Expanding the Abortion Provider Workforce: A Qualitative Study of Organizations Implementing a New California Policy.

Science.gov (United States)

Battistelli, Molly Frances; Magnusson, Sara; Biggs, M Antonia; Freedman, Lori

2018-03-01

Access to abortion care in the United States varies according to multiple factors, including location, state regulation and provider availability. In 2013, California enacted a law that authorized nurse practitioners (NPs), certified nurse-midwives (CNMs) and physician assistants (PAs) to provide first-trimester aspiration abortions; little is known about organizations' experiences in implementing this policy change. Beginning 10 and 24 months after implementation of the new law, semistructured interviews were conducted with 20 administrators whose five organizations trained and employed NPs, CNMs and PAs as providers of aspiration abortions. Interview data on the organizations' experiences were analyzed thematically, and facilitators of and barriers to implementation were identified. Administrators were committed to the provision of aspiration abortions by NPs, CNMs and PAs, and nearly all identified improved access to care and complication management as clear benefits of the policy change. However, integration of the new providers was uneven and depended on a variety of circumstances. Organizational disincentives included financial and logistical costs incurred in trying to deploy and integrate the different types of providers. Some administrators found that increased costs were outweighed by improved patient care, whereas others did not. In general, having a strong administrative champion within the organization made a critical difference. California's expansion of the abortion-providing workforce had a positive impact on patient care in the sampled organizations. However, various organizational obstacles must be addressed to more fully realize the benefits of having NPs, CNMs and PAs provide aspiration abortions. Copyright © 2018 by the Guttmacher Institute.

Semantic distributed resource discovery for multiple resource providers

NARCIS (Netherlands)

Pittaras, C.; Ghijsen, M.; Wibisono, A.; Grosso, P.; van der Ham, J.; de Laat, C.

2012-01-01

An emerging modus operandi among providers of cloud infrastructures is the one where they share and combine their heterogenous resources to offer end user services tailored to specific scientific and business needs. A challenge to overcome is the discovery of suitable resources among these multiple

Circulating Extracellular Histones Are Clinically Relevant Mediators of Multiple Organ Injury.

Science.gov (United States)

Kawai, Chihiro; Kotani, Hirokazu; Miyao, Masashi; Ishida, Tokiko; Jemail, Leila; Abiru, Hitoshi; Tamaki, Keiji

2016-04-01

Extracellular histones are a damage-associated molecular pattern (DAMP) involved in the pathogenesis of various diseases. The mechanisms of histone-mediated injury in certain organs have been extensively studied, but an understanding of the pathophysiological role of histone-mediated injury in multiple organ injury remains elusive. To elucidate this role, we systemically subjected C57BL/6 mice to various doses of histones and performed a chronological evaluation of the morphological and functional changes in the lungs, liver, and kidneys. Notably, histone administration ultimately led to death after a dose-dependent aggravation of multiple organ injury. In chronological studies, pulmonary and hepatic injuries occurred within 15 minutes, whereas renal injuries presented at a later phase, suggesting that susceptibility to extracellular histones varies among organs. Histones bound to pulmonary and hepatic endothelial cells immediately after administration, leading to endothelial damage, which could be ameliorated by pretreatment with heparin. Furthermore, release of another DAMP, high-mobility group protein box 1, followed the histone-induced tissue damage, and an antibody against the molecule ameliorated hepatic and renal failure in a late phase. These findings indicate that extracellular histones induce multiple organ injury in two progressive stages-direct injury to endothelial cells and the subsequent release of other DAMPs-and that combination therapies against extracellular histones and high-mobility group protein box 1 may be a promising strategy for treating multiple organ injury. Copyright © 2016 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

SYSTEM ORGANIZATION OF MATERIAL PROVIDING OF BUILDING

Directory of Open Access Journals (Sweden)

A. V. Rаdkеvich

2014-04-01

Full Text Available Purpose. Development of scientific-methodical bases to the design of rational management of material streams in the field of building providing taking into account intersystem connections with the enterprises of building industry. Methodology. The analysis of last few years of functioning of building industry in Ukraine allows distinguishing a number of problems that negatively influence the steady development of building, as the component of the state economics system. Therefore the research of existent organization methods of the system of building objects providing with material resources is extremely necessary. In connection with this the article justifies the use of method of hierarchies analysis (Saati method for finding the optimal task solution of fixing the enterprises of building industry after building objects. Findings. Results give an opportunity to guidance of building organization to estimate and choose advantageous suppliers - enterprises of building industry, to conduct their rating, estimation taking into account basic descriptions, such as: quality, price, reliability of deliveries, specialization, financial status etc. Originality. On the basis of Saati method the methodologies of organization are improved, planning and managements of the reliable system of providing of building necessary material resources that meet the technological requirements of implementation of building and installation works. Practical value. Contribution to the decisions of many intricate organizational problems that are accompanied by the problems of development of building, provided due to organization of the reliable system of purchase of material resources.

Dental practice satisfaction with preferred provider organizations

Directory of Open Access Journals (Sweden)

Schilling Elizabeth A

2007-11-01

Full Text Available Abstract Background Despite their increasing share of the dental insurance market, little is known about dental practices' satisfaction with preferred provider organizations (PPOs. This analysis examined practice satisfaction with dental PPOs and the extent to which satisfaction was a function of communications from the plan, claims handling and compensation. Methods Data were collected through telephone surveys with dental practices affiliated with MetLife between January 2002 and December 2004. Each respondent was asked a series of questions related to their satisfaction with a systematically selected PPO with which they were affiliated. Six different PPO plans had sufficient observations to allow for comparative analysis (total n = 4582. Multiple imputation procedures were used to adjust for item non-response. Results While the average level of overall satisfaction with the target plan fell between "very satisfied" and "satisfied," regression models revealed substantial differences in overall satisfaction across the 6 PPOs (p Conclusion Results demonstrate the importance of compensation to dental practice satisfaction with PPOs. However, these results also highlight the critical role of service-related factors in differentiating plans and suggest that there are important non-monetary dimensions of PPO performance that can be used to recruit and retain practices.

Patient choice of providers in a preferred provider organization.

Science.gov (United States)

Wouters, A V; Hester, J

1988-03-01

This article is an analysis of patient choice of providers by the employees of the Security Pacific Bank of California and their dependents who have access to the Med Network Preferred Provider Organization (PPO). The empirical results show that not only is the PPO used by individuals who require relatively little medical care (as measured by predicted office visit charges) but that the PPO is most intensively used for low-risk services such as treatment for minor illness and preventive care. Also, the most likely Security Pacific Health Care beneficiary to use a PPO provider is a recently hired employee who lives in the south urban region, has a relatively low income, does not have supplemental insurance coverage, and is without previous attachments to non-PPO primary care providers. In order to maximize their ability to reduce plan paid benefits, insurers who contract with PPOs should focus on increasing PPO utilization among poorer health risks.

Multirate delivery of multiple therapeutic agents from metal-organic frameworks

Directory of Open Access Journals (Sweden)

Alistair C. McKinlay

2014-12-01

Full Text Available The highly porous nature of metal-organic frameworks (MOFs offers great potential for the delivery of therapeutic agents. Here, we show that highly porous metal-organic frameworks can be used to deliver multiple therapeutic agents—a biologically active gas, an antibiotic drug molecule, and an active metal ion—simultaneously but at different rates. The possibilities offered by delivery of multiple agents with different mechanisms of action and, in particular, variable timescales may allow new therapy approaches. Here, we show that the loaded MOFs are highly active against various strains of bacteria.

Multiple organ dysfunction caused by parathyroid adenoma‑induced ...

African Journals Online (AJOL)

We present a 27‑year‑old male with multiple organ dysfunction caused by parathyroid adenoma‑induced primary hyperparathyroidism (PHPT). Initially, the patient experienced a sudden onset of gastrointestinal symptoms, polyuria, polydipsia, bone pain, renal dysfunction, nephrolithiasis, and acute pancreatitis, symptoms ...

Provider-based Medicare risk contracting and subcontracting: opportunities and risks for provider sponsored organizations.

Science.gov (United States)

Levin, H A; Zenner, P A; Kipp, R A; Whitney, E L

1997-01-01

Provider sponsored organizations (PSOs) are increasingly acquiring the risk for the management of Medicare Risk patients by accepting capitation directly from the Health Care Financing Administration (HCFA) or through contracts with HMOs or other organizations contracting with HCFA. The Medicare population and the requirements that the federal administration has put into place with respect to risk contracting are unique and demand specific responses on the part of the PSO for a contract to be successful. The PSO is cautioned to understand the actuarial risk, the clinical uniqueness of the Medicare beneficiary, Medicare reimbursement regulatory requirements, utilization management needs, and necessary reporting before entering into a contractual arrangement. This article attempts to describe some of the more common issues a provider organization must consider.

