... projects. Through an extensive review of the relevant literature on GSD and Cloud Computing, we have identified a set of quality attributes and potential architectural solutions for a cloud-based infrastructure that can provide TaaS to GSD teams. This paper outlines the promised benefits of TaaS to GSD...... efficiently and cost-effectively. Moreover, variations in tools available/used by different GSD team members can also pose challenges. We assert that providing Tools as a Service (TaaS) to GSD teams through a cloud-based infrastructure can be a promising solution to address the tools related challenges in GSD...

  19. Primary Care Provider Perceptions of Colorectal Cancer Screening Barriers: Implications for Designing Quality Improvement Interventions

    Directory of Open Access Journals (Sweden)

    Jennifer M. Weiss


    Full Text Available Aims. Colorectal cancer (CRC screening is underutilized. Increasing CRC screening rates requires interventions targeting multiple barriers at each level of the healthcare organization (patient, provider, and system. We examined groups of primary care providers (PCPs based on perceptions of screening barriers and the relationship to CRC screening rates to inform approaches for conducting barrier assessments prior to designing and implementing quality improvement interventions. Methods. We conducted a retrospective cohort study linking EHR and survey data. PCPs with complete survey responses for questions addressing CRC screening barriers were included (N=166 PCPs; 39,430 patients eligible for CRC screening. Cluster analysis identified groups of PCPs. Multivariate logistic regression estimated odds ratios and 95% confidence intervals for predictors of membership in one of the PCP groups. Results. We found two distinct groups: (1 PCPs identifying multiple barriers to CRC screening at patient, provider, and system levels (N=75 and (2 PCPs identifying no major barriers to screening (N=91. PCPs in the top half of CRC screening performance were more likely to identify multiple barriers than the bottom performers (OR, 4.14; 95% CI, 2.43–7.08. Conclusions. High-performing PCPs can more effectively identify CRC screening barriers. Targeting high-performers when conducting a barrier assessment is a novel approach to assist in designing quality improvement interventions for CRC screening.

  20. Assessing quality of care provided by Indonesian village midwives with a confidential enquiry. (United States)

    D'Ambruoso, Lucia; Achadi, Endang; Adisasmita, Asri; Izati, Yulia; Makowiecka, Krystyna; Hussein, Julia


    to conduct a confidential enquiry to assess the quality of care provided by Indonesian village midwives and to identify opportunities for improvement. local health-care practitioners assessed village-based care in obstetric emergencies in 13 cases of maternal death and near-miss from rural villages in West Java. The study focused on clinical quality of care, but also investigated the influence of the health system and social factors. The reviews were based on transcripts of interviews with health-care providers, family and community members involved in the cases. Both favourable and adverse factors were identified in order to recognise positive contributions, where they occurred. At the end of a series of case reviews, recommendations for practice were generated and disseminated. in the cases reviewed, midwives facilitated referral effectively, reducing delays in reaching health facilities. Midwives' emergency diagnostic skills were accurate but they were less capable in the clinical management of complications. Coverage was poor; in some locations, midwives were responsible for up to five villages. Village midwives were also perceived as unacceptable to women and their families. Families and communities did not prepare for emergencies with finances or transport, partly due to a poorly understood health insurance system. The enquiry had learning effects for those involved. village midwives should: receive appropriate support for the management of obstetric emergencies; engage with communities to promote birth preparedness; and work in partnership with formal and informal providers in the community. The enquiry was a diagnostic tool to identify opportunities for improving care. Practitioners had a unique insight into factors that contribute to quality care and how feasible interventions might be made.

  1. Provider-Payer Partnerships as an Engine for Continuous Quality Improvement. (United States)

    Balfour, Margaret E; Zinn, Tylar E; Cason, Karena; Fox, Jerimya; Morales, Myra; Berdeja, Cesar; Gray, Jay


    The authors describe a quality improvement approach in which a crisis center and a payer collaborate to improve care. Each crisis visit is considered as a potentially missed opportunity for community stabilization. Daily data on crisis visits are sent to the payer for a more up-to-date analysis of trends than is possible with financial claims data, which may lag behind services provided by up to 90 days. Using these trend data, the two organizations collaborate to identify patterns that lead to opportunities for improvement and develop multiple rapid-cycle projects for better management of services, resulting in significant decreases in readmissions and in the number of high utilizers.

  2. Providing Quality Therapeutics in Switzerland: Role of the Stakeholders and Recent Incentives for Further Improvements. (United States)

    Besson, Marie; Samer, Caroline; Rollason, Victoria; Dayer, Pierre; Desmeules, Jules


    Quality therapeutics play an important role in Switzerland's health care and economy. Switzerland holds a key position in the world of research and development, as well as in drug production. Recently, new emphasis has been placed on promoting clinical research and maintaining Switzerland's position as a center of excellence in the field. Recent revisions to the law regarding medical trials in human research allow for better allocation of regulatory resources and simplified procedures for drugs already authorized in Switzerland. The country has its own regulatory agency, the Swiss Agency for Therapeutic Products (Swissmedic), which is a public institution of the Swiss government. Swissmedic is responsible for ensuring safety in medicines, particularly regarding authorizations and market surveillance in the sector of medicinal products and medical devices. Although the centralized authorization procedure of the European Union for medicines does not apply to Switzerland, there are mutual recognition mechanisms between the Swiss medicine regulatory authority and the European Medicines Agency. Swissmedic is also in charge of postmarketing safety and oversees the national pharmacovigilance center, which collaborates closely with the World Health Organization center in Uppsala. In addition, university hospital-based clinical pharmacologists, who are involved in basic science and clinical research, regulatory affairs, ethics committees, and pharmacovigilance, promote quality therapeutics. This article discusses the role of the various stakeholders and the recent efforts made to provide a better allocation of resources aimed at further improving quality therapeutics in Switzerland. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

  3. [Quality of service provided to heart surgery patients of the Unified Health System-SUS]. (United States)

    Borges, Juliana Bassalobre Carvalho; Carvalho, Sebastião Marcos Ribeiro de; Silva, Marcos Augusto de Moraes


    To evaluate the service quality provided to heart surgery patients during their hospital stay, identifying the patient's expectations and perceptions. To associate service quality with: gender, age and the use of extracorporeal circulation. We studied 82 elective heart surgery patients (52.4% females and 47.6% males), operated by midsternal thoracotomy, age: 31 to 83 years (60.4 +/- 13.2 years); period: March to September 2006. Service quality was evaluated in two instances: the expectations at pre-operative and the perceptions of the service received on the 6th post-operative; through the application of the modified SERVQUAL scale (SERVQUAL-Card). The result was obtained by the difference of the sum of the scores on perception minus those of the expectations, and through statistical analysis. The SERVQUAL-Card scale was statistically validated, showing adequate level of internal consistency. We found a higher frequency of myocardial revascularization 55 (67.0%); first heart surgery 72 (87.8%) and the use of ECC 69 (84.1%). We noticed high mean values for expectations and perceptions with significant results (PSERVQUAL scale.

  4. Professional quality of life of Japanese nurses/midwives providing abortion/childbirth care. (United States)

    Mizuno, Maki; Kinefuchi, Emiko; Kimura, Rumiko; Tsuda, Akiko


    This study explored the relationship between professional quality of life and emotion work and the major stress factors related to abortion care in Japanese obstetric and gynecological nurses and midwives. Between October 2011 and January 2012, questionnaires that included questions concerning eight stress factors, the Professional Quality of Life Scale, and the Japanese version of the Frankfurt Emotional Work Scale, were answered by 255 nurses and midwives working in abortion and childbirth services. Professional Quality of Life scores (compassion fatigue, compassion satisfaction, burnout) were significantly associated with stress factors and emotion work. Multiple regression analysis revealed that of all the evaluated variables, the Japanese version of the Frankfurt Emotional Work Scale score for negative emotions display was the most significant positive predictor of compassion fatigue and burnout. The stress factors "thinking that the aborted fetus deserved to live" and "difficulty in controlling emotions during abortion care" were associated with compassion fatigue. These findings indicate that providing abortion services is a highly distressing experience for nurses and midwives.

  5. Male facial attractiveness and masculinity may provide sex- and culture-independent cues to semen quality. (United States)

    Soler, C; Kekäläinen, J; Núñez, M; Sancho, M; Álvarez, J G; Núñez, J; Yaber, I; Gutiérrez, R


    Phenotype-linked fertility hypothesis (PLFH) predicts that male secondary sexual traits reveal honest information about male fertilization ability. However, PLFH has rarely been studied in humans. The aim of the present study was to test PLFH in humans and to investigate whether potential ability to select fertile partners is independent of sex or cultural background. We found that on the contrary to the hypothesis, facial masculinity was negatively associated with semen quality. As increased levels of testosterone have been demonstrated to impair sperm production, this finding may indicate a trade-off between investments in secondary sexual signalling (i.e. facial masculinity) and fertility or status-dependent differences in investments in semen quality. In both sexes and nationalities (Spanish and Colombian), ranked male facial attractiveness predicted male semen quality. However, Spanish males and females estimated facial images generally more attractive (gave higher ranks) than Colombian raters, and in both nationalities, males gave higher ranks than females. This suggests that male facial cues may provide culture- and sex-independent information about male fertility. However, our results also indicate that humans may be more sensitive to facial attractiveness cues within their own populations and also that males may generally overestimate the attractiveness of other men to females. © 2014 The Authors. Journal of Evolutionary Biology © 2014 European Society For Evolutionary Biology.

  6. Monolayer-crystal streptavidin support films provide an internal standard of cryo-EM image quality

    Energy Technology Data Exchange (ETDEWEB)

    Han, Bong-Gyoon [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Watson, Zoe [Univ. of California, Berkeley, CA (United States); Cate, Jamie H. D. [Univ. of California, Berkeley, CA (United States); Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Glaeser, Robert M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)


    Analysis of images of biotinylated Escherichia coli 70S ribosome particles, bound to streptavidin affinity grids, demonstrates that the image-quality of particles can be predicted by the image-quality of the monolayer crystalline support film. Also, the quality of the Thon rings is a good predictor of the image-quality of particles, but only when images of the streptavidin crystals extend to relatively high resolution. When the estimated resolution of streptavidin was 5 Å or worse, for example, the ribosomal density map obtained from 22,697 particles went to only 9.5 Å, while the resolution of the map reached 4.0 Å for the same number of particles, when the estimated resolution of streptavidin crystal was 4 Å or better. It thus is easy to tell which images in a data set ought to be retained for further work, based on the highest resolution seen for Bragg peaks in the computed Fourier transforms of the streptavidin component. The refined density map obtained from 57,826 particles obtained in this way extended to 3.6 Å, a marked improvement over the value of 3.9 Å obtained previously from a subset of 52,433 particles obtained from the same initial data set of 101,213 particles after 3-D classification. These results are consistent with the hypothesis that interaction with the air-water interface can damage particles when the sample becomes too thin. Finally, streptavidin monolayer crystals appear to provide a good indication of when that is the case.

  7. The effect of financial incentives on the quality of health care provided by primary care physicians. (United States)

    Scott, Anthony; Sivey, Peter; Ait Ouakrim, Driss; Willenberg, Lisa; Naccarella, Lucio; Furler, John; Young, Doris


    The use of blended payment schemes in primary care, including the use of financial incentives to directly reward 'performance' and 'quality' is increasing in a number of countries. There are many examples in the US, and the Quality and Outcomes Framework (QoF) for general practitioners (GPs) in the UK is an example of a major system-wide reform. Despite the popularity of these schemes, there is currently little rigorous evidence of their success in improving the quality of primary health care, or of whether such an approach is cost-effective relative to other ways to improve the quality of care. The aim of this review is to examine the effect of changes in the method and level of payment on the quality of care provided by primary care physicians (PCPs) and to identify:i) the different types of financial incentives that have improved quality;ii) the characteristics of patient populations for whom quality of care has been improved by financial incentives; andiii) the characteristics of PCPs who have responded to financial incentives. We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) and Cochrane Database of Systematic Reviews (CDSR) (The Cochrane Library), MEDLINE, HealthSTAR, EMBASE, CINAHL, PsychLIT, and ECONLIT. Searches of Internet-based economics and health economics working paper collections were also conducted. Finally, studies were identified through the reference lists of retrieved articles, websites of key organisations, and from direct contact with key authors in the field. Articles were included if they were published from 2000 to August 2009. Randomised controlled trials (RCT), controlled before and after studies (CBA), and interrupted time series analyses (ITS) evaluating the impact of different financial interventions on the quality of care delivered by primary healthcare physicians (PCPs). Quality of care was defined as patient reported outcome

  8. Perceived quality of care for common childhood illnesses: facility versus community based providers in Uganda.

    Directory of Open Access Journals (Sweden)

    Agnes Nanyonjo

    Full Text Available OBJECTIVE: To compare caretakers' perceived quality of care (PQC for under-fives treated for malaria, pneumonia and diarrhoea by community health workers (CHWs and primary health facility workers (PHFWs. METHODS: Caretaker rated PQC for children aged (2-59 months treated by either CHWs or PHFWs for a bought of malaria, pneumonia or diarrhoea was cross-sectionally compared in quality domains of accessibility, continuity, comprehensiveness, integration, clinical interaction, interpersonal treatment and trust. Child samples were randomly drawn from CHW (419 and clinic (399 records from eight Midwestern Uganda districts. An overall PQC score was predicted through factor analysis. PQC scores were compared for CHWs and PHFWs using Wilcoxon rank-sum test. Multinomial logistic regression models were used to specify the association between categorized PQC and service providers for each quality domain. Finally, overall PQC was dichotomized into "high" and "low" based on median score and relative risks (RR for PQC-service provider association were modeled in a "modified" Poisson regression model. RESULTS: Mean (SD overall PQC was significantly higher for CHWs 0.58 (0 .66 compared to PHFWs -0.58 (0.94, p<0.0001. In "modified" Poisson regression, the proportion of caretakers reporting high PQC was higher for CHWS compared to PHFWs, RR=3.1, 95%CI(2.5-3.8. In multinomial models PQC was significantly higher for CHWs compared to PHFWs in all domains except for continuity. CONCLUSION: PQC was significantly higher for CHWs compared to PHFWs in this resource constrained setting. CHWs should be tapped human resources for universal health coverage while scaling up basic child intervention as PQC might improve intervention utilization.


    Directory of Open Access Journals (Sweden)

    Yu. A. Rolik


    Full Text Available The problem of providing electric power quality in the electric power systems (EPS that are equipped with sufficiently long air or cable transmission lines is under consideration. This problem proved to be of particular relevance to the EPS in which a source of electrical energy is the generator of wind turbines since the wind itself is an instable primary energy source. Determination of the degree of automation of voltage regulation in the EPS is reduced to the choice of methods and means of regulation of power quality parameters. The concept of a voltage loss and the causes of the latter are explained by the simplest power system that is presented by a single-line diagram. It is suggested to regulate voltage by means of changing parameters of the network with the use of the method of reducing loss of line voltage by reducing its reactance. The latter is achieved by longitudinal capacitive compensation of the inductive reactance of the line. The effect is illustrated by vector diagrams of currents and voltages in the equivalent circuits of transmission lines with and without the use of longitudinal capacitive compensation. The analysis of adduced formulas demonstrated that the use of this method of regulation is useful only in the systems of power supply with a relatively low power factor (cosφ < 0.7 to 0.9. This power factor is typical for the situation of inclusion the wind turbine with asynchronous generator in the network since the speed of wind is instable. The voltage regulation fulfilled with the aid of the proposed method will make it possible to provide the required quality of the consumers’ busbars voltage in this situation. In is turn, it will make possible to create the necessary conditions for the economical transmission of electric power with the lowest outlay of reactive power and the lowest outlay of active power losses.

  10. CESAME: Providing High Quality Professional Development in Science and Mathematics for K-12 Teachers (United States)

    Hickman, Paul


    It is appropriate that after almost half a century of Science and Mathematics education reform we take a look back and a peek forward to understand the present state of this wonderfully complex system. Each of the components of this system including teaching, professional development, assessment, content and the district K-12 curriculum all need to work together if we hope to provide quality science, mathematics and technology education for ALL students. How do the state and national standards drive the system? How do state policies on student testing and teacher licensure come into play? How do we improve the preparation, retention and job satisfaction of our K-12 teachers? What initiatives have made or are making a difference? What else needs to be done? What can the physics community do to support local efforts? This job is too big for any single organization or individual but we each can contribute to the effort. Our Center at Northeastern University, with support from the National Science Foundation, has a sharply defined focus: to get high quality, research-based instructional materials into the hands of K-12 classroom teachers and provide the support they need to use the materials effectively in their classrooms.

  11. Running TCP/IP over ATM Networks. (United States)

    Witt, Michael


    Discusses Internet protocol (IP) and subnets and describes how IP may operate over asynchronous transfer mode (ATM). Topics include TCP (transmission control protocol), ATM cells and adaptation layers, a basic architectural model for IP over ATM, address resolution, mapping IP to a subnet technology, and connection management strategy. (LRW)

  12. A randomised controlled trial of time-limited individual placement and support: IPS-LITE trial. (United States)

    Burns, Tom; Yeeles, Ksenija; Langford, Oliver; Montes, Maria Vazquez; Burgess, Jennifer; Anderson, Catriona


    Individual placement and support (IPS) has been repeatedly demonstrated to be the most effective form of mental health vocational rehabilitation. Its no-discharge policy plus fixed caseloads, however, makes it expensive to provide. To test whether introducing a time limit for IPS would significantly alter its clinical effectiveness and consequently its potential cost-effectiveness. Referrals to an IPS service were randomly allocated to either standard IPS or to time-limited IPS (IPS-LITE). IPS-LITE participants were referred back to their mental health teams if still unemployed at 9 months or after 4 months employment support. The primary outcome at 18 months was working for 1 day. Secondary outcomes comprised other vocational measures plus clinical and social functioning. The differential rates of discharge were used to calculate a notional increased capacity and to model potential rates and costs of employment. A total of 123 patients were randomised and data were collected on 120 patients at 18 months. The two groups (IPS-LITE = 62 and IPS = 61) were well matched at baseline. Rates of employment were equal at 18 months (IPS-LITE = 24 (41%) and IPS = 27 (46%)) at which time 57 (97%) had been discharged from the IPS-LITE service and 16 (28%) from IPS. Only 11 patients (4 IPS-LITE and 7 IPS) obtained their first employment after 9 months. There were no significant differences in any other outcomes. IPS-LITE discharges generated a potential capacity increase of 46.5% compared to 12.7% in IPS which would translate into 35.8 returns to work in IPS-LITE compared to 30.6 in IPS over an 18-month period if the rates remained constant. IPS-LITE is equally effective to IPS and only minimal extra employment is gained by persisting beyond 9 months. If released capacity is utilised with similar outcomes, IPS-LITE results in an increase by 17% in numbers gaining employment within 18 months compared to IPS and will increase with prolonged follow-up. IPS-LITE may be more cost

  13. Quality of assistance provided to children with sickle cell disease by primary healthcare services

    Directory of Open Access Journals (Sweden)

    Ludmila Mourão Xavier Gomes


    Full Text Available OBJECTIVE: To evaluate the quality of healthcare provided to sickle cell disease children by primary healthcare services in a region of high prevalence. METHODS: A cross-sectional, descriptive study was performed by interviewing members of families with sickle cell disease children. The children had been identified from the Neonatal Screening Program in Minas Gerais state over the last 12 years in towns of the Montes Claros-Bocaiuva microregion. A structured questionnaire specially developed for this study and based on three axes was used: indicators of the child's health (immunization, growth and development, prophylaxis antibiotic therapy, perception of care by the family (health education and accessibility and knowledge of the family about the disease. RESULTS: Sixty-three of 71 families with children identified as having sickle cell disease were interviewed. The predominant genotypes were Hb SS (44.4% and Hb SC (41.2%. Adequate monitoring of growth and development was recorded for the first year of life in 23 children (36.6% and for the second year of life in 18 children (28.6%. The basic vaccination schedule was completed by 44 children (69.8% but 62 vaccination record cards (98.4% identified delays of special vaccines. Regular use of prophylactic penicillin was reported by 55 caregivers (87.3%. The family's perception of the care provided suggests poor accessibility to health services and lack of opportunities to answer doubts. The average performance of families in knowledge testing was 59.8%. CONCLUSION: The quality of healthcare is unsatisfactory. The care provided to children with sickle cell disease in primary healthcare services needs improvements.

  14. Privately Provided Accommodation Service Quality and Customer Satisfaction: The Case of Nsamizi Training Institute of Social Development

    National Research Council Canada - National Science Library

    Mugambwa, Joshua; Mugerwa, George William; Mutumba, Wilson Williams; Muganzi, Claire; Namubiru, Bridget; Waswa, Yusuf; Kayongo, Isaac Newton


    .... This research took a case study of Nsamizi Training Institute of Social Development (NTISD) to determine the relationship between privately provided accommodation service quality and customer satisfaction...

  15. Iconographic Professional Interests Inventory (3IP): A New Validation Study (United States)

    Boerchi, Diego; Magnano, Paola


    Interests have been a central focus of counselling psychology (and vocational psychology in particular) for over 100 years. The awareness of professional interests increases self-knowledge and provides occupational information. In career counselling, vocational interests are assessed more frequently than any other vocational construct, though early evaluations (before 13 years old) of professional interests are very rare. The aim of this research is to examine the 3IP construct (Iconographic Professional Interests Inventory; an inventory composed of 65 stylised pictures that represent people in the act of performing a job) in depth, testing more models in addition to the 19 vocational areas proposed in the 3IP manual. Results show that most of the vocational areas can be grouped into 4 second-level areas (“things”, “people”, “leisure”, and “culture”). Moreover, Holland’s RIASEC model is tested; an accurate selection of items reveals that this model works well using 24 specific jobs. The research concludes that the inventory has good psychometric qualities which can grow further by mean of the increasing, in a targeted way, of the number of jobs. PMID:27247679

  16. IP Infrastructure Geolocation (United States)


    Provider ITDK Internet Topology Data Kit LIS Location Information Server NPS Naval Postgraduate School PC Personal Computer POP Point of Presence PTR...Information Server (LIS) [6]. Before IETF protocols are enhanced with geolocation features, the location of an Internet device has to be deduced by other...environments may rely on WPS for geolocation. WPS de- vices geolocate their location by querying public WiFi location databases with the Ba- sic Service



    BOLARIĆ, SNJEŽANA; Trusk, Marija; Kozumplik, Vinko; Vokurka, Aleš


    Usporedno s razvojem DNA molekularnih markera kao ishodišnih tehnologija analiza DNA, 90-tih godina prošlog stoljeća znanstvenici su počeli razvijati novu tehnologiju nazvanu DNA-čip. Naziv dolazi od toga što se, tehnički gledano, na maloj staklenoj površini nalaze oligonukleotidni lanci poznatog slijeda baza, što podsječa na elektronički čip. Ostali nazivi koji se spominju u literaturi su: biochip, DNA microarray, gene array, gene chip i drugi. Prema namjeni eksperimenata razvijena su tri gl...

  18. Security Risks in IP Telephony

    Directory of Open Access Journals (Sweden)

    Filip Rezac


    Full Text Available This paper deals with VoIP communication security and various techniques of VoIP attacks. We divided these threats in several categories according to their specific behaviour and their impact on the affected system. We also tried to find effective methods to prevent or mitigate these attacks. We focused our work on Spam over Internet Telephony (SPIT as a real threat for the future. We have developed both a tool generating SPIT attacks and AntiSPIT tool defending communication systems against SPIT attacks. AntiSPIT represents an effective protection based on statistical blacklist and works without participation of the called party which is a significant advantage.

  19. Optimization of mobile IPv6-based handovers to support VoIP services in wireless heterogeneous networks

    DEFF Research Database (Denmark)

    Fathi, Hanane; Chakraborty, Shyam; Prasad, Ramjee


    The support of the voice over Internet Protocol (VoIP) services in next-generation wireless systems requires the coupling of mobility with quality of service. The mobile node can experience disruptions or even intermittent disconnections of an ongoing real-time session due to handovers. The durat......The support of the voice over Internet Protocol (VoIP) services in next-generation wireless systems requires the coupling of mobility with quality of service. The mobile node can experience disruptions or even intermittent disconnections of an ongoing real-time session due to handovers....... The duration of such interruptions is called disruption time or handover delay and can heavily affect user satisfaction. Therefore, this delay needs to be minimized to provide good-quality VoIP services. In this paper, the focus is on the network layer mobility, specifically on dates for providing mobility...... at layer 3. Using analytical models, the authors evaluate MIPv4, MIPv6, fast MIPv6 (FMIPv6), and hierarchical MIPv6 (HMIPv6) and compare their performances in terms of handover delay for VoIP services. To optimize the handover delay, the authors propose to use the adaptive retransmission timer described...

  20. On the Cryptographic Features of a VoIP Service

    Directory of Open Access Journals (Sweden)

    Dimitrios Alvanos


    Full Text Available Security issues of typical Voice over Internet Protocol (VoIP applications are studied in this paper; in particular, the open source Linphone application is being used as a case study. An experimental analysis indicates that protecting signalling data with the TLS protocol, which unfortunately is not always the default option, is needed to alleviate several security concerns. Moreover, towards improving security, it is shown that a VoIP application may operate over a virtual private network without significantly degrading the overall performance. The conclusions of this study provide useful insights to the usage of any VoIP application.

  1. The influence of system quality characteristics on health care providers' performance: Empirical evidence from Malaysia. (United States)

    Mohd Salleh, Mohd Idzwan; Zakaria, Nasriah; Abdullah, Rosni

    The Ministry of Health Malaysia initiated the total hospital information system (THIS) as the first national electronic health record system for use in selected public hospitals across the country. Since its implementation 15 years ago, there has been the critical requirement for a systematic evaluation to assess its effectiveness in coping with the current system, task complexity, and rapid technological changes. The study aims to assess system quality factors to predict the performance of electronic health in a single public hospital in Malaysia. Non-probability sampling was employed for data collection among selected providers in a single hospital for two months. Data cleaning and bias checking were performed before final analysis in partial least squares-structural equation modeling. Convergent and discriminant validity assessments were satisfied the required criterions in the reflective measurement model. The structural model output revealed that the proposed adequate infrastructure, system interoperability, security control, and system compatibility were the significant predictors, where system compatibility became the most critical characteristic to influence an individual health care provider's performance. The previous DeLone and McLean information system success models should be extended to incorporate these technological factors in the medical system research domain to examine the effectiveness of modern electronic health record systems. In this study, care providers' performance was expected when the system usage fits with patients' needs that eventually increased their productivity. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  2. Measuring Sister Chromatid Cohesion Protein Genome Occupancy in Drosophila melanogaster by ChIP-seq. (United States)

    Dorsett, Dale; Misulovin, Ziva


    This chapter presents methods to conduct and analyze genome-wide chromatin immunoprecipitation of the cohesin complex and the Nipped-B cohesin loading factor in Drosophila cells using high-throughput DNA sequencing (ChIP-seq). Procedures for isolation of chromatin, immunoprecipitation, and construction of sequencing libraries for the Ion Torrent Proton high throughput sequencer are detailed, and computational methods to calculate occupancy as input-normalized fold-enrichment are described. The results obtained by ChIP-seq are compared to those obtained by ChIP-chip (genomic ChIP using tiling microarrays), and the effects of sequencing depth on the accuracy are analyzed. ChIP-seq provides similar sensitivity and reproducibility as ChIP-chip, and identifies the same broad regions of occupancy. The locations of enrichment peaks, however, can differ between ChIP-chip and ChIP-seq, and low sequencing depth can splinter broad regions of occupancy into distinct peaks.

  3. Perceived quality in a dementia unit: patients' caregivers as information providers. (United States)

    López-Picazo, J J; de Dios Cánovas-García, J; Antúnez, C; Marín, J; Antequera, M M; Vivancos, L; Martínez, B; Legaz, A; Navarro, D; Leal, M


    Dementia units (DU) provide comprehensive and specialised care to patients with dementia. However, assessment in these units normally focuses on patient management. The aim of this study was to determine satisfaction of the caregivers of patients managed in a DU and how they rated DU care. We created a self-administered questionnaire which was completed by 236 caregivers visiting the DU in 2015. The questionnaire included 6 dimensions (accessibility, organisation, professionalism, relationship with staff, information, and facilities); data were analysed using problem rates. A total of 53.4% caregivers completed the questionnaire; most were women, patients' spouses, or first-degree relatives. The overall problem rates was 15.0% (95% CI, 13.9-16.1), with sizeable differences between dimensions: from 0.1% (95% CI, 0.0-0.4) for 'relationship with staff' and 'professionalism' to 49.3% (95% CI, 45.4-53.2) for 'information'. Waiting times over 30minutes were perceived as excessive. Information problems were not directly related to patient management. Satisfaction was scored 8.29/10 (median 8; SD 1.45); 77.3% (95% CI, 69.8-74.8) of respondents were highly satisfied. Ninety-nine percent of the caregivers stated that they would recommend the DU. This questionnaire provides interesting data on care quality as perceived by patients' caregivers. Our results have allowed us to identify problems and implement corrective actions. Our questionnaire has proved to be a useful tool for evaluating and improving care quality in DUs. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Quality of integrated chronic disease care in rural South Africa: user and provider perspectives. (United States)

    Ameh, Soter; Klipstein-Grobusch, Kerstin; D'ambruoso, Lucia; Kahn, Kathleen; Tollman, Stephen M; Gómez-Olivé, Francesc Xavier


    The integrated chronic disease management (ICDM) model was introduced as a response to the dual burden of HIV/AIDS and non-communicable diseases (NCDs) in South Africa, one of the first of such efforts by an African Ministry of Health. The aim of the ICDM model is to leverage HIV programme innovations to improve the quality of chronic disease care. There is a dearth of literature on the perspectives of healthcare providers and users on the quality of care in the novel ICDM model. This paper describes the viewpoints of operational managers and patients regarding quality of care in the ICDM model. In 2013, we conducted a case study of the seven PHC facilities in the rural Agincourt sub-district in northeast South Africa. Focus group discussions (n = 8) were used to obtain data from 56 purposively selected patients ≥18 years. In-depth interviews were conducted with operational managers of each facility and the sub-district health manager. Donabedian’s structure, process and outcome theory for service quality evaluation underpinned the conceptual framework in this study. Qualitative data were analysed, with MAXQDA 2 software, to identify 17 a priori dimensions of care and unanticipated themes that emerged during the analysis. The manager and patient narratives showed the inadequacies in structure (malfunctioning blood pressure machines and staff shortage); process (irregular prepacking of drugs); and outcome (long waiting times). There was discordance between managers and patients regarding reasons for long patient waiting time which managers attributed to staff shortage and missed appointments, while patients ascribed it to late arrival of managers to the clinics. Patients reported anti-hypertension drug stock-outs (structure); sub-optimal defaulter-tracing (process); rigid clinic appointment system (process). Emerging themes showed that patients reported HIV stigmatisation in the community due to defaulter-tracing activities of home-based carers, while

  5. Introduction to IP address management

    CERN Document Server

    Rooney, Tim


    "The book begins with a basic overview of IP networking, followed by chapters describing each of the three core IPAM technologies: IPv4 and IPv6 addressing, DHCP, and DNS. The next three chapters describe IPAM management techniques and practice, followed by chapters on IPv4-IPv6 co-existence, security and the IPAM business case"--

  6. Clustering of IP3 receptors by IP3 retunes their regulation by IP3 and Ca2+


    Taufiq-Ur-Rahman,; Skupin, Alexander; Falcke, Martin; Taylor, Colin W.


    The versatility of Ca2+ signals derives from their spatio-temporal organization1,2. For Ca2+ signals initiated by inositol trisphosphate (IP3) this requires local interactions between IP3 receptors (IP3R)3,4 mediated by their rapid stimulation and slower inhibition4 by cytosolic Ca2+. This allows hierarchical recruitment of Ca2+ release events as the IP3 concentration increases5. Single IP3R respond first, then clustered IP3R open together giving a local Ca2+ puff, and as puffs become more fr...

  7. Starr: Simple Tiling ARRay analysis of Affymetrix ChIP-chip data

    Directory of Open Access Journals (Sweden)

    Tresch Achim


    Full Text Available Abstract Background Chromatin immunoprecipitation combined with DNA microarrays (ChIP-chip is an assay used for investigating DNA-protein-binding or post-translational chromatin/histone modifications. As with all high-throughput technologies, it requires thorough bioinformatic processing of the data for which there is no standard yet. The primary goal is to reliably identify and localize genomic regions that bind a specific protein. Further investigation compares binding profiles of functionally related proteins, or binding profiles of the same proteins in different genetic backgrounds or experimental conditions. Ultimately, the goal is to gain a mechanistic understanding of the effects of DNA binding events on gene expression. Results We present a free, open-source R/Bioconductor package Starr that facilitates comparative analysis of ChIP-chip data across experiments and across different microarray platforms. The package provides functions for data import, quality assessment, data visualization and exploration. Starr includes high-level analysis tools such as the alignment of ChIP signals along annotated features, correlation analysis of ChIP signals with complementary genomic data, peak-finding and comparative display of multiple clusters of binding profiles. It uses standard Bioconductor classes for maximum compatibility with other software. Moreover, Starr automatically updates microarray probe annotation files by a highly efficient remapping of microarray probe sequences to an arbitrary genome. Conclusion Starr is an R package that covers the complete ChIP-chip workflow from data processing to binding pattern detection. It focuses on the high-level data analysis, e.g., it provides methods for the integration and combined statistical analysis of binding profiles and complementary functional genomics data. Starr enables systematic assessment of binding behaviour for groups of genes that are alingned along arbitrary genomic features.

  8. An IP-10 (CXCL10)-Derived Peptide Inhibits Angiogenesis (United States)

    Yates-Binder, Cecelia C.; Rodgers, Margaret; Jaynes, Jesse; Wells, Alan; Bodnar, Richard J.; Turner, Timothy


    Angiogenesis plays a critical role in processes such as organ development, wound healing, and tumor growth. It requires well-orchestrated integration of soluble and matrix factors and timely recognition of such signals to regulate this process. Previous work has shown that newly forming vessels express the chemokine receptor CXC receptor 3 (CXCR3) and, activation by its ligand IP-10 (CXCL10), both inhibits development of new vasculature and causes regression of newly formed vessels. To identify and develop new therapeutic agents to limit or reverse pathological angiogenesis, we identified a 21 amino acid fragment of IP-10, spanning the α-helical domain residues 77–98, that mimic the actions of the whole IP-10 molecule on endothelial cells. Treatment of the endothelial cells with the 22 amino acid fragment referred to as IP-10p significantly inhibited VEGF-induced endothelial motility and tube formation in vitro, properties critical for angiogenesis. Using a Matrigel plug assay in vivo, we demonstrate that IP-10p both prevented vessel formation and induced involution of nascent vessels. CXCR3 neutralizing antibody was able to block the inhibitory effects of the IP-10p, demonstrating specificity of the peptide. Inhibition of endothelial function by IP-10p was similar to that described for IP-10, secondary to CXCR3-mediated increase in cAMP production, activation of PKA inhibiting cell migration, and inhibition of VEGF-mediated m-calpain activation. IP-10p provides a novel therapeutic agent that inhibits endothelial cell function thus, allowing for the modulation of angiogenesis. PMID:22815829

  9. Providing assistive technology in Italy: the perceived delivery process quality as affecting abandonment. (United States)

    Federici, Stefano; Borsci, Simone


    The study brings together three aspects rarely observed at once in assistive technology (AT) surveys: (i) the assessment of user interaction/satisfaction with AT and service delivery, (ii) the motivational analysis of AT abandonment, and (iii) the management/design evaluation of AT delivery services. 15 health professionals and 4 AT experts were involved in modelling and assessing four AT Local Health Delivery Service (Centres) in Italy through a SWOT analysis and a Cognitive Walkthrough. In addition 558 users of the same Centres were interviewed in a telephone survey to rate their satisfaction and AT use. The overall AT abandonment was equal to 19.09%. Different Centres' management strategies resulted in different percentages of AT disuse, with a range from 12.61% to 24.26%. A significant difference between the declared abandonment and the Centres' management strategies (p = 0.012) was identified. A strong effect on abandonment was also found due to professionals' procedures (p = 0.005) and follow-up systems (p = 0.002). The user experience of an AT is affected not only by the quality of the interaction with the AT, but also by the perceived quality of the Centres in support and follow-up. Implications for Rehabilitation AT abandonment surveys provide useful information for modelling AT assessment and delivery process. SWOT and Cognitive Walkthrough analyses have shown suitable methods for exploring limits and advantages in AT service delivery systems. The study confirms the relevance of person centredness for a successful AT assessment and delivery process.

  10. Variation in Quality of Urgent Health Care Provided During Commercial Virtual Visits. (United States)

    Schoenfeld, Adam J; Davies, Jason M; Marafino, Ben J; Dean, Mitzi; DeJong, Colette; Bardach, Naomi S; Kazi, Dhruv S; Boscardin, W John; Lin, Grace A; Duseja, Reena; Mei, Y John; Mehrotra, Ateev; Dudley, R Adams


    .4%). No statistically significant variation in guideline adherence by mode of communication (videoconference vs telephone vs webchat) was found. Significant variation in quality was found among companies providing virtual visits for management of common acute illnesses. More variation was found in performance for some conditions than for others, but no variation by mode of communication.

  11. Providing effective trauma care: the potential for service provider views to enhance the quality of care (qualitative study nested within a multicentre longitudinal quantitative study). (United States)

    Beckett, Kate; Earthy, Sarah; Sleney, Jude; Barnes, Jo; Kellezi, Blerina; Barker, Marcus; Clarkson, Julie; Coffey, Frank; Elder, Georgina; Kendrick, Denise


    To explore views of service providers caring for injured people on: the extent to which services meet patients' needs and their perspectives on factors contributing to any identified gaps in service provision. Qualitative study nested within a quantitative multicentre longitudinal study assessing longer term impact of unintentional injuries in working age adults. Sampling frame for service providers was based on patient-reported service use in the quantitative study, patient interviews and advice of previously injured lay research advisers. Service providers' views were elicited through semistructured interviews. Data were analysed using thematic analysis. Participants were recruited from a range of settings and services in acute hospital trusts in four study centres (Bristol, Leicester, Nottingham and Surrey) and surrounding areas. 40 service providers from a range of disciplines. Service providers described two distinct models of trauma care: an 'ideal' model, informed by professional knowledge of the impact of injury and awareness of best models of care, and a 'real' model based on the realities of National Health Service (NHS) practice. Participants' 'ideal' model was consistent with standards of high-quality effective trauma care and while there were examples of services meeting the ideal model, 'real' care could also be fragmented and inequitable with major gaps in provision. Service provider accounts provide evidence of comprehensive understanding of patients' needs, awareness of best practice, compassion and research but reveal significant organisational and resource barriers limiting implementation of knowledge in practice. Service providers envisage an 'ideal' model of trauma care which is timely, equitable, effective and holistic, but this can differ from the care currently provided. Their experiences provide many suggestions for service improvements to bridge the gap between 'real' and 'ideal' care. Using service provider views to inform service design

  12. The wavy Mutation Maps to the Inositol 1,4,5-Trisphosphate 3-Kinase 2 (IP3K2 Gene of Drosophila and Interacts with IP3R to Affect Wing Development

    Directory of Open Access Journals (Sweden)

    Derek M. Dean


    Full Text Available Inositol 1,4,5-trisphosphate (IP3 regulates a host of biological processes from egg activation to cell death. When IP3-specific receptors (IP3Rs bind to IP3, they release calcium from the ER into the cytoplasm, triggering a variety of cell type- and developmental stage-specific responses. Alternatively, inositol polyphosphate kinases can phosphorylate IP3; this limits IP3R activation by reducing IP3 levels, and also generates new signaling molecules altogether. These divergent pathways draw from the same IP3 pool yet cause very different cellular responses. Therefore, controlling the relative rates of IP3R activation vs. phosphorylation of IP3 is essential for proper cell functioning. Establishing a model system that sensitively reports the net output of IP3 signaling is crucial for identifying the controlling genes. Here we report that mutant alleles of wavy (wy, a classic locus of the fruit fly Drosophila melanogaster, map to IP3 3-kinase 2 (IP3K2, a member of the inositol polyphosphate kinase gene family. Mutations in wy disrupt wing structure in a highly specific pattern. RNAi experiments using GAL4 and GAL80ts indicated that IP3K2 function is required in the wing discs of early pupae for normal wing development. Gradations in the severity of the wy phenotype provide high-resolution readouts of IP3K2 function and of overall IP3 signaling, giving this system strong potential as a model for further study of the IP3 signaling network. In proof of concept, a dominant modifier screen revealed that mutations in IP3R strongly suppress the wy phenotype, suggesting that the wy phenotype results from reduced IP4 levels, and/or excessive IP3R signaling.

  13. Surgery and trauma care providers' perception of the impact of dual-practice employment on quality of care provided in an Andean country. (United States)

    LaGrone, L N; Isquith-Dicker, L N; Huaman Egoavil, E; Herrera-Matta, J J; Fuhs, A K; Ortega Checa, D; Revoredo, F; Rodriguez Castro, M J A; Mock, C N


    Dual-practice, simultaneous employment by healthcare workers in the public and private sectors is pervasive worldwide. Although an estimated 30 per cent of the global burden of disease is surgical, the implications of dual practice on surgical care are not well understood. Anonymous in-depth individual interviews on trauma quality improvement practices were conducted with healthcare providers who participate in the care of the injured at ten large hospitals in Peru's capital city, Lima. A grounded theory approach to qualitative data analysis was employed to identify salient themes. Fifty interviews were conducted. A group of themes that emerged related to the perceived negative and positive impacts of dual practice on the quality of surgical care. Participants asserted that the majority of physicians in Lima working in the public sector also worked in the private sector. Dual practice has negative impacts on physicians' time, quality of care in the public sector, and surgical education. Dual practice positively affects patient care by allowing physicians to acquire management and quality improvement skills, and providing incentives for research and academic productivity. In addition, dual practice provides opportunities for clinical innovations and raises the economic status of the physician. Surgeons in Peru report that dual practice influences patient care negatively by creating time and human resource conflicts. Participants assert that these conflicts widen the gap in quality of care between rich and poor. This practice warrants redirection through national-level regulation of physician schedules and reorganization of public investment in health via physician remuneration. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  14. Evaluation of the International Prognostic Score (IPS-7) and a Simpler Prognostic Score (IPS-3) for advanced Hodgkin lymphoma in the modern era. (United States)

    Diefenbach, Catherine S; Li, Hailun; Hong, Fangxin; Gordon, Leo I; Fisher, Richard I; Bartlett, Nancy L; Crump, Michael; Gascoyne, Randy D; Wagner, Henry; Stiff, Patrick J; Cheson, Bruce D; Stewart, Douglas A; Kahl, Brad S; Friedberg, Jonathan W; Blum, Kristie A; Habermann, Thomas M; Tuscano, Joseph M; Hoppe, Richard T; Horning, Sandra J; Advani, Ranjana H


    The International Prognostic Score (IPS-7) is the most commonly used risk stratification tool for advanced Hodgkin lymphoma (HL), however recent studies suggest the IPS-7 is less discriminating due to improved outcomes with contemporary therapy. We evaluated the seven variables for IPS-7 recorded at study entry for 854 patients enrolled on Eastern Cooperative Oncology Group 2496 trial. Univariate and multivariate Cox models were used to assess their prognostic ability for freedom from progression (FFP) and overall survival (OS). The IPS-7 remained prognostic however its prognostic range has narrowed. On multivariate analysis, two factors (age, stage) remained significant for FFP and three factors (age, stage, haemoglobin level) for OS. An alternative prognostic index, the IPS-3, was constructed using age, stage and haemoglobin level, which provided four distinct risk groups [FFP (P = 0·0001) and OS (P IPS-3 outperformed the IPS-7 on risk prediction for both FFP and OS by model fit and discrimination criteria. Using reclassification calibration, 18% of IPS-7 low risk patients were re-classified as intermediate risk and 13% of IPS-7 intermediate risk patients as low risk. For patients with advanced HL, the IPS-3 may provide a simpler and more accurate framework for risk assessment in the modern era. Validation of these findings in other large data sets is planned. © 2015 John Wiley & Sons Ltd.

  15. Organization Complexity and Primary Care Providers' Perceptions of Quality Improvement Culture Within the Veterans Health Administration. (United States)

    Korom-Djakovic, Danijela; Canamucio, Anne; Lempa, Michele; Yano, Elizabeth M; Long, Judith A


    This study examined how aspects of quality improvement (QI) culture changed during the introduction of the Veterans Health Administration (VHA) patient-centered medical home initiative and how they were influenced by existing organizational factors, including VHA facility complexity and practice location. A voluntary survey, measuring primary care providers' (PCPs') perspectives on QI culture at their primary care clinics, was administered in 2010 and 2012. Participants were 320 PCPs from hospital- and community-based primary care practices in Pennsylvania, West Virginia, Delaware, New Jersey, New York, and Ohio. PCPs in community-based outpatient clinics reported an improvement in established processes for QI, and communication and cooperation from 2010 to 2012. However, their peers in hospital-based clinics did not report any significant improvements in QI culture. In both years, compared with high-complexity facilities, medium- and low-complexity facilities had better scores on the scales assessing established processes for QI, and communication and cooperation. © The Author(s) 2014.

  16. Complementary ecosystem services provided by pest predators and pollinators increase quantity and quality of coffee yields. (United States)

    Classen, Alice; Peters, Marcell K; Ferger, Stefan W; Helbig-Bonitz, Maria; Schmack, Julia M; Maassen, Genevieve; Schleuning, Matthias; Kalko, Elisabeth K V; Böhning-Gaese, Katrin; Steffan-Dewenter, Ingolf


    Wild animals substantially support crop production by providing ecosystem services, such as pollination and natural pest control. However, the strengths of synergies between ecosystem services and their dependencies on land-use management are largely unknown. Here, we took an experimental approach to test the impact of land-use intensification on both individual and combined pollination and pest control services in coffee production systems at Mount Kilimanjaro. We established a full-factorial pollinator and vertebrate exclosure experiment along a land-use gradient from traditional homegardens (agroforestry systems), shaded coffee plantations to sun coffee plantations (total sample size = 180 coffee bushes). The exclusion of vertebrates led to a reduction in fruit set of ca 9%. Pollinators did not affect fruit set, but significantly increased fruit weight of coffee by an average of 7.4%. We found no significant decline of these ecosystem services along the land-use gradient. Pest control and pollination service were thus complementary, contributing to coffee production by affecting the quantity and quality of a major tropical cash crop across different coffee production systems at Mount Kilimanjaro.