A multiple index integrating different levels of organization.

Science.gov (United States)

Cortes, Rui; Hughes, Samantha; Coimbra, Ana; Monteiro, Sandra; Pereira, Vítor; Lopes, Marisa; Pereira, Sandra; Pinto, Ana; Sampaio, Ana; Santos, Cátia; Carrola, João; de Jesus, Joaquim; Varandas, Simone

2016-10-01

Many methods in freshwater biomonitoring tend to be restricted to a few levels of biological organization, limiting the potential spectrum of measurable of cause-effect responses to different anthropogenic impacts. We combined distinct organisational levels, covering biological biomarkers (histopathological and biochemical reactions in liver and fish gills), community based bioindicators (fish guilds, invertebrate metrics/traits and chironomid pupal exuviae) and ecosystem functional indicators (decomposition rates) to assess ecological status at designated Water Framework Directive monitoring sites, covering a gradient of human impact across several rivers in northern Portugal. We used Random Forest to rank the variables that contributed more significantly to successfully predict the different classes of ecological status and also to provide specific cut levels to discriminate each WFD class based on reference condition. A total of 59 Biological Quality Elements and functional indicators were determined using this procedure and subsequently applied to develop the integrated Multiple Ecological Level Index (MELI Index), a potentially powerful bioassessment tool. Copyright © 2016 Elsevier Inc. All rights reserved.

Adjunctive Therapies During Extracorporeal Membrane Oxygenation to Enhance Multiple Organ Support in Critically Ill Children

Directory of Open Access Journals (Sweden)

Marguerite Orsi Canter

2018-04-01

Full Text Available Since the advent of extracorporeal membrane oxygenation (ECMO over 40 years ago, there has been increasing interest in the use of the extracorporeal circuit as a platform for providing multiple organ support. In this review, we will examine the evidence for the use of continuous renal replacement therapy, therapeutic plasma exchange, leukopheresis, adsorptive therapies, and extracorporeal liver support in conjunction with ECMO.

Enucleation and limited pancreatic resection provide long-term cure for insulinoma in multiple endocrine neoplasia type 1.

Science.gov (United States)

Bartsch, Detlef K; Albers, Max; Knoop, Richard; Kann, Peter H; Fendrich, Volker; Waldmann, Jens

2013-01-01

To assess the characteristics and long-term outcome after surgery in patients with multiple endocrine neoplasia type 1 (MEN1)-associated insulinoma. Retrospective analysis of prospectively collected data of MEN1 patients with organic hyperinsulinism at a tertiary referral center. Thirteen (17%) of 74 patients with MEN1 had organic hyperinsulinism. The median age at diagnosis was 27 (range 9-48) years. In 7 patients insulinoma was the first manifestation of the syndrome. All patients had at least one pancreatic neuroendocrine neoplasm (pNEN) upon imaging, including CT, MRI or endoscopic ultrasonography. Seven patients had solitary lesions upon imaging, 4 patients had one dominant tumor with coexisting multiple small pNENs, and 2 patients had multiple lesions without dominance. Eight patients had limited resections (1 segmental resection, 7 enucleations), 4 subtotal distal pancreatectomies, and 1 patient a partial duodenopancreatectomy. There was no postoperative mortality. Six patients experienced complications, including pancreatic fistula in 5 patients. Pathological examination revealed median three (range 1-14) macro-pNENs sized between 6 and 40 mm, and a total of 14 potentially benign insulinomas were detected in the 13 patients. After median follow-up of 156 months, only 1 patient developed recurrent hyperinsulinism after initial enucleation. Twelve patients developed new pNENs in the pancreatic remnant and 4 patients underwent reoperations (3 for metastatic ZES, 1 for recurrent hyperinsulinism). One of 5 patients with an initial extended pancreatic resection developed insulin-dependent diabetes mellitus. Enucleation and limited resection provide long-term cure for MEN1 insulinoma in patients with solitary or dominant tumors. Subtotal distal pancreatectomy should thus be preserved for patients with multiple pNENs without dominance given the risk of exocrine and endocrine pancreas insufficiency in the mostly young patients. © 2013 S. Karger AG, Basel.

Fragmentation of organic ions bearing fixed multiple charges observed in MALDI MS.

Science.gov (United States)

Lou, Xianwen; Li, Bao; de Waal, Bas F M; Schill, Jurgen; Baker, Matthew B; Bovee, Ralf A A; van Dongen, Joost L J; Milroy, Lech-Gustav; Meijer, E W

2018-01-01

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI TOF MS) was used to analyze a series of synthetic organic ions bearing fixed multiple charges. Despite the multiple intrinsic charges, only singly charged ions were recorded in each case. In addition to the pseudo-molecular ions formed by counterion adduction, deprotonation and electron capture, a number of fragment ions were also observed. Charge splitting by fragmentation was found to be a viable route for charge reduction leading to the formation of the observed singly charged fragment ions. Unlike multivalent metal ions, organic ions can rearrange and/or fragment during charge reduction. This fragmentation process will evidently complicate the interpretation of the MALDI MS spectrum. Because MALDI MS is usually considered as a soft ionization technique, the fragment ion peaks can easily be erroneously interpreted as impurities. Therefore, the awareness and understanding of the underlying MALDI-induced fragmentation pathways is essential for a proper interpretation of the corresponding mass spectra. Due to the fragment ions generated during charge reduction, special care should be taken in the MALDI MS analysis of multiply charged ions. In this work, the possible mechanisms by which the organic ions bearing fixed multiple charges fragment are investigated. With an improved understanding of the fragmentation mechanisms, MALDI TOF MS should still be a useful technique for the characterization of organic ions with fixed multiple charges. Copyright © 2017 John Wiley & Sons, Ltd.

Fragmentation of organic ions bearing fixed multiple charges observed in MALDI MS

NARCIS (Netherlands)

Lou, X.; Li, B.; de Waal, B.F.M.; Schill, J.; Baker, M.B.; Bovee, R.A.A.; van Dongen, J.L.J.; Milroy, L.G.; Meijer, E.W.

2018-01-01

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI TOF MS) was used to analyze a series of synthetic organic ions bearing fixed multiple charges. Despite the multiple intrinsic charges, only singly charged ions were recorded in each case. In addition to the

Health organizations providing and seeking social support: a Twitter-based content analysis.

Science.gov (United States)

Rui, Jian Raymond; Chen, Yixin; Damiano, Amanda

2013-09-01

Providing and seeking social support are important aspects of social exchange. New communication technologies, especially social network sites (SNSs), facilitate the process of support exchange. An increasing number of health organizations are using SNSs. However, how they provide and seek social support via SNSs has yet to garner academic attention. This study examined the types of social support provided and sought by health organizations on Twitter. A content analysis was conducted on 1,500 tweets sent by a random sample of 58 health organizations within 2 months. Findings indicate that providing informational and emotional support, as well as seeking instrumental support, were the main types of social support exchanged by health organizations through Twitter. This study provides a typology for studying social support exchanges by health organizations, and recommends strategies for health organizations regarding the effective use of Twitter.

75 FR 62487 - Compassionate Allowances for Cardiovascular Disease and Multiple Organ Transplants, Office of the...

Science.gov (United States)

2010-10-12

...] Compassionate Allowances for Cardiovascular Disease and Multiple Organ Transplants, Office of the Commissioner... cardiovascular disease and multiple organ transplants, as well as topics covered at the hearing by: (1) e-mail... considering ways to quickly identify diseases and other serious medical conditions that obviously meet the...

Organic foods contain higher levels of certain nutrients, lower levels of pesticides, and may provide health benefits for the consumer.

Science.gov (United States)

Crinnion, Walter J

2010-04-01

The multi-billion dollar organic food industry is fueled by consumer perception that organic food is healthier (greater nutritional value and fewer toxic chemicals). Studies of the nutrient content in organic foods vary in results due to differences in the ground cover and maturity of the organic farming operation. Nutrient content also varies from farmer to farmer and year to year. However, reviews of multiple studies show that organic varieties do provide significantly greater levels of vitamin C, iron, magnesium, and phosphorus than non-organic varieties of the same foods. While being higher in these nutrients, they are also significantly lower in nitrates and pesticide residues. In addition, with the exception of wheat, oats, and wine, organic foods typically provide greater levels of a number of important antioxidant phytochemicals (anthocyanins, flavonoids, and carotenoids). Although in vitro studies of organic fruits and vegetables consistently demonstrate that organic foods have greater antioxidant activity, are more potent suppressors of the mutagenic action of toxic compounds, and inhibit the proliferation of certain cancer cell lines, in vivo studies of antioxidant activity in humans have failed to demonstrate additional benefit. Clear health benefits from consuming organic dairy products have been demonstrated in regard to allergic dermatitis.

Clinical Predictors of Multiple Organ Dysfunction Syndromes in Pediatric patients with Scrub Typhus.

Science.gov (United States)

Zhao, Dongying; Zhang, Yongjun; Yin, Zhaoqing; Zhao, Jing; Yang, Defeng; Zhou, Qun

2017-06-01

Scrub typhus can produce multiple organ dysfunction syndrome (MODS). Early recognition of the patients at risk of MODS would be helpful in providing timely management and reducing the mortality. In all, 449 children with scrub typhus were enrolled at three hospitals in Yunnan, China from January 2010 to January 2015. The patients' clinical status of organ system dysfunction was evaluated on the day of discharge from hospital by using standard criteria. The patients were classified into MODS present (64 cases, 14.3%) or MODS absent (385 cases, 85.7%). Multivariate logistic regression analyses revealed that the prognostic factors for MODS included skin rash (odds ratio, OR = 3.3, p = 0.037), time interval form treatment to defervescence (OR = 1.2, p = 0.035), hemoglobin (OR = 0.54, p = 0.041), platelet counts (OR = 0.06, p scrub typhus, our study provides clinicians with important information to improve the clinical monitoring and prognostication of MODS. © The Author [2016]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Perceptions of informal care givers: health and support services provided to people with multiple sclerosis.

Science.gov (United States)

Buchanan, Robert; Radin, Dagmar; Chakravorty, Bonnie J; Tyry, Tuula

2010-01-01

About 30% of people with multiple sclerosis (MS) need some form of home care assistance, with 80% of that assistance provided by informal or unpaid care givers. This study focuses on the care givers to 530 more disabled people with MS, with the objective to learn more about informal care giving to people with greater dependency and need for assistance. The data presented in this study were collected in a national survey of 530 informal care givers to people with MS who have greater levels of physical dependency. About 70% of informal care givers responded that assisting the person with MS perform daily activities or personal care took up the largest amount of their care giving time. Care givers also reported a range of home and community-based services that would make care giving easier or improve the care provided. However, informal care givers generally reported low satisfaction with health insurance coverage of these services, especially coverage by health maintenance organizations and other managed care plans. Lack of health insurance coverage of needed home and community-based services can reduce the quality of informal care provided, as well as increase the burden of informal care giving.

Native-View Paradigms: Multiple Cultures and Culture Conflicts in Organizations.

Science.gov (United States)

Gregory, Kathleen L.

1983-01-01

After reviewing organizational culture studies done in industrial settings, this paper proposes a native-view paradigm from anthropology for exploring the multiple perspectives of participants in large organizations and describes a study--of Silicon Valley technical professionals' native views--that applies the methods of ethnoscience ethnography.…

Responding to Multiple Institutional Logics in Inter-institutional Temporary Organizations

DEFF Research Database (Denmark)

Söderlund, Jonas; Pemsel, Sofia

2016-01-01

This paper draws on findings from a unique case study of a temporary organization that carried the responsibility for the planning and construction of a new super hospital in Stockholm, Sweden. Our empirical study explores how this temporary organization responded to requirements from different...... and sometimes conflicting institutional logics. The paper identifies four distinct response strategies that project actors relied upon to deal with the multiplicity of logics: total integration, partial decoupling, avoidance, and surfing. We discuss how these response strategies were used in the studied case...

Approaching the Hard-to-Reach in Organized Colorectal Cancer Screening: an Overview of Individual, Provider and System Level Coping Strategies

Directory of Open Access Journals (Sweden)

Jason Liwen Huang

2017-06-01

Full Text Available Background: Despite the proven effectiveness of colorectal cancer (CRC screening on reduction of CRC mortality, the uptake of CRC screening remains low. Participation rate is one of determinants for the success of organized population-based screening program. This review aims to identify those who are hard-to-reach, and summarize the strategies to increase their screening rate from individual, provider and system levels. Methods: A systematic search of electronic English databases was conducted on the factors and strategies of uptake in CRC screening for the hard-to-reach population up to May 2017. Discussion: The coverage rate and participation rate are two indexes to identify the hard-to-reach population in organized CRC screening program. However, the homeless, new immigrants, people with severe mental illness, the jail intimates, and people with characteristics including lower education levels and/or low socioeconomic status, living in rural/remote areas, without insurance, and racial minorities are usually recognized as hard-to-reach populations. For them, organized screening programs offer a better coverage, while novel invitation approaches for eligible individuals and multiple strategies from primary care physicians are still needed to enhance screening rates among subjects who are hard-to-reach. Suggestions implied the effectiveness of interventions at the system level, including linkages to general practice; use of decision making tools; enlisting supports from coalition; and the continuum from screening to diagnosis and treatment. Conclusion: Organized CRC screening offers a system access to approach the hard-to-reach populations. To increase their uptake, multiple and novel strategies from individual, provider and system levels should be applied. For policymakers, public healthcare providers and community stakeholders, it is a test to tailor their potential needs and increase their participation rates through continuous efforts to

Relationships between Organizations and Publics: Development of a Multi-Dimensional Organization-Public Relationship Scale.

Science.gov (United States)

Bruning, Stephen D.; Ledingham, John A.

1999-01-01

Attempts to design a multiple-item, multiple-dimension organization/public relationship scale. Finds that organizations and key publics have three types of relationships: professional, personal, and community. Provides an instrument that can be used to measure the influence that perceptions of the organization/public relationship have on consumer…

Change in donor profile influenced the percentage of organs transplanted from multiple organ donors.

Science.gov (United States)

Meers, C; Van Raemdonck, D; Van Gelder, F; Van Hees, D; Desschans, B; De Roey, J; Vanhaecke, J; Pirenne, J

2009-03-01

We hypothesized that the change in donor profile over the years influenced the percentage of transplantations. We reviewed medical records for all multiple-organ donors (MODs) within our network. The percentage of transplanted organs was compared between 1991-1992 (A) and 2006-2007 (B). In period A, 156 potential MODs were identified compared with 278 in period B. Fifteen potential donors (10%) in period A and 114 (41%) in period B were rejected because they were medically not suitable (40% vs 75%) or there was no family consent (60% vs 25%). Of the remaining effective MODs (141 in period A and 164 in period B), mean (standard deviation = SD) age was 34 (5) years vs 49 (17) years (P organs transplanted in periods A vs B was kidneys, 97% vs 79%; livers, 64% vs 85%; hearts, 60% vs 26%; lungs, 7% vs 35%; and pancreas, 6% vs 13% (P organs (17%), mainly because of medical contraindications. The MOD profile changed to older age, fewer traumatic brain deaths, and longer ventilation time. We transplanted more livers, lungs, and pancreases but fewer kidneys and hearts.

Eliciting Provider and Patient Perspectives on New Obesity Management Services in a Team-Based Primary Care Organization.

Science.gov (United States)

Royall, Dawna; Brauer, Paula; Atta-Konadu, Edwoba; Dwyer, John J M; Edwards, A Michelle; Hussey, Tracy; Kates, Nick

2017-09-01

Both providers and patients may have important insights to inform the development of obesity prevention and management services in Canadian primary care settings. In this formative study, insights for new obesity management services were sought from both providers and patients in 1 progressive citywide organization (150 physicians, team services, separate offices). Seven focus groups with interprofessional health providers (n = 56) and 4 focus groups with patients (n = 34) were conducted. Two clinical vignettes (adult, child) were used to focus discussion. Four analysts coded for descriptive content and interpretative themes on possible tools and care processes using NVivo. Participants identified numerous strategies for care processes, most of which could be categorized into 1 or more of 11 themes: 6 directed at clinical care of patients (raising awareness, screening, clinical care, skill building, ongoing support, and social/peer support) and 5 directed at the organization (coordination/collaboration, creating awareness among health professionals, adding new expertise to the team, marketing, and lobbying/advocacy). The approach was successful in generating an extensive list of diverse activities to be considered for implementation studies. Both patients and providers identified that multiple strategies and systems approaches will be needed to address obesity management in primary care.

Improvisation and the self-organization of multiple musical bodies.