  17. Analyzing of MOS and Codec Selection for Voice over IP Technology

    Directory of Open Access Journals (Sweden)

    Mohd Nazri Ismail


    Full Text Available In this research, we propose an architectural solution to implement the voice over IP (VoIP service in campus environment network. Voice over IP (VoIP technology has become a discussion issue for this time being. Today, the deployment of this technology on an organization truly can give a great financial benefit over traditional telephony. Therefore, this study is to analyze the VoIP Codec selection and investigate the Mean Opinion Score (MOS performance areas evolved with the quality of service delivered by soft phone and IP phone. This study focuses on quality of voice prediction such as i accuracy of MOS between automated system and human perception and ii different types of codec performance measurement via human perception using MOS technique. In this study, network management system (NMS is used to monitor and capture the performance of VoIP in campus environment. In addition, the most apparent of implementing soft phone and IP phone in campus environment is to define the best codec selection that can be used in operational environment. Based on the finding result, the MOS measurement through automated and manual system is able to predict and evaluate VoIP performance. In addition, based on manual MOS measurement, VoIP conversations over LAN contribute more reliability and availability performance compare to WAN.

  18. Quality of Care in Contraceptive Services Provided to Young People in Two Ugandan Districts: A Simulated Client Study (United States)

    Nalwadda, Gorrette; Tumwesigye, Nazarius M.; Faxelid, Elisabeth; Byamugisha, Josaphat; Mirembe, Florence


    Background Low and inconsistent use of contraceptives by young people contributes to unintended pregnancies. This study assessed quality of contraceptive services for young people aged 15–24 in two rural districts in Uganda. Methods Five female and two male simulated clients (SCs) interacted with 128 providers at public, private not-for-profit (PNFP), and private for profit (PFP) health facilities. After consultations, SCs were interviewed using a structured questionnaire. Six aspects of quality of care (client's needs, choice of contraceptive methods, information given to users, client-provider interpersonal relations, constellation of services, and continuity mechanisms) were assessed. Descriptive statistics and factor analysis were performed. Results Means and categorized quality scores for all aspects of quality were low in both public and private facilities. The lowest quality scores were observed in PFP, and medium scores in PNFP facilities. The choice of contraceptive methods and interpersonal relations quality scores were slightly higher in public facilities. Needs assessment scores were highest in PNFP facilities. All facilities were classified as having low scores for appropriate constellation of services. Information given to users was suboptimal and providers promoted specific contraceptive methods. Minority of providers offered preferred method of choice and showed respect for privacy. Conclusions The quality of contraceptive services provided to young people was low. Concurrent quality improvements and strengthening of health systems are needed. PMID:22132168

  19. Internetworking with TCP/IP

    CERN Document Server

    Comer, Douglas E


    An internationally best-selling, conceptual introduction to the TCP/IP protocols and Internetworking, this book interweaves a clear discussion of fundamentals and scientific principles with details and examples drawn from the latest technologies. Leading author Douglas Comer covers layering and packet formats for all the Internet protocols, includingTCP, IPv4, IPv6, DHCP, and DNS. In addition, the text explains new trends in Internet systems, including packet classification, Software Defined Networking (SDN), and mesh protocols used in The Internet of Things. The text is appropriate for individuals interested in learning more about TCP/IP protocols, Internet architecture, and current networking technologies, as well as engineers who build network systems. It is suitable for junior to graduate-level courses in Computer Networks, Data Networks, Network Protocols, and Internetworking.

  20. Content-Adaptive Packetization and Streaming of Wavelet Video over IP Networks

    Directory of Open Access Journals (Sweden)

    Chien-Peng Ho


    Full Text Available This paper presents a framework of content-adaptive packetization scheme for streaming of 3D wavelet-based video content over lossy IP networks. The tradeoff between rate and distortion is controlled by jointly adapting scalable source coding rate and level of forward error correction (FEC protection. A content dependent packetization mechanism with data-interleaving and Reed-Solomon protection for wavelet-based video codecs is proposed to provide unequal error protection. This paper also tries to answer an important question for scalable video streaming systems: given extra bandwidth, should one increase the level of channel protection for the most important packets, or transmit more scalable source data? Experimental results show that the proposed framework achieves good balance between quality of the received video and level of error protection under bandwidth-varying lossy IP networks.

  1. Content-Adaptive Packetization and Streaming of Wavelet Video over IP Networks

    Directory of Open Access Journals (Sweden)

    Ho Chien-Peng


    Full Text Available This paper presents a framework of content-adaptive packetization scheme for streaming of 3D wavelet-based video content over lossy IP networks. The tradeoff between rate and distortion is controlled by jointly adapting scalable source coding rate and level of forward error correction (FEC protection. A content dependent packetization mechanism with data-interleaving and Reed-Solomon protection for wavelet-based video codecs is proposed to provide unequal error protection. This paper also tries to answer an important question for scalable video streaming systems: given extra bandwidth, should one increase the level of channel protection for the most important packets, or transmit more scalable source data? Experimental results show that the proposed framework achieves good balance between quality of the received video and level of error protection under bandwidth-varying lossy IP networks.

  2. OSI and TCP/IP (United States)

    Randolph, Lynwood P.


    The Open Systems Interconnection Transmission Control Protocol/Internet Protocol (OSI TCP/IP) and the Government Open Systems Interconnection Profile (GOSIP) are compared and described in terms of Federal internetworking. The organization and functions of the Federal Internetworking Requirements Panel (FIRP) are discussed and the panel's conclusions and recommendations with respect to the standards and implementation of the National Information Infrastructure (NII) are presented.

  3. Role of Ipsdienol, Ipsenol, and cis-Verbenol in chemical ecology of Ips avulsus, Ips calligraphus, and Ips grandicollis (Coleoptera: Curculionidae: Scolytinae) (United States)

    Jeremy D. Allison; Jessica I. McKenney; Daniel R. Miller; Matthew L. Gimmel


    ABSTRACT Stressed or damaged pine (Pinus sp.) trees in the southeastern United States are often colonized simultaneously by three southern Ips species (Coleoptera: Curculionidae: Scolytinae): small southern pine engraver, Ips avulsus (Eichhoff); sixspined ips, Ips calligraphus (Germar); and...

  4. IP-Based TV Technologies, Services and Multidisciplinary Applications

    NARCIS (Netherlands)

    O.M. Bonastre; M.J. Montpetit; P.S. Cesar Garcia (Pablo Santiago)


    htmlabstractThe move to Internet Protocol (IP)-based content delivery services has challenged the television industry by allowing high-quality television content to be delivered using the Internet, wired and wireless, private and public. The new convergence paradigm is already playing out its

  5. TTI ARO Opportunity Fund: IPS | IDRC - International Development ...

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

    This funding will allow the Think Tank Initiative grantee, the Institute of Policy Studies of Sri Lanka (IPS), to undertake quality, policy-oriented labour migration research. The research will focus on some of the issues identified by the National Human Resources and Employment Policy for Sri Lanka.

  6. TTI ARO Opportunity Fund: IPS | CRDI - Centre de recherches pour ...

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

    This funding will allow the Think Tank Initiative grantee, the Institute of Policy Studies of Sri Lanka (IPS), to undertake quality, policy-oriented labour migration research. The research will focus on some of the issues identified by the National Human Resources and Employment Policy for Sri Lanka.

  7. Ips Bark Beetles in the South (United States)

    Michael D. Conner; Robert C. Wilkinson


    Ips beetles usually attack weakened, dying, or recently felled trees and fresh logging debris. Large numbers Ips may build up when natural events such as lightning storms, ice storms, tornadoes, wildfires, and droughts create large amounts of pine suitable for the breeding of these beetles. Ips populations may also build up following forestry activities, such as...

  8. Physicians' assessments of their ability to provide high-quality care in a changing health care system. (United States)

    Reschovsky, J; Reed, M; Blumenthal, D; Landon, B


    With the growth of managed care, there are increasing concerns but inconclusive evidence regarding deterioration in the quality of medical care. To assess physicians' perceptions of their ability to provide high-quality care and explore what factors, including managed care, affect these perceptions. Bivariate and multivariate analyses of the Community Tracking Study Physician Survey, a cross-sectional, nationally representative telephone survey of 12,385 patient-care physicians conducted in 1996/1997. The response rate was 65%. Physicians who provide direct patient care for > or =20 h/wk, excluding federal employees and those in selected specialties. Level of agreement with 4 statements: 1 regarding overall ability to provide high-quality care and 3 regarding aspects of care delivery associated with quality. Between 21% and 31% of physicians disagreed with the quality statements. Specialists were generally 50% more likely than primary care physicians to express concerns about their ability to provide quality care. Generally, the number of managed care contracts, but not the percent of practice revenue from managed care, was negatively associated with perceived quality. Market-level managed care penetration independently affected physicians' perceptions. Practice setting affected perceptions of quality, with physicians in group settings less likely to express concerns than physicians in solo and 2-physician practices. Specific financial incentives and care management tools had limited positive or negative associations with perceived quality. Managed care involvement is only modestly associated with reduced perceptions of quality among physicians, with some specific tools enhancing perceived quality. Physicians may be able to moderate some negative effects of managed care by altering their practice arrangements.

  9. Quality of healthcare services provided in disaster shelters: An integrative literature review. (United States)

    Veenema, Tener Goodwin; Rains, Adam B; Casey-Lockyer, Mary; Springer, Janice; Kowal, Mary


    Globally, shelters are a resource to promote critical health and safety in disasters, particularly for vulnerable populations (e.g., children, elderly, chronically ill). This study examines the nature and quality of healthcare services rendered in disaster and emergency shelters. To determine based upon systematic and accurate measurement the scope and quality of health care services rendered in disaster shelters and to describe the health outcomes experienced by shelter residents. An integrative review of English-language literature pertaining to the assessment, evaluation, and systematic measurement of healthcare quality and client outcomes in disaster and emergency shelters was undertaken. Articles were identified using a structured search strategy of six databases and indexing services (PubMed, CINAHL, EMBase, Scopus, Web of Science, and Google Scholar). Limited literature exists pertaining specifically to metrics for quality of health care in acute disaster and emergency shelters, and the literature that does exist is predominately U.S. based. Analysis of the existing evidence suggests that nurse staffing levels and staff preparedness, access to medications/medication management, infection control, referrals, communication, and mental health may be important concepts related to quality of disaster health care services. A small number of population-based and smaller, ad hoc outcomes-based evaluation efforts exist; however the existing literature regarding systematic outcomes-based quality assessment of disaster sheltering healthcare services is notably sparse. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Challenges Regarding IP Core Functional Reliability (United States)

    Berg, Melanie D.; LaBel, Kenneth A.


    For many years, intellectual property (IP) cores have been incorporated into field programmable gate array (FPGA) and application specific integrated circuit (ASIC) design flows. However, the usage of large complex IP cores were limited within products that required a high level of reliability. This is no longer the case. IP core insertion has become mainstream including their use in highly reliable products. Due to limited visibility and control, challenges exist when using IP cores and subsequently compromise product reliability. We discuss challenges and suggest potential solutions to critical application IP insertion.

  11. Mobile-ip Aeronautical Network Simulation Study (United States)

    Ivancic, William D.; Tran, Diepchi T.


    NASA is interested in applying mobile Internet protocol (mobile-ip) technologies to its space and aeronautics programs. In particular, mobile-ip will play a major role in the Advanced Aeronautic Transportation Technology (AATT), the Weather Information Communication (WINCOMM), and the Small Aircraft Transportation System (SATS) aeronautics programs. This report presents the results of a simulation study of mobile-ip for an aeronautical network. The study was performed to determine the performance of the transmission control protocol (TCP) in a mobile-ip environment and to gain an understanding of how long delays, handoffs, and noisy channels affect mobile-ip performance.

  12. Optimal use of tandem biotin and V5 tags in ChIP assays

    NARCIS (Netherlands)

    K.E. Kolodziej (Katarzyna); F. Pourfarzad, F. (Farzin); E. de Boer (Ernie); S. Krpic (Sanja); F.G. Grosveld (Frank); J. Strouboulis (John)


    textabstractBackground: Chromatin immunoprecipitation (ChIP) assays coupled to genome arrays (Chip-on-chip) or massive parallel sequencing (ChIP-seq) lead to the genome wide identification of binding sites of chromatin associated proteins. However, the highly variable quality of antibodies and the

  13. Accounting for immunoprecipitation efficiencies in the statistical analysis of ChIP-seq data

    NARCIS (Netherlands)

    Bao, Yanchun; Vinciotti, Veronica; Wit, Ernst; 't Hoen, Peter A C


    Background: ImmunoPrecipitation (IP) efficiencies may vary largely between different antibodies and between repeated experiments with the same antibody. These differences have a large impact on the quality of ChIP-seq data: a more efficient experiment will necessarily lead to a higher signal to


    Directory of Open Access Journals (Sweden)

    Cristian Valentin HAPENCIUC


    Full Text Available Taking into account its pragmatic meaning, the success of a travel agency frequently relies on the activity of travel agents. In the process of promoting and selling flat voyages, customer service can be directly influenced by the interaction of factors such as: offer accuracy, sales representatives quality, employee timeliness, politeness of the travel agent, maintaining eye contact etc., all of which are components of the offered product. Thereby, we conducted, within the period 5 - 15 March 2015, a research based on interviews with 26 travel agents from 20 different units, in order to determine their awareness about potential factors that may have an influence on the quality of offered services. By the instrumentality of a questionnaire, we attempted to assess the integrity and loyalty of employees, their attitude regarding the activities they carry, their dissatisfaction, negative and  positive factors influencing service quality, and their positioning to the organization and brand.

  15. [Data from automated external defibrillators provide important information on the quality of in-hospital resuscitation]. (United States)

    Vestergård, Lone Due; Løfgren, Bo; Krarup, Niels Henrik Vinther; Holm, Tina; Andersen, Lone Kærslund


    International guidelines recommend monitoring the outcome following in-hospital cardiac arrest. Using data from automatic external defibrillators (AED) prospectively collected during a three-year period in a regional hospital, we evaluated the treatment quality of resuscitation. Time to defibrillation was acceptable, but quality of chest compressions did not comply with current international recommendations. AED use led to a high fraction of time with no chest compressions. Survival to discharge was 11%. Consequently, training in basic and advanced life support of hospital staff has been modified.

  16. Optical switching using IP protocol (United States)

    Utreras, Andres J.; Gusqui, Luis; Reyes, Andres; Mena, Ricardo I.; Licenko, Gennady L.; Amirgaliyev, Yedilkhan; Komada, Paweł; Luganskaya, Saule; Kashaganova, Gulzhan


    To understand and evaluate the Optical Layer, and how it will affect the IP protocols over WDM (Switching), the present analyse is proposed. Optical communications have attractive proprieties, but also have some disadvantages, so the challenge is to combine the best of both branches. In this paper, general concepts for different options of switching are reviewed as: optical burst switching (OBS) and automatically switching optical network (ASON). Specific details such as their architectures are also discussed. In addition, the relevant characteristics of each variation for switching are reviewed.

  17. TCP/IP Network Administration

    CERN Document Server

    Hunt, Craig


    This complete guide to setting up and running a TCP/IP network is essential for network administrators, and invaluable for users of home systems that access the Internet. The book starts with the fundamentals -- what protocols do and how they work, how addresses and routing are used to move data through the network, how to set up your network connection -- and then covers, in detail, everything you need to know to exchange information via the Internet. Included are discussions on advanced routing protocols (RIPv2, OSPF, and BGP) and the gated software package that implements them, a tutorial

  18. IPS y el Tercer Mundo

    Directory of Open Access Journals (Sweden)

    Roberto Savio


    Full Text Available CHASQUI, entrevistó al periodista italo-argentino Roberto Savio, director fundador de la IPS, quien respondió a interrogantes como: En América Latina no hay sociedades de comunicación sino de información? ¿ Por qué y cúal la diferencia? ¿Cómo se puede hacer una sociedad comunicacional en A. Latina? ¿Cuál es la diferencia entre comunicación alternativa y popular? ¿Qué hacer para ampliar el mercado de lectores?¿Qué opina de ASIN y ALASE?

  19. Nebula--a web-server for advanced ChIP-seq data analysis. (United States)

    Boeva, Valentina; Lermine, Alban; Barette, Camille; Guillouf, Christel; Barillot, Emmanuel


    ChIP-seq consists of chromatin immunoprecipitation and deep sequencing of the extracted DNA fragments. It is the technique of choice for accurate characterization of the binding sites of transcription factors and other DNA-associated proteins. We present a web service, Nebula, which allows inexperienced users to perform a complete bioinformatics analysis of ChIP-seq data. Nebula was designed for both bioinformaticians and biologists. It is based on the Galaxy open source framework. Galaxy already includes a large number of functionalities for mapping reads and peak calling. We added the following to Galaxy: (i) peak calling with FindPeaks and a module for immunoprecipitation quality control, (ii) de novo motif discovery with ChIPMunk, (iii) calculation of the density and the cumulative distribution of peak locations relative to gene transcription start sites, (iv) annotation of peaks with genomic features and (v) annotation of genes with peak information. Nebula generates the graphs and the enrichment statistics at each step of the process. During Steps 3-5, Nebula optionally repeats the analysis on a control dataset and compares these results with those from the main dataset. Nebula can also incorporate gene expression (or gene modulation) data during these steps. In summary, Nebula is an innovative web service that provides an advanced ChIP-seq analysis pipeline providing ready-to-publish results. Nebula is available at Supplementary data are available at Bioinformatics online.

  20. IP Profiling via Service Cluster Membership Vectors

    Energy Technology Data Exchange (ETDEWEB)

    Bartoletti, A


    This study investigates the feasibility of establishing and maintaining a system of compact IP behavioral profiles as a robust means of computer anomaly definition and detection. These profiles are based upon the degree to which a system's (IP's) network traffic is distributed among stable characteristic clusters derived of the aggregate session traffic generated by each of the major network services. In short, an IP's profile represents its degree of membership in these derived service clusters. The goal is to quantify and rank behaviors that are outside of the statistical norm for the services in question, or present significant deviation from profile for individual client IPs. Herein, we establish stable clusters for accessible features of common session traffic, migrate these clusters over time, define IP behavior profiles with respect to these clusters, migrate individual IP profiles over time, and demonstrate the detection of IP behavioral changes in terms of deviation from profile.

  1. Can branding by health care provider organizations drive the delivery of higher technical and service quality? (United States)

    Snihurowych, Roman R; Cornelius, Felix; Amelung, Volker Eric


    Despite the widespread use of branding in nearly all other major industries, most health care service delivery organizations have not fully embraced the practices and processes of branding. Facilitating the increased and appropriate use of branding among health care delivery organizations may improve service and technical quality for patients. This article introduces the concepts of branding, as well as making the case that the use of branding may improve the quality and financial performance of organizations. The concepts of branding are reviewed, with examples from the literature used to demonstrate their potential application within health care service delivery. The role of branding for individual organizations is framed by broader implications for health care markets. Branding strategies may have a number of positive effects on health care service delivery, including improved technical and service quality. This may be achieved through more transparent and efficient consumer choice, reduced costs related to improved patient retention, and improved communication and appropriateness of care. Patient satisfaction may be directly increased as a result of branding. More research into branding could result in significant quality improvements for individual organizations, while benefiting patients and the health system as a whole.

  2. Leadership qualities when providing therapy for women who suffer from eating difficulties. (United States)

    Rørtveit, Kristine; Severinsson, Elisabeth


    The aim of this study was to reflect on aspects of mental health nursing leadership qualities with special focus on the therapeutic process for women who suffer from eating difficulties (ED). Therapy for patients with ED involves motivating them to make meaningful changes. Leadership qualities in MHN should focus on the relationship with the patient and positive empowerment processes. In-depth interviews were conducted with six women suffering from ED who had participated in art therapy. The interviews were analysed by means of an interpretative hermeneutic approach. A main theme 'The mental health nurse as a formative and mindful leader in a group therapeutic relationship' and two themes 'Leading sensitively towards awakening the patients' awareness of their pre-understanding' and 'Leading dialectically towards solving patients' existential dilemmas' were developed and comprised two aspects of leadership. The nurse-patient relationship is influenced by the patients' pre-understanding and existential dilemmas. Leadership qualities associated with being formative and mindful represent important aspects of this relationship and should be investigated and thematically described in greater detail in future research. The nurse-patient relationship should focus on clinical supervision, in order to strengthen the nurses' leadership qualities in terms of being aware and dialectical. © 2011 Blackwell Publishing Ltd.

  3. Quality of provided care in vascular surgery : outcome assessment & improvement strategies

    NARCIS (Netherlands)

    Flu, Hans Christiaan


    The aim of this thesis was to evaluate the quality of care in vascular surgery in end-stage renal disease (ESRD) and peripheral arterial occlusive disease (PAOD): intermittent claudication (IC) and critical lower limb ischaemia (CLI) patients. Therefore firstly it focused on the improvement of the

  4. Quality in Family Child Care: A Focus Group Study with Canadian Providers (United States)

    Doherty, Gillian


    A substantial proportion of American, Canadian and English preschoolers regularly participate in family child care making its quality of vital importance for the children concerned, their parents, the school system and the society in which they live. This article discusses the seven key caregiver behaviors and physical space characteristics…

  5. The quality of mobile phone services provided by Romanian operators, from consumers` perspective

    Directory of Open Access Journals (Sweden)

    Doru Alexandru Pleşea


    Full Text Available The mobile services are distinguished through their quality, either we speak about the way the client is approached and placed in the centre of the operator's actions, or about the services the client benefits in his capacity as a client. The Romanian mobile operators’ services have greatly evolved from their launch in 1997. Along these times, the mobile operators brought more value to these services, due to their need to meet the consumers' expectations with services of high quality and competitiveness. Usually the Romanian consumers place the price in the forefront of their service/mobile phone services acquisition, but an objective analyze of the quality of the mobile phone services has to take into account both technical aspects of the services and the interfacing services too. Therefore, this paper takes into account technical characteristics of the services such as national telephony coverage, data transmission services coverage, the signal quality, maximum speed of data transfer as well as related services such as distribution network, sales and support sales services, after-sales services, and range of available terminals. Based on mobile services comprehensive analysis made available to consumers by the major players on the Romanian market, this paper aims to highlight the main reasons of the consumers’ satisfaction and dissatisfaction.

  6. Herbal therapy and quality of life in hypertension patients at health facilities providing complementary therapy

    Directory of Open Access Journals (Sweden)

    Nurhayati Nurhayati


    Full Text Available Abstrak Latar belakang: Hipertensi merupakan faktor risiko utama penyakit kardiovaskular yang berpengaruh penting terhadap beberapa organ (jantung, otak, ginjal dan pembuluh darah. Penelitian ini bertujuan untuk untuk mengidentifikasi faktor dominan yang berhubungan dengan kualitas hidup penderita hipertensi. Metode: Disain penelitian ini adalah cross-sectional. Data berasal dari catatan medis pasien hipertensi yang diberikan pengobatan komplementer di fasilitas kesehatan di provinsi: DKI Jakarta, Jawa Tengah, Jawa Barat, Jawa Timur, Bali, Banten, dan Sumatera. Wawancara dan pencatatan catatan medis pasien dilakukan oleh 77 dokter praktek jamu. Pengukuran kualitas hidup pada pasien hipertensi dengan menggunakan kuesioner Short Form 36 WHO. Faktor risiko yang berhubungan dengan kualitas hidup pada pasien hipertensi dianalisis menggunakan regresi Cox. Hasil: Sebanyak 189 subjek pada penelitian ini. Proporsi subjek yang memiliki kualitas hidup yang baik adalah 51,9% (97/187. Faktor risiko dominan yang berhubungan dengan kualitas hidup pada pasien hipertensi adalah tingkat pendidikan dan jenis pengobatan. Dibandingkan dengan subjek yang memiliki tingkat pendidikan rendah, subjek yang tingkat pendidikan menengah dan tinggi memiliki risiko 83% lebih tinggi mempunyai kualitas hidup yang baik. Subjek yang  mendapatkan jenis pengobatan konvensional dan herbal/tradisional berisiko 29% lebih tinggi mempunyai kualitas hidup yang baik. Kesimpulan: Subjek yang memiliki tingkat pendidikan yang lebih tinggi dan mendapatkan pengobatan konvensional dan herbal/tradisional berisiko mempunyai kualitas hidup yang baik.Kata kunci: kualitas hidup, pasien hipertensi Abstract Background: Hypertension is a major cardiovascular risk factor that had serious consequences to some organs (heart, brain, kidneys and blood vessels. This study aimed to investigate the dominant risk factors that related to quality of life in hypertension subjects. Methods: This cross

  7. Evaluation of quality of life in caregivers who are providing home care to cancer patients. (United States)

    Cubukcu, Mahcube


    The author aimed to evaluate the quality of life and the factors affecting the caregivers of cancer patients receiving home care. This cross-sectional descriptive study was performed in 48 cancer patients who were served from home care unit and 48 caregivers between 01 and 28 February 2014. Patients' functional status was evaluated with Katz Index for Activities of Daily Living and the Lawton Scale for Instrumental Activities of Daily Living. The levels of quality of life of caregivers of patients with cancer were determined with Caregiver Quality of Life Index-Cancer (CQOLC). The mean age of forty-eight patients was 69.79 ± 16.09 years; 62.5% of them were female. The mean duration of home care was 5.99 ± 5.26 years; 25% of patients were fully dependent on the bed. 83.3% of caregivers were female, mean age of caregivers was 50.75 ± 14.89 years, and 77.1% of them were family members. The mean CQOLC score was 74.43 ± 24.45. The highest score was detected in the financial distress and the lowest score was detected in the positive adaptation. The quality of life is increasing as the length of care is reduced and income status increased. The quality of life of caregivers is very low. Each characteristic of the caregiver will affect the care he/she gives. From this point of view, it is important to consider the characteristics of caregivers in improving the care given to cancer patients. In this respect, there is a need to support caregivers both materially and spiritually.

  8. The role of health care providers and significant others in evaluating the quality of life of patients with chronic disease

    NARCIS (Netherlands)

    Sneeuw, Kommer C. A.; Sprangers, Mirjam A. G.; Aaronson, Neil K.


    Health-related quality of life (HRQL) studies sometimes rely, in part, on proxy information obtained from patients' significant others (spouse or close companion) or health care providers. This review: (1) provides a quantitative analysis of the results that have been reported in recent studies

  9. Providing high-quality care for limited English proficient patients: the importance of language concordance and interpreter use. (United States)

    Ngo-Metzger, Quyen; Sorkin, Dara H; Phillips, Russell S; Greenfield, Sheldon; Massagli, Michael P; Clarridge, Brian; Kaplan, Sherrie H


    Provider-patient language discordance is related to worse quality care for limited English proficient (LEP) patients who speak Spanish. However, little is known about language barriers among LEP Asian-American patients. We examined the effects of language discordance on the degree of health education and the quality of interpersonal care that patients received, and examined its effect on patient satisfaction. We also evaluated how the presence/absence of a clinic interpreter affected these outcomes. Cross-sectional survey, response rate 74%. A total of 2,746 Chinese and Vietnamese patients receiving care at 11 health centers in 8 cities. Provider-patient language concordance, health education received, quality of interpersonal care, patient ratings of providers, and the presence/absence of a clinic interpreter. Regression analyses were used to adjust for potential confounding. Patients with language-discordant providers reported receiving less health education (beta = 0.17, p interpreter. Patients with language-discordant providers also reported worse interpersonal care (beta = 0.28, p interpreter did not mitigate these effects and in fact exacerbated disparities in patients' perceptions of their providers. Language barriers are associated with less health education, worse interpersonal care, and lower patient satisfaction. Having access to a clinic interpreter can facilitate the transmission of health education. However, in terms of patients' ratings of their providers and the quality of interpersonal care, having an interpreter present does not serve as a substitute for language concordance between patient and provider.

  10. The cost-effectiveness of using financial incentives to improve provider quality: a framework and application

    DEFF Research Database (Denmark)

    Meacock, R.; Kristensen, Søren Rud; Sutton, M.


    , and whether performance improvement is a transitory or investment activity. Our application to the Advancing Quality initiative demonstrates that the incentive payments represented less than half of the 13m pound total programme costs. By generating approximately 5200 quality-adjusted life years and 4.4m......Despite growing adoption of pay-for-performance (P4P) programmes in health care, there is remarkably little evidence on the cost-effectiveness of such schemes. We review the limited number of previous studies and critique the frameworks adopted and the narrow range of costs and outcomes considered......, before proposing a new more comprehensive framework, which we apply to the first P4P scheme introduced for hospitals in England. We emphasise that evaluations of cost-effectiveness need to consider who the residual claimant is on any cost savings, the possibility of positive and negative spillovers...

  11. Design of IP Camera Access Control Protocol by Utilizing Hierarchical Group Key

    Directory of Open Access Journals (Sweden)

    Jungho Kang


    Full Text Available Unlike CCTV, security video surveillance devices, which we have generally known about, IP cameras which are connected to a network either with or without wire, provide monitoring services through a built-in web-server. Due to the fact that IP cameras can use a network such as the Internet, multiple IP cameras can be installed at a long distance and each IP camera can utilize the function of a web server individually. Even though IP cameras have this kind of advantage, it has difficulties in access control management and weakness in user certification, too. Particularly, because the market of IP cameras did not begin to be realized a long while ago, systems which are systematized from the perspective of security have not been built up yet. Additionally, it contains severe weaknesses in terms of access authority to the IP camera web server, certification of users, and certification of IP cameras which are newly installed within a network, etc. This research grouped IP cameras hierarchically to manage them systematically, and provided access control and data confidentiality between groups by utilizing group keys. In addition, IP cameras and users are certified by using PKI-based certification, and weak points of security such as confidentiality and integrity, etc., are improved by encrypting passwords. Thus, this research presents specific protocols of the entire process and proved through experiments that this method can be actually applied.

  12. Evaluating Quality Management of Acute Low Back Problems Provided By Air Force Nurse Practitioners (United States)


    in males less that 20 years old and abdominal aortic aneurysms are to be contemplated if the patient is older than 50 years old. If any critical...resources limited by cost. Bergman (1995) discussed how financial objectives can be achieved without compromising the quality of care in the pediatric arena...Although his article focused on the pediatric population, the issues discussed apply to medical practice in general. The author stated how the

  13. TCP/IP communication between two USRP-E110


    Sanabria-Russo, Luis


    This short report intends to provide an overview of the procedure and statistics of establishing a TCP/IP link between two USRP-E110. The testings are performed using an example GNURadio code and the networking protocol stack provided by the Linux operating system embedded in the USRP-E110.

  14. Development of quality indicators for low-risk labor care provided by midwives using a RAND-modified Delphi method. (United States)

    Ueda, Kayo; Ohtera, Shosuke; Kaso, Misato; Nakayama, Takeo


    In childbirth, most deliveries are low-risk, defined as spontaneous labor at full term without special high-risk facts or complications, especially in high-resource countries where maternal and perinatal mortality rates are very low. Indeed, the majority of mothers and infants have no serious conditions during labor. However, the quality of care provided is not assured, and performance may vary by birthing facility and provider. The overuse of technology in childbirth in some parts of the world is almost certainly based on assumptions like, "something can go wrong at any minute." There is a need to assess the quality of care provided for mothers and infants in low-risk labor. We aimed to develop specific quality indicators for low-risk labor care provided primarily by midwives in Japan. We used a RAND-modified Delphi method, which integrates evidence review with expert consensus development. The procedure comprises five steps: (1) literature review, including clinical practice guidelines, to extract and develop quality indicator candidates; (2) formation of a multidisciplinary panel; (3) independent panel ratings (Round 1); (4) panel meeting and independent panel ratings (Round 2); and (5) independent panel ratings (Round 3). The three independent panel ratings (Rounds 1-3) were held between July and December 2012. The assembled multidisciplinary panel comprised eight clinicians (two pediatricians, three obstetricians, and three midwives) and three mothers who were nonclinicians. Evidentiary review extracted 166 key recommendations from 32 clinical practice guidelines, and 31 existing quality indicators were added. After excluding duplicate recommendations and quality indicators, the panel discussed 25 candidate indicators. Of these, 18 were adopted, one was modified, six were not adopted, and four were added during the meeting, respectively. We established 23 quality indicators for low-risk labor care provided by midwives in labor units in Japan.

  15. Patient satisfaction with the quality of dental treatment provided by interns

    Directory of Open Access Journals (Sweden)

    Kun-Tsung Lee


    Conclusion: Medical centers should guide interns in clinical cases and provide structured training. These measures could enhance the public's confidence in interns and improve patient satisfaction with interns through improved clinical skills, and provide an excellent work force for the dental field.

  16. Providing better thermal and air quality conditions in school classrooms would be cost-effective

    DEFF Research Database (Denmark)

    Wargocki, Pawel; Wyon, David Peter


    codes stipulate that they should be. This is sometimes because financial resources for the maintenance and upgrade of school buildings are inadequate, but it is also because schools are increasingly allowing classroom temperatures to drift above the recommended range of 20–22 °C in warm weather......This paper is an overall summary of research by the authors on how classroom conditions affect the performance of schoolwork by children, motivated by the fact that the thermal and air quality conditions in school classrooms are now almost universally worse than the relevant standards and building...

  17. SEAFOODplus - how to provide health promoting, safe seafood of high eating quality to consumers

    DEFF Research Database (Denmark)

    Børresen, Torger


    of raw materials from aquaculture and from traditional fisheries. The aquaculture component will study the effects of dietary modulation, husbandry, fish physiology, genetics and pre-slaughter conditions. Validated traceability systems are assessed to make it possible to apply a total chain approach from......, by identifying risk factors and avoiding risks caused by viral and bacterial contamination and biogenic amines in seafood. The total value chain is addressed by developing consumer driven tailor-made, functional seafood products to improve health and to ensure nutritional quality and safety by full utilisation...

  18. What Prevents Quality Midwifery Care? A Systematic Mapping of Barriers in Low and Middle Income Countries from the Provider Perspective.

    Directory of Open Access Journals (Sweden)

    Alex Filby

    Full Text Available Quality of care is essential for further progress in reducing maternal and newborn deaths. The integration of educated, trained, regulated and licensed midwives into the health system is associated with improved quality of care and sustained decreases in maternal and newborn mortality. To date, research on barriers to quality of care for women and newborns has not given due attention to the care provider's perspective. This paper addresses this gap by presenting the findings of a systematic mapping of the literature of the social, economic and professional barriers preventing midwifery personnel in low and middle income countries (LMICs from providing quality of care.A systematic search of five electronic databases for literature published between January 1990 and August 2013. Eligible items included published and unpublished items in all languages. Items were screened against inclusion and exclusion criteria, yielding 82 items from 34 countries. 44% discussed countries or regions in Africa, 38% in Asia, and 5% in the Americas. Nearly half the articles were published since 2011. Data was extracted and presented in a narrative synthesis and tables. Items were organized into three categories; social; economic and professional barriers, based on an analytical framework. Barriers connected to the socially and culturally constructed context of childbirth, although least reported, appear instrumental in preventing quality midwifery care.Significant social and cultural, economic and professional barriers can prevent the provision of quality midwifery care in LMICs. An analytical framework is proposed to show how the overlaps between the barriers reinforce each other, and that they arise from gender inequality. Links are made between burn out and moral distress, caused by the barriers, and poor quality care. Ongoing mechanisms to improve quality care will need to address the barriers from the midwifery provider perspective, as well as the underlying

  19. Patient and provider perspectives on quality and health system effectiveness in a transition economy: evidence from Ukraine. (United States)

    Luck, J; Peabody, J W; DeMaria, L M; Alvarado, C S; Menon, R


    Facing a severe population health crisis due to noncommunicable diseases, Ukraine and other former Soviet republics and Eastern European countries have a pressing need for more effective health systems. Policies to enhance health system effectiveness should consider the perspectives of different stakeholder groups, including providers as well as patients. In addition, policies that directly target the quality of clinical care should be based on objective performance measures. In 2009 and 2010 we conducted a coordinated series of household and facility-level surveys to capture the perspectives of Ukrainian household members, outpatient clinic patients, and physicians regarding the country's health system overall, as well as the quality, access, and affordability of health care. We objectively measured the quality of care for heart failure and chronic obstructive pulmonary disease using CPV(®) vignettes. There was broad agreement among household respondents (79%) and physicians (95%) that Ukraine's health system should be reformed. CPV(®) results indicate that the quality of care for common noncommunicable diseases is poor in all regions of the country and in hospitals as well as polyclinics. However, perspectives about the quality of care differ, with household respondents seeing quality as a serious concern, clinic patients having more positive perceptions, and physicians not viewing quality as a reform priority. All stakeholder groups viewed affordability as a problem. These findings have several implications for policies to enhance health system effectiveness. The shared desire for health system reform among all stakeholder groups provides a basis for action in Ukraine. Improving quality, strengthening primary care, and enhancing affordability should be major goals of new health policies. Policies to improve quality directly, such as pay-for-performance, would be mutually reinforcing with purchasing reforms such as transparent payment mechanisms. Such policies

  20. A haemovigilance team provides both significant financial and quality benefits in a University Hospital. (United States)

    Decadt, Ine; Costermans, Els; Van de Poel, Maai; Kesteloot, Katrien; Devos, Timothy


    Haemovigilance is the process of surveillance of blood transfusion procedures including unexpected hazards and reactions during the transfusion pathway in both donors and recipients. The haemovigilance team aims to increase blood transfusion safety and to decrease both morbidity and mortality in donors and recipients. The team collects data about transfusion reactions and incidents, instructs the involved health workers and assures the tracing of blood components. The haemovigilance team at the University Hospitals Leuven has played a pioneering role in the development of haemovigilance in Belgium Although the literature about safety and quality improvements by haemovigilance systems is abundant, there are no published data available measuring their financial impact in a hospital. Therefore, we studied the costs and returns of the haemovigilance team at the University Hospitals Leuven. This study has a descriptive explorative design. Research of the current costs and returns of the haemovigilance team were based upon data from the Medical Administration of the hospital. Data were analyzed descriptively. The haemovigilance team of the University Hospitals Leuven is financially viable: the direct costs are covered by the annual financial support of the National Public Health Service. The indirect returns come from two important tasks of the haemovigilance team itself: correction of the electronic registration of administered blood component and improvement of the return of conform preserved blood components to the blood bank. Besides safety and quality improvement, which are obviously their main goals, the haemovigilance team also implies a financial benefit for the hospital. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Perception of CPR quality: Influence of CPR feedback, Just-in-Time CPR training and provider role. (United States)

    Cheng, Adam; Overly, Frank; Kessler, David; Nadkarni, Vinay M; Lin, Yiqun; Doan, Quynh; Duff, Jonathan P; Tofil, Nancy M; Bhanji, Farhan; Adler, Mark; Charnovich, Alex; Hunt, Elizabeth A; Brown, Linda L


    Many healthcare providers rely on visual perception to guide cardiopulmonary resuscitation (CPR), but little is known about the accuracy of provider perceptions of CPR quality. We aimed to describe the difference between perceived versus measured CPR quality, and to determine the impact of provider role, real-time visual CPR feedback and Just-in-Time (JIT) CPR training on provider perceptions. We conducted secondary analyses of data collected from a prospective, multicenter, randomized trial of 324 healthcare providers who participated in a simulated cardiac arrest scenario between July 2012 and April 2014. Participants were randomized to one of four permutations of: JIT CPR training and real-time visual CPR feedback. We calculated the difference between perceived and measured quality of CPR and reported the proportion of subjects accurately estimating the quality of CPR within each study arm. Participants overestimated achieving adequate chest compression depth (mean difference range: 16.1-60.6%) and rate (range: 0.2-51%), and underestimated chest compression fraction (0.2-2.9%) across all arms. Compared to no intervention, the use of real-time feedback and JIT CPR training (alone or in combination) improved perception of depth (pPerception of depth is more accurate in CPR providers versus team leaders (27.8% vs. 7.4%; p=0.043) when using real-time feedback. Healthcare providers' visual perception of CPR quality is poor. Perceptions of CPR depth are improved by using real-time visual feedback and with prior JIT CPR training. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Novel characteristics of CtIP at damage-induced foci following the initiation of DNA end resection

    Energy Technology Data Exchange (ETDEWEB)

    Fujisawa, Hiroshi [School of Engineering, The University of Tokyo, Tokyo 113-8656 (Japan); Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555 (Japan); Fujimori, Akira [Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555 (Japan); International Open Laboratory, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555 (Japan); Okayasu, Ryuichi [International Open Laboratory, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555 (Japan); Uesaka, Mitsuru [School of Engineering, The University of Tokyo, Tokyo 113-8656 (Japan); Yajima, Hirohiko, E-mail: [Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555 (Japan); International Open Laboratory, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555 (Japan)


    Highlights: • CtIP becomes hyperphosphorylated and forms foci following cell irradiation. • CtIP accumulates in foci subsequent to the peak of hyperphosphorylation. • CtIP is maintained in a hypophosphorylated state at later times. • CtIP is continuously recruited to DNA double strand breaks downstream of resection. • CtIP presumably have a distinct role following the initiation of resection. - Abstract: Homologous recombination (HR) is a major repair pathway for DNA double strand breaks (DSBs), and end resection, which generates a 3′-single strand DNA tail at the DSB, is an early step in the process. Resection is initiated by the Mre11 nuclease together with CtIP. Here, we describe novel characteristics of CtIP at DSBs. At early times following exposure of human cells to ionizing radiation, CtIP localized to the DSB, became hyperphosphorylated and formed foci in an ATM-dependent manner. At later times, when the initiation of resection had occurred, CtIP foci persist but CtIP is maintained in a hypophosphorylated state, which is dependent on ATM and ATR. Exposure to cycloheximide revealed that CtIP turns over at DSB sites downstream of resection. Our findings provide strong evidence that CtIP is continuously recruited to DSBs downstream of both the initiation and extension step of resection, strongly suggesting that CtIP has functions in addition to promoting the initiation of resection during HR.


    Directory of Open Access Journals (Sweden)

    Stanka Preskar


    Full Text Available With Slovenia joining the EU the need for higher quality and faster transit transport of goods through customs procedures has increased. This paper presents the recent logistics approach, which allows a better link between transportation and freight forwarding. Modern computer programs used by forwarding companies have contributed to this. Forwarder companies may have a role of organizer or a place using the transport services of customs clearance of goods at the entry / exit to / from the European Union. Each type of transport has a role to play, but gets even stronger when combined under one category. This is a multimodal transport. As an example we use logistic work in a logistic company. Here the work is divided in to transit of goods, customs clearance of goods, but also touching the law and the ranking of goods by tariff codes.

  4. Effectively teaching self-assessment: preparing the dental hygiene student to provide quality care. (United States)

    Jackson, Sarah C; Murff, Elizabeth J Tipton


    Literature on self-assessment presents substantial evidence regarding the impact of self-assessment on dental practitioners and quality of care. Related dental hygiene research documents a need to enhance self-assessment curricula; however, no published curriculum module exists to effectively teach self-assessment. The purpose of this study was to explore the impact of a self-assessment educational module for dental hygiene curricula designed using adult learning principles. This module was implemented with thirty-three dental hygiene students in their junior year using a one-group, pretest-posttest design. Results analyzed using matched pairs Wilcoxon signed-rank test indicated the self-assessment module was effective (pforms was also enhanced after module implementation (peffective. Findings indicate a self-assessment educational module enhanced these dental hygiene students' self-assessment perceptions and skills.

  5. The diet quality index evaluates the adequacy of energy provided by dietary macronutrients

    Directory of Open Access Journals (Sweden)

    Aline MENDES


    Full Text Available Objective To investigate the relationship between macronutrient intake adequacy and the national diet quality index score. Methods The study analyzed a representative sample of 1,662 individuals from the municipality of São Paulo who participated in a cross-sectional study called Health Survey-Capital (2008/2009. Two 24-hour recalls were collected. Habitual intake was determined by the Multiple Source Method. The Brazilian index was calculated as suggested, and macronutrient adequacy was given by the World Health Organization and Food and Agriculture Organization recommendations. A generalized linear model verified the relationship between the Brazilian index and macronutrient adequacy. All analyses with a descriptive level below 0.05 were considered significant. The analyses were performed by the software Stata 12.0, survey mode. Results The vast majority (91% of the population had inappropriate macronutrient intakes, and the total median Brazilian index score was 61.3 points (interquartile range=10.1. The total Brazilian index score of individuals with high lipid intake was worse than that of individuals with proper lipid intake (β=0,96; p=0,004, while those with high protein intake had a better score (β=1,10; p=0,003 than those with proper protein intake. Conclusion The revised Brazilian Healthy Eating Index assesses diet quality properly regarding high lipid intake, but it has some limitations regarding high protein intake according to the World Health Organization and Food and Agriculture Organization recommendations. New studies should investigate the possibility of adapting this index to the World Health Organization and Food and Agriculture Organization recommendations.

  6. Cancer inhibition by inositol hexaphosphate (IP6) and inositol: from laboratory to clinic. (United States)

    Vucenik, Ivana; Shamsuddin, AbulKalam M


    Inositol hexaphosphate (IP6) is a naturally occurring polyphosphorylated carbohydrate that is present in substantial amounts in almost all plant and mammalian cells. It was recently recognized to possess multiple biological functions. A striking anticancer effect of IP6 was demonstrated in different experimental models. Inositol is also a natural constituent possessing moderate anticancer activity. The most consistent and best anticancer results were obtained from the combination of IP6 plus inositol. In addition to reducing cell proliferation, IP6 increases differentiation of malignant cells, often resulting in a reversion to normal phenotype. Exogenously administered IP6 is rapidly taken into the cells and dephosphorylated to lower-phosphate inositol phosphates, which further interfere with signal transduction pathways and cell cycle arrest. Enhanced immunity and antioxidant properties can also contribute to tumor cell destruction. However, the molecular mechanisms underlying this anticancer action are not fully understood. Because it is abundantly present in regular diet, efficiently absorbed from the gastrointestinal tract, and safe, IP6 holds great promise in our strategies for the prevention and treatment of cancer. IP6 plus inositol enhances the anticancer effect of conventional chemotherapy, controls cancer metastases, and improves the quality of life, as shown in a pilot clinical trial. The data strongly argue for the use of IP6 plus inositol in our strategies for cancer prevention and treatment. However, the effectiveness and safety of IP6 plus inositol at therapeutic doses needs to be determined in phase I and phase II clinical trials in humans.