Directory of Open Access Journals (Sweden)

Ashley eWalton

2015-04-01

Full Text Available Understanding everyday behavior relies heavily upon understanding our ability to improvise, how we are able to continuously anticipate and adapt in order to coordinate with our environment and others. Here we consider the ability of musicians to improvise, where they must spontaneously coordinate their actions with co-performers in order to produce novel musical expressions. Investigations of this behavior have traditionally focused on describing the organization of cognitive structures. The focus, here, however, is on the ability of the time-evolving patterns of inter-musician movement coordination as revealed by the mathematical tools of complex dynamical systems to provide a new understanding of what potentiates the novelty of spontaneous musical action. We demonstrate this approach through the application of cross wavelet spectral analysis, which isolates the strength and patterning of the behavioral coordination that occurs between improvising musicians across a range of nested time-scales. Revealing the sophistication of the previously unexplored dynamics of movement coordination between improvising musicians is an important step towards understanding how creative musical expressions emerge from the spontaneous coordination of multiple musical bodies.

Improvisation and the self-organization of multiple musical bodies.

Science.gov (United States)

Walton, Ashley E; Richardson, Michael J; Langland-Hassan, Peter; Chemero, Anthony

2015-01-01

Understanding everyday behavior relies heavily upon understanding our ability to improvise, how we are able to continuously anticipate and adapt in order to coordinate with our environment and others. Here we consider the ability of musicians to improvise, where they must spontaneously coordinate their actions with co-performers in order to produce novel musical expressions. Investigations of this behavior have traditionally focused on describing the organization of cognitive structures. The focus, here, however, is on the ability of the time-evolving patterns of inter-musician movement coordination as revealed by the mathematical tools of complex dynamical systems to provide a new understanding of what potentiates the novelty of spontaneous musical action. We demonstrate this approach through the application of cross wavelet spectral analysis, which isolates the strength and patterning of the behavioral coordination that occurs between improvising musicians across a range of nested time-scales. Revealing the sophistication of the previously unexplored dynamics of movement coordination between improvising musicians is an important step toward understanding how creative musical expressions emerge from the spontaneous coordination of multiple musical bodies.

Multiple Institutional Logics in Inter-Institutional Temporary Organizations

DEFF Research Database (Denmark)

Pemsel, Sofia; Söderlund, Jonas

for the planning and construction of a new super hospital in the capital of Sweden. Our empirical data demonstrates the important role institutional logics contribute with in understanding logics behind actions as well as emerging conflicts in practice throughout the project process. The paper identifies four......The idea of multiple institutional logics currently draws more and more attention as many organizational actors are forced to operate in ever more complex, temporary and vivid collaborations. We draw on findings from a unique case study of a temporary organization that carried the responsibility...

CIRCADIAN RHYTHMS FROM MULTIPLE OSCILLATORS: LESSONS FROM DIVERSE ORGANISMS

OpenAIRE

Bell-Pedersen, Deborah; Cassone, Vincent M.; Earnest, David J.; Golden, Susan S.; Hardin, Paul E.; Thomas, Terry L.; Zoran, Mark J.

2005-01-01

The organization of biological activities into daily cycles is universal in organisms as diverse as cyanobacteria, fungi, algae, plants, flies, birds and man. Comparisons of circadian clocks in unicellular and multicellular organisms using molecular genetics and genomics have provided new insights into the mechanisms and complexity of clock systems. Whereas unicellular organisms require stand-alone clocks that can generate 24-hour rhythms for diverse processes, organisms with differentiated t...

Tackling Energy Loss for High-Efficiency Organic Solar Cells with Integrated Multiple Strategies.

Science.gov (United States)

Zuo, Lijian; Shi, Xueliang; Jo, Sae Byeok; Liu, Yun; Lin, Fracis; Jen, Alex K-Y

2018-04-01

Limited by the various inherent energy losses from multiple channels, organic solar cells show inferior device performance compared to traditional inorganic photovoltaic techniques, such as silicon and CuInGaSe. To alleviate these fundamental limitations, an integrated multiple strategy is implemented including molecular design, interfacial engineering, optical manipulation, and tandem device construction into one cell. Considering the close correlation among these loss channels, a sophisticated quantification of energy-loss reduction is tracked along with each strategy in a perspective to reach rational overall optimum. A novel nonfullerene acceptor, 6TBA, is synthesized to resolve the thermalization and V OC loss, and another small bandgap nonfullerene acceptor, 4TIC, is used in the back sub-cell to alleviate transmission loss. Tandem architecture design significantly reduces the light absorption loss, and compensates carrier dynamics and thermalization loss. Interfacial engineering further reduces energy loss from carrier dynamics in the tandem architecture. As a result of this concerted effort, a very high power conversion efficiency (13.20%) is obtained. A detailed quantitative analysis on the energy losses confirms that the improved device performance stems from these multiple strategies. The results provide a rational way to explore the ultimate device performance through molecular design and device engineering. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Increased expression of matrix metalloproteinases in the murine zymosan-induced multiple organ dysfunction syndrome.

NARCIS (Netherlands)

Volman, T.J.H.; Goris, R.J.A.; Lomme, R.M.L.M.; Groot, J. de; Verhofstad, A.A.J.; Hendriks, T.

2004-01-01

Matrix metalloproteinases (MMPs) have been implicated as mediators of tissue damage in several inflammatory diseases. Since the multiple organ dysfunction syndrome (MODS) is thought to result from systemic inflammation, overactivation of MMPs could contribute to the organ damage observed. The

Statistics provide guidance for indigenous organic carbon detection on Mars missions.

Science.gov (United States)

Sephton, Mark A; Carter, Jonathan N

2014-08-01

Data from the Viking and Mars Science Laboratory missions indicate the presence of organic compounds that are not definitively martian in origin. Both contamination and confounding mineralogies have been suggested as alternatives to indigenous organic carbon. Intuitive thought suggests that we are repeatedly obtaining data that confirms the same level of uncertainty. Bayesian statistics may suggest otherwise. If an organic detection method has a true positive to false positive ratio greater than one, then repeated organic matter detection progressively increases the probability of indigeneity. Bayesian statistics also reveal that methods with higher ratios of true positives to false positives give higher overall probabilities and that detection of organic matter in a sample with a higher prior probability of indigenous organic carbon produces greater confidence. Bayesian statistics, therefore, provide guidance for the planning and operation of organic carbon detection activities on Mars. Suggestions for future organic carbon detection missions and instruments are as follows: (i) On Earth, instruments should be tested with analog samples of known organic content to determine their true positive to false positive ratios. (ii) On the mission, for an instrument with a true positive to false positive ratio above one, it should be recognized that each positive detection of organic carbon will result in a progressive increase in the probability of indigenous organic carbon being present; repeated measurements, therefore, can overcome some of the deficiencies of a less-than-definitive test. (iii) For a fixed number of analyses, the highest true positive to false positive ratio method or instrument will provide the greatest probability that indigenous organic carbon is present. (iv) On Mars, analyses should concentrate on samples with highest prior probability of indigenous organic carbon; intuitive desires to contrast samples of high prior probability and low prior

Interactions between organic anions on multiple transporters in Caco-2 cells

DEFF Research Database (Denmark)

Grandvuinet, Anne Sophie; Steffansen, Bente

2011-01-01

Caco-2 cell line may be used as an overall model to predict interactions on multiple membrane transporters in the intestine. Taurocholic acid (TCA) and estrone-3-sulfate (E1S) were used as model substrates. Possible inhibitors studied were TCA, E1S, taurolithocholic acid, fluvastatin, and glipizide......-dependent bile acid transporter and the organic solute transporter α/β, and to less extent by the organic anion transporting polypeptide 2B1. However, interactions on efflux transporters were not detected, although they were expected from the literature on the investigated compounds. Biosimulation methods may...

Magnetic resonance imaging correlates of bee sting induced multiple organ dysfunction syndrome: A case report.

Science.gov (United States)

Das, Sushant K; Zeng, Li-Chuan; Li, Bing; Niu, Xiang-Ke; Wang, Jing-Liang; Bhetuwal, Anup; Yang, Han-Feng

2014-09-28

Occasionally systemic complications with high risk of death, such as multiple organ dysfunction syndrome (MODS), can occur following multiple bee stings. This case study reports a patient who presented with MODS, i.e., acute kidney injury, hepatic and cardiac dysfunction, after multiple bee stings. The standard clinical findings were then correlated with magnetic resonance imaging (MRI) findings, which demonstrates that MRI may be utilized as a simpler tool to use than other multiple diagnostics.

The impact of university provided nurse electronic medical record training on health care organizations: an exploratory simulation approach.

Science.gov (United States)

Abrahamson, Kathleen; Anderson, James G; Borycki, Elizabeth M; Kushniruk, Andre W; Malovec, Shannon; Espejo, Angela; Anderson, Marilyn

2015-01-01

Training providers appropriately, particularly early in their caregiving careers, is an important aspect of electronic medical record (EMR) implementation. Considerable time and resources are needed to bring the newly hired providers 'up to speed' with the actual use practices of the organization. Similarly, universities lose valuable clinical training hours when students are required to spend those hours learning organization-specific EMR systems in order to participate in care during clinical rotations. Although there are multiple real-world barriers to university/health care organization training partnerships, the investment these entities share in training care providers, specifically nurses, to use and understand EMR technology encourages a question: What would be the cumulative effect of integrating a mutually agreed upon EMR system training program in to nursing classroom training on downstream hospital costs in terms of hours of direct caregiving lost, and benefits in terms of number of overall EMR trained nurses hired? In order to inform the development of a large scale study, we employed a dynamic systems modeling approach to simulate the theoretical relationships between key model variables and determine the possible effect of integrating EMR training into nursing classrooms on hospital outcomes. The analysis indicated that integrating EMR training into the nursing classroom curriculum results in more available time for nurse bedside care. Also, the simulation suggests that efficiency of clinical training can be potentially improved by centralizing EMR training within the nursing curriculum.

To provide care and be cared for in a multiple-bed hospital room.

Science.gov (United States)

Persson, Eva; Määttä, Sylvia

2012-12-01

To illuminate patients' experiences of being cared for and nurses' experiences of caring for patients in a multiple-bed hospital room. Many patients and healthcare personnel seem to prefer single-bed hospital rooms. However, certain advantages of multiple-bed hospital rooms (MBRs) have also been described. Eight men and eight women being cared for in a multiple-bedroom were interviewed, and two focus-group interviews (FGI) with 12 nurses were performed. A qualitative content analysis was used. One theme--Creating a sphere of privacy--and three categories were identified based on the patient interviews. The categories were: Being considerate, Having company and The patients' area. In the FGI, one theme--Integrating individual care with care for all--and two categories emerged: Experiencing a friendly atmosphere and Providing exigent care. Both patients and nurses described the advantages and disadvantages of multiple-bed rooms. The patient culture of taking care of one another and enjoying the company of room-mates were considered positive and gave a sense of security of both patients and nurses. The advantages were slight and could easily become disadvantages if, for example, room-mates were very ill or confused. The patients tried to maintain their privacy and dignity and claimed that there were small problems with room-mates listening to conversations. In contrast, the nurses stressed patient integrity as a main disadvantage and worked to protect the integrity of individual patients. Providing care for all patients simultaneously had the advantage of saving time. The insights gained in the present study could assist nurses in reducing the disadvantages and taking advantage of the positive elements of providing care in MBRs. Health professionals need to be aware of how attitudes towards male and female patients, respectively, could affect care provision. © 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

Interest in Providing Multiple Sclerosis Care and Subspecializing in Multiple Sclerosis Among Neurology Residents

Science.gov (United States)

Teixeira-Poit, Stephanie; Kane, Heather L.; Frost, A. Corey; Keating, Michael; Olmsted, Murrey

2014-01-01

Background: Although detailed knowledge regarding treatment options for multiple sclerosis (MS) patients is largely limited to neurologists, shortages in the neurologist workforce, including MS subspecialists, are predicted. Thus, MS patients may have difficulties in gaining access to appropriate care. No systematic evaluation has yet been performed of the number of neurology residents planning to pursue MS subspecialization. This study identifies factors affecting interest in providing MS patient care or MS subspecialization among current neurology residents. Methods: We randomly selected half of all Accreditation Council of Graduate Medical Education–certified neurology residency programs in the continental United States to receive the neurology resident survey. Completed surveys were received from 218 residents. Results: Residents were significantly more likely to have increased interest in MS care when they participated in MS research, were interested in teaching, and indicated that the “ability to improve patient outcomes and quality of life” was a positive factor influencing their desire to provide MS patient care. Residents who were interested in providing MS care, interested in teaching, and indicated that “research opportunities” was a positive factor for providing MS patient care were significantly more likely to express interest in MS subspecialization. Conclusions: Increasing opportunities to interact with MS patients, learn about MS care, and participate in MS research may increase interest in MS care and subspecialization among neurology residents. Opportunities to educate residents regarding MS patient care may affect residents’ attitudes. PMID:24688352

Efficient cascade multiple heterojunction organic solar cells with inverted structure

Science.gov (United States)

Guo, Tingting; Li, Mingtao; Qiao, Zhenfang; Yu, Leiming; Zhao, Jianhong; Feng, Nianjun; Shi, Peiguang; Wang, Xiaoyan; Pu, Xiaoyun; Wang, Hai

2018-05-01

In this work, we demonstrate an efficient cascade multiple heterojunction organic solar cell with inverted structure. By using two donor materials, poly(3-hexylthiosphene) (P3HT) and titanyl phthalocyanine (TiOPc), as well as two acceptor materials, [6,6]-phenyl C61 butyric acid methyl ester (PCBM) and C60, the cascade multiple heterojunctions of P3HT:PCBM/TiOPc:C60/C60 have been constructed. Applying the optimized inverted configuration of FTO/Zinc Tin Oxide (ZTO)/C60 (30 nm)/TiOPc:C60 (1:1.5, 25 nm)/P3HT:PCBM (1:0.8, 100 nm)/MoO3 (4 nm)/Ag, the considerably enhanced open circuit voltage (VOC) and short circuit current (JSC) can be harvested together, and the power conversion efficiency (PCE) is three times higher than that of the control cell with conventional structure. The significant improvements of the inverted cell are mostly due to the broadened spectral absorption and high efficient multi-interface exciton dissociation in the cascade multiple heterojunctions, indicating that the optimized cascade heterojunctions match the inverted structure well.

Performance effect of multiple control forms in a Lean organization

DEFF Research Database (Denmark)

Kristensen, Thomas Borup; Israelsen, Poul

2012-01-01

Over the last decades Lean has developed into a prominent management philosophy reaching beyond shop floor tools. However, substantial support of performance effects from Lean is still scarce and at best with mixed results. Recently, research has turned its focus towards perceiving Lean...... as a control package. In this paper we present statistical support for enhanced performance coming from Lean. Furthermore, our results strongly support the perception of Lean as a set of multiple control forms (output, behavioral, and social controls) that complement each other. Therefore, performance...... is increased if the average level of control forms is increased, and performance is further increased if the control forms are balanced at the same level representing a complementary effect between them. Our data are archival data spanning multiple years in a strong Lean organization. The dependent performance...

A case of disseminated hydatid disease by surgery involving multiple organs

Directory of Open Access Journals (Sweden)

Asli Tanrivermis Sayit

2014-09-01

Full Text Available Hydatid disease is the most common parasitic infection in the world, and is caused by the parasite Echinococcus granulosus. The most common site of this disease is the liver (75%, followed by the lungs, kidney, bones, and brain. Multiple abdominal organ and peritoneal involvement can also be seen in some cases. The dissemination of hydatid cyst disease can develop spontaneously or secondary to trauma or surgery. Here, we present the case of a 69-year-old man with multiple cyst hydatidosis, who underwent surgery for acute appendicitis approximately 20 years previously. Computed tomography of the abdomen shows the multiple active and inactive cystic lesions in the liver, spleen, right kidney, and mesentery. This patient required surgery several times, as well as medical treatment, after the rupture of a mesenteric hydatid cyst during the appendectomy. Combined anthelmintic treatment was recommended to the patient who refused further surgical treatment.

Providing Aquatic Organism Passage in Vertically Unstable Streams

Directory of Open Access Journals (Sweden)

JanineM Castro

2016-04-01

Full Text Available Aquatic organism passage barriers have been identified as one of the key impediments to recovery of salmonids and other migratory aquatic organisms in the Pacific Northwest of the United States. As such, state and federal agencies invest millions of dollars annually to address passage barriers. Because many barriers function as ad hoc grade control structures, their removal and/or replacement can unwittingly set off a cascade of effects that can negatively impact the very habitat and passage that project proponents seek to improve. The resultant vertical instability can result in a suite of effects that range from floodplain disconnection and loss of backwater and side channel habitat, to increased levels of turbidity. Risk assessment, including an evaluation of both the stage of stream evolution and a longitudinal profile analysis, provides a framework for determining if grade control is warranted, and if so, what type of structure is most geomorphically appropriate. Potential structures include placement of large wood and roughness elements, and constructed riffles, step-pools, and cascades. The use of structure types that mimic natural reach scale geomorphic analogues should result in improved aquatic organism passage, increased structural resilience, and reduced maintenance.