  7. Research of differentiated QoS routing in GMPLS-based IP/WDM networks (United States)

    Wang, YiYun; Zeng, QingJi; Cao, JunWen


    At this point in technology's evolution, the simplicity, elegance, extensibility, and broad compatibility of the Internet protocol suite has made it the automatic choice for most forms of communication. The attempts at resolution of this apparent dichotomy consist of a collection of technologies and philosophies known as Quality of Service. In an IP network, QoS defines the ability to compensate for traffic characteristics without compromising average throughput. Clearly, optimizing QoS performance for all traffic types on an IP network presents a daunting challenge. To partially address this challenge, several Internet Engineering Task Force groups have been working on standardized approaches for IP-based QoS technologies. The IETF"s approaches fall into four categories: prioritization using differentiated services, reservation using integrated services, label switching using multi-protocol label switching, bandwidth management using the subnet bandwidth manager. Differentiated services classify per-hop behaviors on the basis of a Diffserv code point attached to the type of service byte in each packet"s IP header. This DSCP approach represents a form of soft QoS that rather coarsely classifies services through packet marking. The differentiated QoS routing in GMPLS-based IP/WDM Networks are a promising candidate for the next generation optical Internet networks. By using a unified control plane, such networks make more efficient usage of network resources both at the IP layer and the WDM optical layer. In this paper, we consider prioritized routing of bandwidth-guaranteed Label Switched paths (LSPs) providing service differentiation between classes of high and normal priority traffic. The QoS delay requirements are assumed to be translated into bandwidth and O-E-O conversion requirements. We present a graphical representation of the integrated network state which is different from other conventional graphical representations in that it models the cost of usage of

  8. Efficient yeast ChIP-Seq using multiplex short-read DNA sequencing

    Directory of Open Access Journals (Sweden)

    Yellman Christopher M


    Full Text Available Abstract Background Short-read high-throughput DNA sequencing technologies provide new tools to answer biological questions. However, high cost and low throughput limit their widespread use, particularly in organisms with smaller genomes such as S. cerevisiae. Although ChIP-Seq in mammalian cell lines is replacing array-based ChIP-chip as the standard for transcription factor binding studies, ChIP-Seq in yeast is still underutilized compared to ChIP-chip. We developed a multiplex barcoding system that allows simultaneous sequencing and analysis of multiple samples using Illumina's platform. We applied this method to analyze the chromosomal distributions of three yeast DNA binding proteins (Ste12, Cse4 and RNA PolII and a reference sample (input DNA in a single experiment and demonstrate its utility for rapid and accurate results at reduced costs. Results We developed a barcoding ChIP-Seq method for the concurrent analysis of transcription factor binding sites in yeast. Our multiplex strategy generated high quality data that was indistinguishable from data obtained with non-barcoded libraries. None of the barcoded adapters induced differences relative to a non-barcoded adapter when applied to the same DNA sample. We used this method to map the binding sites for Cse4, Ste12 and Pol II throughout the yeast genome and we found 148 binding targets for Cse4, 823 targets for Ste12 and 2508 targets for PolII. Cse4 was strongly bound to all yeast centromeres as expected and the remaining non-centromeric targets correspond to highly expressed genes in rich media. The presence of Cse4 non-centromeric binding sites was not reported previously. Conclusion We designed a multiplex short-read DNA sequencing method to perform efficient ChIP-Seq in yeast and other small genome model organisms. This method produces accurate results with higher throughput and reduced cost. Given constant improvements in high-throughput sequencing technologies, increasing

  9. Supporting diverse data providers in the open water data initiative: Communicating water data quality and fitness of use (United States)

    Larsen, Sara; Hamilton, Stuart; Lucido, Jessica M.; Garner, Bradley D.; Young, Dwane


    Shared, trusted, timely data are essential elements for the cooperation needed to optimize economic, ecologic, and public safety concerns related to water. The Open Water Data Initiative (OWDI) will provide a fully scalable platform that can support a wide variety of data from many diverse providers. Many of these will be larger, well-established, and trusted agencies with a history of providing well-documented, standardized, and archive-ready products. However, some potential partners may be smaller, distributed, and relatively unknown or untested as data providers. The data these partners will provide are valuable and can be used to fill in many data gaps, but can also be variable in quality or supplied in nonstandardized formats. They may also reflect the smaller partners' variable budgets and missions, be intermittent, or of unknown provenance. A challenge for the OWDI will be to convey the quality and the contextual “fitness” of data from providers other than the most trusted brands. This article reviews past and current methods for documenting data quality. Three case studies are provided that describe processes and pathways for effective data-sharing and publication initiatives. They also illustrate how partners may work together to find a metadata reporting threshold that encourages participation while maintaining high data integrity. And lastly, potential governance is proposed that may assist smaller partners with short- and long-term participation in the OWDI.

  10. What Prevents Quality Midwifery Care? A Systematic Mapping of Barriers in Low and Middle Income Countries from the Provider Perspective (United States)

    McConville, Fran; Portela, Anayda


    Background Quality of care is essential for further progress in reducing maternal and newborn deaths. The integration of educated, trained, regulated and licensed midwives into the health system is associated with improved quality of care and sustained decreases in maternal and newborn mortality. To date, research on barriers to quality of care for women and newborns has not given due attention to the care provider’s perspective. This paper addresses this gap by presenting the findings of a systematic mapping of the literature of the social, economic and professional barriers preventing midwifery personnel in low and middle income countries (LMICs) from providing quality of care. Methods and Findings A systematic search of five electronic databases for literature published between January 1990 and August 2013. Eligible items included published and unpublished items in all languages. Items were screened against inclusion and exclusion criteria, yielding 82 items from 34 countries. 44% discussed countries or regions in Africa, 38% in Asia, and 5% in the Americas. Nearly half the articles were published since 2011. Data was extracted and presented in a narrative synthesis and tables. Items were organized into three categories; social; economic and professional barriers, based on an analytical framework. Barriers connected to the socially and culturally constructed context of childbirth, although least reported, appear instrumental in preventing quality midwifery care. Conclusions Significant social and cultural, economic and professional barriers can prevent the provision of quality midwifery care in LMICs. An analytical framework is proposed to show how the overlaps between the barriers reinforce each other, and that they arise from gender inequality. Links are made between burn out and moral distress, caused by the barriers, and poor quality care. Ongoing mechanisms to improve quality care will need to address the barriers from the midwifery provider perspective

  11. Universal Space IP Transparent Proxy Project (United States)

    National Aeronautics and Space Administration — Communications applications are strategically moving toward Internet Protocol-based architectures and technologies. Despite IP's huge potential, (e.g. cost...

  12. Physicians cite hurdles ranging from lack of coverage to poor communication in providing high-quality care to latinos. (United States)

    Vargas Bustamante, Arturo; Chen, Jie


    We surveyed physicians about their ability to provide high-quality care to patients from diverse ethnic backgrounds. Primarily, we wanted to explore the challenges faced by physicians treating Latino patients compared to physicians whose patients were primarily white and non-Latino. We found that physicians treating Latinos, particularly those who worked in primary care in comparison to specialists, were less likely than physicians treating primarily white patients to believe in their ability to provide high-quality care. They cited problems of inadequate time with patients, patients' ability to pay, patients' nonadherence to recommended treatment, difficulties communicating with patients, relative lack of specialist availability, and lack of timely transmission of reports among physicians. Insurance expansions and complementary reforms mandated by the Affordable Care Act of 2010 and other recent legislation should aid physicians in closing some of these gaps in quality.

  13. ChIP-seq guidelines and practices of the ENCODE and modENCODE consortia (United States)

    Landt, Stephen G.; Marinov, Georgi K.; Kundaje, Anshul; Kheradpour, Pouya; Pauli, Florencia; Batzoglou, Serafim; Bernstein, Bradley E.; Bickel, Peter; Brown, James B.; Cayting, Philip; Chen, Yiwen; DeSalvo, Gilberto; Epstein, Charles; Fisher-Aylor, Katherine I.; Euskirchen, Ghia; Gerstein, Mark; Gertz, Jason; Hartemink, Alexander J.; Hoffman, Michael M.; Iyer, Vishwanath R.; Jung, Youngsook L.; Karmakar, Subhradip; Kellis, Manolis; Kharchenko, Peter V.; Li, Qunhua; Liu, Tao; Liu, X. Shirley; Ma, Lijia; Milosavljevic, Aleksandar; Myers, Richard M.; Park, Peter J.; Pazin, Michael J.; Perry, Marc D.; Raha, Debasish; Reddy, Timothy E.; Rozowsky, Joel; Shoresh, Noam; Sidow, Arend; Slattery, Matthew; Stamatoyannopoulos, John A.; Tolstorukov, Michael Y.; White, Kevin P.; Xi, Simon; Farnham, Peggy J.; Lieb, Jason D.; Wold, Barbara J.; Snyder, Michael


    Chromatin immunoprecipitation (ChIP) followed by high-throughput DNA sequencing (ChIP-seq) has become a valuable and widely used approach for mapping the genomic location of transcription-factor binding and histone modifications in living cells. Despite its widespread use, there are considerable differences in how these experiments are conducted, how the results are scored and evaluated for quality, and how the data and metadata are archived for public use. These practices affect the quality and utility of any global ChIP experiment. Through our experience in performing ChIP-seq experiments, the ENCODE and modENCODE consortia have developed a set of working standards and guidelines for ChIP experiments that are updated routinely. The current guidelines address antibody validation, experimental replication, sequencing depth, data and metadata reporting, and data quality assessment. We discuss how ChIP quality, assessed in these ways, affects different uses of ChIP-seq data. All data sets used in the analysis have been deposited for public viewing and downloading at the ENCODE ( and modENCODE ( portals. PMID:22955991

  14. How Do District Management and Implementation Strategies Relate to the Quality of the Professional Development That Districts Provide to Teachers? (United States)

    Desimone, Laura; Porter, Andrew C.; Birman, Beatrice F.; Garet, Michael S.; Yoon, Kwang Suk


    Examined policy mechanisms and processes that districts used to provide high quality inservice professional development to teachers. Data from a national probability sample of professional development coordinators in districts that received federal funding for professional development highlighted specific management and implementation strategies…

  15. A feedback system in residency to evaluate CanMEDS roles and provide high-quality feedback : Exploring its application

    NARCIS (Netherlands)

    Renting, Nienke; Gans, Rijk O. B.; Borleffs, Jan C. C.; Van Der Wal, Martha A.; Jaarsma, A. Debbie C.; Cohen-Schotanus, Janke

    Introduction: Residents benefit from regular, high quality feedback on all CanMEDS roles during their training. However, feedback mostly concerns Medical Expert, leaving the other roles behind. A feedback system was developed to guide supervisors in providing feedback on CanMEDS roles. We analyzed

  16. Satisfaction of osteoarthritis patients with provided care is not related to the disease-specific quality of life.

    NARCIS (Netherlands)

    Rosemann, T.J.; Wensing, M.J.P.; Szecsenyi, J.; Grol, R.P.T.M.


    BACKGROUND: Osteoarthritis (OA) has a high prevalence in primary care. Patient satisfaction is an important indicator for the quality of care provided to OA patients. Little is known about satisfaction of patients with this condition in a primary care setting in Germany. The aim of the study was to

  17. Impact of Providing Compassion on Job Performance and Mental Health: The Moderating Effect of Interpersonal Relationship Quality. (United States)

    Chu, Li-Chuan


    To examine the relationships of providing compassion at work with job performance and mental health, as well as to identify the role of interpersonal relationship quality in moderating these relationships. This study adopted a two-stage survey completed by 235 registered nurses employed by hospitals in Taiwan. All hypotheses were tested using hierarchical regression analyses. The results show that providing compassion is an effective predictor of job performance and mental health, whereas interpersonal relationship quality can moderate the relationships of providing compassion with job performance and mental health. When nurses are frequently willing to listen, understand, and help their suffering colleagues, the enhancement engendered by providing compassion can improve the provider's job performance and mental health. Creating high-quality relationships in the workplace can strengthen the positive benefits of providing compassion. Motivating employees to spontaneously exhibit compassion is crucial to an organization. Hospitals can establish value systems, belief systems, and cultural systems that support a compassionate response to suffering. In addition, nurses can internalize altruistic belief systems into their own personal value systems through a long process of socialization in the workplace. © 2017 Sigma Theta Tau International.

  18. ChIP-Seq: A Powerful Tool for Studying Protein-DNA Interactions in Plants. (United States)

    Chen, Xifeng; Bhadauria, Vijai; Ma, Bojun


    DNA-binding proteins, including transcription factors, epigenetic and chromatin modifiers, control gene expressions in plants. To pinpoint the binding sits of DNA-binding proteins in genome is crucial for decoding gene regulatory networks. Chromatin immunoprecipitation (ChIP) followed by high-throughput DNA sequencing (ChIP-Seq) is a widely used approach to identify the DNA regions bound by a specific protein in vivo. The information generated from ChIP-Seq has tremendously advanced our understanding on the mechanism of transcription factors, cofactors and histone modifications in regulating gene expression. In this review, we reviewed the recent research advance of ChIP-Seq in plants, including description of the ChIP-Seq workflow and its various applications in plants, and in addition, provided perspective of the potential advances of ChIP-Seq.

  19. Telemetry and Communication IP Video Player (United States)

    OFarrell, Zachary L.


    Aegis Video Player is the name of the video over IP system for the Telemetry and Communications group of the Launch Services Program. Aegis' purpose is to display video streamed over a network connection to be viewed during launches. To accomplish this task, a VLC ActiveX plug-in was used in C# to provide the basic capabilities of video streaming. The program was then customized to be used during launches. The VLC plug-in can be configured programmatically to display a single stream, but for this project multiple streams needed to be accessed. To accomplish this, an easy to use, informative menu system was added to the program to enable users to quickly switch between videos. Other features were added to make the player more useful, such as watching multiple videos and watching a video in full screen.

  20. Quality-of-life metrics with vagus nerve stimulation for epilepsy from provider survey data. (United States)

    Englot, Dario J; Hassnain, Kevin H; Rolston, John D; Harward, Stephen C; Sinha, Saurabh R; Haglund, Michael M


    Drug-resistant epilepsy is a devastating disorder associated with diminished quality of life (QOL). Surgical resection leads to seizure freedom and improved QOL in many epilepsy patients, but not all individuals are candidates for resection. In these cases, neuromodulation-based therapies such as vagus nerve stimulation (VNS) are often used, but most VNS studies focus exclusively on reduction of seizure frequency. QOL changes and predictors with VNS remain poorly understood. Using the VNS Therapy Patient Outcome Registry, we examined 7 metrics related to QOL after VNS for epilepsy in over 5000 patients (including over 3000 with ≥12months follow-up), as subjectively assessed by treating physicians. Trends and predictors of QOL changes were examined and related to post-operative seizure outcome and likelihood of VNS generator replacement. After VNS therapy, physicians reported patient improvement in alertness (58-63%, range over follow-up period), post-ictal state (55-62%), cluster seizures (48-56%), mood change (43-49%), verbal communication (38-45%), school/professional achievements (29-39%), and memory (29-38%). Predictors of net QOL improvement included shorter time to implant (odds ratio [OR], 1.3; 95% confidence interval [CI], 1.1-1.6), generalized seizure type (OR, 1.2; 95% CI, 1.0-1.4), female gender (OR, 1.2; 95% CI, 1.0-1.4), and Caucasian ethnicity (OR, 1.3; 95% CI, 1.0-1.5). No significant trends were observed over time. Patients with net QOL improvement were more likely to have favorable seizure outcomes (chi square [χ 2 ]=148.1, pmetrics subjectively rated by physicians. QOL improvement is associated with favorable seizure outcome and a higher likelihood of generator replacement, suggesting satisfaction with therapy. It is important to consider QOL metrics in neuromodulation for epilepsy, given the deleterious effects of seizures on patient QOL. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  1. Assessment of provider competence and quality of maternal/newborn care in selected Latin American and Caribbean countries. (United States)

    Thompson, Joyce E; Land, Sandra; Camacho-Hubner, Alma Virginia; Fullerton, Judith T


    To obtain a snapshot of the maternal and newborn care provided by different types of maternal and child health providers in Latin America and the Caribbean (LAC) to 1) better inform advocacy and programmatic strategies and interventions to improve the quality of those services in the region, and 2) determine the need for more rigorous study of the issues. A rapid assessment of 83 health workers providing antepartum, intrapartum, and immediate postpartum and newborn care (within two hours of birth) in eight LAC countries was conducted in November and December of 2011. Health workers were observed by two-person expert maternal/newborn clinician teams using pretested forms based on international quality-of-care standards. A total of 105 care encounters were observed, primarily in urban, public, referral-level settings. Providers of care included obstetricians, midwives, generalist physicians, medical residents, registered nurses, auxiliary nurses, and students of medicine, midwifery, and nursing. Hand washing, as an indicator of quality of antepartum care, was observed in only 41% of the observed encounters. Labor management often lacked certain elements of respectful maternity care across all provider groups. Several clinical tasks of high importance in the identification and prevention of common complications of antepartum, intrapartum, and immediate postpartum/newborn care were not documented as performed during the observation periods. Providers self-reported limited competence (ability to perform to a defined level of proficiency) in manual removal of the placenta, bimanual compression of the uterus, and newborn resuscitation. The findings suggest that 1) the quality of maternal and newborn care and 2) the competence of maternal and child health providers in the diverse selection of LAC countries that were studied require substantial attention.

  2. Professional Quality of Life of Veterans Affairs Staff and Providers in a Patient-Centered Care Environment. (United States)

    Locatelli, Sara M; LaVela, Sherri L


    Changes to the work environment prompted by the movement toward patient-centered care have the potential to improve occupational stress among health care workers by improving team-based work activities, collaboration, and employee-driven quality improvement. This study was conducted to examine professional quality of life among providers at patient-centered care pilot facilities. Surveys were conducted with 76 Veterans Affairs employees/providers at facilities piloting patient-centered care interventions, to assess demographics, workplace practices and views (team-based environment, employee voice, quality of communication, and turnover intention), and professional quality of life (compassion satisfaction, burnout, and secondary traumatic stress).Professional quality-of-life subscales were not related to employee position type, age, or gender. Employee voice measures were related to lower burnout and higher compassion satisfaction. In addition, employees who were considering leaving their position showed higher burnout and lower compassion satisfaction scores. None of the work practices showed relationships with secondary traumatic stress.

  3. Construction of a nuclear data server using TCP/IP

    Energy Technology Data Exchange (ETDEWEB)

    Kawano, Toshihiko; Sakai, Osamu [Kyushu Univ., Fukuoka (Japan)


    We construct a nuclear data server which provides data in the evaluated nuclear data library through the network by means of TCP/IP. The client is not necessarily a user but a computer program. Two examples with a prototype server program are demonstrated, the first is data transfer from the server to a user, and the second is to a computer program. (author)

  4. Software project estimation the fundamentals for providing high quality information to decision makers

    CERN Document Server

    Abran, Alain


    Software projects are often late and over-budget and this leads to major problems for software customers. Clearly, there is a serious issue in estimating a realistic, software project budget. Furthermore, generic estimation models cannot be trusted to provide credible estimates for projects as complex as software projects. This book presents a number of examples using data collected over the years from various organizations building software. It also presents an overview of the non-for-profit organization, which collects data on software projects, the International Software Benchmarking Stan

  5. Providing informal home care for pressure ulcer patients: how it affects carers' quality of life and burden. (United States)

    Rodrigues, Alexandre M; Ferreira, Pedro L; Ferré-Grau, Carmen


    To evaluate the quality of life of informal caregivers of patients with pressure ulcer; to assess their levels of burden; to analyse the variables influencing both their quality of life and burden. Informal caregivers of pressure ulcer patients, besides coping with the natural dependency of these patients, deal with the specificity of caring these types of wounds. This situation has an impact on not only the quality of life and burden felt by informal caregivers but also on individual and familiar dynamics. Descriptive and correlational study. This study focused on 145 informal caregivers providing home care. Measurement instruments were: SF-36v2 and the Burden Interview Scale. Descriptive analysis of the quantitative variables was carried out according to measures of central tendency, and the qualitative variables were described using absolute and relative frequencies. The relationships or associations between variables were explored through correlational analysis and, whenever the data allowed, multivariate techniques were used. Informal caregivers showed low levels of quality of life and, most of them, significant burden. Quality of life decreased with overload, with the increasing number of pressure ulcer and with less experience of informal caregivers, with lack of financial remuneration, with unemployment, with patient positioning and with the direct care of the wound. The burden increased with the number of pressure ulcer in each patient and with the lack of financial remuneration. These informal caregivers have low quality of life and are overburdened. Both situations are positively and negatively influenced by factors related to the pressure ulcer and to the patients' sociodemographic data. The results of this study allow more effective monitoring by health professionals of levels of burden and quality of life encountered in pressure ulcer informal caregivers, as well as direct interventions to inhibit the factors inducing burden and enhance those that

  6. Ensuring that the Sentinel-3A altimeter provides climate-quality data (United States)

    Quartly, G. D.; Nencioli, F.; Labroue, S.; Femenias, P.; Scharroo, R.; Abdalla, S.; Bonnefond, P.; Cancet, M.; Frery, M.-L.; Raynal, M.; Baker, S.; Muir, A.; Brockley, D.; Shepherd, A.; Garcia, P.; Roca, M.; Calmant, S.; Cretaux, J.-F.


    Sentinel-3A, launched in February 2016, is part of ESA's long-term commitment to climate monitoring from space. Its suite of instruments for measuring surface topography includes a Microwave Radiometer (MWR) and SRAL, the first delay-Doppler instrument to provide global coverage. SRAL promises fine spatial resolution and reduced noise levels that should together lead to improved performance over all Earth surfaces. The Sentinel-3 Mission Performance Centre (S3MPC) has been developing the methodology to evaluate the accuracy of retrievals, monitor any changes and develop solutions to known problems. The S3MPC monitors internal temperatures, path delays and the shape of the generated pulses to assess the instruments health. The MWR records over known reference surfaces are compared with those from other spaceborne instruments. Over the ocean the SRAL's return pulses are analysed to give range to the sea surface, wave height and signal strength (which can be interpreted as wind speed). The metocean data are regularly contrasted with records from in situ measurements and the output from meteorological models, which rapidly highlights the effects of any changes in processing. Range information is used to give surface elevation, which is assessed in three ways. First, flights over a dedicated radar transponder provide an estimate of path delay to within 10 mm (r.m.s.). Second, measurements are compared to GPS-levelled surfaces near Corsica and over Lake Issyk-kul. Third, there are consistency checks between ascending and descending passes and with other missions. Further waveform analysis techniques are being developed to improve the retrieval of information over sea-ice, land-ice and inland waters.

  7. Localitzador Gràfic de Direccions IP 'IpLocInspector'


    Ordóñez Chapado, Miguel


    En aquest treball s'ha desenvolupat una aplicació capaç de localitzar adreces IP. En este trabajo se ha desarrollado una aplicación capaz de localizar direcciones IP. In this work an application was developed capable of locating IP addresses.

  8. Science spin: iPS cell research in the news. (United States)

    Caulfield, T; Rachul, C


    Big scientific developments have always been spun to meet particular social agendas. We have seen it in the context of global warming, nuclear power, and genetically modified organisms. But few stories illustrate the phenomenon of spin as well as the reaction, and concomitant media coverage, that surrounded the November 2007 announcement regarding the reprogramming of skin cells to produce cells with qualities comparable to those of human embryonic stem cells (hESCs) known as induced pluripotent stem (iPS) cells.

  9. 75 FR 13235 - IP-Enabled Services (United States)


    ... From the Federal Register Online via the Government Publishing Office FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 63 IP-Enabled Services AGENCY: Federal Communications Commission ACTION: Final rule... interconnected Voice over Internet Protocol (VoIP) service the discontinuance obligations that apply to domestic...

  10. Letter to Editor: Electronic Medical Record, Step toward Improving the Quality of Healthcare Services and Treatment Provided to Patients

    Directory of Open Access Journals (Sweden)

    Elahe Gozali


    Full Text Available Information technology can increase the quality of medical care and is a target for many of the pioneers in the development of clinical or medical information. Electronic medical record (EMR, one of such technologies, is a well-known and valuable system to access patient information in hospitals. Electronic medical records which are used for the purpose of providing basic health care are available through a network of computers. All units of the hospital such as examination room, conference room, emergency, patient care units, nursing stations, operating rooms, recovery units, laboratory, radiology, pharmacy and medical records should have access to it. Among its advantages are improved quality of care provided to patients, better organized information, improvement in the timeliness of the process, accuracy and completeness of documentation, patient access to electronic copies of records, prevention of medication errors and allergies, reduced medical errors, immediate access to information in different places, decision support technology and improvement in the process of doing . S urely the use of electronic medical records has created a new dimension to patient care and clinical practice and will provide a comprehensive system to support people in the community and enhance the quality of services provided to them.

  11. The Nutritional Quality of Food Provided from Food Pantries: A Systematic Review of Existing Literature. (United States)

    Simmet, Anja; Depa, Julia; Tinnemann, Peter; Stroebele-Benschop, Nanette


    In many affluent countries, food-insecure households use food pantries to keep their family fed. The long-term dependence of many users on these programs calls for a systematic review of studies on the nutritional quality of food provided by food pantries. The purpose of this systematic review was to summarize the current scientific evidence about the nutritional quality of food bags distributed by food pantries. A systematic literature search was conducted in the electronic databases PubMed, PsycINFO, PsycARTICLES, and Psychology Behavioral Sciences Collection to identify cross-sectional, cohort, and intervention studies reporting baseline data conducted in high-income countries and published between 1980 and 2015, which reported the nutritional quality of food bags distributed by food pantries. Identified citations were screened in two stages and data were independently extracted by two authors using a predefined data sheet. The quality of included studies was evaluated using criteria of an adapted Ottawa Scale. The systematic review was reported in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Applying the two-stage screening, 9 of 1,546 articles were identified for inclusion. Nutritional quality of food bags varied widely between and within studies. Milk products, vitamins A and C, and calcium were provided in particularly low amounts. None of the studies were nationally representative and only a few studies controlled for the household composition of the recipients of food bags. Food pantries likely have a strong influence on users' diets, but the food pantries examined in the selected studies were largely unable to support healthy diets. The distribution of more perishable foods would increase users' diet quality and may have an immense potential to address malnutrition in vulnerable population groups. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  12. The Effect of Primary Care Provider Turnover on Patient Experience of Care and Ambulatory Quality of Care. (United States)

    Reddy, Ashok; Pollack, Craig E; Asch, David A; Canamucio, Anne; Werner, Rachel M


    Primary care provider (PCP) turnover is common and can disrupt patient continuity of care. Little is known about the effect of PCP turnover on patient care experience and quality of care. To measure the effect of PCP turnover on patient experiences of care and ambulatory care quality. Observational, retrospective cohort study of a nationwide sample of primary care patients in the Veterans Health Administration (VHA). We included all patients enrolled in primary care at the VHA between 2010 and 2012 included in 1 of 2 national data sets used to measure our outcome variables: 326,374 patients in the Survey of Healthcare Experiences of Patients (SHEP; used to measure patient experience of care) associated with 8441 PCPs and 184,501 patients in the External Peer Review Program (EPRP; used to measure ambulatory care quality) associated with 6973 PCPs. Whether a patient experienced PCP turnover, defined as a patient whose provider (physician, nurse practitioner, or physician assistant) had left the VHA (ie, had no patient encounters for 12 months). Five patient care experience measures (from SHEP) and 11 measures of quality of ambulatory care (from EPRP). Nine percent of patients experienced a PCP turnover in our study sample. Primary care provider turnover was associated with a worse rating in each domain of patient care experience. Turnover was associated with a reduced likelihood of having a positive rating of their personal physician of 68.2% vs 74.6% (adjusted percentage point difference, -5.3; 95% CI, -6.0 to -4.7) and a reduced likelihood of getting care quickly of 36.5% vs 38.5% (adjusted percentage point difference, -1.1; 95% CI, -2.1 to -0.1). In contrast, PCP turnover was not associated with lower quality of ambulatory care except for a lower likelihood of controlling blood pressure of 78.7% vs 80.4% (adjusted percentage point difference, -1.44; 95% CI, -2.2 to -0.7). In 9 measures of ambulatory care quality, the difference between patients who experienced no

  13. Quality of information about success rates provided on assisted reproductive technology clinic websites in Australia and New Zealand. (United States)

    Hammarberg, Karin; Prentice, Tess; Purcell, Isabelle; Johnson, Louise


    Many factors influence the chance of having a baby with assisted reproductive technologies (ART). A 2016 Australian Competition and Consumer Commission (ACCC) investigation concluded that ART clinics needed to improve the quality of information they provide about chance of ART success. To evaluate changes in the quality of information about success rates provided on the websites of ART clinics in Australia and New Zealand before and after the ACCC investigation. Desktop audits of websites of ART clinics in Australia and New Zealand were conducted in 2016 and 2017 and available information about success rates was scored using a matrix with eight variables and a possible range of scores of 0-9. Of the 54 clinic websites identified in 2016, 32 had unique information and were eligible to be audited. Of these, 29 were also eligible to be audited in 2017. While there was a slight improvement in the mean score from 2016 to 2017 (4.93-5.28), this was not statistically significantly different. Of the 29 clinics, 14 had the same score on both occasions, 10 had a higher and five a lower information quality score in 2017. To allow people who consider ART to make informed decisions about treatment they need comprehensive and accurate information about what treatment entails and what the likely outcomes are. As measured by a scoring matrix, most ART clinics had not improved the quality of the information about success rates following the ACCC investigation. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  14. Increasing supported VoIP flows in WMNs through link-based aggregation

    CSIR Research Space (South Africa)

    Olwal, T


    Full Text Available As Voice over IP (VoIP) becomes a reality, service providers will be able to offer the service to remote and over populated areas that currently are not or are only partially reached by available Public Switched Telephone Network (PSTN...

  15. Space Network IP Services (SNIS): An Architecture for Supporting Low Earth Orbiting IP Satellite Missions (United States)

    Israel, David J.


    The NASA Space Network (SN) supports a variety of missions using the Tracking and Data Relay Satellite System (TDRSS), which includes ground stations in White Sands, New Mexico and Guam. A Space Network IP Services (SNIS) architecture is being developed to support future users with requirements for end-to-end Internet Protocol (IP) communications. This architecture will support all IP protocols, including Mobile IP, over TDRSS Single Access, Multiple Access, and Demand Access Radio Frequency (RF) links. This paper will describe this architecture and how it can enable Low Earth Orbiting IP satellite missions.

  16. Nurses' perception of the quality of care they provide to hospitalized drug addicts: testing the theory of reasoned action. (United States)

    Natan, Merav Ben; Beyil, Valery; Neta, Okev


    A correlational design was used to examine nursing staff attitudes and subjective norms manifested in intended and actual care of drug users based on the Theory of Reasoned Action. One hundred and thirty-five nursing staff from three central Israeli hospitals completed a questionnaire examining theory-based variables as well as sociodemographic and professional characteristics. Most respondents reported a high to very high level of actual or intended care of drug users. Nurses' stronger intentions to provide quality care to drug users were associated with more positive attitudes. Nursing staff members had moderately negative attitudes towards drug users. Nurses were found to hold negative stereotypes of drug addict patients and most considered the management of this group difficult. Positive attitudes towards drug users, perceived expectations of others and perceived correctness of the behaviour are important in their effect on the intention of nurses to provide high-quality care to hospitalized patients addicted to drugs.

  17. Comparison of Quality Oncology Practice Initiative (QOPI) Measure Adherence Between Oncology Fellows, Advanced Practice Providers, and Attending Physicians. (United States)

    Zhu, Jason; Zhang, Tian; Shah, Radhika; Kamal, Arif H; Kelley, Michael J


    Quality improvement measures are uniformly applied to all oncology providers, regardless of their roles. Little is known about differences in adherence to these measures between oncology fellows, advance practice providers (APP), and attending physicians. We investigated conformance across Quality Oncology Practice Initiative (QOPI) measures for oncology fellows, advance practice providers, and attending physicians at the Durham Veterans Affairs Medical Center (DVAMC). Using data collected from the Spring 2012 and 2013 QOPI cycles, we abstracted charts of patients and separated them based on their primary provider. Descriptive statistics and the chi-square test were calculated for each QOPI measure between fellows, advanced practice providers (APPs), and attending physicians. A total of 169 patients were reviewed. Of these, 31 patients had a fellow, 39 had an APP, and 99 had an attending as their primary oncology provider. Fellows and attending physicians performed similarly on 90 of 94 QOPI metrics. High-performing metrics included several core QOPI measures including documenting consent for chemotherapy, recommending adjuvant chemotherapy when appropriate, and prescribing serotonin antagonists when prescribing emetogenic chemotherapies. Low-performing metrics included documentation of treatment summary and taking action to address problems with emotional well-being by the second office visit. Attendings documented the plan for oral chemotherapy more often (92 vs. 63%, P=0.049). However, after the chart audit, we found that fellows actually documented the plan for oral chemotherapy 88% of the time (p=0.73). APPs and attendings performed similarly on 88 of 90 QOPI measures. The quality of oncology care tends to be similar between attendings and fellows overall; some of the significant differences do not remain significant after a second manual chart review, highlighting that the use of manual data collection for QOPI analysis is an imperfect system, and there may

  18. Frequency of high-quality communication behaviors used by primary care providers of heterozygous infants after newborn screening. (United States)

    Farrell, Michael H; Christopher, Stephanie A


    To examine the quality of communication likely to be experienced by parents when being first informed about how newborn screening identified heterozygous "carrier" status for cystic fibrosis or sickle cell disease. Primary care providers (PCPs) of infants found to have carrier status were telephoned over a 48-month period, and asked to rehearse with a standardized patient how they would inform the infants' parent(s). 214 rehearsal transcripts were abstracted using explicit criteria methods to measure the frequency of five categories of high-quality communication behaviors. Overall, PCPs used large amounts of jargon and failed to use high quality communication behaviors. On average, PCPs used 18.6 total jargon words (8.7 unique words), but explained 2.4 jargon words. The most frequent assessment of understanding was the close-ended version, although it was only seen in 129 of 214 transcripts. The most common organizing behavior was importance emphasis (121/214). Precautionary empathy was rare; the most frequent behavior was "instruction about emotion" (33/214). The limited use of high-quality communication behaviors in rehearsals raises concern about parental understanding, decision-making, and psychosocial outcomes after newborn screening. Measurement of specific behaviors may help PCPs to improve communication, and thereby improve the patient experience. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  19. Critical Analysis of the Quality, Readability, and Technical Aspects of Online Information Provided for Neck-Lifts. (United States)

    Rayess, Hani; Zuliani, Giancarlo F; Gupta, Amar; Svider, Peter F; Folbe, Adam J; Eloy, Jean Anderson; Carron, Michael A


    The number of patients using the internet to obtain health information is growing. This material is unregulated and heterogeneous and can influence patient decisions. To compare the quality, readability, and technical aspects of online information about neck-lifts provided by private practice websites vs academic medical centers and reference sources. In this cross-sectional analysis conducted between November 2015 and January 2016, a Google search of the term neck-lift was performed, and the first 45 websites were evaluated. The websites were categorized as private practice vs other. Private websites (PWs) included sites created by private practice physicians. Other websites (OWs) were created by academic medical centers or reference sources. Quality, readability, and technical aspects of online websites related to neck-lifts. Quality was assessed using the DISCERN criteria and the Health on the Net principles (HONcode). Readability was assessed using 7 validated and widely used criteria. Consensus US reading grade level readability was provided by a website ( Twelve technical aspects were evaluated based on criteria specified by medical website creators. Forty-five websites (8 OWs [18%] and 37 PWs [82%]) were analyzed. There was a significant difference in quality between OWs and PWs based on the DISCERN criteria and HONcode principles. The DISCERN overall mean (SD) scores were 2.3 (0.5) for OWs and 1.3 (0.3) for PWs (P analysis, the mean (SD) was 8.6 (1.8) (range, 5-11) for OW, and the mean (SD) was 5.8 (1.7) (range, 2-9) for PW. The mean (SD) readability consensus reading grade level scores were 11.7 (1.9) for OWs and 10.6 (1.9) for PWs. Of a total possible score of 12, the mean (SD) technical scores were 6.3 (1.8) (range, 4-9) for OWs and 6.4 (1.5) (range, 3-9) for PWs. Compared with PWs, OWs had a significantly higher quality score based on both the DISCERN criteria and HONcode principles. The mean readability for OWs and PWs was

  20. IPS guidestar selection for stellar mode (ASTRO) (United States)

    Mullins, Larry; Wooten, Lewis


    This report describes how guide stars are selected for the Optical Sensor Package (OSP) for the Instrument Pointing System (IPS) when it is operating in the stellar mode on the ASTRO missions. It also describes how the objective loads are written and how the various roll angles are related; i.e., the celestial roll or position angle, the objective load roll angles, and the IPS gimbal angles. There is a brief description of how the IPS operates and its various modes of operation; i.e., IDOP, IDIN, and OSPCAL.

  1. Cultivar choice provides options for local production of organic and conventionally produced tomatoes with higher quality and antioxidant content. (United States)

    Aldrich, Heather Troxell; Salandanan, Karen; Kendall, Patricia; Bunning, Marisa; Stonaker, Frank; Külen, Oktay; Stushnoff, Cecil


    Tomatoes (Solanum lycopersicum L.) are widely consumed and well known for their health benefits, many of which have been associated with the high levels of antioxidants present in tomatoes. With a growing interest in local and organic foods, it would be helpful to determine whether farmers could naturally improve the quality and antioxidant content of tomatoes for sale in local markets. This study evaluated antioxidant properties, quality attributes, and yield for 10 tomato cultivars grown for 2 years using certified organic and conventional practices. Cultivar and year effects impacted (P < 0.05) all tests conducted, while growing method influenced (P < 0.05) yield, soluble solids content, ascorbic acid, and antioxidant radical scavenging capacity. Even when accounting for year-to-year variability, cultivars in the highest groups had 1.35- to 1.67-fold higher antioxidant levels than cultivars in the lowest groups. 'New Girl', 'Jet Star', 'Fantastic', and 'First Lady' were always in the highest groups, while 'Roma' and 'Early Girl' consistently had the lowest antioxidant content. Compared to production practices and environmental effects of years that are generally beyond the control of small-scale producers, choice of cultivar provides the simplest and most effective means of increasing antioxidant properties. Knowledge of tomato cultivars with naturally higher antioxidant levels could assist smaller-scale producers to grow fruit that may provide a competitive advantage and the opportunity to capitalize on the increasing popularity of locally grown, high-quality fresh produce. Copyright © 2010 Society of Chemical Industry.

  2. IP, ethernet and MPLS networks resource and fault management

    CERN Document Server

    Perez, André


    This book summarizes the key Quality of Service technologies deployed in telecommunications networks: Ethernet, IP, and MPLS. The QoS of the network is made up of two parts: fault and resource management. Network operation quality is among the functions to be fulfilled in order to offer QoS to the end user. It is characterized by four parameters: packet loss, delay, jitter or the variation of delay over time, and availability. Resource management employs mechanisms that enable the first three parameters to be guaranteed or optimized. Fault management aims to ensure continuity of service.

  3. 77 FR 33227 - Assessment Questionnaire-IP Sector Specific Agency Risk Self Assessment Tool (IP-SSARSAT) (United States)


    ... SECURITY Assessment Questionnaire--IP Sector Specific Agency Risk Self Assessment Tool (IP-SSARSAT) AGENCY... Protection and Programs Directorate (NPPD), Office of Infrastructure Protection (IP), Sector Outreach and...--Assessment Questionnaire--IP Sector Specific Agency Risk Self Assessment Tool (IP-SSARSAT). DHS previously...

  4. Protecting LHC IP1/IP5 Components Against Radiation Resulting from Colliding Beam Interactions

    CERN Document Server

    Mokhov, N V; Kerby, J S; Strait, J B


    Beam-induced energy deposition in the LHC high luminosity interaction region (IR) components due to both pp collisions and beam loss in the IR vicinity is a significant challenge for the design of the high luminosity insertions. It was shown in our previous studies that a set of absorbers would reduce both the peak power density and total heat load to tolerable levels. In this paper the results of further optimization and comprehensive MARS calculations are summarized for the LHC lattice, version 6.4, for the updated IP1 and IP5 layouts and a baseline pp-collision source term. Power density, power dissipation, particle fluxes and spectra, accumulated dose and residual dose rates are studied in the components of the inner triplets including their TAS absorbers, the TAN neutral beam absorbers, separation dipoles, and quadrupoles of the outer triplets and possible collimators there. Results are given for the nominal luminosity of 1034 cm-2 s-1. The current design is proved to provide the best safety margin under...

  5. VoIP Session Capacity Expansion with Packet Transmission Suppression Control in Wireless LAN (United States)

    Morioka, Yasufumi; Higashino, Takeshi; Tsukamoto, Katsutoshi; Komaki, Shozo

    This paper proposes a VoIP (Voice over Internet Protocol) session capacity expansion method that uses periodic packet transmission suppression control for wireless LANs. The proposed method expands the VoIP session capacity of an AP without critically degrading the QoS (Quality of Service) of all stations. Simulation results show the proposed method with 0.5% packet suppression control on each station expands a VoIP session capacity by up to 5% compared to a legacy method while satisfying required QoS for all stations.

  6. Continuous quality improvement programs provide new opportunities to drive value innovation initiatives in hospital-based radiology practices. (United States)

    Steele, Joseph R; Schomer, Don F


    Imaging services constitute a huge portion of the of the total dollar investment within the health care enterprise. Accordingly, this generates competition among medical specialties organized along service lines for their pieces of the pie and increased scrutiny from third-party payers and government regulators. These market and political forces create challenge and opportunity for a hospital-based radiology practice. Clearly, change that creates or builds greater value for patients also creates sustainable competitive advantage for a radiology practice. The somewhat amorphous concept of quality constitutes a significant value driver for innovation in this scenario. Quality initiatives and programs seek to define and manage this amorphous concept and provide tools for a radiology practice to create or build more value. Leadership and the early adoption of these inevitable programs by a radiology practice strengthens relationships with hospital partners and slows the attrition of imaging service lines to competitors.

  7. Narrative review of provider behavior in primary care behavioral health: How process data can inform quality improvement. (United States)

    Beehler, Gregory P; Lilienthal, Kaitlin R; Possemato, Kyle; Johnson, Emily M; King, Paul R; Shepardson, Robyn L; Vair, Christina L; Reyner, Jacqueline; Funderburk, Jennifer S; Maisto, Stephen A; Wray, Laura O


    Primary care behavioral health (PCBH) is a population-based approach to delivering mental and behavioral health care in the primary care setting. Implementation of the PCBH model varies across practice settings, which can impact how PCBH providers deliver services to patients and in turn may predict a variety of important outcomes. This article aims to characterize PCBH provider engagement in key processes of integrated care as demonstrated in results from empirical studies of real-world clinical practice. For this narrative review of published studies on PCBH provider engagement in processes of care, PubMed and PsycINFO databases were searched from January 1990 through May 2016 to identify relevant articles. Provider adherence to the brief, time-limited treatment model appears suboptimal. Common mental health conditions, such as depression, were often the primary focus of provider attention, with less consistent emphasis on behavioral medicine concerns. Whereas providers regularly conducted qualitative functional assessments with patients, routine use of standardized measures was low. Engagement in interprofessional collaboration with the primary care team was also low, but engagement in behaviors that fostered therapeutic relationships was high. This review identified several strengths and weaknesses of typical PCBH provider practices. Results are discussed in relation to their value as areas for future quality improvement initiatives that can improve PCBH service delivery and, ultimately, patient outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  8. ChIP-seq Analysis of Human Chronic Myeloid Leukemia Cells. (United States)

    Anders, Lars; Li, Zhaodong


    Many transcription factors, chromatin-associated proteins and regulatory DNA elements are genetically and/or epigenetically altered in cancer, including Chronic Myeloid Leukemia (CML). This leads to deregulation of transcription that is often causally linked to the tumorigenic state. Chromatin-immunoprecipitation coupled with massively parallel DNA sequencing (ChIP-seq) is the key technology to study transcription as it allows in vivo whole-genome mapping of epigenetic modifications and interactions of proteins with DNA or chromatin. However, numerous DNA/chromatin-binding proteins, including EZH2, remain difficult to "ChIP," thus yielding genome-wide binding maps of only suboptimal quality. Here, we describe a ChIP-seq protocol optimized for high-quality protein-genome binding maps that have proven especially useful for studying difficult to 'ChIP' transcription regulatory factors in Chronic Myeloid Leukemia (CML) and related malignancies.

  9. Providing Doctors With High-Quality Information: An Updated Evaluation of Web-Based Point-of-Care Information Summaries. (United States)

    Kwag, Koren Hyogene; González-Lorenzo, Marien; Banzi, Rita; Bonovas, Stefanos; Moja, Lorenzo


    The complexity of modern practice requires health professionals to be active information-seekers. Our aim was to review the quality and progress of point-of-care information summaries-Web-based medical compendia that are specifically designed to deliver pre-digested, rapidly accessible, comprehensive, and periodically updated information to health care providers. We aimed to evaluate product claims of being evidence-based. We updated our previous evaluations by searching Medline, Google, librarian association websites, and conference proceedings from August 2012 to December 2014. We included Web-based, regularly updated point-of-care information summaries with claims of being evidence-based. We extracted data on the general characteristics and content presentation of products, and we quantitatively assessed their breadth of disease coverage, editorial quality, and evidence-based methodology. We assessed potential relationships between these dimensions and compared them with our 2008 assessment. We screened 58 products; 26 met our inclusion criteria. Nearly a quarter (6/26, 23%) were newly identified in 2014. We accessed and analyzed 23 products for content presentation and quantitative dimensions. Most summaries were developed by major publishers in the United States and the United Kingdom; no products derived from low- and middle-income countries. The main target audience remained physicians, although nurses and physiotherapists were increasingly represented. Best Practice, Dynamed, and UptoDate scored the highest across all dimensions. The majority of products did not excel across all dimensions: we found only a moderate positive correlation between editorial quality and evidence-based methodology (r=.41, P=.0496). However, all dimensions improved from 2008: editorial quality (P=.01), evidence-based methodology (P=.015), and volume of diseases and medical conditions (PUptoDate scored the highest across all dimensions, while others that were marketed as evidence

  10. Intellectual Property and Strategic Agreements (IP/SA) | FNLCR (United States)

    What does IP/SA handle? IP/SA handles all invention issues including patents and copyrights. All employee inventionreports are filed through the IP/SA office for all activities under the OTS contract.Additionally,&nbs

  11. Assessment of the impact of quality improvement interventions on the quality of sick child care provided by Health Extension Workers in Ethiopia. (United States)

    Miller, Nathan P; Amouzou, Agbessi; Hazel, Elizabeth; Legesse, Hailemariam; Degefie, Tedbabe; Tafesse, Mengistu; Black, Robert E; Bryce, Jennifer


    Ethiopia has scaled up integrated community case management of childhood illness (iCCM), including several interventions to improve the performance of Health Extension Workers (HEWs). We assessed associations between interventions to improve iCCM quality of care and the observed quality of care among HEWs. We assessed iCCM implementation strength and quality of care provided by HEWs in Ethiopia. Multivariate logistic regression analyses were performed to assess associations between interventions to improve iCCM quality of care and correct management of iCCM illnesses. Children who were managed by an HEW who had attended a performance review and clinical mentoring meeting (PRCMM) had 8.3 (95% confidence interval (CI) 2.34-29.51) times the odds of being correctly managed, compared to children managed by an HEW who did not attend a PRCMM. Management by an HEW who received follow-up training also significantly increased the odds of correct management (odds ratio (OR) = 2.09, 95% CI 1.05-4.18). Supervision on iCCM (OR = 0.63, 95% CI 0.23-1.72) did not significantly affect the odds of receiving correct care. These results suggest PRCMM and follow-up training were effective interventions, while implementation of supportive supervision needs to be reviewed to improve impact.