Estimating the development assistance for health provided to faith-based organizations, 1990-2013.

Science.gov (United States)

Haakenstad, Annie; Johnson, Elizabeth; Graves, Casey; Olivier, Jill; Duff, Jean; Dieleman, Joseph L

2015-01-01

Faith-based organizations (FBOs) have been active in the health sector for decades. Recently, the role of FBOs in global health has been of increased interest. However, little is known about the magnitude and trends in development assistance for health (DAH) channeled through these organizations. Data were collected from the 21 most recent editions of the Report of Voluntary Agencies. These reports provide information on the revenue and expenditure of organizations. Project-level data were also collected and reviewed from the Bill & Melinda Gates Foundation and the Global Fund to Fight AIDS, Tuberculosis and Malaria. More than 1,900 non-governmental organizations received funds from at least one of these three organizations. Background information on these organizations was examined by two independent reviewers to identify the amount of funding channeled through FBOs. In 2013, total spending by the FBOs identified in the VolAg amounted to US$1.53 billion. In 1990, FB0s spent 34.1% of total DAH provided by private voluntary organizations reported in the VolAg. In 2013, FBOs expended 31.0%. Funds provided by the Global Fund to FBOs have grown since 2002, amounting to $80.9 million in 2011, or 16.7% of the Global Fund's contributions to NGOs. In 2011, the Gates Foundation's contributions to FBOs amounted to $7.1 million, or 1.1% of the total provided to NGOs. Development assistance partners exhibit a range of preferences with respect to the amount of funds provided to FBOs. Overall, estimates show that FBOS have maintained a substantial and consistent share over time, in line with overall spending in global health on NGOs. These estimates provide the foundation for further research on the spending trends and effectiveness of FBOs in global health.

Estimating the development assistance for health provided to faith-based organizations, 1990-2013.

Directory of Open Access Journals (Sweden)

Annie Haakenstad

Full Text Available Faith-based organizations (FBOs have been active in the health sector for decades. Recently, the role of FBOs in global health has been of increased interest. However, little is known about the magnitude and trends in development assistance for health (DAH channeled through these organizations.Data were collected from the 21 most recent editions of the Report of Voluntary Agencies. These reports provide information on the revenue and expenditure of organizations. Project-level data were also collected and reviewed from the Bill & Melinda Gates Foundation and the Global Fund to Fight AIDS, Tuberculosis and Malaria. More than 1,900 non-governmental organizations received funds from at least one of these three organizations. Background information on these organizations was examined by two independent reviewers to identify the amount of funding channeled through FBOs.In 2013, total spending by the FBOs identified in the VolAg amounted to US$1.53 billion. In 1990, FB0s spent 34.1% of total DAH provided by private voluntary organizations reported in the VolAg. In 2013, FBOs expended 31.0%. Funds provided by the Global Fund to FBOs have grown since 2002, amounting to $80.9 million in 2011, or 16.7% of the Global Fund's contributions to NGOs. In 2011, the Gates Foundation's contributions to FBOs amounted to $7.1 million, or 1.1% of the total provided to NGOs.Development assistance partners exhibit a range of preferences with respect to the amount of funds provided to FBOs. Overall, estimates show that FBOS have maintained a substantial and consistent share over time, in line with overall spending in global health on NGOs. These estimates provide the foundation for further research on the spending trends and effectiveness of FBOs in global health.

Controlled multiple neutral planes by low elastic modulus adhesive for flexible organic photovoltaics.

Science.gov (United States)

Kim, Wansun; Lee, Inhwa; Yoon Kim, Dong; Yu, Youn-Yeol; Jung, Hae-Yoon; Kwon, Seyeoul; Seo Park, Weon; Kim, Taek-Soo

2017-05-12

To protect brittle layers in organic photovoltaic devices, the mechanical neutral plane strategy can be adopted through placing the brittle functional materials close to the neutral plane where stress and strain are zero during bending. However, previous research has been significantly limited in the location and number of materials to protect through using a single neutral plane. In this study, multiple neutral planes are generated using low elastic modulus adhesives and are controlled through quantitative analyses in order to protect the multiple brittle materials at various locations. Moreover, the protection of multiple brittle layers at various locations under both concave and convex bending directions is demonstrated. Multilayer structures that have soft adhesives are further analyzed using the finite element method analysis in order to propose guidelines for structural design when employing multiple neutral planes.

[Ulysses network: an approach to integral post-ICU treatment of patients with multiple organ dysfunction syndrome].

Science.gov (United States)

Nolla-Salas, M; Monmany-Roca, J; Vázquez-Mata, G

2007-01-01

The concept of continuity of care by intensivists as an element of quality control in the medical care of Intensive Care Unit (ICU) patients surviving multiple organ dysfunction syndrome has led to a rethinking of the ICU model in recent years. We discuss the rationale to design and implement a hospital-based, prospective, randomized, multicenter Intervention/Control study in order to estimate the impact of an interdisciplinary intervention during the post-ICU recovery phase on medium-term medical outcomes in ICU patients with multiple organ dysfunction.

A search engine to identify pathway genes from expression data on multiple organisms

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Zambon Alexander C

2007-05-01

Full Text Available Abstract Background The completion of several genome projects showed that most genes have not yet been characterized, especially in multicellular organisms. Although most genes have unknown functions, a large collection of data is available describing their transcriptional activities under many different experimental conditions. In many cases, the coregulatation of a set of genes across a set of conditions can be used to infer roles for genes of unknown function. Results We developed a search engine, the Multiple-Species Gene Recommender (MSGR, which scans gene expression datasets from multiple organisms to identify genes that participate in a genetic pathway. The MSGR takes a query consisting of a list of genes that function together in a genetic pathway from one of six organisms: Homo sapiens, Drosophila melanogaster, Caenorhabditis elegans, Saccharomyces cerevisiae, Arabidopsis thaliana, and Helicobacter pylori. Using a probabilistic method to merge searches, the MSGR identifies genes that are significantly coregulated with the query genes in one or more of those organisms. The MSGR achieves its highest accuracy for many human pathways when searches are combined across species. We describe specific examples in which new genes were identified to be involved in a neuromuscular signaling pathway and a cell-adhesion pathway. Conclusion The search engine can scan large collections of gene expression data for new genes that are significantly coregulated with a pathway of interest. By integrating searches across organisms, the MSGR can identify pathway members whose coregulation is either ancient or newly evolved.

Legitimating New Forms of Organizing and New International Activities in the Eyes of Multiple Stakeholders

DEFF Research Database (Denmark)

Turcan, Romeo V.

The research on new venture legitimation strategies is emerging; although, it is yet to form a central line of enquiry in entrepreneurship research. To contribute to this development, this paper explores the process of legitimation in a non-for-profit venture (hereafter as NGO, non-governmental...... organization). The paper explores (1) how this NGO acquired cognitive legitimacy, defined as knowledge about the new form of organizing and new activity and what is needed to succeed in respective sector, and socio-political legitimacy, defined as the value placed on the new form of organizing and new activity...... by its multiple stakeholders; and (2) what legitimation strategies it developed and adopted to legitimate itself in the eyes of its multiple stakeholders. Theoretically, the paper is grounded within legitimation theory. The empirical context is defined by a new, international NGO entering an established...

The invisible work of personal health information management among people with multiple chronic conditions: qualitative interview study among patients and providers.

Science.gov (United States)

Ancker, Jessica S; Witteman, Holly O; Hafeez, Baria; Provencher, Thierry; Van de Graaf, Mary; Wei, Esther

2015-06-04

A critical problem for patients with chronic conditions who see multiple health care providers is incomplete or inaccurate information, which can contribute to lack of care coordination, low quality of care, and medical errors. As part of a larger project on applications of consumer health information technology (HIT) and barriers to its use, we conducted a semistructured interview study with patients with multiple chronic conditions (MCC) with the objective of exploring their role in managing their personal health information. Semistructured interviews were conducted with patients and providers. Patients were eligible if they had multiple chronic conditions and were in regular care with one of two medical organizations in New York City; health care providers were eligible if they had experience caring for patients with multiple chronic conditions. Analysis was conducted from a grounded theory perspective, and recruitment was concluded when saturation was achieved. A total of 22 patients and 7 providers were interviewed; patients had an average of 3.5 (SD 1.5) chronic conditions and reported having regular relationships with an average of 5 providers. Four major themes arose: (1) Responsibility for managing medical information: some patients perceived information management and sharing as the responsibility of health care providers; others—particularly those who had had bad experiences in the past—took primary responsibility for information sharing; (2) What information should be shared: although privacy concerns did influence some patients' perceptions of sharing of medical data, decisions about what to share were also heavily influenced by their understanding of health and disease and by the degree to which they understood the health care system; (3) Methods and tools varied: those patients who did take an active role in managing their records used a variety of electronic tools, paper tools, and memory; and (4) Information management as invisible work

The Activities of Community Organizations in Providing Assistance to Prisoners of World War I

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Gulzhaukhar K. Kokebayeva

2016-12-01

Full Text Available The main purpose of this article is to examine the activities of the International Committee of the Red Cross and other community organizations in providing assistance to prisoners of the World War I. According to Article 15 of the Hague Convention of 1907, organizations that assist the prisoners of war, as well as their representatives can use all the benefits from the authorities of the warring countries. Representatives of these organizations are allowed to distribute benefits to places of detention of POWs, provided that a nominal permit is issued by the military authorities. During the World War I, the community organizations played a significant role in providing material and moral support to prisoners of war of belligerent countries. The role of the Red Cross in the protection of war victims and providing assistance to the POWs during the World War I is undeniable, international and national organizations interacted as natural mediators and influenced their own governments, in order to further alleviate the plight of the prisoners of war.