  12. Providing High Quality Care in Low-Income Areas of Maryland: Definitions, Resources, and Challenges from Parents and Child Care Providers' Perspectives. Publication #2012-45 (United States)

    Forry, Nicole; Simkin, Shana; Wessel, Julia; Rodrigues, Katherine


    Early life experiences are critical to a child's development. Research has shown that, for a variety of reasons, children born into low-income families are at a disadvantage when compared to their higher-income peers. Fortunately, research has also shown a positive association between high quality child care and the academic and social-emotional…

  13. Sequential chromatin immunoprecipitation protocol for global analysis through massive parallel sequencing (reChIP-seq)




    Authors: Marco Antonio Mendoza-Parra, Shankaranarayanan Pattabhiraman & Hinrich Gronemeyer ### Abstract Chromatin immunoprecipitation combined with massive parallel sequencing (ChIP-seq) is increasingly used to study protein-chromatin interactions or local epigenetic modifications at genome-wide scale. ChIP-seq can be performed directly with several ng of immunoprecipitated DNA, which is generally obtained from a several million cells, depending on the quality of the antibody. ChI...

  14. Informal cash payments for birth in Hungary: Are women paying to secure a known provider, respect, or quality of care? (United States)

    Baji, Petra; Rubashkin, Nicholas; Szebik, Imre; Stoll, Kathrin; Vedam, Saraswathi


    In Central and Eastern Europe, many women make informal cash payments to ensure continuity of provider, i.e., to have a "chosen" doctor who provided their prenatal care, be present for birth. High rates of obstetric interventions and disrespectful maternity care are also common to the region. No previous study has examined the associations among informal payments, intervention rates, and quality of maternity care. We distributed an online cross-sectional survey in 2014 to a nationally representative sample of Hungarian internet-using women (N = 600) who had given birth in the last 5 years. The survey included items related to socio-demographics, type of provider, obstetric interventions, and experiences of care. Women reported if they paid informally, and how much. We built a two-part model, where a bivariate probit model was used to estimate conditional probabilities of women paying informally, and a GLM model to explore the amount of payments. We calculated marginal effects of the covariates (provider choice, interventions, respectful care). Many more women (79%) with a chosen doctor paid informally (191 euros on average) compared to 17% of women without a chosen doctor (86 euros). Based on regression analysis, the chosen doctor's presence at birth was the principal determinant of payment. Intervention and procedure rates were significantly higher for women with a chosen doctor versus without (cesareans 45% vs. 33%; inductions 32% vs. 19%; episiotomy 75% vs. 62%; epidural 13% vs. 5%), but had no direct effect on payments. Half of the sample (42% with a chosen doctor, 62% without) reported some form of disrespectful care, but this did not reduce payments. Despite reporting disrespect and higher rates of interventions, women rewarded the presence of a chosen doctor with informal payments. They may be unaware of evidence-based standards, and trust that their chosen doctor provided high quality maternity care. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Surgical innovation-enhanced quality and the processes that assure patient/provider safety: A surgical conundrum. (United States)

    Bruny, Jennifer; Ziegler, Moritz


    Innovation is a crucial part of surgical history that has led to enhancements in the quality of surgical care. This comprises both changes which are incremental and those which are frankly disruptive in nature. There are situations where innovation is absolutely required in order to achieve quality improvement or process improvement. Alternatively, there are innovations that do not necessarily arise from some need, but simply are a new idea that might be better. All change must assure a significant commitment to patient safety and beneficence. Innovation would ideally enhance patient care quality and disease outcomes, as well stimulate and facilitate further innovation. The tensions between innovative advancement and patient safety, risk and reward, and demonstrated effectiveness versus speculative added value have created a contemporary "surgical conundrum" that must be resolved by a delicate balance assuring optimal patient/provider outcomes. This article will explore this delicate balance and the rules that govern it. Recommendations are made to facilitate surgical innovation through clinical research. In addition, we propose options that investigators and institutions may use to address competing priorities. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Trifocal intraocular lenses: a comparison of the visual performance and quality of vision provided by two different lens designs

    Directory of Open Access Journals (Sweden)

    Gundersen KG


    Full Text Available Kjell G Gundersen,1 Rick Potvin2 1IFocus Øyeklinikk AS, Haugesund, Norway; 2Science in Vision, Akron, NY, USA Purpose: To compare two different diffractive trifocal intraocular lens (IOL designs, evaluating longer-term refractive outcomes, visual acuity (VA at various distances, low contrast VA and quality of vision.Patients and methods: Patients with binocularly implanted trifocal IOLs of two different designs (FineVision [FV] and Panoptix [PX] were evaluated 6 months to 2 years after surgery. Best distance-corrected and uncorrected VA were tested at distance (4 m, intermediate (80 and 60 cm and near (40 cm. A binocular defocus curve was collected with the subject’s best distance correction in place. The preferred reading distance was determined along with the VA at that distance. Low contrast VA at distance was also measured. Quality of vision was measured with the National Eye Institute Visual Function Questionnaire near subset and the Quality of Vision questionnaire.Results: Thirty subjects in each group were successfully recruited. The binocular defocus curves differed only at vergences of −1.0 D (FV better, P=0.02, −1.5 and −2.00 D (PX better, P<0.01 for both. Best distance-corrected and uncorrected binocular vision were significantly better for the PX lens at 60 cm (P<0.01 with no significant differences at other distances. The preferred reading distance was between 42 and 43 cm for both lenses, with the VA at the preferred reading distance slightly better with the PX lens (P=0.04. There were no statistically significant differences by lens for low contrast VA (P=0.1 or for quality of vision measures (P>0.3.Conclusion: Both trifocal lenses provided excellent distance, intermediate and near vision, but several measures indicated that the PX lens provided better intermediate vision at 60 cm. This may be important to users of tablets and other handheld devices. Quality of vision appeared similar between the two lens designs

  17. DNA end resection by CtIP and exonuclease 1 prevents genomic instability

    DEFF Research Database (Denmark)

    Eid, Wassim; Steger, Martin; El-Shemerly, Mahmoud


    ). In this study, we show that the localization of EXO1 to DSBs depends on both CtIP and MRN. We also establish that CtIP interacts with EXO1 and restrains its exonucleolytic activity in vitro. Finally, we show that on exposure to camptothecin, depletion of EXO1 in CtIP-deficient cells increases the frequency......End resection of DNA-which is essential for the repair of DNA double-strand breaks (DSBs) by homologous recombination-relies first on the partnership between MRE11-RAD50-NBS1 (MRN) and CtIP, followed by a processive step involving helicases and exonucleases such as exonuclease 1 (EXO1...... of DNA-PK-dependent radial chromosome formation. Thus, our study identifies new functions of CtIP and EXO1 in DNA end resection and provides new information on the regulation of DSB repair pathways, which is a key factor in the maintenance of genome integrity....

  18. Non-canonical protein-DNA interactions identified by ChIP are not artifacts (United States)


    Background ChIP-chip and ChIP-seq are widely used methods to map protein-DNA interactions on a genomic scale in vivo. Waldminghaus and Skarstad recently reported, in this journal, a modified method for ChIP-chip. Based on a comparison of our previously-published ChIP-chip data for Escherichia coli σ32 with their own data, Waldminghaus and Skarstad concluded that many of the σ32 targets identified in our earlier work are false positives. In particular, we identified many non-canonical σ32 targets that are located inside genes or are associated with genes that show no detectable regulation by σ32. Waldminghaus and Skarstad propose that such non-canonical sites are artifacts, identified due to flaws in the standard ChIP methodology. Waldminghaus and Skarstad suggest specific changes to the standard ChIP procedure that reportedly eliminate the claimed artifacts. Results We reanalyzed our published ChIP-chip datasets for σ32 and the datasets generated by Waldminghaus and Skarstad to assess data quality and reproducibility. We also performed targeted ChIP/qPCR for σ32 and an unrelated transcription factor, AraC, using the standard ChIP method and the modified ChIP method proposed by Waldminghaus and Skarstad. Furthermore, we determined the association of core RNA polymerase with disputed σ32 promoters, with and without overexpression of σ32. We show that (i) our published σ32 ChIP-chip datasets have a consistently higher dynamic range than those of Waldminghaus and Skarstad, (ii) our published σ32 ChIP-chip datasets are highly reproducible, whereas those of Waldminghaus and Skarstad are not, (iii) non-canonical σ32 target regions are enriched in a σ32 ChIP in a heat shock-dependent manner, regardless of the ChIP method used, (iv) association of core RNA polymerase with some disputed σ32 target genes is induced by overexpression of σ32, (v) σ32 targets disputed by Waldminghaus and Skarstad are predominantly those that are most weakly bound, and (vi) the

  19. Can a mobile app improve the quality of patient care provided by trainee doctors? Analysis of trainees' case reports. (United States)

    Webb, Katie; Bullock, Alison; Dimond, Rebecca; Stacey, Mark


    To explore how a medical textbook app ('iDoc') supports newly qualified doctors in providing high-quality patient care. The iDoc project, funded by the Wales Deanery, provides new doctors with an app which gives access to key medical textbooks. Participants' submitted case reports describing self-reported accounts of specific instances of app use. The size of the data set enabled analysis of a subsample of 'complex' case reports. Of the 568 case reports submitted by Foundation Year 1s (F1s)/Year 2s (F2s), 142 (25%) detailed instances of diagnostic decision-making and were identified as 'complex'. We analysed these data against the Quality Improvement (QI) Framework using thematic content analysis. Clinical settings across Wales, UK. Newly qualified doctors (2012-2014; n=114), F1 and F2. The iDoc app, powered by Dr Companion software, provided newly qualified doctors in Wales with a selection of key medical textbooks via individuals' personal smartphone. Doctors' use of the iDoc app supported 5 of the 6 QI elements: efficiency, timeliness, effectiveness, safety and patient-centredness. None of the case reports were coded to the equity element. Efficiency was the element which attracted the highest number of case report references. We propose that the QI Framework should be expanding to include 'learning' as a 7th element. Access to key medical textbooks via an app provides trusted and valuable support to newly qualified doctors during a period of transition. On the basis of these doctors' self-reported accounts, our evidence indicates that the use of the app enhances efficiency, effectiveness and timeliness of patient-care in addition consolidating a safe, patient-centred approach. We propose that there is scope to extend the QI Framework by incorporating 'learning' as a 7th element in recognition of the relationship between providing high-quality care through educational engagement. Published by the BMJ Publishing Group Limited. For permission to use (where not

  20. Editorial: Advances in healthcare provider and patient training to improve the quality and safety of patient care

    Directory of Open Access Journals (Sweden)

    Elizabeth M. Borycki


    Full Text Available This special issue of the Knowledge Management & E-Learning: An International Journal is dedicated to describing “Advances in Healthcare Provider and Patient Training to Improve the Quality and Safety of Patient Care.” Patient safety is an important and fundamental requirement of ensuring the quality of patient care. Training and education has been identified as a key to improving healthcare provider patient safety competencies especially when working with new technologies such as electronic health records and mobile health applications. Such technologies can be harnessed to improve patient safety; however, if not used properly they can negatively impact on patient safety. In this issue we focus on advances in training that can improve patient safety and the optimal use of new technologies in healthcare. For example, use of clinical simulations and online computer based training can be employed both to facilitate learning about new clinical discoveries as well as to integrate technology into day to day healthcare practices. In this issue we are publishing papers that describe advances in healthcare provider and patient training to improve patient safety as it relates to the use of educational technologies, health information technology and on-line health resources. In addition, in the special issue we describe new approaches to training and patient safety including, online communities, clinical simulations, on-the-job training, computer based training and health information systems that educate about and support safer patient care in real-time (i.e. when health professionals are providing care to patients. These educational and technological initiatives can be aimed at health professionals (i.e. students and those who are currently working in the field. The outcomes of this work are significant as they lead to safer care for patients and their family members. The issue has both theoretical and applied papers that describe advances in patient

  1. Research on customer satisfaction with the quality of services provided by public utilities of the city of Belgrade

    Directory of Open Access Journals (Sweden)

    Živković Radmila


    Full Text Available Monopoly market conditions, in which public companies used to operate ten to twenty years ago, substantially dictated the way of considering and creating business of public companies in Serbia. However, introduction of changes to the environment, such as more intensive competition and changes of needs and demands of the customers requires abandoning old orientations to business. Public companies are in position to create and offer a higher level of service quality, based on better and more intensified communication with their customers. Public enterprises are monitored by public authorities, especially in the areas of restrictions on the choice of business strategies, pricing and price restrictions, selection of suppliers and the like. On the other hand, there is a branch competition occurring, on which public companies must count. In such an environment, creating effective services should be the key strategic objective for the development of public utility companies of the city of Belgrade. Service companies should be modern service companies, able to actively participate in the market, looking upon customers - citizens as users of their services. The aim of the research is to determine the perception of value and customer satisfaction with the services provided by the public utilities of Belgrade. The results of the study indicate that respondents are not satisfied with provided services and do not have clearly defined attitudes towards key aspects of public enterprises, which are supposed to be important for positioning and improving the quality of services in the market.

  2. Dissemination Approaches to Participating Primary Care Providers in a Quality Improvement Program Addressing Opioid Use in Central Appalachia. (United States)

    Cardarelli, Roberto; Workman, Charlotte Sue; Weatherford, Sarah; Whanger, Stacey; King, Dana E


    Practice-based research networks (PBRNs) have been described as new clinical laboratories for primary care research and dissemination. PBRNs, however, have struggled to disseminate research results in a meaningful way to participating providers and clinics. The Central Appalachia Inter-Professional Pain Education Collaborative was developed to work with PBRN clinics using quality improvement methods, deliver statewide continuing education activities to address the issue of opioid use in patients with chronic pain, and develop a multimodal mechanism to disseminate project results to clinics and participating providers. Successful change in the delivery of chronic pain care was dependent on the clinic's commitment to a team-based, patient-centered approach. Statistically significant improvements were shown in 10 of 16 process measures, and 80% of the participants agreed that the quality improvement process activity increased their knowledge and would improve their performance in managing patients with chronic pain, as well as patient outcomes in their practice. The Central Appalachia Inter-Professional Pain Education Collaborative project used an extensive and innovative dissemination plan under the rubric of "continual dissemination." Unlike traditional dissemination efforts that focus on summary presentations, this initiative used a continual dissemination approach that updated participants quarterly through multiple means throughout the project, which improved engagement in the project.

  3. Multi-layer service function chaining scheduling based on auxiliary graph in IP over optical network (United States)

    Li, Yixuan; Li, Hui; Liu, Yuze; Ji, Yuefeng


    Software Defined Optical Network (SDON) can be considered as extension of Software Defined Network (SDN) in optical networks. SDON offers a unified control plane and makes optical network an intelligent transport network with dynamic flexibility and service adaptability. For this reason, a comprehensive optical transmission service, able to achieve service differentiation all the way down to the optical transport layer, can be provided to service function chaining (SFC). IP over optical network, as a promising networking architecture to interconnect data centers, is the most widely used scenarios of SFC. In this paper, we offer a flexible and dynamic resource allocation method for diverse SFC service requests in the IP over optical network. To do so, we firstly propose the concept of optical service function (OSF) and a multi-layer SFC model. OSF represents the comprehensive optical transmission service (e.g., multicast, low latency, quality of service, etc.), which can be achieved in multi-layer SFC model. OSF can also be considered as a special SF. Secondly, we design a resource allocation algorithm, which we call OSF-oriented optical service scheduling algorithm. It is able to address multi-layer SFC optical service scheduling and provide comprehensive optical transmission service, while meeting multiple optical transmission requirements (e.g., bandwidth, latency, availability). Moreover, the algorithm exploits the concept of Auxiliary Graph. Finally, we compare our algorithm with the Baseline algorithm in simulation. And simulation results show that our algorithm achieves superior performance than Baseline algorithm in low traffic load condition.

  4. Combining QOF data with the care bundle approach may provide a more meaningful measure of quality in general practice

    Directory of Open Access Journals (Sweden)

    de Wet Carl


    Full Text Available Abstract Background A significant minority of patients do not receive all the evidence-based care recommended for their conditions. Health care quality may be improved by reducing this observed variation. Composite measures offer a different patient-centred perspective on quality and are utilized in acute hospitals via the ‘care bundle’ concept as indicators of the reliability of specific (evidence-based care delivery tasks and improved outcomes. A care bundle consists of a number of time-specific interventions that should be delivered to every patient every time. We aimed to apply the care bundle concept to selected QOF data to measure the quality of evidence-based care provision. Methods Care bundles and components were selected from QOF indicators according to defined criteria. Five clinical conditions were suitable for care bundles: Secondary Prevention of Coronary Heart Disease (CHD, Stroke & Transient Ischaemic Attack (TIA, Chronic Kidney Disease (CKD, Chronic Obstructive Pulmonary Disease (COPD and Diabetes Mellitus (DM. Each bundle has 3-8 components. A retrospective audit was undertaken in a convenience sample of nine general medical practices in the West of Scotland. Collected data included delivery (or not of individual bundle components to all patients included on specific disease registers. Practice level and overall compliance with bundles and components were calculated in SPSS and expressed as a percentage. Results Nine practices (64.3% with a combined patient population of 56,948 were able to provide data in the format requested. Overall compliance with developed QOF-based care bundles (composite measures was as follows: CHD 64.0%, range 35.0-71.9%; Stroke/TIA 74.1%, range 51.6-82.8%; CKD 69.0%, range 64.0-81.4%; and COPD 82.0%, range 47.9-95.8%; and DM 58.4%, range 50.3-65.2%. Conclusions In this small study compliance with individual QOF-based care bundle components was high, but overall (‘all or nothing’ compliance was

  5. M1 ipRGCs Influence Visual Function through Retrograde Signaling in the Retina. (United States)

    Prigge, Cameron L; Yeh, Po-Ting; Liou, Nan-Fu; Lee, Chi-Chan; You, Shih-Feng; Liu, Lei-Lei; McNeill, David S; Chew, Kylie S; Hattar, Samer; Chen, Shih-Kuo; Zhang, Dao-Qi


    Melanopsin-expressing intrinsically photosensitive retinal ganglion cells (ipRGCs, with five subtypes named M1-M5) are a unique subclass of RGCs with axons that project directly to many brain nuclei involved in non-image-forming functions such as circadian photoentrainment and the pupillary light reflex. Recent evidence suggests that melanopsin-based signals also influence image-forming visual function, including light adaptation, but the mechanisms involved are unclear. Intriguingly, a small population of M1 ipRGCs have intraretinal axon collaterals that project toward the outer retina. Using genetic mouse models, we provide three lines of evidence showing that these axon collaterals make connections with upstream dopaminergic amacrine cells (DACs): (1) ipRGC signaling to DACs is blocked by tetrodotoxin both in vitro and in vivo, indicating that ipRGC-to-DAC transmission requires voltage-gated Na(+) channels; (2) this transmission is partly dependent on N-type Ca(2+) channels, which are possibly expressed in the axon collateral terminals of ipRGCs; and (3) fluorescence microscopy reveals that ipRGC axon collaterals make putative presynaptic contact with DACs. We further demonstrate that elimination of M1 ipRGCs attenuates light adaptation, as evidenced by an impaired electroretinogram b-wave from cones, whereas a dopamine receptor agonist can potentiate the cone-driven b-wave of retinas lacking M1 ipRGCs. Together, the results strongly suggest that ipRGCs transmit luminance signals retrogradely to the outer retina through the dopaminergic system and in turn influence retinal light adaptation. Melanopsin-expressing intrinsically photosensitive retinal ganglion cells (ipRGCs) comprise a third class of retinal photoreceptors that are known to mediate physiological responses such as circadian photoentrainment. However, investigation into whether and how ipRGCs contribute to vision has just begun. Here, we provide convergent anatomical and physiological evidence that

  6. Do childcare menus meet nutrition guidelines? Quantity, variety and quality of food provided in New Zealand Early Childhood Education services. (United States)

    Gerritsen, Sarah; Dean, Brianna; Morton, Susan M B; Wall, Clare R


    To describe food provision and evaluate menus in New Zealand childcare services, determining associations with service characteristics and/or cost of menu. Licensed services in three regions of New Zealand participated in an online survey, uploading a weekly menu where applicable. Menus were scored for compliance with guidelines on quantity, variety and quality of foods served. Bivariate and multivariate associations between menu score and service characteristics were analysed. A total of 257 services participated (30% of 847 services invited). Food was provided daily in 56%, with 34% providing lunch and snacks daily. Of the 57 full menus analysed, only three (5%) met all 10 scoring criteria (mean score of 6.8/10). Higher menu scores were statistically associated with employing a cook, high and low (not medium) neighbourhood deprivation, the Heart Foundation's Healthy Heart Award program; there was no association with food costs. The Healthy Heart Award remained statistically associated with higher menu score after adjustment for other service characteristics. Most menus did not meet current nutrition guidelines for quantity, variety, and limiting 'sometimes' and 'occasional' foods. Implications for public health: This study provides a baseline for monitoring menu compliance in New Zealand and evidence for nutrition promotion and menu improvement programmes in early education. © 2017 The Authors.

  7. Impact of a service provider incentive payment scheme on quality of reproductive and child-health services in Egypt. (United States)

    Huntington, Dale; Zaky, Hassan H M; Shawky, Sherine; Fattah, Faten Abdel; El-Hadary, Eman


    A case-control, quasi-experimental study was designed (post-test only) to investigate the effect of a performance-based incentive payment scheme on behaviours of public-sector service providers in delivering a basic package of maternal and child-health services in Egyptian primary healthcare units. The results showed significant improvements in the quality of family-planning, antenatal care, and child-care services as reported by women seen in clinics where the incentive payment scheme was in operation as measured by various indicators, including both technical and inter-personal communication content. An analysis of characteristics of the service providers and clients found no significant or meaningful differences between the study groups, and the facilities of both the study groups were essentially the same. Some findings are suggestive of other influences on behaviours of the service providers not captured by the data-collection instruments of the study. Subsequent to this study, the payment scheme has been rolled out to other districts in Egypt.

  8. Integrative analysis of ChIP-chip and ChIP-seq dataset. (United States)

    Zhu, Lihua Julie


    Epigenetic regulation and interactions between transcription factors and regulatory genomic regions play crucial roles in controlling transcriptional regulatory networks that drive development, environmental responses, and disease. Chromatin immunoprecipitation (ChIP) followed by high-throughput sequencing (ChIP-seq) and ChIP followed by genomic tiling microarray hybridization (ChIP-chip) are the two of the most widely used technologies for genome-wide identification of DNA protein interactions and histone modification in vivo. Many algorithms and tools have been developed and evaluated that allow identification of transcription factor binding sites from ChIP-seq or ChIP-chip datasets. However, binding site identification is only the first step; the ultimate goal is to discover the regulatory network of the transcription factor (TF). Here, we present a common workflow for downstream analysis of ChIP-chip and ChIP-seq with an emphasis on annotating binding sites and integration with gene expression data to identify direct and indirect targets of the TF. These tools will help with the overall goal of unraveling transcriptional regulatory networks using datasets publicly available in GEO.

  9. Analysis and proposed model of family caregivers' relationships with home health providers and perceptions of the quality of formal services. (United States)

    Funk, Laura; Stajduhar, Kelli


    Relationships between families and home health nurses promote effective care and service access for those at end of life, positive caregiver experiences, and satisfaction with care. This study explores family caregivers' accounts of relationships with home care nurses; findings inform a model of relationships and satisfaction with home health services. Ethnographic, qualitative interviews were conducted with 26 bereaved caregivers in one Western Canadian regional health agency. Data analysis was informed by symbolic interactionism. Participants described their relationships with home care nurses and spoke about their assessments of the care provided. Findings highlighted the importance of the length, frequency, and continuity of contact, conversation, socializing, and sharing information. Participants were cognizant of their own and care recipients' roles in building relationship. Nurse behaviors demonstrating affection, acknowledgment, commitment, and understanding were appreciated. A model links relationship preconditions, relational demonstrations, and perceived care quality and may be used to identify points of intervention.

  10. AHT-ChIP-seq: a completely automated robotic protocol for high-throughput chromatin immunoprecipitation. (United States)

    Aldridge, Sarah; Watt, Stephen; Quail, Michael A; Rayner, Tim; Lukk, Margus; Bimson, Michael F; Gaffney, Daniel; Odom, Duncan T


    ChIP-seq is an established manually-performed method for identifying DNA-protein interactions genome-wide. Here, we describe a protocol for automated high-throughput (AHT) ChIP-seq. To demonstrate the quality of data obtained using AHT-ChIP-seq, we applied it to five proteins in mouse livers using a single 96-well plate, demonstrating an extremely high degree of qualitative and quantitative reproducibility among biological and technical replicates. We estimated the optimum and minimum recommended cell numbers required to perform AHT-ChIP-seq by running an additional plate using HepG2 and MCF7 cells. With this protocol, commercially available robotics can perform four hundred experiments in five days.

  11. Satisfaction with Quality of Care Received by Patients without ...

    African Journals Online (AJOL)


    Original Article. [Downloaded free from on Tuesday, April 23, 2013, IP:] || Click here to download free Android application for this journal ... and hospital management on the quality of care provided with the aim of ..... behavior and coping mechanisms and overall quality of life of patients.

  12. Electronic symptom reporting between patient and provider for improved health care service quality: a systematic review of randomized controlled trials. part 2: methodological quality and effects. (United States)

    Johansen, Monika Alise; Berntsen, Gro K Rosvold; Schuster, Tibor; Henriksen, Eva; Horsch, Alexander


    We conducted in two parts a systematic review of randomized controlled trials (RCTs) on electronic symptom reporting between patients and providers to improve health care service quality. Part 1 reviewed the typology of patient groups, health service innovations, and research targets. Four innovation categories were identified: consultation support, monitoring with clinician support, self-management with clinician support, and therapy. To assess the methodological quality of the RCTs, and summarize effects and benefits from the methodologically best studies. We searched Medline, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, and IEEE Xplore for original studies presented in English-language articles between 1990 and November 2011. Risk of bias and feasibility were judged according to the Cochrane recommendation, and theoretical evidence and preclinical testing were evaluated according to the Framework for Design and Evaluation of Complex Interventions to Improve Health. Three authors assessed the risk of bias and two authors extracted the effect data independently. Disagreement regarding bias assessment, extraction, and interpretation of results were resolved by consensus discussions. Of 642 records identified, we included 32 articles representing 29 studies. No articles fulfilled all quality requirements. All interventions were feasible to implement in a real-life setting, and theoretical evidence was provided for almost all studies. However, preclinical testing was reported in only a third of the articles. We judged three-quarters of the articles to have low risk for random sequence allocation and approximately half of the articles to have low risk for the following biases: allocation concealment, incomplete outcome data, and selective reporting. Slightly more than one fifth of the articles were judged as low risk for blinding of outcome assessment. Only 1 article had low risk of bias for blinding of participants and personnel. We excluded 12

  13. VoIP for Telerehabilitation: A Pilot Usability Study for HIPAA Compliance

    Directory of Open Access Journals (Sweden)

    Valerie R. Watzlaf


    Full Text Available Consumer-based, free Voice and video over the Internet Protocol (VoIP software systems such as Skype and others are used by health care providers to deliver telerehabilitation and other health-related services to clients. Privacy and security applications as well as HIPAA compliance within these protocols have been questioned by practitioners, health information managers, and other healthcare entities. This pilot usability study examined whether four respondents who used the top three, free consumer-based, VoIP software systems perceived these VoIP technologies to be private, secure, and HIPAA compliant;  most did not.  While the pilot study limitations include the number of respondents and systems assessed, the protocol can be applied to future research and replicated for instructional purposes.  Recommendations are provided for VoIP companies, providers, and users. 

  14. Optimization of OSPF Routing in IP Networks (United States)

    Bley, Andreas; Fortz, Bernard; Gourdin, Eric; Holmberg, Kaj; Klopfenstein, Olivier; Pióro, Michał; Tomaszewski, Artur; Ümit, Hakan

    The Internet is a huge world-wide packet switching network comprised of more than 13,000 distinct subnetworks, referred to as Autonomous Systems (ASs) autonomous system AS . They all rely on the Internet Protocol (IP) internet protocol IP for transport of packets across the network. And most of them use shortest path routing protocols shortest path routing!protocols , such as OSPF or IS-IS, to control the routing of IP packets routing!of IP packets within an AS. The idea of the routing is extremely simple — every packet is forwarded on IP links along the shortest route between its source and destination nodes of the AS. The AS network administrator can manage the routing of packets in the AS by supplying the so-called administrative weights of IP links, which specify the link lengths that are used by the routing protocols for their shortest path computations. The main advantage of the shortest path routing policy is its simplicity, allowing for little administrative overhead. From the network engineering perspective, however, shortest path routing can pose problems in achieving satisfactory traffic handling efficiency. As all routing paths depend on the same routing metric routing!metric , it is not possible to configure the routing paths for the communication demands between different pairs of nodes explicitly or individually; the routing can be controlled only indirectly and only as a whole by modifying the routing metric. Thus, one of the main tasks when planning such networks is to find administrative link weights that induce a globally efficient traffic routing traffic!routing configuration of an AS. It turns out that this task leads to very difficult mathematical optimization problems. In this chapter, we discuss and describe exact integer programming models and solution approaches as well as practically efficient smart heuristics for such shortest path routing problems shortest path routing!problems .

  15. Secure IP mobility management for VANET

    CERN Document Server

    Taha, Sanaa


    This brief presents the challenges and solutions for VANETs' security and privacy problems occurring in mobility management protocols including Mobile IPv6 (MIPv6), Proxy MIPv6 (PMIPv6), and Network Mobility (NEMO). The authors give an overview of the concept of the vehicular IP-address configurations as the prerequisite step to achieve mobility management for VANETs, and review the current security and privacy schemes applied in the three mobility management protocols. Throughout the brief, the authors propose new schemes and protocols to increase the security of IP addresses within VANETs in

  16. Training Sessional Academic Staff to Provide Quality Feedback on University Students' Assessment: Lessons from a Faculty of Law Learning and Teaching Project (United States)

    Richards, Kelly; Bell, Tamara; Dwyer, Angela


    The quality of feedback provided to university students has long been recognised as the most important predictor of student learning and satisfaction. However, providing quality feedback to students is challenging in the current context, in which universities increasingly rely on casualised and inexperienced academic staff to assess undergraduate…

  17. Antarctic Space Weather Data Managed by IPS Radio and Space Services of Australia

    Directory of Open Access Journals (Sweden)

    K Wang


    Full Text Available Ionospheric Prediction Services (IPS has an extensive collection of data from Antarctic field instruments, the oldest being ionospheric recordings from the 1950s. Its sensor network (IPSNET spans Australasia and Antarctica collecting information on space weather. In Antarctica, sensors include ionosondes, magnetometers, riometers, and cosmic ray detectors. The (mostly real-time data from these sensors flow into the IPS World Data Centre at Sydney, where the majority are available online to clients worldwide. When combined with other IPSNET-station data, they provide the basis for Antarctic space weather reports. This paper summarizes the datasets collected from Antarctica and their data management within IPS.

  18. Analysis list: Terf2ip [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Terf2ip Embryonic fibroblast + mm9

  19. 76 FR 81955 - Assessment Questionnaire-IP Sector Specific Agency Risk Self Assessment Tool (IP-SSARSAT) (United States)


    ... SECURITY Assessment Questionnaire--IP Sector Specific Agency Risk Self Assessment Tool (IP-SSARSAT) AGENCY... Protection and Programs Directorate (NPPD), Office of Infrastructure Protection (IP), Sector Specific Agency.../IP/SSA EMO, 245 Murray Lane SW., Mail Stop 0640, Arlington, VA 20598-0630. Emailed requests should go...

  20. Combining tissue-phantom ratios to provide a beam-quality specifier for flattening filter free photon beams. (United States)

    Dalaryd, Mårten; Knöös, Tommy; Ceberg, Crister


    mean square deviation (RMSD) of 0.0028 with a maximum deviation of 0.0043 (0.39%) from Monte Carlo calculated values. For all beams in this study, the RMSD between the proposed model and the Monte Carlo calculated values was 0.0006 with a maximum deviation of 0.0013 (0.1%). Using an earlier proposed relationship [Xiong and Rogers, Med. Phys. 35, 2104-2109 (2008)] between %dd(10)x and L̄/ρair (water) gave a RMSD of 0.0018 with a maximum deviation of 0.0029 (0.26%) for all beams in this study (compared to RMSD 0.0015 and a maximum deviation of 0.0048 (0.47%) for the relationship used in AAPM TG-51 published by Almond et al. [Med. Phys. 26, 1847-1870 (1999)]). Using TPR20,10 as a beam-quality specifier, for the flattening filter free beams used in this study, gave a maximum difference of 0.39% between L̄/ρair (water) predicted using IAEA TRS-398 and Monte Carlo calculations. An additional parameter for determining L̄/ρair (water) has been presented. This parameter is easy to measure; it requires only an additional dose measurement at 5 cm depth with SSD 95 cm, and provides information for accurate determination of the L̄/ρair (water) ratio for beams both with and without a flattening filter at the investigated energies.

  1. A decision tree model to estimate the value of information provided by a groundwater quality monitoring network (United States)

    Khader, A. I.; Rosenberg, D. E.; McKee, M.


    Groundwater contaminated with nitrate poses a serious health risk to infants when this contaminated water is used for culinary purposes. To avoid this health risk, people need to know whether their culinary water is contaminated or not. Therefore, there is a need to design an effective groundwater monitoring network, acquire information on groundwater conditions, and use acquired information to inform management options. These actions require time, money, and effort. This paper presents a method to estimate the value of information (VOI) provided by a groundwater quality monitoring network located in an aquifer whose water poses a spatially heterogeneous and uncertain health risk. A decision tree model describes the structure of the decision alternatives facing the decision-maker and the expected outcomes from these alternatives. The alternatives include (i) ignore the health risk of nitrate-contaminated water, (ii) switch to alternative water sources such as bottled water, or (iii) implement a previously designed groundwater quality monitoring network that takes into account uncertainties in aquifer properties, contaminant transport processes, and climate (Khader, 2012). The VOI is estimated as the difference between the expected costs of implementing the monitoring network and the lowest-cost uninformed alternative. We illustrate the method for the Eocene Aquifer, West Bank, Palestine, where methemoglobinemia (blue baby syndrome) is the main health problem associated with the principal contaminant nitrate. The expected cost of each alternative is estimated as the weighted sum of the costs and probabilities (likelihoods) associated with the uncertain outcomes resulting from the alternative. Uncertain outcomes include actual nitrate concentrations in the aquifer, concentrations reported by the monitoring system, whether people abide by manager recommendations to use/not use aquifer water, and whether people get sick from drinking contaminated water. Outcome costs

  2. A decision tree model to estimate the value of information provided by a groundwater quality monitoring network

    Directory of Open Access Journals (Sweden)

    A. I. Khader


    Full Text Available Groundwater contaminated with nitrate poses a serious health risk to infants when this contaminated water is used for culinary purposes. To avoid this health risk, people need to know whether their culinary water is contaminated or not. Therefore, there is a need to design an effective groundwater monitoring network, acquire information on groundwater conditions, and use acquired information to inform management options. These actions require time, money, and effort. This paper presents a method to estimate the value of information (VOI provided by a groundwater quality monitoring network located in an aquifer whose water poses a spatially heterogeneous and uncertain health risk. A decision tree model describes the structure of the decision alternatives facing the decision-maker and the expected outcomes from these alternatives. The alternatives include (i ignore the health risk of nitrate-contaminated water, (ii switch to alternative water sources such as bottled water, or (iii implement a previously designed groundwater quality monitoring network that takes into account uncertainties in aquifer properties, contaminant transport processes, and climate (Khader, 2012. The VOI is estimated as the difference between the expected costs of implementing the monitoring network and the lowest-cost uninformed alternative. We illustrate the method for the Eocene Aquifer, West Bank, Palestine, where methemoglobinemia (blue baby syndrome is the main health problem associated with the principal contaminant nitrate. The expected cost of each alternative is estimated as the weighted sum of the costs and probabilities (likelihoods associated with the uncertain outcomes resulting from the alternative. Uncertain outcomes include actual nitrate concentrations in the aquifer, concentrations reported by the monitoring system, whether people abide by manager recommendations to use/not use aquifer water, and whether people get sick from drinking contaminated water

  3. The ChIP-Seq tools and web server: a resource for analyzing ChIP-seq and other types of genomic data. (United States)

    Ambrosini, Giovanna; Dreos, René; Kumar, Sunil; Bucher, Philipp


    ChIP-seq and related high-throughput chromatin profilig assays generate ever increasing volumes of highly valuable biological data. To make sense out of it, biologists need versatile, efficient and user-friendly tools for access, visualization and itegrative analysis of such data. Here we present the ChIP-Seq command line tools and web server, implementing basic algorithms for ChIP-seq data analysis starting with a read alignment file. The tools are optimized for memory-efficiency and speed thus allowing for processing of large data volumes on inexpensive hardware. The web interface provides access to a large database of public data. The ChIP-Seq tools have a modular and interoperable design in that the output from one application can serve as input to another one. Complex and innovative tasks can thus be achieved by running several tools in a cascade. The various ChIP-Seq command line tools and web services either complement or compare favorably to related bioinformatics resources in terms of computational efficiency, ease of access to public data and interoperability with other web-based tools. The ChIP-Seq server is accessible at .

  4. Evaluation of quality of TB control services by private health care providers in Plateau state, Nigeria; 2012. (United States)

    Ibrahim, Luka Mangveep; Oleribe, Obinna O; Nguku, Patrick; Tongwong, Gabriel Chukwak; Mato, Lakda Gonen; Longkyer, Musa Istifanus; Ogiri, Samuel; Nsubuga, Peter


    Tuberculosis (TB) is public health concern in Nigeria. The country uses the Directly Observed Treatment Short course (DOTS) strategy for its control. Plateau state started using the DOTS strategy in 2001 and had the Private health facilities (PHF) as an important stakeholder. We evaluated their contributions to case finding and quality of the services to identify gaps in monitoring and evaluation in the TB control services within the PHF to plan for intervention so as to meet the set target for TB control in the state. We used the logical framework approach to identify and analyze the problem. We drew up an objective tree and from the objective tree developed a logical framework matrix including evaluation plan. We also conducted desk review to extract data on case findings, case management and outcomes of the treatment. We interviewed TB focal persons and laboratory personnel using structured questionnaire. The data was analyzed using excel spread sheet. Of the 127 health facilities with TB patients on treatment 27 (21.3%) were PHF. The PHF reported 54.6% (1494) of TB cases in 2011. The sputum conversion rates, cured rate, treatment success rate, and default rates were 85%, 73%, 81.4% and 6.6% respectively. The discordant rates were 3.1% and 1.2% for the state and private health facilities respectively. Log frame approach is a useful tool for evaluation of TB control services and helps provide evidence for decision making to improve quality of the TB services in the public and private health facilities in the state.

  5. Enhancement of BLM-DNA2-Mediated Long-Range DNA End Resection by CtIP

    Directory of Open Access Journals (Sweden)

    James M. Daley


    Full Text Available DNA double-strand break repair by homologous recombination entails the resection of DNA ends to reveal ssDNA tails, which are used to invade a homologous DNA template. CtIP and its yeast ortholog Sae2 regulate the nuclease activity of MRE11 in the initial stage of resection. Deletion of CtIP in the mouse or SAE2 in yeast engenders a more severe phenotype than MRE11 nuclease inactivation, indicative of a broader role of CtIP/Sae2. Here, we provide biochemical evidence that CtIP promotes long-range resection via the BLM-DNA2 pathway. Specifically, CtIP interacts with BLM and enhances its helicase activity, and it enhances DNA cleavage by DNA2. Thus, CtIP influences multiple aspects of end resection beyond MRE11 regulation.

  6. Threshold-based generic scheme for encrypted and tunneled Voice Flows Detection over IP Networks

    Directory of Open Access Journals (Sweden)

    M. Mazhar U. Rathore


    Full Text Available VoIP usage is rapidly growing due to its cost effectiveness, dramatic functionality over the traditional telephone network and its compatibility with public switched telephone network (PSTN. In some countries, like Pakistan, the commercial usage of VoIP is prohibited. Internet service providers (ISPs and telecommunication authorities are interested in detecting VoIP calls to either block or prioritize them. So detection of VoIP calls is important for both types of authorities. Signature-based, port-based, and pattern-based VoIP detection techniques are inefficient due to complex and confidential security and tunneling mechanisms used by VoIP. In this paper, we propose a generic, robust, efficient, and practically implementable statistical analysis-based solution to identify encrypted, non-encrypted, or tunneled VoIP media (voice flows using threshold values of flow statistical parameters. We have made a comparison with existing techniques and evaluated our system with respect to accuracy and efficiency. Our system has 97.54% direct rate and .00015% false positive rate.

  7. Integrating QoS and security functions in an IP-VPN gateway (United States)

    Fan, Kuo-Pao; Chang, Shu-Hsin; Lin, Kuan-Ming; Pen, Mau-Jy


    IP-based Virtual Private Network becomes more and more popular. It can not only reduce the enterprise communication cost but also increase the revenue of the service provider. The common IP-VPN application types include Intranet VPN, Extranet VPN, and remote access VPN. For the large IP-VPN market, some vendors develop dedicated IP-VPN devices; while some vendors add the VPN functions into their existing network equipment such as router, access gateway, etc. The functions in the IP-VPN device include security, QoS, and management. The common security functions supported are IPSec (IP Security), IKE (Internet Key Exchange), and Firewall. The QoS functions include bandwidth control and packet scheduling. In the management component, policy-based network management is under standardization in IETF. In this paper, we discuss issues on how to integrate the QoS and security functions in an IP-VPN Gateway. We propose three approaches to do this. They are (1) perform Qos first (2) perform IPSec first and (3) reserve fixed bandwidth for IPSec. We also compare the advantages and disadvantages of the three proposed approaches.

  8. Standardizing chromatin research: a simple and universal method for ChIP-seq. (United States)

    Arrigoni, Laura; Richter, Andreas S; Betancourt, Emily; Bruder, Kerstin; Diehl, Sarah; Manke, Thomas; Bönisch, Ulrike


    Chromatin immunoprecipitation followed by next generation sequencing (ChIP-seq) is a key technique in chromatin research. Although heavily applied, existing ChIP-seq protocols are often highly fine-tuned workflows, optimized for specific experimental requirements. Especially the initial steps of ChIP-seq, particularly chromatin shearing, are deemed to be exceedingly cell-type-specific, thus impeding any protocol standardization efforts. Here we demonstrate that harmonization of ChIP-seq workflows across cell types and conditions is possible when obtaining chromatin from properly isolated nuclei. We established an ultrasound-based nuclei extraction method (NEXSON: Nuclei EXtraction by SONication) that is highly effective across various organisms, cell types and cell numbers. The described method has the potential to replace complex cell-type-specific, but largely ineffective, nuclei isolation protocols. By including NEXSON in ChIP-seq workflows, we completely eliminate the need for extensive optimization and sample-dependent adjustments. Apart from this significant simplification, our approach also provides the basis for a fully standardized ChIP-seq and yields highly reproducible transcription factor and histone modifications maps for a wide range of different cell types. Even small cell numbers (∼10,000 cells per ChIP) can be easily processed without application of modified chromatin or library preparation protocols. © The Author(s) 2015. Published by Oxford University Press on behalf of Nucleic Acids Research.

  9. Important biological information uncovered in previously unaligned reads from chromatin immunoprecipitation experiments (ChIP-Seq) (United States)

    Ouma, Wilberforce Zachary; Mejia-Guerra, Maria Katherine; Yilmaz, Alper; Pareja-Tobes, Pablo; Li, Wei; Doseff, Andrea I.; Grotewold, Erich


    Establishing the architecture of gene regulatory networks (GRNs) relies on chromatin immunoprecipitation followed by massively parallel sequencing (ChIP-Seq) methods that provide genome-wide transcription factor binding sites (TFBSs). ChIP-Seq furnishes millions of short reads that, after alignment, describe the genome-wide binding sites of a particular TF. However, in all organisms investigated an average of 40% of reads fail to align to the corresponding genome, with some datasets having as much as 80% of reads failing to align. We describe here the provenance of previously unaligned reads in ChIP-Seq experiments from animals and plants. We show that a substantial portion corresponds to sequences of bacterial and metazoan origin, irrespective of the ChIP-Seq chromatin source. Unforeseen was the finding that 30%–40% of unaligned reads were actually alignable. To validate these observations, we investigated the characteristics of the previously unaligned reads corresponding to TAL1, a human TF involved in lineage specification of hemopoietic cells. We show that, while unmapped ChIP-Seq read datasets contain foreign DNA sequences, additional TFBSs can be identified from the previously unaligned ChIP-Seq reads. Our results indicate that the re-evaluation of previously unaligned reads from ChIP-Seq experiments will significantly contribute to TF target identification and determination of emerging properties of GRNs. PMID:25727450

  10. A Framework for an IP-Based DVB Transmission Network

    Directory of Open Access Journals (Sweden)

    Nimbe L. Ewald-Arostegui


    Full Text Available One of the most important challenges for next generation all-IP networks is the convergence and interaction of wireless and wired networks in a smooth and efficient manner. This challenge will need to be faced if broadcast transmission networks are to converge with IP infrastructure. The 2nd generation of DVB standards supports the Generic Stream, allowing the direct transmission of IP-based content using the Generic Stream Encapsulation (GSE, in addition to the native Transport Stream (TS. However, the current signalling framework is based on MPEG-2 Tables that rely upon the TS. This paper examines the feasibility of providing a GSE signalling framework, eliminating the need for the TS. The requirements and potential benefits of this new approach are described. It reviews prospective methods that may be suitable for network discovery and selection and analyses different options for the transport and syntax of this signalling metadata. It is anticipated that the design of a GSE-only signalling system will enable DVB networks to function as a part of the Internet.