The Importance of Providing Multiple-Channel Sections in Dredging Activities to Improve Fish Habitat Environments

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Hung-Pin Chiu

2016-01-01

Full Text Available After Typhoon Morakot, dredging engineering was conducted while taking the safety of humans and structures into consideration, but partial stream reaches were formed in the multiple-channel sections in Cishan Stream because of anthropogenic and natural influences. This study mainly explores the distribution of each fish species in both the multiple- and single-channel sections in the Cishan Stream. Parts of the environments did not exhibit significant differences according to a one-way ANOVA comparing the multiple- and single-channel sections, but certain areas of the multiple-channel sections had more diverse habitats. Each fish species was widely distributed by non-metric multidimensional scaling in the multiple-channel sections as compared to those in the single-channel sections. In addition, according to the principal component analysis, each fish species has a preferred environment, and all of them have a wide choice of habitat environments in the multiple-channel sections. Finally, the existence of multiple-channel sections could significantly affect the existence of the fish species under consideration in this study. However, no environmental factors were found to have an influence on fish species in the single-channel sections, with the exception of Rhinogobius nantaiensis. The results show that providing multiple-channel sections in dredging activities could improve fish habitat environments.

Workflow Management for Multiple Sclerosis Patients: IT and Organization

NARCIS (Netherlands)

Michel-Verkerke, Margreet B.; Michel-Verkerke, M.B.; Schuring, R.W.; Spil, Antonius A.M.; Sprague, R.H.

2004-01-01

Patients with Multiple Sclerosis (MS) visit various healthcare providers during the course of their disease. It was suggested that IT might help to orchestrate their care provision. We have applied the USE IT-tool to get insight in the relevant problems, solutions and constraints of the MS-care and

Interconnection blocks: a method for providing reusable, rapid, multiple, aligned and planar microfluidic interconnections

DEFF Research Database (Denmark)

Sabourin, David; Snakenborg, Detlef; Dufva, Hans Martin

2009-01-01

In this paper a method is presented for creating 'interconnection blocks' that are re-usable and provide multiple, aligned and planar microfluidic interconnections. Interconnection blocks made from polydimethylsiloxane allow rapid testing of microfluidic chips and unobstructed microfluidic observ...

Contemporary Patterns of Multiple Organ Dysfunction in Trauma.

Science.gov (United States)

Shepherd, Joanna M; Cole, Elaine; Brohi, Karim

2017-04-01

Multiple organ dysfunction syndrome (MODS) is associated with poor outcomes for trauma patients. Different forms of MODS may exist and have different consequences. The ability to distinguish them clinically may have implications for prognosis and treatment. We wished to study whether prolonged MODS (PRMODS) could be observed as a distinct clinical entity to early resolving MODS (ERMODS) in critically injured patients. Adult major trauma patients recruited to a prospective observational study at a single major trauma center were eligible for inclusion. MODS was defined as Sequential Organ Failure Assessment (SOFA) score >5; and PRMODS as lasting >7 days. Time to recovery (TTR) was calculated as the number of days before the SOFA fell below the MODS threshold (≤5). Five hundred ninety-five patients were enrolled of whom 285 developed ERMODS (48%) and 184 (31%) PRMODS. Organ dysfunction was more severe and protracted in PRMODS, especially in patients without brain injury (mean SOFA 11 vs. 6, Day 2, P < 0.001; TTR 17 vs. 3 days, P < 0.001). PRMODS exhibited higher rates of hepatic and renal dysfunction (84% vs. 56%; and 78% vs. 47%, P≤0.001). Patterns of recovery were distinct in hepatic, renal, and neurological systems (TTR 15 vs. 4; 20 vs. 3; and 28 vs. 7 days, P < 0.01). PRMODS was associated with higher infection and mortality rates (91% vs. 41%; and 22% vs. 7%, P < 0.001). PRMODS appears common, a distinct clinical entity, and associated with worse patient outcomes. PRMODS may represent an important endpoint for studies evaluating outcomes following trauma.

Estimating the Development Assistance for Health Provided to Faith-Based Organizations, 1990–2013

Science.gov (United States)

Haakenstad, Annie; Johnson, Elizabeth; Graves, Casey; Olivier, Jill; Duff, Jean; Dieleman, Joseph L.

2015-01-01

Background Faith-based organizations (FBOs) have been active in the health sector for decades. Recently, the role of FBOs in global health has been of increased interest. However, little is known about the magnitude and trends in development assistance for health (DAH) channeled through these organizations. Material and Methods Data were collected from the 21 most recent editions of the Report of Voluntary Agencies. These reports provide information on the revenue and expenditure of organizations. Project-level data were also collected and reviewed from the Bill & Melinda Gates Foundation and the Global Fund to Fight AIDS, Tuberculosis and Malaria. More than 1,900 non-governmental organizations received funds from at least one of these three organizations. Background information on these organizations was examined by two independent reviewers to identify the amount of funding channeled through FBOs. Results In 2013, total spending by the FBOs identified in the VolAg amounted to US$1.53 billion. In 1990, FB0s spent 34.1% of total DAH provided by private voluntary organizations reported in the VolAg. In 2013, FBOs expended 31.0%. Funds provided by the Global Fund to FBOs have grown since 2002, amounting to $80.9 million in 2011, or 16.7% of the Global Fund’s contributions to NGOs. In 2011, the Gates Foundation’s contributions to FBOs amounted to $7.1 million, or 1.1% of the total provided to NGOs. Conclusion Development assistance partners exhibit a range of preferences with respect to the amount of funds provided to FBOs. Overall, estimates show that FBOS have maintained a substantial and consistent share over time, in line with overall spending in global health on NGOs. These estimates provide the foundation for further research on the spending trends and effectiveness of FBOs in global health. PMID:26042731

Multiple Problem-Solving Strategies Provide Insight into Students' Understanding of Open-Ended Linear Programming Problems

Science.gov (United States)

Sole, Marla A.

2016-01-01

Open-ended questions that can be solved using different strategies help students learn and integrate content, and provide teachers with greater insights into students' unique capabilities and levels of understanding. This article provides a problem that was modified to allow for multiple approaches. Students tended to employ high-powered, complex,…

Multiple organ failure in the newborn: the point of view of the pathologist

Directory of Open Access Journals (Sweden)

Clara Gerosa

2014-06-01

Full Text Available One of the most severe events occurring in critically ill patients admitted to a neonatal intensive care unit (NICU center is represented by the multiple organ failure (MOF, a systemic inflammatory response leading to a progressive organ dysfunction and mortality in newborns. MOF may occur in newborns primarily affected by multiple single organ diseases, including respiratory distress syndrome neonatal sepsis with acute kidney injury, post-asphyxial hypoxic-ischemic encephalopathy and pandemic influenza A (H1N1 infection. In a previous article from our group, based on the histological examination of all organs at autopsy of newborns affected by MOF, all organs studied did not escape to be damaged, including thymus and pancreas normally not mentioned in the literature of MOF. The aim of this article is to review the most important pathological changes pathologists should look for in every case of MOF occurring in the perinatal period, with particular attention to systemic endothelial changes occurring in blood vessels in all organs and sytems. On the basis of our experience, matching data during the last phases of the clinicopathological diagnosis represents a useful method, much more productive as compared to the method based on giving pathological answers to the clinical questions prospected before autopsy. As for the pathological features observed in neonatal MOF, one of them deserves a particular attention: the vascular lesions, and in particular the multiple changes occurring during MOF development in endothelial cells, ending with the loss of the endothelial barrier, probably the most relevant histological lesion followed by the insurgence of interstitial edema and disseminated intravascular coagulation. Small vessels should be observed at high power, with particular attention to the size and shape of endothelial nuclei, in order to evidence endothelial swelling, probably the initial modification of the endothelial cells leading to their

Technical and Scientific Support Organizations Providing Support to Regulatory Functions. Companion CD-ROM

International Nuclear Information System (INIS)

2018-01-01

This publication introduces the general principles underlying the provision of technical and scientific support to a regulatory body and the characteristics of organizations providing such support. It describes the services provided to support regulatory functions as well as the associated activities and processes to maintain the needed level of expertise, state of the art tools and equipment. The publication is intended for use primarily by organizations that provide technical and scientific support in the field of nuclear and radiation safety. This also includes organizations that acquire such support, and regulatory bodies and governments, as they make decisions on the model of technical and scientific support to be developed at the national level, for example in the case of a country embarking on the development of a nuclear power programme. It is the first IAEA publication dedicated to the specific practices and challenges to be met by the technical and scientific support organizations. This CD-ROM includes the annexes to the printed publication of examples of TSOs and their interactions with key stakeholders.