  11. Teaching Network Security with IP Darkspace Data (United States)

    Zseby, Tanja; Iglesias Vázquez, Félix; King, Alistair; Claffy, K. C.


    This paper presents a network security laboratory project for teaching network traffic anomaly detection methods to electrical engineering students. The project design follows a research-oriented teaching principle, enabling students to make their own discoveries in real network traffic, using data captured from a large IP darkspace monitor…

  12. Wireless IP and building the mobile Internet

    National Research Council Canada - National Science Library

    Dixit, Sudhir; Prasad, Ramjee


    ..., as well as the shortage of technical material in a single place in the field of wireless IP and closely related technologies that form the critical success factors. Therefore, we decided to invite the experts who are truly active in the field: the equipment manufacturers, mobile operators, and those working in research laboratories and unive...


    Directory of Open Access Journals (Sweden)

    Dessyanto Boedi P


    Full Text Available Ipsec (IP Security and SSL (Secure Socket Layer is the most widely used techniques to secure data communications over the Internet. Both of these techniques has advantages and disadvantages of each. The purpose of this study is to present an analysis of the two techniques above in terms of security and performance.

  14. Relationship between Interplanetary (IP) Parameters and ...

    Indian Academy of Sciences (India)

    environment results in various space weather changes, including the phenomenon of the geomagnetic storm and its manifestations (Chapman 1936). Since the 1960s, orbiting and geostationary satellites have made it possible to study the linkage between solar emissions, their manifestations in IP space, and geomagnetic ...


    DEFF Research Database (Denmark)


    The present invention relates to an immunological method and, more particularly, a method for measuring cell-mediated immune reactivity (CMI) in mammals based on the production of IP-10.The invention further discloses an assay and a kit for measuring CMI to an antigen using whole blood or other...

  16. Voice Quality Estimation in Wireless Networks

    Directory of Open Access Journals (Sweden)

    Petr Zach


    Full Text Available This article deals with the impact of Wireless (Wi-Fi networks on the perceived quality of voice services. The Quality of Service (QoS metrics must be monitored in the computer network during the voice data transmission to ensure proper voice service quality the end-user has paid for, especially in the wireless networks. In addition to the QoS, research area called Quality of Experience (QoE provides metrics and methods for quality evaluation from the end-user’s perspective. This article focuses on a QoE estimation of Voice over IP (VoIP calls in the wireless networks using network simulator. Results contribute to voice quality estimation based on characteristics of the wireless network and location of a wireless client.

  17. Relating family satisfaction to the care provided in intensive care units: quality outcomes in Saudi accredited hospitals. (United States)

    Mahrous, Mohamed Saad


    This study aims to identify the satisfaction levels of the family members of patients in intensive care units. This is a cross-sectional analytical study. General intensive care units offer a variety of services to clinical and surgical patients. For the purpose of this study, a trained interviewer communicated with the families of patients, either before or after visiting hours. The study included 208 participants: 119 (57.2%) males and 89 (42.8%) females. Seventy-three (35.1%) of the patients attended a private hospital, and 135 (64.9%) attended a public hospital in the city of Al Madinah Al- Munawarah. All of the participants were either family members or friends of patients admitted to the intensive care units at the hospitals. The responses of both groups yielded low scores on the satisfaction index. However, a relatively high score was noted in response to questions 2, 6, and 10, which concerned the care that was extended by the hospital staff to their patients, the courteous attitude of intensive care unit staff members towards patients, and patients' satisfaction with the medical care provided, respectively. A very low score was obtained for item 11, which was related to the possibility for improvements to the medical care that the patients received. Overall, greater satisfaction with the services offered by the public intensive care units was reported compared to the satisfaction with the services offered by the private intensive care units. An overall low score on the satisfaction index was obtained, and further studies are recommended to assess the current situation and improve the satisfaction and quality of care provided by intensive care units.

  18. Health-Related Quality of Life after Pediatric Liver Transplantation: A Qualitative Analysis of the Perspectives of Health Care Providers

    Directory of Open Access Journals (Sweden)

    Mar Miserachs


    Full Text Available With improved survival outcomes after pediatric liver transplantation (LT, health-related quality of life (HRQoL is an important outcome metric. Understanding the elements contributing to HRQoL after LT in children would enable more targeted strategies towards optimizing best outcomes. This qualitative study aimed to explore health care providers (HCP perceptions about HRQoL after pediatric LT. Thirteen experienced HCP participated in two focus group discussions. Data analysis via a thematic analysis approach revealed 4 major themes: “LT as a facilitator of better HRQoL,” “coping and adapting to LT,” “living with a transplanted liver,” and “the family context.” HCP identified elements that both enhance (improved physical health, peer relationship, and activities of daily living and challenge (need for immunosuppression, transplant follow-up, and restrictions the multidimensional domains of HRQoL. HCP perceived LT to be a stressful life-changing event for children and their families. Patients and their parents’ ability to cope and adjust positively to LT was perceived as a key contributor to better HRQoL. HCP perspective highlights the importance of promoting psychosocial support and a family-centered care delivery model towards the overarching goal of optimizing durable outcomes.

  19. Parallel experimental design and multivariate analysis provides efficient screening of cell culture media supplements to improve biosimilar product quality. (United States)

    Brühlmann, David; Sokolov, Michael; Butté, Alessandro; Sauer, Markus; Hemberger, Jürgen; Souquet, Jonathan; Broly, Hervé; Jordan, Martin


    Rational and high-throughput optimization of mammalian cell culture media has a great potential to modulate recombinant protein product quality. We present a process design method based on parallel design-of-experiment (DoE) of CHO fed-batch cultures in 96-deepwell plates to modulate monoclonal antibody (mAb) glycosylation using medium supplements. To reduce the risk of losing valuable information in an intricate joint screening, 17 compounds were separated into five different groups, considering their mode of biological action. The concentration ranges of the medium supplements were defined according to information encountered in the literature and in-house experience. The screening experiments produced wide glycosylation pattern ranges. Multivariate analysis including principal component analysis and decision trees was used to select the best performing glycosylation modulators. Subsequent D-optimal quadratic design with four factors (three promising compounds and temperature shift) in shake tubes confirmed the outcome of the selection process and provided a solid basis for sequential process development at a larger scale. The glycosylation profile with respect to the specifications for biosimilarity was greatly improved in shake tube experiments: 75% of the conditions were equally close or closer to the specifications for biosimilarity than the best 25% in 96-deepwell plates. Biotechnol. Bioeng. 2017;114: 1448-1458. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  20. Practical Guidelines for the Comprehensive Analysis of ChIP-seq Data (United States)

    Bailey, Timothy; Krajewski, Pawel; Ladunga, Istvan; Lefebvre, Celine; Li, Qunhua; Liu, Tao; Madrigal, Pedro; Taslim, Cenny; Zhang, Jie


    Mapping the chromosomal locations of transcription factors, nucleosomes, histone modifications, chromatin remodeling enzymes, chaperones, and polymerases is one of the key tasks of modern biology, as evidenced by the Encyclopedia of DNA Elements (ENCODE) Project. To this end, chromatin immunoprecipitation followed by high-throughput sequencing (ChIP-seq) is the standard methodology. Mapping such protein-DNA interactions in vivo using ChIP-seq presents multiple challenges not only in sample preparation and sequencing but also for computational analysis. Here, we present step-by-step guidelines for the computational analysis of ChIP-seq data. We address all the major steps in the analysis of ChIP-seq data: sequencing depth selection, quality checking, mapping, data normalization, assessment of reproducibility, peak calling, differential binding analysis, controlling the false discovery rate, peak annotation, visualization, and motif analysis. At each step in our guidelines we discuss some of the software tools most frequently used. We also highlight the challenges and problems associated with each step in ChIP-seq data analysis. We present a concise workflow for the analysis of ChIP-seq data in Figure 1 that complements and expands on the recommendations of the ENCODE and modENCODE projects. Each step in the workflow is described in detail in the following sections. PMID:24244136

  1. Stimulation of inositol 1,4,5-trisphosphate (IP3 receptor subtypes by adenophostin A and its analogues.

    Directory of Open Access Journals (Sweden)

    Huma Saleem

    Full Text Available Inositol 1,4,5-trisphosphate receptors (IP3R are intracellular Ca(2+ channels. Most animal cells express mixtures of the three IP3R subtypes encoded by vertebrate genomes. Adenophostin A (AdA is the most potent naturally occurring agonist of IP3R and it shares with IP3 the essential features of all IP3R agonists, namely structures equivalent to the 4,5-bisphosphate and 6-hydroxyl of IP3. The two essential phosphate groups contribute to closure of the clam-like IP3-binding core (IBC, and thereby IP3R activation, by binding to each of its sides (the α- and β-domains. Regulation of the three subtypes of IP3R by AdA and its analogues has not been examined in cells expressing defined homogenous populations of IP3R. We measured Ca(2+ release evoked by synthetic adenophostin A (AdA and its analogues in permeabilized DT40 cells devoid of native IP3R and stably expressing single subtypes of mammalian IP3R. The determinants of high-affinity binding of AdA and its analogues were indistinguishable for each IP3R subtype. The results are consistent with a cation-π interaction between the adenine of AdA and a conserved arginine within the IBC α-domain contributing to closure of the IBC. The two complementary contacts between AdA and the α-domain (cation-π interaction and 3″-phosphate allow activation of IP3R by an analogue of AdA (3″-dephospho-AdA that lacks a phosphate group equivalent to the essential 5-phosphate of IP3. These data provide the first structure-activity analyses of key AdA analogues using homogenous populations of all mammalian IP3R subtypes. They demonstrate that differences in the Ca(2+ signals evoked by AdA analogues are unlikely to be due to selective regulation of IP3R subtypes.

  2. Investigation of Viral and Host Chromatin by ChIP-PCR or ChIP-Seq Analysis. (United States)

    Günther, Thomas; Theiss, Juliane M; Fischer, Nicole; Grundhoff, Adam


    Complex regulation of viral transcription patterns and DNA replication levels is a feature of many DNA viruses. This is especially true for those viruses which establish latent or persistent infections (e.g., herpesviruses, papillomaviruses, polyomaviruses, or adenovirus), as long-term persistence often requires adaptation of gene expression programs and/or replication levels to the cellular milieu. A key factor in the control of such processes is the establishment of a specific chromatin state on promoters or replication origins, which in turn will determine whether or not the underlying DNA is accessible for other factors that mediate downstream processes. Chromatin immunoprecipitation (ChIP) is a powerful technique to investigate viral chromatin, in particular to study binding patterns of modified histones, transcription factors or other DNA-/chromatin-binding proteins that regulate the viral lifecycle. Here, we provide protocols that are suitable for performing ChIP-PCR and ChIP-Seq studies on chromatin of large and small viral genomes. Copyright © 2016 John Wiley & Sons, Inc.

  3. SU-E-T-571: Newly Emerging Integrated Transmission Detector Systems Provide Online Quality Assurance of External Beam Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hoffman, D; Chung, E; Hess, C; Stern, R; Benedict, S [UC Davis Cancer Center, Sacramento, CA (United States)


    Purpose: Two newly emerging transmission detectors positioned upstream from the patient have been evaluated for online quality assurance of external beam radiotherapy. The prototype for the Integral Quality Monitor (IQM), developed by iRT Systems GmbH (Koblenz, Germany) is a large-area ion chamber mounted on the linac accessory tray to monitor photon fluence, energy, beam shape, and gantry position during treatment. The ion chamber utilizes a thickness gradient which records variable response dependent on beam position. The prototype of Delta4 Discover™, developed by ScandiDos (Uppsala, Sweden) is a linac accessory tray mounted 4040 diode array that measures photon fluence during patient treatment. Both systems are employable for patient specific QA prior to treatment delivery. Methods: Our institution evaluated the reproducibility of measurements using various beam types, including VMAT treatment plans with both the IQM ion chamber and the Delta4 Discover diode array. Additionally, the IQM’s effect on photon fluence, dose response, simulated beam error detection, and the accuracy of the integrated barometer, thermometer, and inclinometer were characterized. The evaluated photon beam errors are based on the annual tolerances specified in AAPM TG-142. Results: Repeated VMAT treatments were measured with 0.16% reproducibility by the IQM and 0.55% reproducibility by the Delta4 Discover. The IQM attenuated 6, 10, and 15 MV photon beams by 5.43±0.02%, 4.60±0.02%, and 4.21±0.03% respectively. Photon beam profiles were affected <1.5% in the non-penumbra regions. The IQM’s ion chamber’s dose response was linear and the thermometer, barometer, and inclinometer agreed with other calibrated devices. The device detected variations in monitor units delivered (1%), field position (3mm), single MLC leaf positions (13mm), and photon energy. Conclusion: We have characterized two new transmissions detector systems designed to provide in-vivo like measurements upstream


    Directory of Open Access Journals (Sweden)

    Larisa N. Paskhalova


    Full Text Available The aim of the investigation is to generalize the experience on implementation of the Program of development of educational institution that allows providing high quality of education in the conditions of introduction of Federal Educational Standards of New Generation. Methods. Traditional psychological and pedagogical methods involve: stating, developing and control. Analysis of the average data and dynamics of educational results, an expert estimation, interrogations and questioning are used. Results. Transition of a gymnasium to educational institution of new type has become result of introduction of the Program of development. The unique profile of establishment is created and priority positions are taken in the educational environment of the region; in response to an implementation of the program of the development focused on the social procurement. Efficiency of the Program is confirmed with intermediate results of monitoring concerning all subjects of educational space: trained, teachers and parents. The program allows all participants of educational process to be involved in process of introduction of new quality of education via the mechanism of realization of system. The program represents improvement of activity of structures of educational space of a gymnasium, development of resource base, and also a control system as a factor of ensuring stability of functioning and innovative development of a gymnasium. Scientific novelty. The possibility of implementation of the Program of development of educational institution through introduction of system-activity and project-based approach which connected nine sub-programmes in one complex (structured in three modules is shown. It includes introduction of Federal State Educational Standard (FSES, an international exam, development of a progymnasium, formation of the personality, ongoing support to gifted children, extension of innovative culture of teachers, efficiency of management and

  5. The quality of health care services provided in health care centers of Khorramabad using SERVQUAL model in 2010

    Directory of Open Access Journals (Sweden)

    mohammad javad tarrahi


    Conclusion: Expectations of the clients in all aspects of offering services are beyond than their perceptions, and needed to improve the quality of offering services in these centers in all the dimensions especially empathy dimension. It is recommended that the quality of the offering services be assessed periodically in these centers and intervene to improve the delivering of health services.

  6. Modelling ChIP-seq Data Using HMMs. (United States)

    Vinciotti, Veronica


    Chromatin ImmunoPrecipitation-sequencing (ChIP-seq) experiments have now become routine in biology for the detection of protein binding sites. In this chapter, we show how hidden Markov models can be used for the analysis of data generated by ChIP-seq experiments. We show how a hidden Markov model can naturally account for spatial dependencies in the ChIP-seq data, how it can be used in the presence of data from multiple ChIP-seq experiments under the same biological condition, and how it naturally accounts for the different IP efficiencies of individual ChIP-seq experiments.

  7. A statistical framework for power calculations in ChIP-seq experiments (United States)

    Zuo, Chandler; Keleş, Sündüz


    Motivation: ChIP-seq technology enables investigators to study genome-wide binding of transcription factors and mapping of epigenomic marks. Although the availability of basic analysis tools for ChIP-seq data is rapidly increasing, there has not been much progress on the related design issues. A challenging question for designing a ChIP-seq experiment is how deeply should the ChIP and the control samples be sequenced? The answer depends on multiple factors some of which can be set by the experimenter based on pilot/preliminary data. The sequencing depth of a ChIP-seq experiment is one of the key factors that determine whether all the underlying targets (e.g. binding locations or epigenomic profiles) can be identified with a targeted power. Results: We developed a statistical framework named CSSP (ChIP-seq Statistical Power) for power calculations in ChIP-seq experiments by considering a local Poisson model, which is commonly adopted by many peak callers. Evaluations with simulations and data-driven computational experiments demonstrate that this framework can reliably estimate the power of a ChIP-seq experiment at different sequencing depths based on pilot data. Furthermore, it provides an analytical approach for calculating the required depth for a targeted power while controlling the false discovery rate at a user-specified level. Hence, our results enable researchers to use their own or publicly available data for determining required sequencing depths of their ChIP-seq experiments and potentially make better use of the multiplexing functionality of the sequencers. Evaluation of power for multiple public ChIP-seq datasets indicate that, currently, typical ChIP-seq studies are powered well for detecting large fold changes of ChIP enrichment over the control sample, but they have considerably less power for detecting smaller fold changes. Availability: Available at∼zuo/CSSP. Contact: Supplementary information: Supplementary

  8. Purification of nanogram-range immunoprecipitated DNA in ChIP-seq application. (United States)

    Zhong, Jian; Ye, Zhenqing; Lenz, Samuel W; Clark, Chad R; Bharucha, Adil; Farrugia, Gianrico; Robertson, Keith D; Zhang, Zhiguo; Ordog, Tamas; Lee, Jeong-Heon


    Chromatin immunoprecipitation-sequencing (ChIP-seq) is a widely used epigenetic approach for investigating genome-wide protein-DNA interactions in cells and tissues. The approach has been relatively well established but several key steps still require further improvement. As a part of the procedure, immnoprecipitated DNA must undergo purification and library preparation for subsequent high-throughput sequencing. Current ChIP protocols typically yield nanogram quantities of immunoprecipitated DNA mainly depending on the target of interest and starting chromatin input amount. However, little information exists on the performance of reagents used for the purification of such minute amounts of immunoprecipitated DNA in ChIP elution buffer and their effects on ChIP-seq data. Here, we compared DNA recovery, library preparation efficiency, and ChIP-seq results obtained with several commercial DNA purification reagents applied to 1 ng ChIP DNA and also investigated the impact of conditions under which ChIP DNA is stored. We compared DNA recovery of ten commercial DNA purification reagents and phenol/chloroform extraction from 1 to 50 ng of immunopreciptated DNA in ChIP elution buffer. The recovery yield was significantly different with 1 ng of DNA while similar in higher DNA amounts. We also observed that the low nanogram range of purified DNA is prone to loss during storage depending on the type of polypropylene tube used. The immunoprecipitated DNA equivalent to 1 ng of purified DNA was subject to DNA purification and library preparation to evaluate the performance of four better performing purification reagents in ChIP-seq applications. Quantification of library DNAs indicated the selected purification kits have a negligible impact on the efficiency of library preparation. The resulting ChIP-seq data were comparable with the dataset generated by ENCODE consortium and were highly correlated between the data from different purification reagents. This study provides

  9. 76 FR 59916 - Interconnected VoIP Service; Wireless E911 Location Accuracy Requirements; E911 Requirements for... (United States)


    ... network-based location technology, the Commission required wireless carriers to provide confidence and... applications, examining emerging E911 public safety location technologies, and recommending options to CSRIC...] Interconnected VoIP Service; Wireless E911 Location Accuracy Requirements; E911 Requirements for IP-Enabled...

  10. Changes in sexual roles and quality of life for gay men after prostate cancer: challenges for sexual health providers. (United States)

    Hart, Tae L; Coon, David W; Kowalkowski, Marc A; Zhang, Karen; Hersom, Justin I; Goltz, Heather H; Wittmann, Daniela A; Latini, David M


    Gay men with prostate cancer (GMPCa) may have differential health-related quality of life (HRQOL) and sexual health outcomes than heterosexual men with prostate cancer (PCa), but existing information is based on clinical experience and small studies. Our goals were to: (i) describe HRQOL and examine changes in sexual functioning and bother; (ii) explore the psychosocial aspects of sexual health after PCa; and (iii) examine whether there were significant differences on HRQOL and sexual behavior between GMPCa and published norms. A convenience sample of GMPCa completed validated disease-specific and general measures of HRQOL, ejaculatory function and bother, fear of cancer recurrence, and satisfaction with prostate cancer care. Measures of self-efficacy for PCa management, illness intrusiveness, and disclosure of sexual orientation were also completed. Where possible, scores were compared against published norms. Main outcome measures were self-reported sexual functioning and bother on the Expanded Prostate Cancer Index. Compared with norms, GMPCa reported significantly worse functioning and more severe bother scores on urinary, bowel, hormonal symptom scales (Ps sexual functioning scores (P sexual bother scores were similar to that of published samples. GMPCa tended to be more "out" about their sexual orientation than other samples of gay men. GMPCa reported substantial changes in sexual functioning after PCa treatment. They also reported significantly worse disease-specific and general HRQOL, fear of recurrence, and were less satisfied with their medical care than other published PCa samples. Sexual health providers must have an awareness of the unique functional and HRQOL differences between gay and heterosexual men with PCa. © 2014 International Society for Sexual Medicine.

  11. Security Analysis System to Detect Threats on a SIP VoIP Infrasctructure Elements

    Directory of Open Access Journals (Sweden)

    Filip Rezac


    Full Text Available SIP PBX is definitely the alpha and omega of any IP telephony infrastructure and frequently also provides other services than those related to VoIP traffic. These exchanges are, however, very often the target of attacks by external actors. The article describes a system that was developed on VSB-TU Ostrava as a testing tool to verify if the target VoIP PBX is adequately secured and protected against any real threats. The system tests the SIP element for several usually occurring attacks and it compiles evaluation of its overall security on the basis of successfully or unsuccessfully penetrations. The article describes the applications and algorithms that are used by system and the conclusion consists recommendations and guidelines to ensure effective protection against VoIP PBX threats. The system is designed as an open-source web application, thus allowing independent access and is fully extensible to other test modules.

  12. Rationale, Scenarios, and Profiles for the Application of the Internet Protocol Suite (IPS) in Space Operations (United States)

    Benbenek, Daniel B.; Walsh, William


    This greenbook captures some of the current, planned and possible future uses of the Internet Protocol (IP) as part of Space Operations. It attempts to describe how the Internet Protocol is used in specific scenarios. Of primary focus is low-earth-orbit space operations, which is referred to here as the design reference mission (DRM). This is because most of the program experience drawn upon derives from this type of mission. Application profiles are provided. This includes parameter settings programs have proposed for sending IP datagrams over CCSDS links, the minimal subsets and features of the IP protocol suite and applications expected for interoperability between projects, and the configuration, operations and maintenance of these IP functions. Of special interest is capturing the lessons learned from the Constellation Program in this area, since that program included a fairly ambitious use of the Internet Protocol.

  13. Development of quality indicators for transition from pediatric to adult care in sickle cell disease: A modified Delphi survey of adult providers. (United States)

    Sobota, Amy E; Shah, Nishita; Mack, Jennifer W


    Transition from pediatric to adult care is a vulnerable time for young adults with sickle cell disease (SCD); however, improvements in transition are limited by a lack of quality indicators. The purpose of this study was to establish quality indicators for transition in SCD and to determine the optimal timing between the final pediatric visit and the first adult provider visit. We conducted a modified Delphi survey to reach a consensus on which quality indicators are most important for a successful transition. Our expert panel consisted of members of the Sickle Cell Adult Provider Network. In the first round, the participants ranked a list of quality indicators by importance. In the second round, the participants chose their "top 5" quality indicators in terms of importance and also ranked them on feasibility. The response rates for the two rounds were 68 and 96%, respectively. Nine quality indicators were chosen as "top 5" by a majority of respondents, including communication between pediatric and adult providers, timing of first adult visit, patient self-efficacy, quality of life, and trust with their adult provider. Based on the comments from round 1, respondents were also asked for the optimal timing between leaving pediatric care and entering adult care. Most recommended a first adult visit within 2 months of the final pediatric visit. By using these quality indicators chosen by the majority of respondents, we can better develop and evaluate transition programs for young adults with SCD and improve health outcomes for these vulnerable patients. © 2016 Wiley Periodicals, Inc.

  14. Delivering Service Quality in Alcohol Treatment: A Qualitative Comparison of Public and Private Treatment Centres by Service Users and Service Providers (United States)

    Resnick, Sheilagh M.; Griffiths, Mark D.


    In the UK, quality of care has now been placed at the centre of the National Health Service (NHS) modernisation programme. To date, there has been little research on the service quality delivery of alcohol treatment services from the perspective of both the service user and service provider. Therefore, this qualitative study explored the…

  15. DREME: motif discovery in transcription factor ChIP-seq data. (United States)

    Bailey, Timothy L


    Transcription factor (TF) ChIP-seq datasets have particular characteristics that provide unique challenges and opportunities for motif discovery. Most existing motif discovery algorithms do not scale well to such large datasets, or fail to report many motifs associated with cofactors of the ChIP-ed TF. We present DREME, a motif discovery algorithm specifically designed to find the short, core DNA-binding motifs of eukaryotic TFs, and optimized to analyze very large ChIP-seq datasets in minutes. Using DREME, we discover the binding motifs of the the ChIP-ed TF and many cofactors in mouse ES cell (mESC), mouse erythrocyte and human cell line ChIP-seq datasets. For example, in mESC ChIP-seq data for the TF Esrrb, we discover the binding motifs for eight cofactor TFs important in the maintenance of pluripotency. Several other commonly used algorithms find at most two cofactor motifs in this same dataset. DREME can also perform discriminative motif discovery, and we use this feature to provide evidence that Sox2 and Oct4 do not bind in mES cells as an obligate heterodimer. DREME is much faster than many commonly used algorithms, scales linearly in dataset size, finds multiple, non-redundant motifs and reports a reliable measure of statistical significance for each motif found. DREME is available as part of the MEME Suite of motif-based sequence analysis tools (

  16. Analisis Kualitas VoIP pada SCTP Menggunakan ECN dan AQM

    Directory of Open Access Journals (Sweden)

    La Surimi


    Abstract VoIP is the real time applications that are highly dependent on the quality of  delay and jitter, which it is difficult to be met by protocol that has reliable data transfer feature and  congestion control such as TCP. On the other hand the use of UDP that has no congestion control make chance of causing congestion in the network is very large. The use of SCTP as an alternative protocol was also not able to accommodate the weaknesses of TCP and UDP. Some research shows that repairs or modifications to the SCTP congestion control mechanism is needed. The Use of ECN and AQM in some studies show that these two mechanisms can reduce delay and jitter. This study tested the quality of VoIP over SCTP with ECN and AVQ, in NS2. Simulations carried out by independent replication technique, and the results showed that ECN and AVQ can increase the value of MOS VoIP calls significantly in non ideal network scenarios. This study also did comparison of SCTP MOS that uses ECN and AVQ with MOS values VoIP using TCP and UDP. The result showed that SCTP with ECN and AVQ outperform TCP but can not surpass UDP yet.   Keywords— VoIP, SCTP, ECN, AQM,AVQ.

  17. Automatic Classification of Attacks on IP Telephony

    Directory of Open Access Journals (Sweden)

    Jakub Safarik


    Full Text Available This article proposes an algorithm for automatic analysis of attack data in IP telephony network with a neural network. Data for the analysis is gathered from variable monitoring application running in the network. These monitoring systems are a typical part of nowadays network. Information from them is usually used after attack. It is possible to use an automatic classification of IP telephony attacks for nearly real-time classification and counter attack or mitigation of potential attacks. The classification use proposed neural network, and the article covers design of a neural network and its practical implementation. It contains also methods for neural network learning and data gathering functions from honeypot application.

  18. TCP/IP Implementations and Vendors Guide, (United States)


    IMAGEN and others. The applications are integrated inwo the generic device, pathname...8217 . + ’. ’, " . . " .’ .- . - .- - - -- .. .- . . . . ’ - . . + ’ - .’ . . . , . ..++ - . -. ". , .-’ . , , - - . . . -+ ’- - - - , , - - , . . .. ... , - . % F 2.8. Imagen 2.8.1. Imprint-10 PRODUCT NAME: IMPRINT-10 TCP/IP Ethernet Printer DESCRIPTION: 4. The IMPRINT-10 is an...hardware O/S: Proprietary, not user-programmable IMPLEMENTATION-LANGUAGE: C DISTRIBUTOR: Imagen Corporation 2660 Marine

  19. La competenza per materia delle sezioni IP


    Luigi Carlo Ubertazzi


    Italian Law 12/12/2002, n. 273 [0] as implemented through the Legislative Decree 168/2003 [1] has created "specialized sections" for IP-related matters in the courts (both first and second level) of Bari, Bologna, Catania, Firenze, Genova, Milano, Napoli, Palermo, Roma, Torino, Trieste and Venezia. These sections "deal with cases of national and communitarian trademarks, patents for inventions and new plant varieties, utility models, pictures and models, author rights and all cases of unfair ...

  20. Research study on IPS digital controller design (United States)

    Kuo, B. C.; Folkerts, C.


    The performance is investigated of the simplified continuous-data model of the Instrument Pointing System (IPS). Although the ultimate objective is to study the digital model of the system, knowledge on the performance of the continuous-data model is important in the sense that the characteristics of the digital system should approach those of the continuous-data system as the sampling period approaches zero.

  1. Intellectual Property and Strategic Agreements (IP/SA) | FNLCR Staging (United States)

    IP/SA handles all invention issues including patents and copyrights. All employee inventionreports are filed through the IP/SA office for all activities under the OTS contract.Additionally,request for assignment ofcopyri

  2. Media Distribution in Heterogeneous Environments using IP-Multicast


    Parnes, Peter


    This document discusses problems and solutions around distribution of media in heterogeneous environments when using IP-multicast. This document discusses problems and solutions around distribution of media in heterogeneous environments when using IP-multicast.

  3. Role of ipsdienol, ipsenol, and cis-verbenol in chemical ecology of Ips avulsus, Ips calligraphus, and Ips grandicollis (Coleoptera: Curculionidae: Scolytinae). (United States)

    Allison, Jeremy D; McKenney, Jessica L; Miller, Daniel R; Gimmel, Matthew L


    Stressed or damaged pine (Pinus sp.) trees in the southeastern United States are often colonized simultaneously by three southern Ips species (Coleoptera: Curculionidae: Scolytinae): small southern pine engraver, Ips avulsus (Eichhoff); sixspined ips, Ips calligraphus (Germar); and eastern fivespined ips, Ips grandicollis (Eichhoff). All three species mediate colonization of host material with volatile pheromones. All of the southern Ips produce cis-verbenol, and either ipsdienol or ipsenol, and electrophysiological studies have demonstrated that all three southern Ips are able to detect all three compounds. This study examined the role of ipsdienol, ipsenol, and cis-verbenol in the chemical ecology of the southern Ips in Georgia and Louisiana. The most attractive blends of pheromones, with the fewest number of components, were ipsdienol plus ipsenol for I. avulsus, cis-verbenol plus ipsdienol for I. calligraphus, and either cis-verbenol plus ipsenol or ipsdienol plus ipsenol for I. grandicollis. Cross-attraction of I. grandicollis to the pheromone blend most attractive to I. avulsus was observed. Although the presence of heterospecific pheromone reduced the catches of all three species (i.e., the tertiary blend captured fewer beetles than the most attractive binary blends) in both states (significantly in two cases), high numbers of all three species were still captured in traps baited with all three compounds. These results suggest that the pheromones cis-verbenol, ipsdienol, and ipsenol can be combined for monitoring all three species of the southern Ips simultaneously.

  4. Fish the ChIPs: a pipeline for automated genomic annotation of ChIP-Seq data

    Directory of Open Access Journals (Sweden)

    Minucci Saverio


    Full Text Available Abstract Background High-throughput sequencing is generating massive amounts of data at a pace that largely exceeds the throughput of data analysis routines. Here we introduce Fish the ChIPs (FC, a computational pipeline aimed at a broad public of users and designed to perform complete ChIP-Seq data analysis of an unlimited number of samples, thus increasing throughput, reproducibility and saving time. Results Starting from short read sequences, FC performs the following steps: 1 quality controls, 2 alignment to a reference genome, 3 peak calling, 4 genomic annotation, 5 generation of raw signal tracks for visualization on the UCSC and IGV genome browsers. FC exploits some of the fastest and most effective tools today available. Installation on a Mac platform requires very basic computational skills while configuration and usage are supported by a user-friendly graphic user interface. Alternatively, FC can be compiled from the source code on any Unix machine and then run with the possibility of customizing each single parameter through a simple configuration text file that can be generated using a dedicated user-friendly web-form. Considering the execution time, FC can be run on a desktop machine, even though the use of a computer cluster is recommended for analyses of large batches of data. FC is perfectly suited to work with data coming from Illumina Solexa Genome Analyzers or ABI SOLiD and its usage can potentially be extended to any sequencing platform. Conclusions Compared to existing tools, FC has two main advantages that make it suitable for a broad range of users. First of all, it can be installed and run by wet biologists on a Mac machine. Besides it can handle an unlimited number of samples, being convenient for large analyses. In this context, computational biologists can increase reproducibility of their ChIP-Seq data analyses while saving time for downstream analyses. Reviewers This article was reviewed by Gavin Huttley, George

  5. Denoising genome-wide histone ChIP-seq with convolutional neural networks. (United States)

    Koh, Pang Wei; Pierson, Emma; Kundaje, Anshul


    Chromatin immune-precipitation sequencing (ChIP-seq) experiments are commonly used to obtain genome-wide profiles of histone modifications associated with different types of functional genomic elements. However, the quality of histone ChIP-seq data is affected by many experimental parameters such as the amount of input DNA, antibody specificity, ChIP enrichment and sequencing depth. Making accurate inferences from chromatin profiling experiments that involve diverse experimental parameters is challenging. We introduce a convolutional denoising algorithm, Coda, that uses convolutional neural networks to learn a mapping from suboptimal to high-quality histone ChIP-seq data. This overcomes various sources of noise and variability, substantially enhancing and recovering signal when applied to low-quality chromatin profiling datasets across individuals, cell types and species. Our method has the potential to improve data quality at reduced costs. More broadly, this approach-using a high-dimensional discriminative model to encode a generative noise process-is generally applicable to other biological domains where it is easy to generate noisy data but difficult to analytically characterize the noise or underlying data distribution. .

  6. Association of State-Level Restrictions in Nurse Practitioner Scope of Practice With the Quality of Primary Care Provided to Medicare Beneficiaries. (United States)

    Perloff, Jennifer; Clarke, Sean; DesRoches, Catherine M; O'Reilly-Jacob, Monica; Buerhaus, Peter


    State scope of practice (SoP) laws impose significant restrictions on the services that a nurse practitioner (NP) may provide in some states, yet evidence about SoP limitations on the quality of primary care is very limited. This study uses six different classifications of state regulations and bivariate and multivariate analyses to compare beneficiaries attributed to primary care nurse practitioners and primary care physicians in 2013 testing two hypotheses: (1) chronic disease management, cancer screening, preventable hospitalizations, and adverse outcomes of care provided by primary care nurse practitioners are better in reduced and restricted practice states compared to states without restrictions and (2) by decreasing access to care, SoP restrictions negatively affect the quality of primary care. Results show a lack of consistent association between quality of primary care provided by NPs and state SoP restrictions. State regulations restricting NP SoP do not improve the quality of care.

  7. Dynamic Mobile IP routers in ad hoc networks

    NARCIS (Netherlands)

    Kock, B.A.; Schmidt, J.R.


    This paper describes a concept combining mobile IP and ad hoc routing to create a robust mobile network. In this network all nodes are mobile and globally and locally reachable under the same IP address. Essential for implementing this network are the dynamic mobile IP routers. They act as gateways

  8. How can we integrate IP strategy with corporate strategy? Combining IP strategy with management strategy making process


    田中, 義敏; Tanaka, Yoshitoshi


    Intellectual property systems have been introduced and used in manycountries as a global standard. However, its practical utilisation is still not yetmature because of the lack of IP strategy. Each enterprise has to define aunique IP strategy and be differentiated by other enterprises because the outsideenvironment and internal resource are different. IP people have to havebetter understandings on strategy making process, which is fundamental to themanagement field. In addition, IP strategy s...

  9. 75 FR 44971 - Medicaid Program; Request for Comments on Legislative Changes To Provide Quality of Care to Children (United States)


    ... conditions. + Chronic health care. + Health services to ameliorate the effects of physical and mental... these factors affecting the quality of care given to children under titles XIX and XXI, the Secretary is... Doc No: 2010-18140] DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services...

  10. Computerized Provider Order Entry and Health Care Quality on Hospital Level among Pediatric Patients during 2006-2009 (United States)

    Wang, Liya


    This study examined the association between Computerized Physician Order Entry (CPOE) application and healthcare quality in pediatric patients at hospital level. This was a retrospective study among 1,428 hospitals with pediatric setting in Healthcare Cost and Utilization Project (HCUP) Kid's Inpatient Database (KID) and Health Information and…

  11. Providing High-Quality Support Services to Home-Based Child Care: A Conceptual Model and Literature Review (United States)

    Bromer, Juliet; Korfmacher, Jon


    Research Findings: Home-based child care accounts for a significant proportion of nonparental child care arrangements for young children in the United States. Yet the early care and education field lacks clear models or pathways for how to improve quality in these settings. The conceptual model presented here articulates the components of…

  12. Health Care of Latino Children with Autism and Other Developmental Disabilities: Quality of Provider Interaction Mediates Utilization (United States)

    Parish, Susan; Magana, Sandra; Rose, Roderick; Timberlake, Maria; Swaine, Jamie G.


    This study examines access to, utilization of, and quality of health care for Latino children with autism and other developmental disabilities. We analyze data from the National Survey of Children with Special Health Care Needs (N = 4,414 children with autism and other developmental disabilities). Compared with White children, Latino children with…

  13. The Effect of Cognitive Appraisal on Quality of Life of Providers of Home Care for Patients With Stroke. (United States)

    Pai, Hsiang-Chu; Tsai, Yi-Chen


    Stroke is a major cause of long-term disability. Most stroke survivors return to their own home and need to be cared for by family members, most of whom are informal caregivers. The aim of this study was to identify whether cognitive appraisal influences health-related quality of life. A cross-sectional, descriptive, correlational design was used. Participants included 77 primary support persons, mean age = 59.47 years, who were younger than stroke survivors (mean age = 78.13 years). Data were collected between March-November 2012 and obtained through face-to-face interviews, using the Short-Form-36 Health Survey, Caregiver Burden Inventory, and five cognitive appraisal questions. In addition, the Barthel Index, Modified Rankin Scale, and Glasgow Coma Scale were used to assess patient disease severity. Hierarchical multiple regression analysis was used to identify predictors of health-related quality of life. The results indicated that 61% of participants rated their health as poor or fair. Patient severity, gender of primary support person, age, employment, burden, and cognitive appraisal impact accounted for 45.8% of the variance in primary support persons' physical component summary of health-related quality of life, with age, burden, and appraisal impact being the strongest of six predictors. In addition, burden and appraisal impact were the strongest of six predictors, explaining 18.1% of the variance in primary support persons' mental component summary of health-related quality of life. The results of the current study further highlight the importance of cognitive appraisal on the stroke survivor's primary support person's health-related quality of life.

  14. CETCh-seq: CRISPR epitope tagging ChIP-seq of DNA-binding proteins. (United States)

    Savic, Daniel; Partridge, E Christopher; Newberry, Kimberly M; Smith, Sophia B; Meadows, Sarah K; Roberts, Brian S; Mackiewicz, Mark; Mendenhall, Eric M; Myers, Richard M


    Chromatin immunoprecipitation followed by next-generation DNA sequencing (ChIP-seq) is a widely used technique for identifying transcription factor (TF) binding events throughout an entire genome. However, ChIP-seq is limited by the availability of suitable ChIP-seq grade antibodies, and the vast majority of commercially available antibodies fail to generate usable data sets. To ameliorate these technical obstacles, we present a robust methodological approach for performing ChIP-seq through epitope tagging of endogenous TFs. We used clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9-based genome editing technology to develop CRISPR epitope tagging ChIP-seq (CETCh-seq) of DNA-binding proteins. We assessed the feasibility of CETCh-seq by tagging several DNA-binding proteins spanning a wide range of endogenous expression levels in the hepatocellular carcinoma cell line HepG2. Our data exhibit strong correlations between both replicate types as well as with standard ChIP-seq approaches that use TF antibodies. Notably, we also observed minimal changes to the cellular transcriptome and to the expression of the tagged TF. To examine the robustness of our technique, we further performed CETCh-seq in the breast adenocarcinoma cell line MCF7 as well as mouse embryonic stem cells and observed similarly high correlations. Collectively, these data highlight the applicability of CETCh-seq to accurately define the genome-wide binding profiles of DNA-binding proteins, allowing for a straightforward methodology to potentially assay the complete repertoire of TFs, including the large fraction for which ChIP-quality antibodies are not available. © 2015 Savic et al.; Published by Cold Spring Harbor Laboratory Press.

  15. EMSODEV and EPOS-IP: key findings for effective management of EU research infrastructure projects (United States)

    Materia, Paola; Bozzoli, Sabrina; Beranzoli, Laura; Cocco, Massimo; Favali, Paolo; Freda, Carmela; Sangianantoni, Agata


    EMSO (European Multidisciplinary Seafloor and water-column Observatory, and EPOS (European Plate Observing System, are pan-European Research Infrastructures (RIs) in the ESFRI 2016 Roadmap. EMSO has recently become an ERIC (European Research Infrastructure Consortium), whilst EPOS application is in progress. Both ERICs will be hosted in Italy and the "Representing Entity" is INGV. EMSO consists of oceanic environment observation systems spanning from the Arctic through the Atlantic and Mediterranean, to the Black Sea for long-term, high-resolution, real-time monitoring of natural and man-induced processes such as hazards, climate, and marine ecosystems changes to study their evolution and interconnections. EPOS aims at creating a pan-European infrastructure for solid Earth science to support a safe and sustainable society. EPOS will enable innovative multidisciplinary research for a better understanding of Earth's physical and chemical processes controlling earthquakes, volcanic eruptions, ground instability, tsunami, and all those processes driving tectonics and Earth's surface dynamics. Following the conclusion of their Preparatory Phases the two RIs are now in their Implementation Phase still supported by the EC through the EMSODEV and EPOS-IP projects, both run by dedicated Project Management Offices at INGV with sound experience in EU projects. EMSODEV (H2020 project, 2015-2018) involves 11 partners and 9 associate partners and aims at improving the harmonization among the EMSO ERIC observation systems through the realization of EMSO Generic Instrument Modules (EGIMs), and a Data Management Platform (DMP) to implement interoperability and standardization. The DMP will provide access to data from all EMSO nodes, providing a unified, homogeneous, infrastructure-scale and user-oriented platform integrated with the increased measurement capabilities and functions provided by the EGIMs. EPOS IP (H2020 project, 2015

  16. Improving the quality of paediatric malaria diagnosis and treatment by rural providers in Myanmar: an evaluation of a training and support intervention. (United States)

    Aung, Tin; Longfield, Kim; Aye, Nyo Me; San, Aung Kyaw; Sutton, Thea S; Montagu, Dominic


    This study evaluates the effectiveness of a training programme for improving the diagnostic and treatment quality of the most complex service offered by Sun Primary Health (SPH) providers, paediatric malaria. The study further assesses whether any quality improvements were sustained over the following 12 months. The study took place in 13 townships in central Myanmar between January 2011 and October 2012. A total of 251 community health workers were recruited and trained in the provision of paediatric and adult malaria diagnosis and treatment; 197 were surveyed in all three rounds: baseline, 6 and 12 months. Townships were selected based on a lack of alterative sources of medical care, averaging 20 km from government or private professional health care treatment facilities. Seventy percent of recruits were assistant nurse midwives or had other basic health training; the rest had no health training experience. Recruits were evaluated on their ability to properly diagnosis and treat a simulated 5-year-old patient using a previously validated method known as Observed Simulated Patient. A trained observer scored SPH providers on a scale of 1-100, based on WHO and Myanmar MOH established best practices. During a pilot test, 20 established private physicians operating in malaria-endemic areas of Myanmar scored an average of 70/100. Average quality scores of newly recruited SPH providers prior to training (baseline) were 12/100. Six months after training, average quality scores were 48/100. This increase was statistically significant (p training, providers were retested and average quality scores were 45/100 (R3-R1, p training programme was able to improve the quality of paediatric malaria care significantly, and to maintain that improvement over time. Quality of care remains lower than that of trained physicians; however, SPH providers operate in rural areas where no trained physicians operate. More research is needed to establish acceptable and achievable levels of

  17. Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study. (United States)

    McNabb, Marion; Chukwu, Emeka; Ojo, Oluwayemisi; Shekhar, Navendu; Gill, Christopher J; Salami, Habeeb; Jega, Farouk


    Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs) are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre. Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care. Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (peducation. These study results suggest that the introduction of a low-cost mobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.


    Directory of Open Access Journals (Sweden)

    R. Shalin


    Full Text Available The most preferred mode for communication of multimedia data is through the TCP/IP protocol. But on the other hand the TCP/IP protocol produces huge packet loss unavoidable due to network traffic and congestion. In order to provide a efficient communication it is necessary to recover the loss of packets. The proposed scheme implements Hash based FEC with auto XOR scheme for this purpose. The scheme is implemented through Forward error correction, MD5 and XOR for providing efficient transmission of multimedia data. The proposed scheme provides transmission high accuracy, throughput and low latency and loss.

  19. Analysis list: Atf7ip [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Atf7ip Pluripotent stem cell + mm9 ...

  20. Dbp5, Gle1-IP6 and Nup159 (United States)

    Folkmann, Andrew W.; Noble, Kristen N.; Cole, Charles N.


    Gene expression is a stepwise process involving distinct cellular processes including transcription, mRNA (mRNA) processing, mRNA export, and translation. As mRNAs are being synthesized, proteins associate with the RNA to form messenger ribonucleoprotein particles (mRNPs). Previous studies have demonstrated that the RNA-binding protein composition of these mRNPs is dynamic, changing as the mRNP moves through the different steps of gene expression, and playing a critical role in these events. An important step during this maturation process occurs at the cytoplasmic face of the nuclear pore complex (NPC) where the export protein Gle1 bound to inositol hexakisphosphate (IP6) spatially activates the ATP-hydrolysis and mRNP-remodeling activity of the DEAD-box protein Dbp5. Recent work from our laboratory and others has provided important insights into the function and regulation of Dbp5. These include a more detailed explanation of the mechanism of Dbp5 RNP remodeling, the role of Gle1-IP6 in stimulating Dbp5 ATPase activity, and the identification of a novel paradigm for regulation of Dbp5 by Nup159. Based on in vitro biochemical assays, X-ray crystallography, and corresponding in vivo phenotypes, we propose here an updated model of the Dbp5 cycle during mRNP export through the NPC. This takes into account all available data and provides a platform for future studies. PMID:22064466

  1. Low latency IP mobility management: protocol and analysis

    Directory of Open Access Journals (Sweden)

    Guo Xiaobing


    Full Text Available Abstract Mobile IP is one of the dominating protocols that enable a mobile node to remain reachable while moving around in the Internet. However, it suffers from long handoff latency and route inefficiency. In this article, we present a novel distributed mobility management architecture, ADA (Asymmetric Double-Agents, which introduces double mobility agents to serve one end-to-end communication. One mobility agent is located close to the MN and the other close to the CN. ADA can achieve both low handoff latency and low transmission latency, which is crucial for improvement of user perceived QoS. It also provides an easy-to-use mechanism for MNs to manage and control each traffic session with a different policy and provide specific QoS support. We apply ADA to MIPv6 communications and present a detailed protocol design. Subsequently, we propose an analytical framework for systematic and thorough performance evaluation of mobile IP-based mobility management protocols. Equipped with this model, we analyze the handoff latency, single interaction delay and total time cost under the bidirectional tunneling mode and the route optimization mode for MIPv6, HMIPv6, CNLP, and ADA. Through both quantitative analysis and NS2-based simulations, we show that ADA significantly outperforms the existing mobility management protocols.

  2. Continuous Renal Replacement Therapy: Reviewing Current Best Practice to Provide High-Quality Extracorporeal Therapy to Critically Ill Patients. (United States)

    Connor, Michael J; Karakala, Nithin


    Continuous renal replacement therapy (CRRT) use continues to expand globally. Despite improving technology, CRRT remains a complex intervention. Delivery of high-quality CRRT requires close collaboration of a multidisciplinary team including members of the critical care medicine, nephrology, nursing, pharmacy, and nutrition support teams. While significant gaps in medical evidence regarding CRRT persist, the growing evidence base supports evolving best practice and consensus to define high-quality CRRT. Unfortunately, there is wide variability in CRRT operating characteristics and limited uptake of these best practices. This article will briefly review the current best practice on important aspects of CRRT delivery including CRRT dose, anticoagulation, dialysis vascular access, fluid management, and drug dosing in CRRT. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  3. Evolving science enhanced with iPS

    Directory of Open Access Journals (Sweden)



    Full Text Available Dear friends, Greetings from all in the team. With the stage set for online submissions and the review-response-revision-resubmission process standardized, we have come with the first regular issue and from now there will be quarterly issues of the journal. Since the starting of the JSRM in a short span there have been a lot of developments, which we would rather say as "evolutions" keeping in mind, the recent iPS! This evolution we would like you to see from a background of the various developments in the art and science of medicine throughout in the past three centuries. We have come across the era of investigative tools such as bamboo made laryngoscopes to era of vaccines and antibiotics followed by the era of revolutionary non-invasive procedures and recently the nano technology based drugs and now the iPS! Macro to Micro, but still more to go. All through the influence of the society, religions, philosophies have been playing a very important role in every step the science of biology moves ahead. Starting with the contraception, assisted reproduction then the gene modified plants....and now the embryonic stem cells! With the advent of the iPS, though the issues of oncogenes, teratoma yet to be ruled out, we have found there is a way which can bypass the ES cells! Hats off to those scientists who have burnt their midnight oil to have found this way out! The lesson we learn is to explore things with an open mind and continue to proceed further without spending much time fingers crossed. Yours sincerely,The Editorial team.

  4. [Providing quality pharmaceutical services in Brazil: items pending the unified health on the Unified Health System's agenda]. (United States)

    Vieira, Fabiola Sulpino


    To identify items on the agenda of Brazil's Unified Health System that are related to the quality of pharmaceutical services and have not yet been implemented. Data were collected from the inspection reports issued by the federal government's controllership office. Inspection reports completed from August 2004-July 2006, available on the Internet, were reviewed. The issues identified were classified into 15 categories. Of the 660 inspections that were carried out, 659 were analyzed (one was unavailable). In 62 cities pharmaceutical assistance services had not been audited, therefore, a the final sample of 597 cities was analyzed (10.7% of Brazil's municipalities). Of these, 90.3% had issues associated with the management of resources or services. In 71% of the municipalities, the reports indicated lack of or deficient inventory control, and in 39%, inadequate storage conditions. A shortage of drugs was observed in 24% of the municipalities. The goals of Brazil's national drug and pharmaceutical assistance policies are far from being met. Quality pharmaceutical services must again be included on the agenda at all three government levels since it is impossible to have effective health care without quality pharmaceutical services.

  5. Pre-equilibrium Longitudinal Flow in the IP-Glasma Framework for Pb+Pb Collisions at the LHC (United States)

    McDonald, Scott; Shen, Chun; Fillion-Gourdeau, François; Jeon, Sangyong; Gale, Charles


    In this work, we debut a new implementation of IP-Glasma and quantify the pre-equilibrium longitudinal flow in the IP-Glasma framework. The saturation physics based IP-Glasma model naturally provides a non-zero initial longitudinal flow through its pre-equilibrium Yang-Mills evolution. A hybrid IP-Glasma+MUSIC+UrQMD frame-work is employed to test this new implementation against experimental data and to make further predictions about hadronic flow observables in Pb+Pb collisions at 5.02 TeV. Finally, the non-zero pre-equilibrium longitudinal flow of the IP-Glasma model is quantified, and its origin is briefly discussed.

  6. Optimal design of an IP/MPLS over DWDM network

    Directory of Open Access Journals (Sweden)

    Eduardo Canale


    Full Text Available Different approaches for deploying resilient optical networks of low cost constitute a traditional group of NP-Hard problems that have been widely studied. Most of them are based on the construction of low cost networks that fulfill connectivity constraints. However, recent trends to virtualize optical networks over the legacy fiber infrastructure, modified the nature of network design problems and turned inappropriate many of these models and algorithms. In this paper we study a design problem arising from the deployment of an IP/MPLS network over an existing DWDM infrastructure. Besides cost and resiliency, this problem integrates traffic and capacity constraints. We present: an integer programming formulation for the problem, theoretical results, and describe how several metaheuristics were applied in order to find good quality solutions, for a real application case of a telecommunications company.

  7. The use of microbead-based spoligotyping for Mycobacterium tuberculosis complex to evaluate the quality of the conventional method: providing guidelines for Quality Assurance when working on membranes.

    NARCIS (Netherlands)

    Abadia, E.; Zhang, Jian; Ritacco, V.; Kremer, K.; Ruimy, R.; Rigouts, L.; Gomes, H.M.; Elias, A.R.; Fauville-Dufaux, M.; Stoffels, K.; Rasolofo-Razanamparany, V.; rcia de Viedma, D. Ga; Herranz, M.; Al-Hajoj, S.; Rastogi, N.; Garzelli, C.; Tortoli, E.; Suffys, P.N.; Soolingen, D. van; Refregier, G.; Sola, C.


    BACKGROUND: The classical spoligotyping technique, relying on membrane reverse line-blot hybridization of the spacers of the Mycobacterium tuberculosis CRISPR locus, is used world-wide (598 references in Pubmed on April 8th, 2011). However, until now no inter-laboratory quality control study had

  8. Impact of VoIP and QoS on Open and Distance Learning

    Directory of Open Access Journals (Sweden)

    Sanjay JASOLA


    Full Text Available Voice over Internet Protocol (VoIP is becoming a reality in many organizations. The potential for mobility in voice over wi-fi networks will derive demand for the technology. Wireless VoIP is poised to rival VoIP as an alternative telephony tool. Internet has been used to transport data in the form of packet. In the past, Internet did not support any kind of sophisticated quality of service (QoS mechanism. Although the type of service (TOS field in the Internet protocol (IP header has been existing and has been allowing the differentiated treatment of packets, it was never really used on a large scale. The voice is sensitive to delay and jitter so bandwidth must be guaranteed while transporting it. With the extensive use of Internet for carrying voice, there is a need to add QoS functionality in it. QoS with reference to VoIP has been discussed in the paper. Limited bandwidth and network latency are the issues which need to be considered while using wireless LAN for packetized voice data. Efforts of standards like 802.11e which will take care of these issues, have also been explored. The impact of these technologies on distance education has also been explored in the paper.

  9. ejIP: A TCP/IP Stack for Embedded Java

    DEFF Research Database (Denmark)

    Schoeberl, Martin


    To enable Java on resource constraint embedded devices, the whole system should be implemented in a single programming language to avoid overheads on language boundaries. However, most of the functionality that is dedicated to the operating system layer is usually written in C. In this paper we...... present the design and implementation of a network stack written entirely in Java. This implementation serves as an example how to implement system functions in a safe language and gives evidence that Java can be used for operating system related functionality. The described TCP/IP stack ejIP has already...... been successfully used in industrial projects on pure Java embedded systems....

  10. ReMap 2018: an updated atlas of regulatory regions from an integrative analysis of DNA-binding ChIP-seq experiments. (United States)

    Chèneby, Jeanne; Gheorghe, Marius; Artufel, Marie; Mathelier, Anthony; Ballester, Benoit


    With this latest release of ReMap (, we present a unique collection of regulatory regions in human, as a result of a large-scale integrative analysis of ChIP-seq experiments for hundreds of transcriptional regulators (TRs) such as transcription factors, transcriptional co-activators and chromatin regulators. In 2015, we introduced the ReMap database to capture the genome regulatory space by integrating public ChIP-seq datasets, covering 237 TRs across 13 million (M) peaks. In this release, we have extended this catalog to constitute a unique collection of regulatory regions. Specifically, we have collected, analyzed and retained after quality control a total of 2829 ChIP-seq datasets available from public sources, covering a total of 485 TRs with a catalog of 80M peaks. Additionally, the updated database includes new search features for TR names as well as aliases, including cell line names and the ability to navigate the data directly within genome browsers via public track hubs. Finally, full access to this catalog is available online together with a TR binding enrichment analysis tool. ReMap 2018 provides a significant update of the ReMap database, providing an in depth view of the complexity of the regulatory landscape in human. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.

  11. GMI-IPS: Python Processing Software for Aircraft Campaigns (United States)

    Damon, M. R.; Strode, S. A.; Steenrod, S. D.; Prather, M. J.


    NASA's Atmospheric Tomography Mission (ATom) seeks to understand the impact of anthropogenic air pollution on gases in the Earth's atmosphere. Four flight campaigns are being deployed on a seasonal basis to establish a continuous global-scale data set intended to improve the representation of chemically reactive gases in global atmospheric chemistry models. The Global Modeling Initiative (GMI), is creating chemical transport simulations on a global scale for each of the ATom flight campaigns. To meet the computational demands required to translate the GMI simulation data to grids associated with the flights from the ATom campaigns, the GMI ICARTT Processing Software (GMI-IPS) has been developed and is providing key functionality for data processing and analysis in this ongoing effort. The GMI-IPS is written in Python and provides computational kernels for data interpolation and visualization tasks on GMI simulation data. A key feature of the GMI-IPS, is its ability to read ICARTT files, a text-based file format for airborne instrument data, and extract the required flight information that defines regional and temporal grid parameters associated with an ATom flight. Perhaps most importantly, the GMI-IPS creates ICARTT files containing GMI simulated data, which are used in collaboration with ATom instrument teams and other modeling groups. The initial main task of the GMI-IPS is to interpolate GMI model data to the finer temporal resolution (1-10 seconds) of a given flight. The model data includes basic fields such as temperature and pressure, but the main focus of this effort is to provide species concentrations of chemical gases for ATom flights. The software, which uses parallel computation techniques for data intensive tasks, linearly interpolates each of the model fields to the time resolution of the flight. The temporally interpolated data is then saved to disk, and is used to create additional derived quantities. In order to translate the GMI model data to the

  12. Steganography and steganalysis in voice-over IP scenarios: operational aspects and first experiences with a new steganalysis tool set (United States)

    Dittmann, Jana; Hesse, Danny; Hillert, Reyk


    Based on the knowledge and experiences from existing image steganalysis techniques, the overall objective of the paper is to evaluate existing audio steganography with a special focus on attacks in ad-hoc end-to-end media communications on the example of Voice over IP (VoIP) scenarios. One aspect is to understand operational requirements of recent steganographic techniques for VoIP applications. The other aspect is to elaborate possible steganalysis approaches applied to speech data. In particular we have examined existing VoIP applications with respect to their extensibility to steganographic algorithms. We have also paid attention to the part of steganalysis in PCM audio data which allows us to detect hidden communication while a running VoIP communication with the usage of the PCM codec. In our impelementation we use Jori's Voice over IP library by Jori Liesenborgs (JVOIPLIB) that provides primitives for a voice over IP communication. Finally we show first results of our prototypic implementation which extents the common VoIP scenario by the new feature of steganography. We also show the results for our PCM steganalyzer framework that is able to detect this kind of hidden communication by using a set of 13 first and second order statistics.

  13. Evaluation of VoIP QoS Performance in Wireless Mesh Networks

    Directory of Open Access Journals (Sweden)

    Mohammad Tariq Meeran


    Full Text Available The main focus of this research article is the evaluation of selected voice over Internet protocol (VoIP solutions in wireless mesh network (WMN scenarios. While WMNs have self-healing, self-forming, and dynamic topology features, they still pose challenges for the implementation of multimedia applications such as voice in various scenarios. Therefore, various solutions to make WMN more suitable for VoIP application have been proposed in the scientific literature. In this work, we have extensively explored a set of applicable scenarios by conducting experiments by means of a network simulator. The following scenarios were selected as the most representatives for performance evaluation: first responders, flooded village, remote village, and platoon deployment. Each selected scenario has been studied under six sub-scenarios corresponding to various combinations of the IEEE 802.11g, 802.11n, 802.11s, and 802.11e standards; the G.711 and G.729 codecs; and the ad hoc on demand distance vector (AODV and hybrid wireless mesh protocol (HWMP routing protocols. The results in terms of quality of service (measured with the mean opinion score rating scale, supported by the analysis of delay, jitter and packet loss, show that 802.11g integration with both VoIP codecs and AODV routing protocol results in better VoIP performance as compared to most other scenarios. In case of 802.11g integration with 802.11s, VoIP performance decreases as compared to the other sub-scenarios without 802.11s. The results also show that 802.11n integration with 802.11e decreases VoIP performance in larger deployments. We conclude the paper with some recommendations in terms of combinations of those standards and protocols with a view to achieve a higher quality of service for the given scenarios.

  14. Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study.

    Directory of Open Access Journals (Sweden)

    Marion McNabb

    Full Text Available Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre.Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care.Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (p<0.0001, out of a total possible score of 25, with the most significant improvements related to health counseling, technical services provided, and quality of health education.These study results suggest that the introduction of a low-cost mobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.

  15. Bilateral Waveform Similarity Overlap-and-Add Based Packet Loss Concealment for Voice over IP

    Directory of Open Access Journals (Sweden)

    J.F. Yeh


    Full Text Available This paper invested a bilateral waveform similarity overlap-and-add algorithm for voice packet lost. Since Packet lost will cause the semantic misunderstanding, it has become one of the most essential problems in speech communication. This investment is based on waveform similarity measure using overlap-and-Add algorithm and provides the bilateral information to enhance the speech signal reconstruction. Traditionally, it has been improved that waveform similarity overlap-and-add (WSOLA technique is an effective algorithm to deal with packet loss concealment (PLC for real-time time communication. WSOLA algorithm is widely applied to deal with the length adaptation and packet loss concealment of speech signal. Time scale modification of audio signal is one of the most essential research topics in data communication, especially in voice of IP (VoIP. Herein, the proposed the bilateral WSOLA (BWSOLA that is derived from WSOLA. Instead of only exploitation one direction speech data, the proposed method will reconstruct the lost voice data according to the preceding and cascading data. The related algorithms have been developed to achieve the optimal reconstructing estimation. The experimental results show that the quality of the reconstructed speech signal of the bilateral WSOLA is much better compared to the standard WSOLA and GWSOLA on different packet loss rate and length using the metrics PESQ and MOS. The significant improvement is obtained by bilateral information and proposed method. The proposed bilateral waveform similarity overlap-and-add (BWSOLA outperforms the traditional approaches especially in the long duration data loss.

  16. La competenza per materia delle sezioni IP

    Directory of Open Access Journals (Sweden)

    Luigi Carlo Ubertazzi


    Full Text Available Italian Law 12/12/2002, n. 273 [0] as implemented through the Legislative Decree 168/2003 [1] has created "specialized sections" for IP-related matters in the courts (both first and second level of Bari, Bologna, Catania, Firenze, Genova, Milano, Napoli, Palermo, Roma, Torino, Trieste and Venezia. These sections "deal with cases of national and communitarian trademarks, patents for inventions and new plant varieties, utility models, pictures and models, author rights and all cases of unfair competition when these cases interfere with the protection of industrial and intellectual property". This paper discusses the different positions of Italian law scholars and lawyers as to whether the list of subjects, on which the specialized sections are competent as written in the law, is intensive or extensive - in other words, whether the specialized sections should take care *only* of the matters that the law clearly specifies, or whether they should take care of everything "related to" intellectual and industrial property. In this paper several justifications are made for giving full responsibility to IP sections over all law cases dealing with intellectual property (extensive interpretation, together with a rebuttal of the most relevant positions advocating an intensive interpretation of the law.

  17. Quality and safety of hospital discharge: a study on experiences and perceptions of patients, relatives and care providers

    NARCIS (Netherlands)

    Hesselink, G.J.; Schoonhoven, L.; Plas, M. van der; Wollersheim, H.C.H.; Vernooij-Dassen, M.J.F.J.


    OBJECTIVE: To identify barriers experienced and perceived at discharge by physicians, nurses, patients and relatives. DESIGN: We developed questionnaires based on focus group interviews with hospital and community care providers, and individual interviews with patients and relatives. A survey was

  18. Quality of Service in Networks Supporting Cultural Multimedia Applications (United States)

    Kanellopoulos, Dimitris N.


    Purpose: This paper aims to provide an overview of representative multimedia applications in the cultural heritage sector, as well as research results on quality of service (QoS) mechanisms in internet protocol (IP) networks that support such applications. Design/methodology/approach: The paper's approach is a literature review. Findings: Cultural…

  19. Chromatin immunoprecipitation (ChIP) of plant transcription factors followed by sequencing (ChIP-SEQ) or hybridization to whole genome arrays (ChIP-CHIP)

    NARCIS (Netherlands)

    Kaufmann, K.; Muiño, J.M.; Østerås, M.; Farinelli, L.; Krajewski, P.; Angenent, G.C.


    Chromatin immunoprecipitation (ChIP) is a powerful technique to study interactions between transcription factors (TFs) and DNA in vivo. For genome-wide de novo discovery of TF-binding sites, the DNA that is obtained in ChIP experiments needs to be processed for sequence identification. The sequences

  20. 2D XD-GRASP provides better image quality than conventional 2D cardiac cine MRI for patients who cannot suspend respiration (United States)

    Piekarski, Eve; Chitiboi, Teodora; Ramb, Rebecca; Latson, Larry A; Bhatla, Puneet; Feng, Li; Axel, Leon


    Object Residual respiratory motion degrades image quality in conventional cardiac cine MRI (CCMR). We evaluated whether a free-breathing (FB) radial imaging CCMR sequence with compressed sensing reconstruction (eXtra-Dimension (e.g. cardiac and respiratory phases) Golden-angle RAdial Sparse Parallel, or XD-GRASP) could provide better image quality than a conventional Cartesian breath-held (BH) sequence, in an unselected population of patients undergoing clinical CCMR. Material and Methods 101 patients who underwent BH and FB imaging in a mid-ventricular short-axis plane at a matching location were included. Visual and quantitative image analysis was performed by two blinded experienced readers, using a 5-point qualitative scale to score overall image quality and visual signal-to-noise ratio (SNR) grade, with measures of noise and sharpness. End-diastole (ED) and end-systole (ES) left-ventricular areas were also measured and compared for both BH and FB images. Results Image quality was generally better with the BH cines (overall quality grade BH vs FB: 4 vs 2.9, pcine in general, it provided improved image quality in the subgroup of patients presenting respiratory motion-induced artifacts on breath-held images. PMID:29067539

  1. The directed differentiation of human iPS cells into kidney podocytes.

    Directory of Open Access Journals (Sweden)

    Bi Song

    Full Text Available The loss of glomerular podocytes is a key event in the progression of chronic kidney disease resulting in proteinuria and declining function. Podocytes are slow cycling cells that are considered terminally differentiated. Here we provide the first report of the directed differentiation of induced pluripotent stem (iPS cells to generate kidney cells with podocyte features. The iPS-derived podocytes share a morphological phenotype analogous with cultured human podocytes. Following 10 days of directed differentiation, iPS podocytes had an up-regulated expression of mRNA and protein localization for podocyte markers including synaptopodin, nephrin and Wilm's tumour protein (WT1, combined with a down-regulation of the stem cell marker OCT3/4. In contrast to human podocytes that become quiescent in culture, iPS-derived cells maintain a proliferative capacity suggestive of a more immature phenotype. The transduction of iPS podocytes with fluorescent labeled-talin that were immunostained with podocin showed a cytoplasmic contractile response to angiotensin II (AII. A permeability assay provided functional evidence of albumin uptake in the cytoplasm of iPS podocytes comparable to human podocytes. Moreover, labeled iPS-derived podocytes were found to integrate into reaggregated metanephric kidney explants where they incorporated into developing glomeruli and co-expressed WT1. This study establishes the differentiation of iPS cells to kidney podocytes that will be useful for screening new treatments, understanding podocyte pathogenesis, and offering possibilities for regenerative medicine.

  2. Perceptions of final-year nursing students on the facilities, resources and quality of education provided by schools in Turkey. (United States)

    Güner, Perihan


    The purpose of this study is to determine the perceptions of final-year nursing students regarding the adequacy of education, resources and internships in preparation for graduation. The study design was a descriptive cross-sectional study of nursing students (n: 1804) in their final year of education and questionnaires were used to collect data. Information related to student-to-instructor ratios and internships was obtained from each institution. Most students reported receiving instruction or supervision by lecturers and clinicians who did not specialise in the field. Overall, students did not find the facilities, educational or technological resources and the quality of education offered by their respective schools adequate. The proportion of students who found the level of theoretical education, clinical practice and instructor support adequate was higher in state university colleges of nursing/faculties of health sciences than in state university schools of health sciences.

  3. A high-quality carrot genome assembly provides new insights into carotenoid accumulation and asterid genome evolution. (United States)

    Iorizzo, Massimo; Ellison, Shelby; Senalik, Douglas; Zeng, Peng; Satapoomin, Pimchanok; Huang, Jiaying; Bowman, Megan; Iovene, Marina; Sanseverino, Walter; Cavagnaro, Pablo; Yildiz, Mehtap; Macko-Podgórni, Alicja; Moranska, Emilia; Grzebelus, Ewa; Grzebelus, Dariusz; Ashrafi, Hamid; Zheng, Zhijun; Cheng, Shifeng; Spooner, David; Van Deynze, Allen; Simon, Philipp


    We report a high-quality chromosome-scale assembly and analysis of the carrot (Daucus carota) genome, the first sequenced genome to include a comparative evolutionary analysis among members of the euasterid II clade. We characterized two new polyploidization events, both occurring after the divergence of carrot from members of the Asterales order, clarifying the evolutionary scenario before and after radiation of the two main asterid clades. Large- and small-scale lineage-specific duplications have contributed to the expansion of gene families, including those with roles in flowering time, defense response, flavor, and pigment accumulation. We identified a candidate gene, DCAR_032551, that conditions carotenoid accumulation (Y) in carrot taproot and is coexpressed with several isoprenoid biosynthetic genes. The primary mechanism regulating carotenoid accumulation in carrot taproot is not at the biosynthetic level. We hypothesize that DCAR_032551 regulates upstream photosystem development and functional processes, including photomorphogenesis and root de-etiolation.

  4. The effect of IPS-modified, an early intervention for people with mood and anxiety disorders

    DEFF Research Database (Denmark)

    Hellström, Lone; Bech, Per; Nordentoft, Merete


    Anxiety and affective disorders can be disabling and have a major impact on the ability to work. In Denmark, people with a mental disorder, and mainly non-psychotic disorders, represent a substantial and increasing part of those receiving disability pensions. Previous studies have indicated...... that Individual Placement and Support (IPS) has a positive effect on employment when provided to people with severe mental illness. This modified IPS intervention is aimed at supporting people with recently diagnosed anxiety or affective disorders in regaining their ability to work and facilitate their return...... to work or education.Aim: To investigate whether an early modified IPS intervention has an effect on employment and education when provided to people with recently diagnosed anxiety or affective disorders in a Danish context.Methods/design: The trial is a randomised, assessor-blinded, clinical superiority...

  5. Developing VoIP Honeypots: a Preliminary Investigation into Malfeasant Activity

    Directory of Open Access Journals (Sweden)

    Craig Valli


    Full Text Available 30 years ago PABX systems were compromised by hackers wanting to make long distance calls at some other entities expense. This activity faded as telephony became cheaper and PABX systems had countermeasures installed to overcome attacks. Now the world has moved onto the provision of telephony via broadband enabled Voice over Internet Protocol (VoIP with this service now being provided as a replacement for conventional fixed wire telephony by major telecommunication providers worldwide. Due to increasing bandwidth it is possible for systems to support multiple voice connections simultaneously. The networked nature of the Internet allows for attackers of these VoIP systems to enumerate and potentially attack and compromise a wide range of vulnerable systems. This paper is an outline of preliminary research into malfeasant VoIP activity on the Internet.

  6. Evaluation of input and process components of quality of child health services provided at 24 × 7 primary health centers of a district in Central Gujarat. (United States)

    Chavda, Paragkumar; Misra, Shobha


    With the critical Indian challenge on child survival and health, time is ripe to initiate focus on quality of services apart from measuring coverage, to bring about improvements. To assess the quality of child health services provided at 24 × 7 Primary Health Centers of Vadodara District in Gujarat in terms of Input and Process Indicators. The study was carried out in 12 randomly chosen 24 × 7 Primary Health Centers (PHCs) of Vadodara district using a modified quality assessment checklist of the Program on District Quality Assurance for Reproductive and Child Health (RCH) services with use of scores from May 2010 to June 2011. Inputs assessment was done by facility survey. Process assessment for the four child health service components used actual observation of service, review of records and interview of service providers and clients. The mean obtained score for facilities in Input section was 65%. Highest score was obtained for Drugs and Consumables (86%) followed by Equipments and Supplies (74%). The score obtained for Infrastructure facility was 65%, Personnel and training was 56% and Essential protocols and guidelines scored 43%. The mean obtained score in the process section was 55%. Highest scores were obtained for immunization at 76%. This was followed by newborn care (52%), growth monitoring (52%). management of sick child (41%). Quality improvement efforts should focus not only on resource-intensive structural improvements, but also on cost-effective measures at improving service delivery process, especially adherence to service guidelines by providers.

  7. IPS-1 signaling has a nonredundant role in mediating antiviral responses and the clearance of respiratory syncytial virus. (United States)

    Demoor, Tine; Petersen, Bryan C; Morris, Susan; Mukherjee, Sumanta; Ptaschinski, Catherine; De Almeida Nagata, Denise E; Kawai, Taro; Ito, Toshihiro; Akira, Shizuo; Kunkel, Steven L; Schaller, Matthew A; Lukacs, Nicholas W


    The cytosolic RNA helicases melanoma differentiation-associated gene 5 and retinoic acid-inducible gene-I and their adaptor IFN-β promoter stimulator (IPS-1) have been implicated in the recognition of viral RNA and the production of type I IFN. Complementing the endosomal TLR, melanoma differentiation-associated gene 5, and retinoic acid-inducible gene-I provides alternative mechanisms for viral detection in cells with reduced phagocytosis or autophagy. The infection route of respiratory syncytial virus (RSV)-via fusion of virus particles with the cell membrane-points to IPS-1 signaling as the pathway of choice for downstream antiviral responses. In the current study, viral clearance and inflammation resolution were indeed strongly affected by the absence of an initial IPS-1-mediated IFN-β response. Despite the blunted inflammatory response in IPS-1-deficient alveolar epithelial cells, pulmonary macrophages, and CD11b(+) dendritic cells (DC), the lungs of RSV-infected IPS-1-knockout mice showed augmented recruitment of inflammatory neutrophils, monocytes, and DC. Interestingly, pulmonary CD103(+) DC could functionally compensate for IPS-1 deficiency with the upregulation of certain inflammatory cytokines and chemokines, possibly via TLR3 and TLR7 signaling. The increased inflammation and reduced viral clearance in IPS-1-knockout mice was accompanied by increased T cell activation and IFN-γ production. Experiments with bone marrow chimeras indicated that RSV-induced lung pathology was most severe when IPS-1 expression was lacking in both immune and nonimmune cell populations. Similarly, viral clearance was rescued upon restored IPS-1 signaling in either the nonimmune or the immune compartment. These data support a nonredundant function for IPS-1 in controlling RSV-induced inflammation and viral replication.

  8. Two-dimensional XD-GRASP provides better image quality than conventional 2D cardiac cine MRI for patients who cannot suspend respiration. (United States)

    Piekarski, Eve; Chitiboi, Teodora; Ramb, Rebecca; Latson, Larry A; Bhatla, Puneet; Feng, Li; Axel, Leon


    Residual respiratory motion degrades image quality in conventional cardiac cine MRI (CCMRI). We evaluated whether a free-breathing (FB) radial imaging CCMRI sequence with compressed sensing reconstruction [extradimensional (e.g. cardiac and respiratory phases) golden-angle radial sparse parallel, or XD-GRASP] could provide better image quality than a conventional Cartesian breath-held (BH) sequence in an unselected population of patients undergoing clinical CCMRI. One hundred one patients who underwent BH and FB imaging in a midventricular short-axis plane at a matching location were included. Visual and quantitative image analysis was performed by two blinded experienced readers, using a five-point qualitative scale to score overall image quality and visual signal-to-noise ratio (SNR) grade, with measures of noise and sharpness. End-diastolic and end-systolic left ventricular areas were also measured and compared for both BH and FB images. Image quality was generally better with the BH cines (overall quality grade for BH vs FB images 4 vs 2.9, p images regarding end-diastolic or end-systolic areas (p = 0.35 and p = 0.12). Eighteen of the 101 patients had poor BH image quality (grade 1 or 2). In this subgroup, the quality of the FB images was better (p = 0.0032), as was the SNR grade (p = 0.003), but there were no significant differences regarding noise and sharpness (p = 0.45 and p = 0.47). Although FB XD-GRASP CCMRI was visually inferior to conventional BH CCMRI in general, it provided improved image quality in the subgroup of patients with respiratory-motion-induced artifacts on BH images.


    Directory of Open Access Journals (Sweden)

    Masagus Zainuri


    Full Text Available AbstractInduced Pluripotent Stemcell (iPS are adult cells which the genetic information in the nucleus of those cells being reprogrammed (reprogram by inserting exogenous pluripotential genes. The exogenous gene transduction is using vectors, such as lentivirus, retrovirus, or adenovirus, which suppressed the gene expression of the original cells, so they will express the transduced exogenous gene. Viral vectors are then used to reprogramming and producing iPS clones that are pluripotent. iPS derived from adult cells of patient with certain diseases will be used as a tool to study the mechanisms of those specific diseases and the effects of selected drugs against the diseases. Several previous studies have shown that iPS clones developed from specific genetic disease have its original genotype and retain the character of the response to the drug that similar as the original adult cells. Opportunities for the utilization of autologous iPS cell therapy in the future is wide open as expected iPS transplant will not be rejected when transplanted back to the patient. Behind all its potential, iPS production is still facing some problems to be applicable clinically. The use of viruses as vectors may cause problems due to virus gene sequences may be integrated into the genome of the DNA donor cell, thereby causing mutations of the iPS clones. Several subsequent studies have succeeded in replacing the use of viruses as vectors, but the level of efficiency obtained is still very low. Another problem that arises is that epigenetic changes may occur in iPS cultures. Many advanced research related to iPS may be developed in Indonesia and is necessary to improve the production efficiency of iPS and solve iPS clones epigenetic changes problems in the future.Keywords: iPS, pluripotency, transduction, transfection.AbstrakInduced Pluripotent Stemcell (iPS adalah sel somatic dewasa yang informasi genetika dalam inti selnyadiprogram ulang (reprogram dengan cara

  10. The use of microbead-based spoligotyping for Mycobacterium tuberculosis complex to evaluate the quality of the conventional method: Providing guidelines for Quality Assurance when working on membranes

    Directory of Open Access Journals (Sweden)

    Garzelli Carlo


    Full Text Available Abstract Background The classical spoligotyping technique, relying on membrane reverse line-blot hybridization of the spacers of the Mycobacterium tuberculosis CRISPR locus, is used world-wide (598 references in Pubmed on April 8th, 2011. However, until now no inter-laboratory quality control study had been undertaken to validate this technique. We analyzed the quality of membrane-based spoligotyping by comparing it to the recently introduced and highly robust microbead-based spoligotyping. Nine hundred and twenty-seven isolates were analyzed totaling 39,861 data points. Samples were received from 11 international laboratories with a worldwide distribution. Methods The high-throughput microbead-based Spoligotyping was performed on CTAB and thermolyzate DNA extracted from isolated Mycobacterium tuberculosis complex (MTC strains coming from the genotyping participating centers. Information regarding how the classical Spoligotyping method was performed by center was available. Genotype discriminatory analyses were carried out by comparing the spoligotypes obtained by both methods. The non parametric U-Mann Whitney homogeneity test and the Spearman rank correlation test were performed to validate the observed results. Results Seven out of the 11 laboratories (63 %, perfectly typed more than 90% of isolates, 3 scored between 80-90% and a single center was under 80% reaching 51% concordance only. However, this was mainly due to discordance in a single spacer, likely having a non-functional probe on the membrane used. The centers using thermolyzate DNA performed as well as centers using the more extended CTAB extraction procedure. Few centers shared the same problematic spacers and these problematic spacers were scattered over the whole CRISPR locus (Mostly spacers 15, 14, 18, 37, 39, 40. Conclusions We confirm that classical spoligotyping is a robust method with generally a high reliability in most centers. The applied DNA extraction procedure (CTAB

  11. Using a quality improvement model to enhance providers' performance in maternal and newborn health care : a post-only intervention and comparison design

    NARCIS (Netherlands)

    Ayalew, Firew; Eyassu, Gizachew; Seyoum, Negash; van Roosmalen, Jos; Bazant, Eva; Kim, Young Mi; Tekleberhan, Alemnesh; Gibson, Hannah; Daniel, Ephrem; Stekelenburg, Jelle


    Background: The Standards Based Management and Recognition (SBM-R (R)) approach to quality improvement has been implemented in Ethiopia to strengthen routine maternal and newborn health (MNH) services. This evaluation assessed the effect of the intervention on MNH providers' performance of routine

  12. A reduced factor structure for the PROQOL-HIV questionnaire provided reliable indicators of health-related quality of life. (United States)

    Lalanne, Christophe; Chassany, Olivier; Carrieri, Patrizia; Marcellin, Fabienne; Armstrong, Andrew R; Lert, France; Spire, Bruno; Dray-Spira, Rosemary; Duracinsky, Martin


    To identify a simplified factor structure for the PROQOL-human immunodeficiency virus (HIV) questionnaire to improve the measurement of the health-related quality of life (HRQL) of HIV-positive patients in clinical care and research settings. HRQL data were collected using the eight-dimension PROQOL-HIV questionnaire from 2,537 patients (VESPA2 study). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) validated a simpler four-factor structure and assessed measurement invariance (MI). Multigroup analysis assessed the effect of sex, age, and antiretroviral therapy (ART) on the resulting factor scores. Correlations with symptom and Short Form (SF)-12 self-reports assessed convergent validity. Item analysis, EFA, and CFAs confirmed the validity [comparative fit index (CFI), 0.948; root mean square error of approximation, 0.064] and reliability (α's ≥ 0.8) of four dimensions: physical health and symptoms, health concerns and mental distress, social and intimate relationships, and treatment-related impact. Strong MI was demonstrated across sex and age (decrease in CFI indicator model indicated that HRQL correlated as expected with sex, age, and the ART status. Correlations of HRQL, symptom reports, and SF-12 scores evidenced convergent validity criterion. The simplified factor structure and scoring scheme for PROQOL-HIV will allow clinicians to monitor with greater reliability the HRQL of patients in clinical care and research settings. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Platform for capacity reservation in IP networks

    Directory of Open Access Journals (Sweden)

    Maksić Nataša


    Full Text Available The fast development of multimedia devices and services causes the need for increase of the transport capacity of packet networks. OSPF-TE uses both the information about network topology and the link utilization when finding the routing path. Accordingly, it might find path even in the cases when the shortest path routing would cause overloaded link and dropped packets. In this paper we develop the platform for capacity reservation in IP networks. We implement OSPF-TE protocol as an extension of the existing OSPF. In addition, the basic functionalities of the reservation protocol and the user interface are implemented. We present the simulation environment for the verification of our implementation and for the analysis of various routing algorithms based on the information conveyed by OSPF-TE.


    Directory of Open Access Journals (Sweden)

    Dina Fitrohtur Rohmah


    Full Text Available Text book is an instructional material which is often used in learning. Text book which is used in learning should be contextual with students’ characteristic and environment. The aim of this research is to develop supplement book in learning that is contextual Social Studies Textbooks which is valid, interesting, practical, and effective. Data are collected by questionnaire, test, and documentation. Based on data analysis, it shows that the text book is valid, interseting, practical, and effective to use in learning. Buku ajar merupakan bahan ajar yang sering digunakan dalam pembelajaran. Buku ajar yang digunakan dalam pembelajaran hendaknya kontekstual dengan karakteristik dan lingkungan siswa. Tujuan penelitian ini untuk mengembangkan buku suplemen dalam pembelajaran berupa buku ajar IPS SD berbasis kontekstual yang valid, menarik, praktis, dan efektif. Data dikumpulkan melalui angket, tes, dan dokumentasi. Berdasarkan analisis data, menunjukkan bahwa buku yang dikembangkan valid, menarik, praktis, dan efektif digunakan dalam pembelajaran.

  15. Machinability of IPS Empress 2 framework ceramic. (United States)

    Schmidt, C; Weigl, P


    Using ceramic materials for an automatic production of ceramic dentures by CAD/CAM is a challenge, because many technological, medical, and optical demands must be considered. The IPS Empress 2 framework ceramic meets most of them. This study shows the possibilities for machining this ceramic with economical parameters. The long life-time requirement for ceramic dentures requires a ductile machined surface to avoid the well-known subsurface damages of brittle materials caused by machining. Slow and rapid damage propagation begins at break outs and cracks, and limits life-time significantly. Therefore, ductile machined surfaces are an important demand for machine dental ceramics. The machining tests were performed with various parameters such as tool grain size and feed speed. Denture ceramics were machined by jig grinding on a 5-axis CNC milling machine (Maho HGF 500) with a high-speed spindle up to 120,000 rpm. The results of the wear test indicate low tool wear. With one tool, you can machine eight occlusal surfaces including roughing and finishing. One occlusal surface takes about 60 min machining time. Recommended parameters for roughing are middle diamond grain size (D107), cutting speed v(c) = 4.7 m/s, feed speed v(ft) = 1000 mm/min, depth of cut a(e) = 0.06 mm, width of contact a(p) = 0.8 mm, and for finishing ultra fine diamond grain size (D46), cutting speed v(c) = 4.7 m/s, feed speed v(ft) = 100 mm/min, depth of cut a(e) = 0.02 mm, width of contact a(p) = 0.8 mm. The results of the machining tests give a reference for using IPS Empress(R) 2 framework ceramic in CAD/CAM systems. Copyright 2000 John Wiley & Sons, Inc.

  16. Benthic Food Web Structure across the Canadian Arctic Ocean: Insights from stable isotopes and the IP25 biomarker (United States)

    Friscourt, N.; Archambault, P.; Masse, G.; Nozais, C.


    In recent decades, the Arctic Ocean has undergone unprecedented changes, such as an increase in the surface temperature and a reduction of sea ice cover. These changes may cause variations in the intensity and spatial distribution of primary production and the nature of pelagic-benthic coupling. This could affect the amount and quality of organic matter that settles onto the seafloor, and the benthic communities that feed upon it. The objectives of this study were i) to describe the trophic structure and resilience of regional benthic food webs using stable carbon and nitrogen isotope analyses and ii) to evaluate the significance of ice algae in the diet of benthic communities using the sea ice proxy IP25. The study area extends from the North Water Polynya to the Chukchi Sea across five geographic regions (North Water Polynya, Canadian Archipelago, Amundsen Gulf, Beaufort Sea and Chukchi Sea) based on environmental factors. To reach these objectives, we collected particulate organic matter (POM), sediments and zoobenthic samples from July to October 2014 aboard the CCGS Amundsen. Stable isotope and IP25 data, the trophic structure within regions and comparison between regions will be presented. Potential impacts of climate change and human activities on benthic ecosystems in the Arctic are still difficult to assess because of the lack of baseline data. The baseline data once provided will enable us to make further predictions on how these changes may affect benthic food web structure.

  17. A Quality Improvement Project to Improve Education Provided by Nurses to ED Patients Prescribed Opioid Analgesics at Discharge. (United States)

    Waszak, Daria L; Mitchell, Ann M; Ren, Dianxu; Fennimore, Laura A


    The opioid crisis continues to take an unprecedented number of lives and is the top cause of injury death in the United States. The emergency department is a setting where patients with pain seek care and may be prescribed an opioid, yet many patients do not receive evidence-based education about taking their opioid safely. Like many communities across the country, Allegheny County, Pennsylvania, has experienced an increased rate of opioid overdoses; from 2015-2016, the number of opioid-related overdose deaths in the county increased by 44%. This quality improvement project is the implementation of a nurse-delivered, evidence-based education initiative for patients prescribed an opioid in an emergency department. Nurses were briefly trained on opioid safety and patient education, then over 12 weeks, delivered the dual-modal (verbal and written) education with a patient teach-back to verify comprehension. Nurses who completed the project training on opioid safety and patient education had a statistically significant improvement in their knowledge. Patient satisfaction surveys showed 100% of patients reported clear understanding of how to take their pain medication, and out of the patients receiving the opioid pain education for the first time, 88.2% learned something new about how to safely take, store, or dispose of their pain medication. Improving the delivery of opioid prescription education at emergency department discharge will enhance patient knowledge and promote safety, which may help mitigate the opioid crisis by reducing the rate of opioid use disorder and accidental overdoses. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Extending Tactical Fleet Communications Through VoIP (United States)


    Router Network SPIT Spam-over-Internet- Telephony SRTP Secure Real-time Transport Protocol SVoIP Secure Voice Over IP TCP Transmission Control...that encodes and decodes (digital to analog or analog to digital) a signal for efficient transmission . In VoIP terminology the term codec describes the...designed for this purpose [47]. It takes an analog audio signal on a voice interface port and converts it to RTP audio packets for digital transmission

  19. Adoption and Usage of mHealth Technology on Quality and Experience of Care Provided by Frontline Workers: Observations From Rural India. (United States)

    Kaphle, Sangya; Chaturvedi, Sharad; Chaudhuri, Indrajit; Krishnan, Ram; Lesh, Neal


    mHealth apps are deployed with the aim of improving access, quality, and experience of health care. It is possible that any mHealth intervention can yield differential impacts for different types of users. Mediating and determining factors, including personal and socioeconomic factors, affect technology adoption, the way health workers leverage and use the technology, and subsequently the quality and experience of care they provide. To develop a framework to assess whether mHealth platforms affect the quality and experience of care provided by frontline workers, and whether these effects on quality and experience are different depending on the level of technology adoption and individual characteristics of the health worker. Literacy, education, age, and previous mobile experience are identified as individual factors that affect technology adoption and use, as well as factors that affect the quality and experience of care directly and via the technology. Formative research was conducted with 15 community health workers (CHWs) using CommCare, an mHealth app for maternal and newborn care, in Bihar, India. CHWs were first classified on the level of CommCare adoption using data from CommCareHQ and were then shadowed on home visits to evaluate their levels of technology proficiency, and the quality and experience of care provided. Regression techniques were employed to test the relationships. Out of all the CHWs, 2 of them refused to participate in the home visits, however, we did have information on their levels of technology adoption and background characteristics, which were included in the analysis as relevant. Level of technology adoption was important for both quality and experience of care. The quality score for high users of CommCare was higher by 33.4% (P=.04), on average, compared to low users of CommCare. Those who scored higher on CommCare proficiency also provided significantly higher quality and experience of care, where an additional point in Comm

  20. Pipeline for the Analysis of ChIP-seq Data and New Motif Ranking Procedure

    KAUST Repository

    Ashoor, Haitham


    This thesis presents a computational methodology for ab-initio identification of transcription factor binding sites based on ChIP-seq data. This method consists of three main steps, namely ChIP-seq data processing, motif discovery and models selection. A novel method for ranking the models of motifs identified in this process is proposed. This method combines multiple factors in order to rank the provided candidate motifs. It combines the model coverage of the ChIP-seq fragments that contain motifs from which that model is built, the suitable background data made up of shuffled ChIP-seq fragments, and the p-value that resulted from evaluating the model on actual and background data. Two ChIP-seq datasets retrieved from ENCODE project are used to evaluate and demonstrate the ability of the method to predict correct TFBSs with high precision. The first dataset relates to neuron-restrictive silencer factor, NRSF, while the second one corresponds to growth-associated binding protein, GABP. The pipeline system shows high precision prediction for both datasets, as in both cases the top ranked motif closely resembles the known motifs for the respective transcription factors.

  1. Connexin expression and gap-junctional intercellular communication in ES cells and iPS cells. (United States)

    Oyamada, Masahito; Takebe, Kumiko; Endo, Aya; Hara, Sachiko; Oyamada, Yumiko


    Pluripotent stem cells, i.e., embryonic stem (ES) and induced pluripotent stem (iPS) cells, can indefinitely proliferate without commitment and differentiate into all cell lineages. ES cells are derived from the inner cell mass of the preimplantation blastocyst, whereas iPS cells are generated from somatic cells by overexpression of a few transcription factors. Many studies have demonstrated that mouse and human iPS cells are highly similar but not identical to their respective ES cell counterparts. The potential to generate basically any differentiated cell types from these cells offers the possibility to establish new models of mammalian development and to create new sources of cells for regenerative medicine. ES cells and iPS cells also provide useful models to study connexin expression and gap-junctional intercellular communication (GJIC) during cell differentiation and reprogramming. In 1996, we reported connexin expression and GJIC in mouse ES cells. Because a substantial number of papers on these subjects have been published since our report, this Mini Review summarizes currently available data on connexin expression and GJIC in ES cells and iPS cells during undifferentiated state, differentiation, and reprogramming.

  2. Phenotypic correction of murine hemophilia A using an iPS cell-based therapy. (United States)

    Xu, Dan; Alipio, Zaida; Fink, Louis M; Adcock, Dorothy M; Yang, Jianchang; Ward, David C; Ma, Yupo


    Hemophilia A is caused by mutations within the Factor VIII (FVIII) gene that lead to depleted protein production and inefficient blood clotting. Several attempts at gene therapy have failed for various reasons-including immune rejection. The recent generation of induced pluripotent stem (iPS) cells from somatic cells by the ectopic expression of 3 transcription factors, Oct4, Sox2, and Klf4, provides a means of circumventing the immune rejection barrier. To date, iPS cells appear to be indistinguishable from ES cells and thus provide tremendous therapeutic potential. Here we prepared murine iPS cells from tail-tip fibroblasts and differentiated them to both endothelial cells and endothelial progenitor cells by using the embryoid body differentiation method. These iPS cells express major ES cell markers such as Oct4, Nanog, SSEA-1, alkaline phosphatase, and SALL4. Endothelial/endothelial progenitor cells derived from iPS cells expressed cell-specific markers such as CD31, CD34, and Flk1 and secreted FVIII protein. These iPS-derived cells were injected directly into the liver of irradiated hemophilia A mice. At various times after transplantation (7-90 days) hemophilia A mice and their control mice counterparts were challenged by a tail-clip bleeding assay. Nontransplanted hemophilia A mice died within a few hours, whereas transplanted mice survived for more than 3 months. Plasma FVIII levels increased in transplanted hemophilia A mice during this period to 8% to 12% of wild type and corrected the hemophilia A phenotype. Our studies provide additional evidence that iPS cell therapy may be able to treat human monogenetic disorders in the future.

  3. Diffusion of IP Telephony in Undergraduate Private Colleges

    Directory of Open Access Journals (Sweden)

    Patrick C. Olson, PhD


    Full Text Available Over the summer of 2000 Menlo College implemented enterprise wide Internet Protocol (IP Telephony (Voice over Internet Protocol [VoIP]. More than five years have passed, and analysts are predicting that in the near future the only available Private Branch Exchange (PBX solutions will be VoIP [4]. In view of this market trend, the diffusion of this technology in these institutions seems slow. The Menlo College implementation is very successful, but has the concept diffused to other institutions? What factors influence the diffusion of this technology to other institutions? This paper examines the status of VoIP at these institutions.

  4. Mobile location services over the next generation IP core network

    DEFF Research Database (Denmark)

    Thongthammachart, Saowanee; Olesen, Henning


    network is changing from circuit-switched to packet-switched technology and evolving to an IP core network based on IPv6. The IP core network will allow all IP devices to be connected seamlessly. Due to the movement detection mechanism of Mobile IPv6, mobile terminals will periodically update....... The concept of mobile location services over the next generation IP networks is described. We also discuss the effectiveness of the short-range wireless network regarding a mobile user's position inside buildings and hotspot areas....

  5. Inositol hexaphosphate (IP6): a novel treatment for pancreatic cancer. (United States)

    Somasundar, Ponnandai; Riggs, Dale R; Jackson, Barbara J; Cunningham, Cynthia; Vona-Davis, Linda; McFadden, David W


    Inositol hexaphosphate (IP6) is a naturally occurring polyphosphorylated carbohydrate found in food sources high in fiber content. IP6 has been reported to have significant inhibitory effects against a variety of primary tumors including breast and colon. The effects of IP6 have not been evaluated in pancreatic cancer. We hypothesized that IP6 would significantly inhibit cell growth and increase the apoptotic rate of pancreatic cancer in vitro. Two pancreatic cancer cell lines (MIAPACA and PANC1) were cultured using standard techniques and treated with IP6 at doses of 0.5, 1.0, and 5.0 mm. Cell viability was measured by MTT at 24 and 72 h. Apoptosis was evaluated by Annexin V-FITC and results calculated using FACS analysis. Statistical analysis was performed by ANOVA. Significant reductions (P < 0.01) in cellular proliferation were observed with all IP6 concentrations tested in both cell lines and at both time points. Reductions in cell proliferation ranged from 37.1 to 91.5%. IP6 increased early and late apoptotic activity (P < 0.01). Treatment of pancreatic cancer with the common dietary polyphosphorylated carbohydrate IP6 significantly decreased cellular growth and increased apoptosis. Our findings suggest that IP6 has the potential to become an effective adjunct for pancreatic cancer treatment. Further in vivo and human studies are needed to evaluate safety and clinical utility of this agent in patients with pancreatic cancer.

  6. Nurse-midwifery education through graduate programs to provide a sufficient number of high quality nurse-midwives

    Directory of Open Access Journals (Sweden)

    Kyung Hye Lee


    Full Text Available There is a decrease in the number of new midwives, resulting from the shutdown of midwifery education program in hospitals due to a decrease in birthrate in the Republic of Korea. To solve this problem, the current medical laws on midwifery education system in Korea should be revised; nurse-midwifery specialist programs must be established in educational institutes with nursing programs. To support this argument, the midwifery education programs of America, Europe, Australia, and Japan have been discussed, and a nurse-midwifery specialist curriculum at the master s level, based on the nurse-practitioner system of Korea, has been suggested. Since this assertion is very important and urgent for solving the future population problem of Korea and providing health care for women and children, it should be realized into action immediately.

  7. Protocol: methodology for chromatin immunoprecipitation (ChIP in Chlamydomonas reinhardtii

    Directory of Open Access Journals (Sweden)

    Strenkert Daniela


    Full Text Available Abstract We report on a detailed chromatin immunoprecipitation (ChIP protocol for the unicellular green alga Chlamydomonas reinhardtii. The protocol is suitable for the analysis of nucleosome occupancy, histone modifications and transcription factor binding sites at the level of mononucleosomes for targeted and genome-wide studies. We describe the optimization of conditions for crosslinking, chromatin fragmentation and antibody titer determination and provide recommendations and an example for the normalization of ChIP results as determined by real-time PCR.

  8. IPS activity observed as a precursor of solar induced terrestrial activity. [solar wind density fluctuations (United States)

    Cronyn, W. M.; Shawhan, S. D.; Rickard, J. J.; Mitchell, D. G.; Roelof, E. C.; Gotwols, B. L.


    A radio telescope designed to exploit the interplanetary scintillation (IPS) technique and locate, map, and track solar wind disturbances which result in geomagnetic disturbances, thereby providing a forecast capability, is described. Preliminary results from operation of the telescope include: (1) evidence for a precursor signal in the IPS activity with a 1-2 day lead time with respect to density enhancements which frequently give rise to geomagnetic activity; (2) detection of a spectral broadening signature which also serves as a precursor of geomagnetic activity; (3) out-of-the-ecliptic plasma density enhancements which were not detected by near-Earth, ecliptic plane spacecraft; (4) detection of 12 corotating density enhancements;(5) detection of over 80 sources which give detectable scintillation of which 45 have been used for detailed synoptic analysis and 9 for spectral analysis; and (6) measurement of 0-lag coefficient of 0.56 between density and IPS activity enhancements.

  9. Whole Genome Chromatin IP-Sequencing (ChIP-Seq) in Skeletal Muscle Cells. (United States)

    So, Karl Kamhei; Peng, Xianlu Laura; Sun, Hao; Wang, Huating


    Transcriptional control of gene expression in skeletal muscle cell is involved in different processes ranging from muscle formation to regeneration. The identification of an increasing number of transcription factors, co-factors, and histone modifications has been greatly advanced by methods that allow studies of genome-wide chromatin-protein interactions. Chromatin immunoprecipitation with massively parallel DNA sequencing, or ChIP-seq, is a powerful tool for identifying binding sites of TFs/co-factors and histone modifications. The major steps of this technique involve immunoprecipitation of fragmented chromatin, followed by high-throughput sequencing to identify the protein bound regions genome-wide. Here, in this protocol, we will illustrate how the entire ChIP-seq is performed using global H3K27ac profiling in myoblast cells as an example.

  10. Computational Methods for ChIP-seq Data Analysis and Applications

    KAUST Repository

    Ashoor, Haitham


    The development of Chromatin immunoprecipitation followed by sequencing (ChIP-seq) technology has enabled the construction of genome-wide maps of protein-DNA interaction. Such maps provide information about transcriptional regulation at the epigenetic level (histone modifications and histone variants) and at the level of transcription factor (TF) activity. This dissertation presents novel computational methods for ChIP-seq data analysis and applications. The work of this dissertation addresses four main challenges. First, I address the problem of detecting histone modifications from ChIP-seq cancer samples. The presence of copy number variations (CNVs) in cancer samples results in statistical biases that lead to inaccurate predictions when standard methods are used. To overcome this issue I developed HMCan, a specially designed algorithm to handle ChIP-seq cancer data by accounting for the presence of CNVs. When using ChIP-seq data from cancer cells, HMCan demonstrates unbiased and accurate predictions compared to the standard state of the art methods. Second, I address the problem of identifying changes in histone modifications between two ChIP-seq samples with different genetic backgrounds (for example cancer vs. normal). In addition to CNVs, different antibody efficiency between samples and presence of samples replicates are challenges for this problem. To overcome these issues, I developed the HMCan-diff algorithm as an extension to HMCan. HMCan-diff implements robust normalization methods to address the challenges listed above. HMCan-diff significantly outperforms another state of the art methods on data containing cancer samples. Third, I investigate and analyze predictions of different methods for enhancer prediction based on ChIP-seq data. The analysis shows that predictions generated by different methods are poorly overlapping. To overcome this issue, I developed DENdb, a database that integrates enhancer predictions from different methods. DENdb also

  11. Molecular mechanisms for the antitumor activity of inositol hexakisphosphate (IP6). (United States)

    Bozsik, Anikó; Kökény, Szabolcs; Olah, Edith


    Inositol hexakisphosphate (IP6), a naturally occurring polyphosphorylated carbohydrate, has been reported to have significant in vivo and in vitro anticancer activity against numerous tumors. However, the molecular mechanism of the anticancer effect of IP6 has not been fully elucidated. Using K-562 human leukemia cells we analysed the induction of the erythroid differentiation program, as well as modulation of the gene expression profile of K-562 leukemia cells treated with IP6. A single treatment with IP6 (0.75 or 5.0 mM) resulted in a time- and dose-dependent growth inhibition of K-562 cells and also activation of the erythroid differentiation program. K-562 cells expressed a concomitant differentiation after 12 hours of exposure. Possible molecular mechanisms and key signaling pathways, as well as gene expression behind this anticancer effect were examined using oligonucleotide microarrays and quantitative real-time PCR. Treatment with IP6 (750 microM, 5 mM) had a marked impact, resulting in early (60 min) and late (12 h) modulation of expression of about 1800 and 1200 transcripts (at p<0.05). Through microarray analysis, the anticancer effect of IP6 in K-562 was found to be associated with the modulation of multiple genes involved in immunity, Wnt and IGF pathways, PI3 kinase signaling and apoptosis. Using selected subsets of genes, the microarray hits could be validated by Q-PCR. A 2-fold upregulation of the apoptosis pathway, measured using the BAX/BCL-2 ratio was observed for 12 hours. IP6 (5 mM) induced up to 6-fold increases in differentiation measured by hemoglobin synthesis, yielding up to 70% of benzidine-positive cells at 120 hours. The results of this study show that IP6 is a strong inducer of differentiation (cytostatic effect) and a moderately strong inducer of apoptosis (cytotoxic effect). Evidence has been provided to show that the growth inhibitory effects of IP6 are mediated through the modulation of key signaling pathways.

  12. ChIP-seq Identification of Weakly Conserved Heart Enhancers

    Energy Technology Data Exchange (ETDEWEB)

    Blow, Matthew J.; McCulley, David J.; Li, Zirong; Zhang, Tao; Akiyama, Jennifer A.; Holt, Amy; Plajzer-Frick, Ingrid; Shoukry, Malak; Wright, Crystal; Chen, Feng; Afzal, Veena; Bristow, James; Ren, Bing; Black, Brian L.; Rubin, Edward M.; Visel, Axel; Pennacchio, Len A.


    Accurate control of tissue-specific gene expression plays a pivotal role in heart development, but few cardiac transcriptional enhancers have thus far been identified. Extreme non-coding sequence conservation successfully predicts enhancers active in many tissues, but fails to identify substantial numbers of heart enhancers. Here we used ChIP-seq with the enhancer-associated protein p300 from mouse embryonic day 11.5 heart tissue to identify over three thousand candidate heart enhancers genome-wide. Compared to other tissues studied at this time-point, most candidate heart enhancers are less deeply conserved in vertebrate evolution. Nevertheless, the testing of 130 candidate regions in a transgenic mouse assay revealed that most of them reproducibly function as enhancers active in the heart, irrespective of their degree of evolutionary constraint. These results provide evidence for a large population of poorly conserved heart enhancers and suggest that the evolutionary constraint of embryonic enhancers can vary depending on tissue type.

  13. Secure Protocol and IP Core for Configuration of Networking Hardware IPs in the Smart Grid

    Directory of Open Access Journals (Sweden)

    Marcelo Urbina


    Full Text Available Nowadays, the incorporation and constant evolution of communication networks in the electricity sector have given rise to the so-called Smart Grid, which is why it is necessary to have devices that are capable of managing new communication protocols, guaranteeing the strict requirements of processing required by the electricity sector. In this context, intelligent electronic devices (IEDs with network architectures are currently available to meet the communication, real-time processing and interoperability requirements of the Smart Grid. The new generation IEDs include an Field Programmable Gate Array (FPGA, to support specialized networking switching architectures for the electric sector, as the IEEE 1588-aware High-availability Seamless Redundancy/Parallel Redundancy Protocol (HSR/PRP. Another advantage to using an FPGA is the ability to update or reconfigure the design to support new requirements that are being raised to the standards (IEC 61850. The update of the architecture implemented in the FPGA can be done remotely, but it is necessary to establish a cyber security mechanism since the communication link generates vulnerability in the case the attacker gains physical access to the network. The research presented in this paper proposes a secure protocol and Intellectual Property (IP core for configuring and monitoring the networking IPs implemented in a Field Programmable Gate Array (FPGA. The FPGA based implementation proposed overcomes this issue using a light Layer-2 protocol fully implemented on hardware and protected by strong cryptographic algorithms (AES-GCM, defined in the IEC 61850-90-5 standard. The proposed secure protocol and IP core are applicable in any field where remote configuration over Ethernet is required for IP cores in FPGAs. In this paper, the proposal is validated in communications hardware for Smart Grids.

  14. Improving health care quality for racial/ethnic minorities: a systematic review of the best evidence regarding provider and organization interventions

    Directory of Open Access Journals (Sweden)

    Smarth Carole


    Full Text Available Abstract Background Despite awareness of inequities in health care quality, little is known about strategies that could improve the quality of healthcare for ethnic minority populations. We conducted a systematic literature review and analysis to synthesize the findings of controlled studies evaluating interventions targeted at health care providers to improve health care quality or reduce disparities in care for racial/ethnic minorities. Methods We performed electronic and hand searches from 1980 through June 2003 to identify randomized controlled trials or concurrent controlled trials. Reviewers abstracted data from studies to determine study characteristics, results, and quality. We graded the strength of the evidence as excellent, good, fair or poor using predetermined criteria. The main outcome measures were evidence of effectiveness and cost of strategies to improve health care quality or reduce disparities in care for racial/ethnic minorities. Results Twenty-seven studies met criteria for review. Almost all (n = 26 took place in the primary care setting, and most (n = 19 focused on improving provision of preventive services. Only two studies were designed specifically to meet the needs of racial/ethnic minority patients. All 10 studies that used a provider reminder system for provision of standardized services (mostly preventive reported favorable outcomes. The following quality improvement strategies demonstrated favorable results but were used in a small number of studies: bypassing the physician to offer preventive services directly to patients (2 of 2 studies favorable, provider education alone (2 of 2 studies favorable, use of a structured questionnaire to assess adolescent health behaviors (1 of 1 study favorable, and use of remote simultaneous translation (1 of 1 study favorable. Interventions employing more than one main strategy were used in 9 studies with inconsistent results. There were limited data on the costs of these

  15. Linking international trademark databases to inform IP research and policy

    Energy Technology Data Exchange (ETDEWEB)

    Petrie, P.


    Researchers and policy makers are concerned with many international issues regarding trademarks, such as trademark squatting, cluttering, and dilution. Trademark application data can provide an evidence base to inform government policy regarding these issues, and can also produce quantitative insights into economic trends and brand dynamics. Currently, national trademark databases can provide insight into economic and brand dynamics at the national level, but gaining such insight at an international level is more difficult due to a lack of internationally linked trademark data. We are in the process of building a harmonised international trademark database (the “Patstat of trademarks”), in which equivalent trademarks have been identified across national offices. We have developed a pilot database that incorporates 6.4 million U.S., 1.3 million Australian, and 0.5 million New Zealand trademark applications, spanning over 100 years. The database will be extended to incorporate trademark data from other participating intellectual property (IP) offices as they join the project. Confirmed partners include the United Kingdom, WIPO, and OHIM. We will continue to expand the scope of the project, and intend to include many more IP offices from around the world. In addition to building the pilot database, we have developed a linking algorithm that identifies equivalent trademarks (TMs) across the three jurisdictions. The algorithm can currently be applied to all applications that contain TM text; i.e. around 96% of all applications. In its current state, the algorithm successfully identifies ~ 97% of equivalent TMs that are known to be linked a priori, as they have shared international registration number through the Madrid protocol. When complete, the internationally linked trademark database will be a valuable resource for researchers and policy-makers in fields such as econometrics, intellectual property rights, and brand policy. (Author)

  16. Information technology implementing globalization on strategies for quality care provided to children submitted to cardiac surgery: International Quality Improvement Collaborative Program - IQIC (United States)

    Sciarra, Adilia Maria Pires; Croti, Ulisses Alexandre; Batigalia, Fernando


    Introduction Congenital heart diseases are the world's most common major birth defect, affecting one in every 120 children. Ninety percent of these children are born in areas where appropriate medical care is inadequate or unavailable. Objective To share knowledge and experience between an international center of excellence in pediatric cardiac surgery and a related program in Brazil. Methods The strategy used by the program was based on long-term technological and educational support models used in that center, contributing to the creation and implementation of new programs. The Telemedicine platform was used for real-time monthly broadcast of themes. A chat software was used for interaction between participating members and the group from the center of excellence. Results Professionals specialized in care provided to the mentioned population had the opportunity to share to the knowledge conveyed. Conclusion It was possible to observe that the technological resources that implement the globalization of human knowledge were effective in the dissemination and improvement of the team regarding the care provided to children with congenital heart diseases. PMID:24896168

  17. Information technology implementing globalization on strategies for quality care provided to children submitted to cardiac surgery: International Quality Improvement Collaborative Program--IQIC. (United States)

    Sciarra, Adilia Maria Pires; Croti, Ulisses Alexandre; Batigalia, Fernando


    Congenital heart diseases are the world's most common major birth defect, affecting one in every 120 children. Ninety percent of these children are born in areas where appropriate medical care is inadequate or unavailable. To share knowledge and experience between an international center of excellence in pediatric cardiac surgery and a related program in Brazil. The strategy used by the program was based on long-term technological and educational support models used in that center, contributing to the creation and implementation of new programs. The Telemedicine platform was used for real-time monthly broadcast of themes. A chat software was used for interaction between participating members and the group from the center of excellence. Professionals specialized in care provided to the mentioned population had the opportunity to share to the knowledge conveyed. It was possible to observe that the technological resources that implement the globalization of human knowledge were effective in the dissemination and improvement of the team regarding the care provided to children with congenital heart diseases.

  18. A Vote for School Lunches: School Lunches Provide Superior Nutrient Quality than Lunches Obtained from Other Sources in a Nationally Representative Sample of US Children

    Directory of Open Access Journals (Sweden)

    Jacqueline A. Vernarelli


    Full Text Available Childhood obesity is an ongoing public health program. As such, a major public health research objective is to identify potential targets for intervention; one such area is school lunches (SL. The National School Lunch Program (NSLP serves over 31 million children each day; the National Health and Nutrition Examination Survey (NHANES is uniquely positioned to allow researchers to assess diet quality in federal nutrition assistance programs. The objective of the study was to investigate whether lunches provided by schools provide different nutritional value than lunches obtained elsewhere. In a nationally representative sample of 2190 children, consumption of a school-provided lunch (SL was associated with greater nutritional quality compared to lunches obtained elsewhere across both age and income categories. Children who were eligible for no-cost school lunch, but did not participate in the NSLP consumed approximately 60% more energy, 58% more total fat, 60% more saturated fat, 50% more solid fat, 61% more sodium, double the amount of added sugars and less than half the amount of fruit than NSLP participants (all p < 0.001. The results of this study suggest that though widely criticized, school lunches provide superior nutrient quality than lunches obtained from other sources, particularly for low-income children.

  19. Antigen list - ChIP-Atlas | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available Description of data contents A list of all antigen names of data provided on ChIP-Atlas. See details here: https:...See details of data processing here: N

  20. Cell type list - ChIP-Atlas | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available 005 Description of data contents A list of all cell type names of data provided on ChIP-Atlas. See details here: https:...s method See details of data processing here:

  1. Dynamic energy management employing renewable energy sources in IP over DWDM networks

    DEFF Research Database (Denmark)

    Chen, Xin; Phillips, Chris; Wang, Jiayuan


    management framework employing renewable energy sources in IP over DWDM core networks. The main concept is to combine infrastructure sleeping and virtual router migration to improve the network energy efficiency. By using the energy source information provided by the smart grid, the nodes that are powered...

  2. A Network Steganography Lab on Detecting TCP/IP Covert Channels (United States)

    Zseby, Tanja; Vázquez, Félix Iglesias; Bernhardt, Valentin; Frkat, Davor; Annessi, Robert


    This paper presents a network security laboratory to teach data analysis for detecting TCP/IP covert channels. The laboratory is mainly designed for students of electrical engineering, but is open to students of other technical disciplines with similar background. Covert channels provide a method for leaking data from protected systems, which is a…

  3. Efficacy of IP6 + inositol in the treatment of breast cancer patients receiving chemotherapy: prospective, randomized, pilot clinical study. (United States)

    Bacić, Ivan; Druzijanić, Nikica; Karlo, Robert; Skifić, Ivan; Jagić, Stjepan


    Prospective, randomized, pilot clinical study was conducted to evaluate the beneficial effects of inositol hexaphosphate (IP6) + Inositol in breast cancer patients treated with adjuvant therapy. Patients with invasive ductal breast cancer where polychemotherapy was indicated were monitored in the period from 2005-2007. Fourteen patients in the same stage of ductal invasive breast cancer were involved in the study, divided in two randomized groups. One group was subjected to take IP6 + Inositol while the other group was taking placebo. In both groups of patients the same laboratory parameters were monitored. When the treatment was finished, all patients have filled questionnaires QLQ C30 and QLQ-BR23 to determine the quality of life. Patients receiving chemotherapy, along with IP6 + Inositol did not have cytopenia, drop in leukocyte and platelet counts. Red blood cell counts and tumor markers were unaltered in both groups. However, patients who took IP6 + Inositol had significantly better quality of life (p = 0.05) and functional status (p = 0.0003) and were able to perform their daily activities. IP6 + Inositol as an adjunctive therapy is valuable help in ameliorating the side effects and preserving quality of life among the patients treated with chemotherapy.

  4. Validation of a new method for testing provider clinical quality in rural settings in low- and middle-income countries: the observed simulated patient.

    Directory of Open Access Journals (Sweden)

    Tin Aung

    Full Text Available BACKGROUND: Assessing the quality of care provided by individual health practitioners is critical to identifying possible risks to the health of the public. However, existing assessment methods can be inaccurate, expensive, or infeasible in many developing country settings, particularly in rural areas and especially for children. Following an assessment of the strengths and weaknesses of the existing methods for provider assessment, we developed a synthesis method combining components of direct observation, clinical vignettes, and medical mannequins which we have termed "Observed Simulated Patient" or OSP. An OSP assessment involves a trained actor playing the role of a 'mother', a life-size doll representing a 5-year old boy, and a trained observer. The provider being assessed was informed in advance of the role-playing, and told to conduct the diagnosis and treatment as he normally would while verbally describing the examinations. METHODOLOGY/PRINCIPAL FINDINGS: We tested the validity of OSP by conducting parallel scoring of medical providers in Myanmar, assessing the quality of their diagnosis and treatment of pediatric malaria, first by direct observation of true patients and second by OSP. Data were collected from 20 private independent medical practitioners in Mon and Kayin States, Myanmar between December 26, 2010 and January 12, 2011. All areas of assessment showed agreement between OSP and direct observation above 90% except for history taking related to past experience with malaria medicines. In this area, providers did not ask questions of the OSP to the same degree that they questioned real patients (agreement 82.8%. CONCLUSIONS/SIGNIFICANCE: The OSP methodology may provide a valuable option for quality assessment of providers in places, or for health conditions, where other assessment tools are unworkable.

  5. Validation of a new method for testing provider clinical quality in rural settings in low- and middle-income countries: the observed simulated patient. (United States)

    Aung, Tin; Montagu, Dominic; Schlein, Karen; Khine, Thin Myat; McFarland, Willi


    Assessing the quality of care provided by individual health practitioners is critical to identifying possible risks to the health of the public. However, existing assessment methods can be inaccurate, expensive, or infeasible in many developing country settings, particularly in rural areas and especially for children. Following an assessment of the strengths and weaknesses of the existing methods for provider assessment, we developed a synthesis method combining components of direct observation, clinical vignettes, and medical mannequins which we have termed "Observed Simulated Patient" or OSP. An OSP assessment involves a trained actor playing the role of a 'mother', a life-size doll representing a 5-year old boy, and a trained observer. The provider being assessed was informed in advance of the role-playing, and told to conduct the diagnosis and treatment as he normally would while verbally describing the examinations. We tested the validity of OSP by conducting parallel scoring of medical providers in Myanmar, assessing the quality of their diagnosis and treatment of pediatric malaria, first by direct observation of true patients and second by OSP. Data were collected from 20 private independent medical practitioners in Mon and Kayin States, Myanmar between December 26, 2010 and January 12, 2011. All areas of assessment showed agreement between OSP and direct observation above 90% except for history taking related to past experience with malaria medicines. In this area, providers did not ask questions of the OSP to the same degree that they questioned real patients (agreement 82.8%). The OSP methodology may provide a valuable option for quality assessment of providers in places, or for health conditions, where other assessment tools are unworkable.

  6. Providing Our Fellows in Training with Education on Inflammatory Bowel Disease Health Maintenance to Improve the Quality of Care in Our Health Care System. (United States)

    Lee, Ann Joo; Kraemer, Dale F; Smotherman, Carmen; Eid, Emely


    Inflammatory bowel disease (IBD) quality measures were established in an effort to standardize IBD health care. Despite effort to improve clinical performance, considerable variations in practice still exist. To further improve IBD health care, we propose incorporating an in-service educational session on IBD health maintenance to provide trainees with increasing awareness and knowledge on IBD management. Fifty electronic medical charts were randomly selected, and the level of quality documentation was assessed for 15 core IBD quality measures. Data were reported as the percentage of charts meeting audit criteria (compliance score). Fellows then attended an in-service educational session to review IBD quality measures and reinforce practice expectations. A second audit was then performed on an additional 50 patient charts to determine whether documentation practices improved after the educational session. We found a positive correlation between an in-service educational session and fellows' compliance with IBD health maintenance. Overall, the fellows' compliance score increased by 18% (before intervention, 65%; after intervention, 83%; P training level. Although the magnitude of improvement was comparable, the mean compliance score was highest in year 2 at 81% (year 1: 72% [P = 0.019] and year 3: 70% [P = 0.002]). Fellows expressed a high degree of satisfaction with the educational intervention and emphasized the value in reviewing the conceptual bases for IBD health maintenance. Incorporating a standard curriculum on IBD health maintenance provides fellows in training with increased awareness and guidance on managing the unique preventive care needs of patients with IBD.


    Directory of Open Access Journals (Sweden)

    Lisna Handayani


    Full Text Available Tujuan  penelitian adalah menghasilkan perangkat pembelajaran IPS dengan Pendekatan Inquiry. Penelitian pengembangan ini menggunakan langkah-langkah Borg and Gall yang terdiri dari tiga tahapan utama yaitu pendahuluan, pengembangan dan validasi. Data yang diperoleh adalah hasil belajar, aktivitas diskusi dan respon peserta didik. Data dianalisis menggunakan analisis deskriptif dan uji t. Penggunaan pendekatan inquiry sebagai salah satau strategi pembelajaran IPS dapat dilakukan dengan mempersiapkan terlebih dahulu perangkat pembelajarannya. Hasil pengembangan divalidasi oleh pakar, diujicobakan pada kelas terbatas dan selanjutnya dilakukan ujicoba pada kelas eksperimen yang dibandingkan hasilnya dengan kelas kontrol. Perangkat pembelajaran tergolong efektif untuk meningkatkan hasil belajar peserta didik di kelas VII SMP Negeri 2 Jepara, terbukti dari adanya peningkatan yang nyata terbukti dari hasil uji paired sampel t-test dengan nilai signifikansi 0,000 <0,05, dan terjadi peningkatan yang tinggi (gain > 0,7, serta hasil belajar yang dicapai berbeda secara signifikan dengan kelompok kontrol. Di samping hasil belajar, pembelajaran yang dilakukan juga berdampak pada proses belajar yang membawa tingginya aktivitas peserta didik dalam memberikan gagasan, kerjasama, inisiatif, keaktifan dan kedisiplinan. The purpose of this research is creating Social Lesson Material with Inquiry Approach.This developing of the research is used of  the steps of Borg and Gall. They are Introducing, developing and evaluating. Learning materials are developed and validity by expert. Datas are gooten by study result, discussion activity and students, respone. Analizing datas are used descriptive analize and t- try out. The use of inquiry approach as one of learning strategy on Social Lesson Material can be done by preparing those. The result of  developing are being validity by expert,  try out on limited group and experiment group ad compare with control group

  8. Using a quality improvement model to enhance providers' performance in maternal and newborn health care: a post-only intervention and comparison design. (United States)

    Ayalew, Firew; Eyassu, Gizachew; Seyoum, Negash; van Roosmalen, Jos; Bazant, Eva; Kim, Young Mi; Tekleberhan, Alemnesh; Gibson, Hannah; Daniel, Ephrem; Stekelenburg, Jelle


    The Standards Based Management and Recognition (SBM-R(©)) approach to quality improvement has been implemented in Ethiopia to strengthen routine maternal and newborn health (MNH) services. This evaluation assessed the effect of the intervention on MNH providers' performance of routine antenatal care (ANC), uncomplicated labor and delivery and immediate postnatal care (PNC) services. A post-only evaluation design was conducted at three hospitals and eight health centers implementing SBM-R and the same number of comparison health facilities. Structured checklists were used to observe MNH providers' performance on ANC (236 provider-client interactions), uncomplicated labor and delivery (226 provider-client interactions), and immediate PNC services in the six hours after delivery (232 provider-client interactions); observations were divided equally between intervention and comparison groups. Main outcomes were provider performance scores, calculated as the percentage of essential tasks in each service area completed by providers. Multilevel analysis was used to calculate adjusted mean percentage performance scores and standard errors to compare intervention and comparison groups. There was no statistically significant difference between intervention and comparison facilities in overall mean performance scores for ANC services (63.4% at intervention facilities versus 61.0% at comparison facilities, p = 0.650) or in any specific ANC skill area. MNH providers' overall mean performance score for uncomplicated labor and delivery care was 11.9 percentage points higher in the intervention than in the comparison group (77.5% versus 65.6%; p = 0.002). Overall mean performance scores for immediate PNC were 22.2 percentage points higher at intervention than at comparison facilities (72.8% versus 50.6%; p = 0.001); and there was a significant difference of 22 percentage points between intervention and comparison facilities for each PNC skill area: care for the newborn

  9. Do mobile clinics provide high-quality antenatal care? A comparison of care delivery, knowledge outcomes and perception of quality of care between fixed and mobile clinics in central Haiti. (United States)

    Phillips, Erica; Stoltzfus, Rebecca J; Michaud, Lesly; Pierre, Gracia Lionel Fils; Vermeylen, Francoise; Pelletier, David


    Antenatal care (ANC) is an important health service for women in developing countries, with numerous proven benefits. Global coverage of ANC has steadily increased over the past 30 years, in part due to increased community-based outreach. However, commensurate improvements in health outcomes such as reductions in the prevalence of maternal anemia and infants born small-for-gestational age have not been achieved, even with increased coverage, indicating that quality of care may be inadequate. Mobile clinics are one community-based strategy used to further improve coverage of ANC, but their quality of care delivery has rarely been evaluated. To determine the quality of care of ANC in central Haiti, we compared adherence to national guidelines between fixed and mobile clinics by performing direct observations of antenatal care consultations and exit interviews with recipients of care using a multi-stage random sampling procedure. Outcome variables were eight components of care, and women's knowledge and perception of care quality. There were significant differences in the predicted proportion or probability of recommended services for four of eight care components, including intake, laboratory examinations, infection control, and supplies, iron folic acid supplements and Tetanus Toxoid vaccine provided to women. These care components were more likely performed in fixed clinics, except for distribution of supplies, iron-folic acid supplements, and Tetanus Toxoid vaccine, more likely provided in mobile clinics. There were no differences between clinic type for the proportion of total physical exam procedures performed, health and communication messages delivered, provider communication or documentation. Women's knowledge about educational topics was poor, but women perceived extremely high quality of care in both clinic models. Although adherence to guidelines differed by clinic type for half of the care components, both clinics had a low percentage of overall services

  10. ChEA: transcription factor regulation inferred from integrating genome-wide ChIP-X experiments. (United States)

    Lachmann, Alexander; Xu, Huilei; Krishnan, Jayanth; Berger, Seth I; Mazloom, Amin R; Ma'ayan, Avi


    Experiments such as ChIP-chip, ChIP-seq, ChIP-PET and DamID (the four methods referred herein as ChIP-X) are used to profile the binding of transcription factors to DNA at a genome-wide scale. Such experiments provide hundreds to thousands of potential binding sites for a given transcription factor in proximity to gene coding regions. In order to integrate data from such studies and utilize it for further biological discovery, we collected interactions from such experiments to construct a mammalian ChIP-X database. The database contains 189,933 interactions, manually extracted from 87 publications, describing the binding of 92 transcription factors to 31,932 target genes. We used the database to analyze mRNA expression data where we perform gene-list enrichment analysis using the ChIP-X database as the prior biological knowledge gene-list library. The system is delivered as a web-based interactive application called ChIP Enrichment Analysis (ChEA). With ChEA, users can input lists of mammalian gene symbols for which the program computes over-representation of transcription factor targets from the ChIP-X database. The ChEA database allowed us to reconstruct an initial network of transcription factors connected based on shared overlapping targets and binding site proximity. To demonstrate the utility of ChEA we present three case studies. We show how by combining the Connectivity Map (CMAP) with ChEA, we can rank pairs of compounds to be used to target specific transcription factor activity in cancer cells. The ChEA software and ChIP-X database is freely available online at:

  11. Human amniotic epithelial cell feeder layers maintain iPS cell pluripotency by inhibiting endogenous DNA methyltransferase 1. (United States)

    Chen, Qing; Qiu, Chaolin; Huang, Yongyi; Jiang, Lizhen; Huang, Qin; Guo, Lihe; Liu, Te


    Maintaining induced pluripotent stem (iPS) cells in an undifferentiated, self-renewing state during long-term cultivation is, at present, a major challenge. We previously showed that human amniotic epithelial cells (HuAECs) were able to provide a good source of feeder cells for mouse and human embryonic or spermatogonial stem cells; however, the epigenetic mechanisms have not been elucidated. In the present study, mouse embryonic fibroblasts (MEFs) and HuAECs were compared as feeder layers for the long-term culture of human iPS cells. The HuAEC feeders allowed human iPS cells to maintain a high level of alkaline phosphatase (AP) activity and to express key stem cell markers during long-term subculture whereas the MEF feeders did not,. Moreover, the HuAEC feeders significantly affected the cell cycle regulation of the iPS cells, maintaining them in the resting stage and the early stage of DNA synthesis (G0/G1 stage). Furthermore, the CpG islands of the Nanog and Oct4 promoters were hypomethylated, while the Nanog- and Oct4-specific loci exhibited higher levels of histone H3 acetylation and lower levels of H3K27 trimethylation in iPS cells cultured on HuAECs compared with those cultured on MEFs. The DNA methyltransferase 1 (DNMT1) expression in iPS cells cultured on HuAECs was shown to be lower than in those cultured on MEFs. In addition, DNMT1-silenced human iPS cells were able to maintain pluripotency over long-term culture on MEFs. In combination, these results suggest that endogenous DNMT1 expression in human iPS cells may be regulated by HuAEC feeder cells and that Nanog and Oct4 are crucial components required for the maintenance of iPS cells in an undifferentiated, proliferative state, capable of self-renewal.

  12. The relation of innate and adaptive immunity with viral-induced acute asthma attacks: Focusing on IP-10 and cathelicidin. (United States)

    Arikoglu, T; Akyilmaz, E; Yildirim, D D; Batmaz, S B; Ulger, S T; Aslan, G; Kuyucu, S

    Despite growing evidence suggesting potential association between innate and adaptive immunity in viral-induced acute asthma, there is paucity of data in this area. This study aimed to investigate the association of innate and adaptive immunity with acute asthma attacks by analysing the role of IFN-γ-inducible protein 10 (IP-10), TLR2, cathelicidin, vitamin D and cytokines. This prospective study included 33 patients with viral-induced acute asthma and 30 children with controlled asthma. Nasopharyngeal swab samples were collected for virus identification and asthma attack scores assessed in acute asthma group. Blood sampling for IP-10, TLR2, cathelicidin, vitamin D levels, and spirometric indices were employed. Serum IP-10 and cathelicidin levels of acute asthma group were significantly higher and vitamin D levels were lower than controlled asthma group (IP-10; p=0.006, cathelicidin; p=0.002, vitamin D; p, TLR2 (p=0.05) and spirometric indices (p=0.002) in all asthmatics and a significant positive correlation with parameters of asthma attack severity (p=0.03) in acute asthma group. Higher cathelicidin values showed significant positive relation to IP-10 (beta coefficient: 33, p=0.02). Serum IP-10 levels higher than 38.9pg/ml (sensitivity: 85%, specificity: 47%, p=0.002) were predictive of virus-induced asthma. Serum IP-10 and vitamin D levels were found to be significantly related to viral-asthma attacks (IP-10; aOR: 8.93, p=0.03 and vitamin D; aOR: 0.82, p=0.001). Innate immunity biomarkers such as serum IP-10 and cathelicidin can be used to predict viral-induced acute asthma. These biomarkers may provide potential new treatment targets for acute asthma. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  13. A conserved mechanism of DEAD-box ATPase activation by nucleoporins and IP6 in mRNA export (United States)

    Montpetit, Ben; Thomsen, Nathan D.; Helmke, Kara J.; Seeliger, Markus A.; Berger, James M.; Weis, Karsten


    Superfamily 1 (SF1) and superfamily 2 (SF2) RNA helicases are ubiquitous mRNA-protein (mRNP) remodelling enzymes that play critical roles in all aspects of RNA metabolism1, 2. The SF2 DEAD-box ATPase Dbp5/Ddx19 functions in mRNA export and is thought to remodel mRNPs at the nuclear pore complex (NPC)3–8. Dbp5 is localized to the NPC via an interaction with Nup159/Nup2143–5, 8, 9 and is locally activated there by Gle1 together with the small-molecule inositol hexakisphosphate (IP6) 10, 11. Local activation of Dbp5 at the NPC by Gle1 is essential for mRNA export in vivo11, 12; however, the mechanistic role of Dbp5 in mRNP export is poorly understood and it is not known how Gle1IP6 and Nup159 regulate the activity of Dbp5. Here we report structures of Dbp5 in complex with Gle1IP6, Nup159/Gle1IP6, and RNA. These structures reveal that IP6 functions as a small-molecule tether for the Gle1-Dbp5 interaction. Surprisingly, the Gle1IP6-Dbp5 complex is structurally similar to another DEAD-box ATPase complex essential for translation initiation, eIF4G-eIF4A, and we demonstrate that Gle1IP6 and eIF4G both activate their DEAD-box partner by stimulating RNA release. Furthermore, Gle1IP6 relieves Dbp5 auto- regulation and cooperates with Nup159 in stabilizing an open Dbp5-intermediate that precludes RNA binding. These findings explain how Gle1IP6, Nup159, and Dbp5 collaborate in mRNA export and provide a general mechanism for DEAD-box ATPase regulation by Gle1/eIF4G-like activators. PMID:21441902

  14. In silico modeling of Itk activation kinetics in thymocytes suggests competing positive and negative IP4 mediated feedbacks increase robustness.

    Directory of Open Access Journals (Sweden)

    Sayak Mukherjee

    Full Text Available The inositol-phosphate messenger inositol(1,3,4,5tetrakisphosphate (IP4 is essential for thymocyte positive selection by regulating plasma-membrane association of the protein tyrosine kinase Itk downstream of the T cell receptor (TCR. IP4 can act as a soluble analog of the phosphoinositide 3-kinase (PI3K membrane lipid product phosphatidylinositol(3,4,5trisphosphate (PIP3. PIP3 recruits signaling proteins such as Itk to cellular membranes by binding to PH and other domains. In thymocytes, low-dose IP4 binding to the Itk PH domain surprisingly promoted and high-dose IP4 inhibited PIP3 binding of Itk PH domains. However, the mechanisms that underlie the regulation of membrane recruitment of Itk by IP4 and PIP3 remain unclear. The distinct Itk PH domain ability to oligomerize is consistent with a cooperative-allosteric mode of IP4 action. However, other possibilities cannot be ruled out due to difficulties in quantitatively measuring the interactions between Itk, IP4 and PIP3, and in generating non-oligomerizing Itk PH domain mutants. This has hindered a full mechanistic understanding of how IP4 controls Itk function. By combining experimentally measured kinetics of PLCγ1 phosphorylation by Itk with in silico modeling of multiple Itk signaling circuits and a maximum entropy (MaxEnt based computational approach, we show that those in silico models which are most robust against variations of protein and lipid expression levels and kinetic rates at the single cell level share a cooperative-allosteric mode of Itk regulation by IP4 involving oligomeric Itk PH domains at the plasma membrane. This identifies MaxEnt as an excellent tool for quantifying robustness for complex TCR signaling circuits and provides testable predictions to further elucidate a controversial mechanism of PIP3 signaling.

  15. Cognitive Status Correlates with CXCL10/IP-10 Levels in Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Natália Pessoa Rocha


    Full Text Available Cognitive impairment and depressive symptoms are of great interest in Parkinson’s disease (PD, since they are very common and lead to increased disability with poor quality of life. Inflammatory mechanisms have been implicated in PD and its nonmotor symptoms. In the current pilot study, we aimed to evaluate plasma levels of chemokines in PD patients and to analyze the putative association of chemokines with depressive symptoms and cognitive performance. We hypothesized that higher chemokines levels are associated with worse cognitive performance and increased depressive symptoms in PD. For this purpose, 40 PD patients and 25 age- and gender-matched controls were subjected to a clinical evaluation including cognitive and mood tests. Peripheral blood was drawn and plasma levels of CCL2/MCP-1, CCL11/eotaxin, CCL24/eotaxin-2, and CXCL10/IP-10 were measured by enzyme-linked immunosorbent assay. PD patients and control individuals presented comparable plasma concentrations of all the evaluated chemokines. In PD patients, CXCL10/IP-10 plasma levels correlated positively with Hoehn and Yahr staging scale. In addition, the higher CXCL10/IP-10 levels, the worse performance on cognitive tests. Although there was no significant difference between PD patients and control individuals regarding chemokines levels, our preliminary results showed that CXCL10/IP-10 may be associated with cognitive status in PD.

  16. IndigoVision IP video keeps watch over remote gas facilities in Amazon rainforest

    Energy Technology Data Exchange (ETDEWEB)



    In Brazil, IndigoVision's complete IP video security technology is being used to remotely monitor automated gas facilities in the Amazon rainforest. Twelve compounds containing millions of dollars of process automation, telemetry, and telecom equipment are spread across many thousands of miles of forest and centrally monitored in Rio de Janeiro using Control Center, the company's Security Management software. The security surveillance project uses a hybrid IP network comprising satellite, fibre optic, and wireless links. In addition to advanced compression technology and bandwidth tuning tools, the IP video system uses Activity Controlled Framerate (ACF), which controls the frame rate of the camera video stream based on the amount of motion in a scene. In the absence of activity, the video is streamed at a minimum framerate, but the moment activity is detected the framerate jumps to the configured maximum. This significantly reduces the amount of bandwidth needed. At each remote facility, fixed analog cameras are connected to transmitter nodules that convert the feed to high-quality digital video for transmission over the IP network. The system also integrates alarms with video surveillance. PIR intruder detectors are connected to the system via digital inputs on the transmitters. Advanced alarm-handling features in the Control Center software process the PIR detector alarms and alert operators to potential intrusions. This improves operator efficiency and incident response. 1 fig.

  17. [Retinal regeneration with iPS cells ‒ Clinical trials for retinal degenerative disorders]. (United States)

    Sugita, Sunao


    Potential for re-programming cells has become widely accepted as a tool for obtaining transplantation materials. There has been great interest in cell-based therapies, including retinal transplants, because there is a reduced risk of immune rejection. Stem cells have the capacity for self-renewal plus the capacity to generate several differentiated cells. They are derived from many sources including human adult-derived induced pluripotent stem (iPS) cells and have found early application in the context of ocular disease. In results, our established iPS-retinal pigment epithelial (RPE) cells are high-quality RPE cells. iPS cells-derived RPE cells clearly showed polygonal morphology (mostly hexagonal) and contained melanin. Moreover, RPE cells derived from iPS cells had many characteristics of mature RPE cells in vivo, but no characteristics of pluripotent stem cells. Recently, we transplanted RPE cell sheets to treat a patient with wet age-related macular degeneration (September, 2014). In addition, we are now conducting experiments to determine whether allogeneic T cells can recognize iPS-RPE cells from HLA-A, B, DRB1 locus homozygote donors. iPS bank might be useful as allografts in retinal disorders, if the recipient T cells cannot respond to allogeneic RPE cells because of match to some of main HLA antigens.

  18. A Real-time Spectrum Handoff Algorithm for VoIP based Cognitive Radio Networks: Design and Performance Analysis (United States)

    Chakraborty, Tamal; Saha Misra, Iti


    Secondary Users (SUs) in a Cognitive Radio Network (CRN) face unpredictable interruptions in transmission due to the random arrival of Primary Users (PUs), leading to spectrum handoff or dropping instances. An efficient spectrum handoff algorithm, thus, becomes one of the indispensable components in CRN, especially for real-time communication like Voice over IP (VoIP). In this regard, this paper investigates the effects of spectrum handoff on the Quality of Service (QoS) for VoIP traffic in CRN, and proposes a real-time spectrum handoff algorithm in two phases. The first phase (VAST-VoIP based Adaptive Sensing and Transmission) adaptively varies the channel sensing and transmission durations to perform intelligent dropping decisions. The second phase (ProReact-Proactive and Reactive Handoff) deploys efficient channel selection mechanisms during spectrum handoff for resuming communication. Extensive performance analysis in analytical and simulation models confirms a decrease in spectrum handoff delay for VoIP SUs by more than 40% and 60%, compared to existing proactive and reactive algorithms, respectively and ensures a minimum 10% reduction in call-dropping probability with respect to the previous works in this domain. The effective SU transmission duration is also maximized under the proposed algorithm, thereby making it suitable for successful VoIP communication.

  19. Telephony Over IP: A QoS Measurement-Based End to End Control Algorithm

    Directory of Open Access Journals (Sweden)

    Luigi Alcuri


    Full Text Available This paper presents a method for admitting voice calls in Telephony over IP (ToIP scenarios. This method, called QoS-Weighted CAC, aims to guarantee Quality of Service to telephony applications. We use a measurement-based call admission control algorithm, which detects network congested links through a feedback on overall link utilization. This feedback is based on the measures of packet delivery latencies related to voice over IP connections at the edges of the transport network. In this way we introduce a close loop control method, which is able to auto-adapt the quality margin on the basis of network load and specific service level requirements. Moreover we evaluate the difference in performance achieved by different Queue management configurations to guarantee Quality of Service to telephony applications, in which our goal was to evaluate the weight of edge router queue configuration in complex and real-like telephony over IP scenario. We want to compare many well-know queue scheduling algorithms, such as SFQ, WRR, RR, WIRR, and Priority. This comparison aims to locate queue schedulers in a more general control scheme context where different elements such as DiffServ marking and Admission control algorithms contribute to the overall Quality of Service required by real-time voice conversations. By means of software simulations we want to compare this solution with other call admission methods already described in scientific literature in order to locate this proposed method in a more general control scheme context. On the basis of the results we try to evidence the possible advantages of this QoS-Weighted solution in comparison with other similar CAC solutions ( in particular Measured Sum, Bandwidth Equivalent with Hoeffding Bounds, and Simple Measure CAC, on the planes of complexity, stability, management, tune-ability to service level requirements, and compatibility with actual network implementation.

  20. Project quality assurance plan for research and development services provided by Oak Ridge National Laboratory in support of the Hanford Grout Disposal Program

    Energy Technology Data Exchange (ETDEWEB)

    Spence, R.D.; Gilliam, T.M.


    This Project Quality Assurance Plan (PQAP) is being published to provide the sponsor with referenceable documentation for work conducted in support of the Hanford WHC Grout Disposal Program. This plan, which meets NQA-1 requirements, is being applied to work performed at Oak Ridge National Laboratory (ORNL) during FY 1991 in support of this program. It should also be noted that with minor revisions, this plan should be applicable to other projects involving research and development that must comply with NQA-1 requirements.

  1. IP-10 release assays in the diagnosis of tuberculosis infection

    DEFF Research Database (Denmark)

    Ruhwald, Morten; Aabye, Martine G; Ravn, Pernille


    The current state-of-the-art tests for infection with Mycobacterium tuberculosis - the IFN-γ release assays - rely on accurate measurement of the cytokine IFN-γ. Many other potential biomarkers are expressed in concert with IFN-γ, and IP-10 in particular has shown promising results. IP-10...

  2. Capturing value from IP in a global environment

    DEFF Research Database (Denmark)

    Alcacer, Juan; Beukel, Karin; Cassiman, Bruno

    of patenting globally. For trademarks and industrial designs, globalization has created more potential infringers and an increase in piracy, as evidenced by a significant increase in customs seizures. The problems with IP even go beyond individual firms, as when governments use IP policies to favor local firms...

  3. Special rights for the development of Indigenous Peoples (IPS) in ...

    African Journals Online (AJOL)

    Indigenous Peoples (IPs) have been subjected to a series of humiliation, discrimination and in some cases dis-membership of a state. This is germane, but not peculiar, to the developing states with special reference to Africa. Globalization and efforts to link human, cultural and social rights to the IPs remain blurred and ...

  4. Probabilistic Route Selection Algorithm for IP Traceback (United States)

    Yim, Hong-Bin; Jung, Jae-Il

    DoS(Denial of Service) or DDoS(Distributed DoS) attack is a major threaten and the most difficult problem to solve among many attacks. Moreover, it is very difficult to find a real origin of attackers because DoS/DDoS attacker uses spoofed IP addresses. To solve this problem, we propose a probabilistic route selection traceback algorithm, namely PRST, to trace the attacker's real origin. This algorithm uses two types of packets such as an agent packet and a reply agent packet. The agent packet is in use to find the attacker's real origin and the reply agent packet is in use to notify to a victim that the agent packet is reached the edge router of the attacker. After attacks occur, the victim generates the agent packet and sends it to a victim's edge router. The attacker's edge router received the agent packet generates the reply agent packet and send it to the victim. The agent packet and the reply agent packet is forwarded refer to probabilistic packet forwarding table (PPFT) by routers. The PRST algorithm runs on the distributed routers and PPFT is stored and managed by routers. We validate PRST algorithm by using mathematical approach based on Poisson distribution.

  5. Research on implementation of proxy Arp in IP DSLAM (United States)

    Cheng, Chuanqing; Wang, Li; Huang, Qiugen


    While the ethernet is applied more and more in public network environment and xdsl service become the most common access mode ,IP kenel DSLAM undertakes some functions such as service distribution and convergence ,security management and customer management.Facing the contradiction of the need of port isolation and the shortage of ip address,VLAN aggregation technology is applied in DSLAM.How to implement the communicatio between the two vlan but share the same ip subnet,proxy arp does this. This paper introduces how to implement proxy arp in the DSLAM. TCP/IP communication detail procedure betweent two host ,the relation of VLAN and network segment are discussed. The proxy arp model and its implementation in IP DSLAM is also expatiated in this paper and a conformance tesing is given.

  6. Modeling Alzheimer's disease with human induced pluripotent stem (iPS) cells. (United States)

    Mungenast, Alison E; Siegert, Sandra; Tsai, Li-Huei


    In the last decade, induced pluripotent stem (iPS) cells have revolutionized the utility of human in vitro models of neurological disease. The iPS-derived and differentiated cells allow researchers to study the impact of a distinct cell type in health and disease as well as performing therapeutic drug screens on a human genetic background. In particular, clinical trials for Alzheimer's disease (AD) have been failing. Two of the potential reasons are first, the species gap involved in proceeding from initial discoveries in rodent models to human studies, and second, an unsatisfying patient stratification, meaning subgrouping patients based on the disease severity due to the lack of phenotypic and genetic markers. iPS cells overcome this obstacles and will improve our understanding of disease subtypes in AD. They allow researchers conducting in depth characterization of neural cells from both familial and sporadic AD patients as well as preclinical screens on human cells. In this review, we briefly outline the status quo of iPS cell research in neurological diseases along with the general advantages and pitfalls of these models. We summarize how genome-editing techniques such as CRISPR/Cas9 will allow researchers to reduce the problem of genomic variability inherent to human studies, followed by recent iPS cell studies relevant to AD. We then focus on current techniques for the differentiation of iPS cells into neural cell types that are relevant to AD research. Finally, we discuss how the generation of three-dimensional cell culture systems will be important for understanding AD phenotypes in a complex cellular milieu, and how both two- and three-dimensional iPS cell models can provide platforms for drug discovery and translational studies into the treatment of AD. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Applying high-frequency surrogate measurements and a wavelet-ANN model to provide early warnings of rapid surface water quality anomalies. (United States)

    Shi, Bin; Wang, Peng; Jiang, Jiping; Liu, Rentao


    It is critical for surface water management systems to provide early warnings of abrupt, large variations in water quality, which likely indicate the occurrence of spill incidents. In this study, a combined approach integrating a wavelet artificial neural network (wavelet-ANN) model and high-frequency surrogate measurements is proposed as a method of water quality anomaly detection and warning provision. High-frequency time series of major water quality indexes (TN, TP, COD, etc.) were produced via a regression-based surrogate model. After wavelet decomposition and denoising, a low-frequency signal was imported into a back-propagation neural network for one-step prediction to identify the major features of water quality variations. The precisely trained site-specific wavelet-ANN outputs the time series of residual errors. A warning is triggered when the actual residual error exceeds a given threshold, i.e., baseline pattern, estimated based on long-term water quality variations. A case study based on the monitoring program applied to the Potomac River Basin in Virginia, USA, was conducted. The integrated approach successfully identified two anomaly events of TP variations at a 15-minute scale from high-frequency online sensors. A storm event and point source inputs likely accounted for these events. The results show that the wavelet-ANN model is slightly more accurate than the ANN for high-frequency surface water quality prediction, and it meets the requirements of anomaly detection. Analyses of the performance at different stations and over different periods illustrated the stability of the proposed method. By combining monitoring instruments and surrogate measures, the presented approach can support timely anomaly identification and be applied to urban aquatic environments for watershed management. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Challenges in the delivery of public HIV testing and counselling (HTC) in Douala, Cameroon: providers perspectives and implications on quality of HTC services. (United States)

    Ngangue, Patrice; Gagnon, Marie-Pierre; Bedard, Emmanuelle


    The Cameroon government has made HIV testing and counselling (HTC) a priority in its HIV/AIDS strategic plan. However, there is a dearth of literature on the perspectives of providers on the quality of HTC services. The aim of this study was to explore challenges in the provision of HTC services and their implications on quality of HTC services in Douala's district hospitals. Two primary data collection methods supported by the Donabedian's model of healthcare were used to explain the challenges in the provision of HTC services and their implications on quality of HTC services. This consisted of semi-structured individual interviews with 6 nurses and 16 lay counsellors and a non-participant observation of the physical environment for HTC by site. The study sites were the prevention and voluntary testing and counselling centre (PVTCC) of the six district hospitals of the city of Douala. The study reveals concerns about confidentiality and privacy during the counselling sessions due to inadequate and limited space. An absence of consent, even verbal, was reported in one PVTCC. There is no specific accredited training curriculum that leads to a formal registration as a PVTCC staff, and some lay counsellors work without training. Lay counsellors carry the burden of HIV counselling, but the majority of them work for many years without remuneration and recognition. Another quality challenge is the high workload in the district hospitals' lab, which leads to long waiting times for HIV test results, thus contributing to failure to return for results. The findings of this study highlighted some issues such as lack of adequate space and equipment for HIV testing and counselling that hinder the quality of HTC services and should challenge the health authorities of Cameroon on the need to reorganize HTC services and create a national HIV quality assurance program.

  9. Social media: opportunities for quality improvement and lessons for providers-a networked model for patient-centered care through digital engagement. (United States)

    Bornkessel, Alexandra; Furberg, Robert; Lefebvre, R Craig


    Social media brings a new dimension to health care for patients, providers, and their support networks. Increasing evidence demonstrates that patients who are more actively involved in their healthcare experience have better health outcomes and incur lower costs. In the field of cardiology, social media are proposed as innovative tools for the education and update of clinicians, physicians, nurses, and medical students. This article reviews the use of social media by healthcare providers and patients and proposes a model of "networked care" that integrates the use of digital social networks and platforms by both patients and providers and offers recommendations for providers to optimize their use and understanding of social media for quality improvement.

  10. Systems Biology Analyses in Chicken: Workflow for Transcriptome and ChIP-Seq Analyses Using the Chicken Skin Paradigm. (United States)

    Lai, Yung-Chih; Widelitz, Randall B; Chuong, Cheng-Ming


    With advances in molecular biology, various biological phenomena can now be explored at higher resolution using mRNA sequencing (RNA-Seq) and chromatin immunoprecipitation followed by high-throughput sequencing (ChIP-Seq), two powerful high-throughput next-generation sequencing (NGS) technologies. While methods are used widely in mouse, human, etc., less information is available in other animals, such as the chicken. Here we assemble a workflow of the RNA-Seq and ChIP-Seq analyses for the chicken studies using chicken skin appendage tissue as an example. We present guidelines for RNA-Seq quality control, alignment, quantification, normalization, and differentially expressed gene analysis. In the meantime, we outline a bioinformatics pipeline for ChIP-Seq quality control, alignment, peak calling, super-enhancer identification, and differential enrichment analysis.

  11. Anti-angiogenic activity of inositol hexaphosphate (IP6). (United States)

    Vucenik, Ivana; Passaniti, Antonino; Vitolo, Michele I; Tantivejkul, Kwanchanit; Eggleton, Paul; Shamsuddin, Abulkalam M


    A significant anticancer activity of the naturally occurring carbohydrate inositol hexaphosphate (IP(6)) has been reported against numerous cancer models. Since tumors require angiogenesis for growth and metastasis, we hypothesize that IP(6) reduces tumor growth by inhibiting angiogenesis. Because angiogenesis depends on the interaction between endothelial and tumor cells, we investigated the effect of IP(6) on both. IP(6) inhibited the proliferation and induced the differentiation of endothelial cells in vitro; the growth of bovine aortic endothelial cells (BAECs) evaluated by MTT proliferation assay was inhibited in a dose-dependent manner (IC(50) = 0.74 mM). The combination of IP(6) and vasostatin, a calreticulin fragment with anti-angiogenic activity, was synergistically superior in growth inhibition than either compound. IP(6) inhibited human umbilical vein endothelial cell (HUVEC) tube formation (in vitro capillary differentiation) on a reconstituted extracellular matrix, Matrigel, and disrupted pre-formed tubes. IP(6) significantly reduced basic fibroblast growth factor (bFGF)-induced vessel formation (P < 0.01) in vivo in Matrigel plug assay. Exposure of HepG2, a human hepatoma cell line, to IP(6) for 8 h, resulted in a dose-dependent decrease in the mRNA levels of vascular endothelial growth factor (VEGF), as assessed by RT-PCR. IP(6) treatment of HepG2 cells for 24 h also significantly reduced the VEGF protein levels in conditioned medium, in a concentration-dependent manner (P = 0.012). Thus, IP(6) has an inhibitory effect on induced angiogenesis.

  12. A highly efficient and effective motif discovery method for ChIP-seq/ChIP-chip data using positional information. (United States)

    Ma, Xiaotu; Kulkarni, Ashwinikumar; Zhang, Zhihua; Xuan, Zhenyu; Serfling, Robert; Zhang, Michael Q


    Identification of DNA motifs from ChIP-seq/ChIP-chip [chromatin immunoprecipitation (ChIP)] data is a powerful method for understanding the transcriptional regulatory network. However, most established methods are designed for small sample sizes and are inefficient for ChIP data. Here we propose a new k-mer occurrence model to reflect the fact that functional DNA k-mers often cluster around ChIP peak summits. With this model, we introduced a new measure to discover functional k-mers. Using simulation, we demonstrated that our method is more robust against noises in ChIP data than available methods. A novel word clustering method is also implemented to group similar k-mers into position weight matrices (PWMs). Our method was applied to a diverse set of ChIP experiments to demonstrate its high sensitivity and specificity. Importantly, our method is much faster than several other methods for large sample sizes. Thus, we have developed an efficient and effective motif discovery method for ChIP experiments.

  13. Inositol hexakisphosphate (IP6) generated by IP5K mediates cullin-COP9 signalosome interactions and CRL function. (United States)

    Scherer, Paul C; Ding, Yan; Liu, Zhiqing; Xu, Jing; Mao, Haibin; Barrow, James C; Wei, Ning; Zheng, Ning; Snyder, Solomon H; Rao, Feng


    The family of cullin-RING E3 Ligases (CRLs) and the constitutive photomorphogenesis 9 (COP9) signalosome (CSN) form dynamic complexes that mediate ubiquitylation of 20% of the proteome, yet regulation of their assembly/disassembly remains poorly understood. Inositol polyphosphates are highly conserved signaling molecules implicated in diverse cellular processes. We now report that inositol hexakisphosphate (IP6) is a major physiologic determinant of the CRL-CSN interface, which includes a hitherto unidentified electrostatic interaction between the N-terminal acidic tail of CSN subunit 2 (CSN2) and a conserved basic canyon on cullins. IP6, with an EC50 of 20 nM, acts as an intermolecular "glue," increasing cullin-CSN2 binding affinity by 30-fold, thereby promoting assembly of the inactive CRL-CSN complexes. The IP6 synthase, Ins(1,3,4,5,6)P5 2-kinase (IPPK/IP5K) binds to cullins. Depleting IP5K increases the percentage of neddylated, active Cul1 and Cul4A, and decreases levels of the Cul1/4A substrates p27 and p21. Besides dysregulating CRL-mediated cell proliferation and UV-induced apoptosis, IP5K depletion potentiates by 28-fold the cytotoxic effect of the neddylation inhibitor MLN4924. Thus, IP5K and IP6 are evolutionarily conserved components of the CRL-CSN system and are potential targets for cancer therapy in conjunction with MLN4924.

  14. Attributes associated with probability of infestation by the pinon Ips, Ips confusus, (Coleoptera: Scolytidae) in pinon pine, Pinus edulis (United States)

    Jose F. Negron; Jill L. Wilson


    (Please note, this is an abstract only) We examined attributes associated with the probability of infestation by pinon ips (Ips confusus), in pinon pine (Pinus edulis), in an outbreak in the Coconino National Forest, Arizona. We used data collected from 87 plots, 59 infested and 28 uninfested, and a logistic regression approach to estimate the probability of...

  15. Pro-apoptotic effect of rice bran inositol hexaphosphate (IP6) on HT-29 colorectal cancer cells. (United States)

    Shafie, Nurul Husna; Esa, Norhaizan Mohd; Ithnin, Hairuszah; Saad, Norazalina; Pandurangan, Ashok Kumar


    Inositol hexaphosphate (IP6), or phytic acid is a natural dietary ingredient and has been described as a "natural cancer fighter", being an essential component of nutritional diets. The marked anti-cancer effect of IP6 has resulted in our quest for an understanding of its mechanism of action. In particular, our data provided strong evidence for the induction of apoptotic cell death, which may be attributable to the up-regulation of Bax and down-regulation of Bcl-xl in favor of apoptosis. In addition, the up-regulation of caspase-3 and -8 expression and activation of both caspases may also contribute to the apoptotic cell death of human colorectal adenocarcinoma HT-29 cells when exposed to IP6. Collectively, this present study has shown that rice bran IP6 induces apoptosis, by regulating the pro- and anti-apoptotic markers; Bax and Bcl-xl and via the activation of caspase molecules (caspase-3 and -8).

  16. ChIP-seq in studying epigenetic mechanisms of disease and promoting precision medicine: progresses and future directions. (United States)

    Yan, Huihuang; Tian, Shulan; Slager, Susan L; Sun, Zhifu


    Chromatin immunoprecipitation followed by sequencing (ChIP-seq) is widely used for mapping histone modifications, histone proteins, chromatin regulators, transcription factors and other DNA-binding proteins. It has played a significant role in our understanding of disease mechanisms and in exploring epigenetic changes for potential clinical applications. However, the conventional protocol requires large amounts of starting material and does not quantify the actual occupancy, limiting its applications in clinical settings. Herein we summarize the latest progresses in utilizing ChIP-seq to link epigenetic alterations to disease initiation and progression, and the implications in precision medicine. We provide an update on the newly developed ChIP-seq protocols, especially those suitable for scare clinical samples. Technical and analytical challenges are outlined together with recommendations for improvement. Finally, future directions in expediting ChIP-seq use in clinic are discussed.

  17. The Impact of Combat Deployment on Health Care Provider Burnout in a Military Emergency Department: A Cross-Sectional Professional Quality of Life Scale V Survey Study. (United States)

    Cragun, Joshua N; April, Michael D; Thaxton, Robert E


    Compassion fatigue is a problem for many health care providers manifesting as physical, mental, and spiritual exhaustion. Our objective was to evaluate the association between prior combat deployment and compassion fatigue among military emergency medicine providers. We conducted a nonexperimental cross-sectional survey of health care providers assigned to the San Antonio Military Medical Center, Department of Emergency Medicine. We used the Professional Quality of Life Scale V survey instrument that evaluates provider burnout, secondary traumatic stress, and compassion satisfaction. Outcomes included burnout, secondary traumatic stress, and compassion satisfaction raw scores. Scores were compared between providers based on previous combat deployments using two-tailed independent sample t tests and multiple regression models. Surveys were completed by 105 respondents: 42 nurses (20 previously deployed), 30 technicians (11 previously deployed), and 33 physicians (16 previously deployed). No statistically significant differences in burnout, secondary traumatic stress, or compassion satisfaction scores were detected between previously deployed providers versus providers not previously deployed. There was no association between previous combat deployment and emergency department provider burnout, secondary traumatic stress, or compassion satisfaction scores. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  18. What is the quality of information on social oocyte cryopreservation provided by websites of Society for Assisted Reproductive Technology member fertility clinics? (United States)

    Avraham, Sarit; Machtinger, Ronit; Cahan, Tal; Sokolov, Amit; Racowsky, Catherine; Seidman, Daniel S


    To evaluate adequacy and adherence to American Society for Reproductive Medicine (ASRM) guidelines of internet information provided by Society for Assisted Reproductive Technology (SART)-affiliated clinics regarding social oocyte cryopreservation (SOC). Systematic evaluation of websites of all SART member fertility clinics. The internet. None. All websites offering SOC services were scored using a 0-13 scale, based on 10 questions designed to assess website quality and adherence to the ASRM/SART guidelines. The websites were analyzed independently by two authors. Whenever disagreement occurred, a third investigator determined the score. Scores defined website quality as excellent, ≥9; moderate, 5-8; or poor, ≤4 points. Of the 387 clinics registered as SART members, 200 offered oocyte cryopreservation services for either medical or social reasons; 147 of these advertised SOC. The average website scores of those clinics offering SOC was 3.4 ± 2.1 (range, 2-11) points. There was no significant difference in scores between private versus academic clinics or clinics performing more or less than 500 cycles per year. The majority of the websites do not follow the SART/ASRM guidelines for SOC, indicating that there is a need to improve the type and quality of information provided on SOC by SART member websites. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  19. An Efficient and Secure m-IPS Scheme of Mobile Devices for Human-Centric Computing

    Directory of Open Access Journals (Sweden)

    Young-Sik Jeong


    Full Text Available Recent rapid developments in wireless and mobile IT technologies have led to their application in many real-life areas, such as disasters, home networks, mobile social networks, medical services, industry, schools, and the military. Business/work environments have become wire/wireless, integrated with wireless networks. Although the increase in the use of mobile devices that can use wireless networks increases work efficiency and provides greater convenience, wireless access to networks represents a security threat. Currently, wireless intrusion prevention systems (IPSs are used to prevent wireless security threats. However, these are not an ideal security measure for businesses that utilize mobile devices because they do not take account of temporal-spatial and role information factors. Therefore, in this paper, an efficient and secure mobile-IPS (m-IPS is proposed for businesses utilizing mobile devices in mobile environments for human-centric computing. The m-IPS system incorporates temporal-spatial awareness in human-centric computing with various mobile devices and checks users’ temporal spatial information, profiles, and role information to provide precise access control. And it also can extend application of m-IPS to the Internet of things (IoT, which is one of the important advanced technologies for supporting human-centric computing environment completely, for real ubiquitous field with mobile devices.

  20. GTRD: a database of transcription factor binding sites identified by ChIP-seq experiments. (United States)

    Yevshin, Ivan; Sharipov, Ruslan; Valeev, Tagir; Kel, Alexander; Kolpakov, Fedor


    GTRD-Gene Transcription Regulation Database ( a database of transcription factor binding sites (TFBSs) identified by ChIP-seq experiments for human and mouse. Raw ChIP-seq data were obtained from ENCODE and SRA and uniformly processed: (i) reads were aligned using Bowtie2; (ii) ChIP-seq peaks were called using peak callers MACS, SISSRs, GEM and PICS; (iii) peaks for the same factor and peak callers, but different experiment conditions (cell line, treatment, etc.), were merged into clusters; (iv) such clusters for different peak callers were merged into metaclusters that were considered as non-redundant sets of TFBSs. In addition to information on location in genome, the sets contain structured information about cell lines and experimental conditions extracted from descriptions of corresponding ChIP-seq experiments. A web interface to access GTRD was developed using the BioUML platform. It provides: (i) browsing and displaying information; (ii) advanced search possibilities, e.g. search of TFBSs near the specified gene or search of all genes potentially regulated by a specified transcription factor; (iii) integrated genome browser that provides visualization of the GTRD data: read alignments, peaks, clusters, metaclusters and information about gene structures from the Ensembl database and binding sites predicted using position weight matrices from the HOCOMOCO database. © The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

  1. HPeak: an HMM-based algorithm for defining read-enriched regions in ChIP-Seq data

    Directory of Open Access Journals (Sweden)

    Maher Christopher A


    Full Text Available Abstract Background Protein-DNA interaction constitutes a basic mechanism for the genetic regulation of target gene expression. Deciphering this mechanism has been a daunting task due to the difficulty in characterizing protein-bound DNA on a large scale. A powerful technique has recently emerged that couples chromatin immunoprecipitation (ChIP with next-generation sequencing, (ChIP-Seq. This technique provides a direct survey of the cistrom of transcription factors and other chromatin-associated proteins. In order to realize the full potential of this technique, increasingly sophisticated statistical algorithms have been developed to analyze the massive amount of data generated by this method. Results Here we introduce HPeak, a Hidden Markov model (HMM-based Peak-finding algorithm for analyzing ChIP-Seq data to identify protein-interacting genomic regions. In contrast to the majority of available ChIP-Seq analysis software packages, HPeak is a model-based approach allowing for rigorous statistical inference. This approach enables HPeak to accurately infer genomic regions enriched with sequence reads by assuming realistic probability distributions, in conjunction with a novel weighting scheme on the sequencing read coverage. Conclusions Using biologically relevant data collections, we found that HPeak showed a higher prevalence of the expected transcription factor binding motifs in ChIP-enriched sequences relative to the control sequences when compared to other currently available ChIP-Seq analysis approaches. Additionally, in comparison to the ChIP-chip assay, ChIP-Seq provides higher resolution along with improved sensitivity and specificity of binding site detection. Additional file and the HPeak program are freely available at

  2. Removing Ambiguities of IP Telephony Traffic Using Protocol Scrubbers

    Directory of Open Access Journals (Sweden)

    Bazara I. A. Barry


    Full Text Available Network intrusion detection systems (NIDSs face the serious challenge of attacks such as insertion and evasion attacks that are caused by ambiguous network traffic. Such ambiguity comes as a result of the nature of network traffic which includes protocol implementation variations and errors alongside legitimate network traffic. Moreover, attackers can intentionally introduce further ambiguities in the traffic. Consequently, NIDSs need to be aware of these ambiguities when detection is performed and make sure to differentiate between true attacks and protocol implementation variations or errors; otherwise, detection accuracy can be affected negatively. In this paper we present the design and implementation of tools that are called protocol scrubbers whose main functionality is to remove ambiguities from network traffic before it is presented to the NIDS. The proposed protocol scrubbers are designed for session initiation and data transfer protocols in IP telephony systems. They guarantee that the traffic presented to NIDSs is unambiguous by eliminating ambiguous behaviors of protocols using well-designed protocol state machines, and walking through packet headers of protocols to make sure packets will be interpreted in the desired way by the NIDS. The experimental results shown in this paper demonstrate the good quality and applicability of the introduced scrubbers.

  3. Inositol hexaphosphate (IP6) inhibits cellular proliferation in melanoma. (United States)

    Rizvi, Irfan; Riggs, Dale R; Jackson, Barbara J; Ng, Alex; Cunningham, Cynthia; McFadden, David W


    Inositol Hexaphosphate (IP6) is a naturally occurring polyphosphorylated carbohydrate found in food sources high in fiber content. We have previously reported IP6 to have significant inhibitory effects against pancreatic cancer in vitro. We hypothesized that the IP6 would significantly inhibit cell growth of cutaneous melanoma in vitro. The melanoma line HTB68 was cultured using standard techniques and treated with IP6 at doses ranging from 0.2 to 1.0 mM/well. Cell viability was measured by MTT at 72 h. VEGF production was measured in the cell supernatants by ELISA. Apoptosis was evaluated by Annexin V-FITC and results calculated using FACS analysis. Statistical analysis was performed by ANOVA. Significant reductions (P < 0.001) in cellular proliferation were observed with IP6. Overall, IP6 exhibited a mean inhibition of cell growth of 52.1 +/- 11.5% (range, 1.6-83.0%) at 72 h of incubation. VEGF production was significantly reduced (P < 0.001) by the addition of IP6 (7.5 pg/ml) compared to control (40.9 pg/ml). IP6 significantly increased (P = 0.029) late apoptosis from 5.3 to 7.0% gated events. No changes in necrosis or early apoptosis were observed. Adjuvant treatment of melanoma continues to challenge clinicians and patients. Our findings that IP6 significantly decreased cellular growth, VEGF production and increased late apoptosis in melanoma suggest its potential therapeutic value. Further in vivo studies are planned to evaluate safety and clinical utility of this agent.

  4. IP TV – påverkan och anpassning av IP-nätet hos en datakomoperatör.


    Eriksson, Jessica


    TDC Song has just entered the private market with Internet Access and VoIP services. To stay competitive on the market in the future, the company will be required to offer the customers video- and TV- services and have a complete triple play packet. The purpose of this master’s thesis is to determine which techniques that exist within IPTV, analyze TDC Song’s network and see what actions the company needs to take in network design and network quality in order to distribute a premium packet wi...

  5. Lessons from Korea Telecom's VoIP testbed (United States)

    Lee, Ki Jong; Yang, Junhwan; Kim, Dongkweon


    This paper describers the results and lessons from the voice over IP trial service on the Korea Telecom's VoIP Testbed. The testbed was made up of four different vendors' systems and solutions constituted four separate zones. Even though the backbone network of the testbed was not commercial IP network, we could comprehend some engineering parameters essential to packetized voice QoS. And we got some know-how. These kinds of results will be much help to traditional telco confronted with many difficult issues especially on packet voice network.

  6. Actuator development for the Instrument Pointing System (IPS) (United States)

    Suttner, K.


    The mechanisms of the instrument pointing system (IPS) are described. Particular emphasis is placed on the actuators which are necessary for operating the IPS. The actuators are described as follows: (1) two linear actuators that clamp the gimbals down during ascent and descent; (2) two linear actuators that attach the payload to the IPS during the mission, and release it into the payload clamps; (3) one rotational actuator that opens and closes the payload clamps; and (4) three identical drive units that represent the three orthogonal gimbal axes and are the prime movers for pointing. Design features, manufacturing problems, test performance, and results are presented.

  7. A Novel Smart Meter Controlling System with Dynamic IP Addresses

    DEFF Research Database (Denmark)

    Manembu, Pinrolinvic; Welang, Brammy; Kalua Lapu, Aditya


    Smart meters are the electronic devices for measuring energy consumption in real time. Usually, static public IP addresses are allocated to realize the point-to-point (P2P) communication and remote controlling for smart metering systems. This, however, restricts the wide deployment of smart meters......, due to the deficiency of public IP resources. This paper proposes a novel subscription-based communication architecture for the support of dynamic IP addresses and group controlling of smart meters. The paper evaluates the proposed architecture by comparing the traditional P2P architecture...

  8. Application of Mobile-ip to Space and Aeronautical Networks (United States)

    Leung, Kent; Shell, Dan; Ivancic, William D.; Stewart, David H.; Bell, Terry L.; Kachmar, Brian A.


    The National Aeronautics and Space Administration (NASA) is interested in applying mobile Internet protocol (mobile-ip) technologies to its space and aeronautics programs. In particular, mobile-ip will play a major role in the Advanced Aeronautic Transportation Technology (AAT-F), the Weather Information Communication (WINCOMM), and the Small Aircraft Transportation System (SATS) aeronautics programs. This paper describes mobile-ip and mobile routers--in particular, the features, capabilities, and initial performance of the mobile router are presented. The application of mobile-router technology to NASA's space and aeronautics programs is also discussed.

  9. Primary care quality and safety systems in the English National Health Service: a case study of a new type of primary care provider. (United States)

    Baker, Richard; Willars, Janet; McNicol, Sarah; Dixon-Woods, Mary; McKee, Lorna


    Although the predominant model of general practice in the UK National Health Service (NHS) remains the small partnership owned and run by general practitioners (GPs), new types of provider are emerging. We sought to characterize the quality and safety systems and processes used in one large, privately owned company providing primary care through a chain of over 50 general practices in England. Senior staff with responsibility for policy on quality and safety were interviewed. We also undertook ethnographic observation in non-clinical areas and interviews with staff in three practices. A small senior executive team set policy and strategy on quality and safety, including a systematic incident reporting and investigation system and processes for disseminating learning with a strong emphasis on customer focus. Standardization of systems was possible because of the large number of practices. Policies appeared generally well implemented at practice level. However, there was some evidence of high staff turnover, particularly of GPs. This caused problems for continuity of care and challenges in inducting new GPs in the company's systems and procedures. A model of primary care delivery based on a corporate chain may be useful in standardizing policies and procedures, facilitating implementation of systems, and relieving clinical staff of administrative duties. However, the model also poses some risks, including those relating to stability. Provider forms that retain the long term, personal commitment of staff to their practices, such as federations or networks, should also be investigated; they may offer the benefits of a corporate chain combined with the greater continuity and stability of the more traditional general practice.

  10. Effect of using HIV and infant feeding counselling cards on the quality of counselling provided to HIV positive mothers: a cluster randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Babaniyi Olusegun


    Full Text Available Abstract Background Counselling human immunodeficiency virus (HIV positive mothers on safer infant and young child feeding (IYCF options is an important component of programmes to prevent mother to child transmission of HIV, but the quality of counselling is often inadequate. The aim of this study was to determine the effect the World Health Organization HIV and infant feeding cards on the quality of counselling provided to HIV positive mothers by health workers about safer infant feeding options. Method This was a un-blinded cluster-randomized controlled field trial in which 36 primary health facilities in Kafue and Lusaka districts in Zambia were randomized to intervention (IYCF counselling with counselling cards or non- intervention arm (IYCF counselling without counselling cards. Counselling sessions with 10 HIV positive women attending each facility were observed and exit interviews were conducted by research assistants. Results Totals of 180 women in the intervention group and 180 women in the control group were attended to by health care providers and interviewed upon exiting the health facility. The health care providers in the intervention facilities more often discussed the advantages of disclosing their HIV status to a household member (RR = 1.46, 95% CI [1.11, 1.92]; used visual aids in explaining the risk of HIV transmission through breast milk (RR = 4.65, 95% CI [2.28, 9.46]; and discussed the advantages and disadvantages of infant feeding options for HIV positive mothers (all p values Conclusion The addition of counselling cards to the IYCF counselling session for HIV positive mothers were a valuable aid to counselling and significantly improved the quality of the counselling session.

  11. Anticipation of Traffic Demands to Guarantee QoS in IP/Optical Networks

    Directory of Open Access Journals (Sweden)

    Carolina Pinart


    Full Text Available Traffic in the Internet backbone is expected to grow above a few Tbit/s in 2020. To cope with this, operators are moving to IP/optical network architectures, where IP is the convergence layer for all services. On the other hand, the quality of service (QoS requirements of future applications encompasses the individualization of services and the assurance of stricter quality parameters such as latency, jitter or capacity. In other words, future optical networks will not only transport more IP data, but they will also have to offer differentiated QoS requirements to services. Finally, some emerging applications, e.g., grid computing, need greater flexibility in the usage of network resources, which involves establishing and releasing connections as if they were virtualized resources controlled by other elements or layers. In this context, traffic-driven lightpath provisioning and service-plane approaches arise as very interesting candidate solutions to solve the main challenges described above. This work reviews the concepts of service-oriented and self-managed networks and relates them to propose an integrated approach to assure QoS by offering flow-aware networking in the sense that traffic demands will be anticipated in a suitable way, lightpaths will be established taking into account QoS information (i.e., impairments and complex services will be decomposed into optical connections so that the above techniques can be employed to assure QoS for any service.

  12. Optimizing Low Speed VoIP Network for Rural Next Generation Network (R-NGN

    Directory of Open Access Journals (Sweden)

    Yoanes Bandung


    Full Text Available In this research, we propose an optimization method based-on E-Model for designing an efficient low speed VoIP network for Rural Next Generation Network (R-NGN. We are choosing 128 kbps and 256 kbps bandwidth as the typical community link to be used in the designing of R-NGN infrastructure. The method is based on selection of some VoIP network parameters such as voice coder, communication protocol, packet loss level, network utilization and resource allocation. We draw analytic approach for achieving rating value (R of E-model that represent level of quality of service. In this approach, we focus on delay and packet loss calculation to find the rating value. We state the rating value = 70 as minimum level of quality of service for each call, equivalent to 3.6 of Mean Opinion Score (MOS. In our experiments, either G.723.1 5.3 kbps or G.729 is chosen for maximizing the number of VoIP calls, it depends on link utilization and level of packet loss.

  13. Communication-Gateway Software For NETEX, DECnet, And TCP/IP (United States)

    Keith, B.; Ferry, D.; Fendler, E.


    Communications gateway software, GATEWAY, provides process-to-process communication between remote applications programs in different protocol domains. Communicating peer processes may be resident on any paired combination of NETEX, DECnet, or TCP/IP hosts. Provides necessary mapping from one protocol to another and facilitates practical intermachine communications in cost-effective manner by eliminating need to standardize on single protocol or to implement multiple protocols in host computers. Written in Ada.

  14. Legislation should support optimal breastfeeding practices and access to low-cost, high-quality complementary foods: Indonesia provides a case study. (United States)

    Soekarjo, Damayanti; Zehner, Elizabeth


    It is important to support women to exclusively breastfeed for 6 months and continue breastfeeding for 24 months and beyond. It is also necessary to provide the poor with access to affordable ways to improve the quality of complementary foods. Currently, many countries do not have the legal and policy environment necessary to support exclusive and continued breastfeeding. Legislative and policy changes are also necessary for introducing complementary food supplements, allowing them to be marketed to those who need them, and ensuring that marketing remains appropriate and in full compliance with the International Code of Marketing of Breastmilk Substitutes. This paper aims to illustrate the above with examples from Indonesia and to identify legislative requirements for supporting breastfeeding and enabling appropriate access to high-quality complementary food supplements for children 6-24 months of age. Requirements include improved information, training, monitoring and enforcement systems for the International Code of Marketing of Breastmilk Substitutes; implementation and monitoring of the Baby-Friendly Hospital Initiative; establishment of a registration category for complementary food supplements to enhance availability of high-quality, low-cost fortified products to help improve young child feeding; clear identification and marketing of these products as complementary food supplements for 6-24-month-olds so as to promote proper use and not interfere with breastfeeding. © 2011 Blackwell Publishing Ltd.

  15. GenoGAM: genome-wide generalized additive models for ChIP-Seq analysis. (United States)

    Stricker, Georg; Engelhardt, Alexander; Schulz, Daniel; Schmid, Matthias; Tresch, Achim; Gagneur, Julien


    Chromatin immunoprecipitation followed by deep sequencing (ChIP-Seq) is a widely used approach to study protein-DNA interactions. Often, the quantities of interest are the differential occupancies relative to controls, between genetic backgrounds, treatments, or combinations thereof. Current methods for differential occupancy of ChIP-Seq data rely however on binning or sliding window techniques, for which the choice of the window and bin sizes are subjective. Here, we present GenoGAM (Genome-wide Generalized Additive Model), which brings the well-established and flexible generalized additive models framework to genomic applications using a data parallelism strategy. We model ChIP-Seq read count frequencies as products of smooth functions along chromosomes. Smoothing parameters are objectively estimated from the data by cross-validation, eliminating ad hoc binning and windowing needed by current approaches. GenoGAM provides base-level and region-level significance testing for full factorial designs. Application to a ChIP-Seq dataset in yeast showed increased sensitivity over existing differential occupancy methods while controlling for type I error rate. By analyzing a set of DNA methylation data and illustrating an extension to a peak caller, we further demonstrate the potential of GenoGAM as a generic statistical modeling tool for genome-wide assays. Software is available from Bioconductor: . Supplementary information is available at Bioinformatics online.

  16. Cyclic AMP Recruits a Discrete Intracellular Ca2+ Store by Unmasking Hypersensitive IP3 Receptors

    Directory of Open Access Journals (Sweden)

    Vera Konieczny


    Full Text Available Inositol 1,4,5-trisphosphate (IP3 stimulates Ca2+ release from the endoplasmic reticulum (ER, and the response is potentiated by 3′,5′-cyclic AMP (cAMP. We investigated this interaction in HEK293 cells using carbachol and parathyroid hormone (PTH to stimulate formation of IP3 and cAMP, respectively. PTH alone had no effect on the cytosolic Ca2+ concentration, but it potentiated the Ca2+ signals evoked by carbachol. Surprisingly, however, the intracellular Ca2+ stores that respond to carbachol alone could be both emptied and refilled without affecting the subsequent response to PTH. We provide evidence that PTH unmasks high-affinity IP3 receptors within a discrete Ca2+ store. We conclude that Ca2+ stores within the ER that dynamically exchange Ca2+ with the cytosol maintain a functional independence that allows one store to be released by carbachol and another to be released by carbachol with PTH. Compartmentalization of ER Ca2+ stores adds versatility to IP3-evoked Ca2+ signals.

  17. Differential peak calling of ChIP-seq signals with replicates with THOR. (United States)

    Allhoff, Manuel; Seré, Kristin; F Pires, Juliana; Zenke, Martin; G Costa, Ivan


    The study of changes in protein-DNA interactions measured by ChIP-seq on dynamic systems, such as cell differentiation, response to treatments or the comparison of healthy and diseased individuals, is still an open challenge. There are few computational methods comparing changes in ChIP-seq signals with replicates. Moreover, none of these previous approaches addresses ChIP-seq specific experimental artefacts arising from studies with biological replicates. We propose THOR, a Hidden Markov Model based approach, to detect differential peaks between pairs of biological conditions with replicates. THOR provides all pre- and post-processing steps required in ChIP-seq analyses. Moreover, we propose a novel normalization approach based on housekeeping genes to deal with cases where replicates have distinct signal-to-noise ratios. To evaluate differential peak calling methods, we delineate a methodology using both biological and simulated data. This includes an evaluation procedure that associates differential peaks with changes in gene expression as well as histone modifications close to these peaks. We evaluate THOR and seven competing methods on data sets with distinct characteristics from in vitro studies with technical replicates to clinical studies of cancer patients. Our evaluation analysis comprises of 13 comparisons between pairs of biological conditions. We show that THOR performs best in all scenarios. © The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

  18. Quantification of histone modification ChIP-seq enrichment for data mining and machine learning applications

    Directory of Open Access Journals (Sweden)

    Bekiranov Stefan


    Full Text Available Abstract Background The advent of ChIP-seq technology has made the investigation of epigenetic regulatory networks a computationally tractable problem. Several groups have applied statistical computing methods to ChIP-seq datasets to gain insight into the epigenetic regulation of transcription. However, methods for estimating enrichment levels in ChIP-seq data for these computational studies are understudied and variable. Since the conclusions drawn from these data mining and machine learning applications strongly depend on the enrichment level inputs, a comparison of estimation methods with respect to the performance of statistical models should be made. Results Various methods were used to estimate the gene-wise ChIP-seq enrichment levels for 20 histone methylations and the histone variant H2A.Z. The Multivariate Adaptive Regression Splines (MARS algorithm was applied for each estimation method using the estimation of enrichment levels as predictors and gene expression levels as responses. The methods used to estimate enrichment levels included tag counting and model-based methods that were applied to whole genes and specific gene regions. These methods were also applied to various sizes of estimation windows. The MARS model performance was assessed with the Generalized Cross-Validation Score (GCV. We determined that model-based methods of enrichment estimation that spatially weight enrichment based on average patterns provided an improvement over tag counting methods. Also, methods that included information across the entire gene body provided improvement over methods that focus on a specific sub-region of the gene (e.g., the 5' or 3' region. Conclusion The performance of data mining and machine learning methods when applied to histone modification ChIP-seq data can be improved by using data across the entire gene body, and incorporating the spatial distribution of enrichment. Refinement of enrichment estimation ultimately improved accuracy

  19. Bandwidth Impacts of Localizing Peer-to-Peer IP Video Traffic in Access and Aggregation Networks

    Directory of Open Access Journals (Sweden)

    Kerpez Kenneth


    Full Text Available Abstract This paper examines the burgeoning impact of peer-to-peer (P2P traffic IP video traffic. High-quality IPTV or Internet TV has high-bandwidth requirements, and P2P IP video could severely strain broadband networks. A model for the popularity of video titles is given, showing that some titles are very popular and will often be available locally; making localized P2P attractive for video titles. The bandwidth impacts of localizing P2P video to try and keep traffic within a broadband access network area or within a broadband access aggregation network area are examined. Results indicate that such highly localized P2P video can greatly lower core bandwidth usage.

  20. Bandwidth Impacts of Localizing Peer-to-Peer IP Video Traffic in Access and Aggregation Networks

    Directory of Open Access Journals (Sweden)

    Kenneth Kerpez


    Full Text Available This paper examines the burgeoning impact of peer-to-peer (P2P traffic IP video traffic. High-quality IPTV or Internet TV has high-bandwidth requirements, and P2P IP video could severely strain broadband networks. A model for the popularity of video titles is given, showing that some titles are very popular and will often be available locally; making localized P2P attractive for video titles. The bandwidth impacts of localizing P2P video to try and keep traffic within a broadband access network area or within a broadband access aggregation network area are examined. Results indicate that such highly localized P2P video can greatly lower core bandwidth usage.