Technology-Enhanced Peer Review: Benefits and Implications of Providing Multiple Reviews

DEFF Research Database (Denmark)

Papadopoulos, Pantelis M.; Lagkas, Thomas D.; Demetriadis, Stavros N.

2017-01-01

This study analyses the impact of self and peer feedback in technology-enhanced peer review settings. The impact of receiving peer comments (“receiver” perspective) is compared to that of reaching own insights by reviewing others’ work (“giver” perspective). In this study, 38 sophomore students...... were randomly assigned in two conditions and engaged in peer review activity facilitated by a web-based learning environment asking them to provide multiple reviews. In the Peer Reviewed (PR) condition students both reviewed peer work and received peer comments for their own work. By contrast......, in the Self Reviewed (SR) condition students provided peer reviews, but did not receive any. Instead, they were asked to perform self reviewing, before proceeding to any revisions of their work. Result showed that the two groups were comparable in all aspects, suggesting that the lack of getting peer reviews...

Adsorption of histones on natural polysaccharides: The potential as agent for multiple organ failure in sepsis.

Science.gov (United States)

Isobe, Takashi; Kofuji, Kyoko; Okada, Kenji; Fujimori, Junya; Murata, Mikio; Shigeyama, Masato; Hanioka, Nobumitsu; Murata, Yoshifumi

2016-03-01

Histones are intracellular proteins that are structural elements of nuclear chromatin and regulate gene transcription. However, the extracellular histones released in response to bacterial challenges have been identified as mediators contributing to endothelial dysfunction, organ failure, and death during sepsis. In the present study, the adsorption of histones as well as plasma proteins (α1-acid glycoprotein (AGP), albumin, and γ-globulin) on alginic acid, pectin, dextran, and chitosan was examined in order to evaluate the potential of natural polysaccharides as therapeutic agents for multiple organ failure in sepsis. Alginic acid and pectin strongly adsorbed histones, whereas the adsorption abilities of dextran and chitosan toward histones were very low or negligible. Among the natural polysaccharides examined, only alginic acid did not adsorb any of the plasma proteins. These results demonstrated that alginic acid strongly adsorbed histones, but not plasma proteins; therefore, it has potential as a candidate drug for the treatment of multiple organ failure in sepsis. Copyright © 2015 Elsevier B.V. All rights reserved.

Guidelines for providing privileges and credentials to physicians for transvaginal placement of surgical mesh for pelvic organ prolapse.

Science.gov (United States)

2012-01-01

The adoption of new technology or procedures into a clinician's surgical armamentarium is driven by multiple factors. Patient safety and anticipated long-term improvement in outcomes should be the primary objective that guides a surgeon's decision to deliver care involving new procedures. Surgically complex procedures require a balance of knowledge, surgical skill, and experience, with appropriate ongoing surgical volume and monitoring of outcomes and adverse events. Transvaginal placement of surgical mesh for pelvic organ prolapse has the potential to improve quality of life and anatomic outcomes (especially in the anterior compartment), but also has potential serious adverse events as outlined by the FDA's July 2011 Safety Communication. This document provides Guidelines for privileging and credentialing of physicians planning to implement or continue using this new technology in clinical practice.

Fusing Multiple Satellite Datasets Toward Defining and Understanding Organized Convection

Science.gov (United States)

Elsaesser, G.; Del Genio, A. D.

2017-12-01

How do we differentiate unorganized from organized convection? We might think of organized convection as being long lasting (at least longer than the lifetime of any individual cumulus cell), clustered at larger spatial scales (>100 km), and responsible for substantial rainfall accumulation. Organized convection is sustained on such scales due to the arrangement of moist/dry and buoyant/non-buoyant mesoscale circulations. The nature of these circulations is tied to system diabatic heating profiles; in particular, the 2nd baroclinic (top-heavy), stratiform heating mode is thought to be important for organized convection maintenance/propagation. We investigate the extent to which these characteristics are jointly found in propagating convective systems. Lifecycle information comes from hi-res IR data. Diabatic heating profiles, convective fractions and rainfall are provided by GPM retrievals mapped to convective system tracks. Moisture is provided by AIRS/AMSU and passive microwave retrievals. Instead of compositing heating profile information along a system track, where information is smoothed out, we sort system heating profile structures according to their "top heaviness" and then analyze PDFs of system rainfall, system sizes, durations, convective/stratiform ratios, etc. as a function of diabatic heating structure. Perhaps contrary to expectation, we find only small differences in PDFs of rainfall rates, system sizes, and system duration for different heating profile structures. If organization is defined according to heating structures, then one possible interpretation of these results is that organization is independent of system size, duration, and many times, even lifecycle stage. Is it possible that most systems "hobble" along and exhibit varying degrees of organization, dependent on local environment moisture/buoyancy variations, unlike the archetypical MCS paradigm? This presentation will also discuss the questions posed above within the context of

Medication adherence among adolescent solid-organ transplant recipients: A survey of healthcare providers.

Science.gov (United States)

Mehta, Pooja; Steinberg, Elizabeth A; Kelly, Sarah L; Buchanan, Cindy; Rawlinson, Alana Resmini

2017-11-01

The aim of this study was to assess healthcare provider perspectives on barriers to medication adherence and to discover recommendations for interventions among providers of pediatric solid-organ transplant patients. An anonymous online survey was administered to a multidisciplinary pool of pediatric transplant providers from February 2015 to March 2016. It consisted of 15 questions regarding transplant providers' attitudes, clinical practice, and beliefs pertaining to medication adherence among teenage solid-organ transplant recipients. Data were analyzed using descriptive statistics. Responses to open-ended questions were coded and categorized into themes. One hundred ten surveys were completed by providers specializing in pediatric heart, kidney, liver, lung, and/or intestinal transplantation. Commonly cited reasons for poor adherence were forgetting/poor planning (94%), the desire to be normal (86%), lack of support (86%), and poor parental monitoring (79%). Suggestions to improve adherence included increasing peer and family support, providing education, and incorporating technology into adherence regimens. Barriers to adherence in transplant patients are recognized by providers and are both similar to and disparate from patient and family identified barriers published in the literature. Providers recognize the importance of education, social support, and technologically driven interventions on improving outcomes in the transplant population. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

HMGB1 and Extracellular Histones Significantly Contribute to Systemic Inflammation and Multiple Organ Failure in Acute Liver Failure

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Runkuan Yang

2017-01-01

Full Text Available Acute liver failure (ALF is the culmination of severe liver cell injury from a variety of causes. ALF occurs when the extent of hepatocyte death exceeds the hepatic regenerative capacity. ALF has a high mortality that is associated with multiple organ failure (MOF and sepsis; however, the underlying mechanisms are still not clear. Emerging evidence shows that ALF patients/animals have high concentrations of circulating HMGB1, which can contribute to multiple organ injuries and mediate gut bacterial translocation (BT. BT triggers/induces systemic inflammatory responses syndrome (SIRS, which can lead to MOF in ALF. Blockade of HMGB1 significantly decreases BT and improves hepatocyte regeneration in experimental acute fatal liver injury. Therefore, HMGB1 seems to be an important factor that links BT and systemic inflammation in ALF. ALF patients/animals also have high levels of circulating histones, which might be the major mediators of systemic inflammation in patients with ALF. Extracellular histones kill endothelial cells and elicit immunostimulatory effect to induce multiple organ injuries. Neutralization of histones can attenuate acute liver, lung, and brain injuries. In conclusion, HMGB1 and histones play a significant role in inducing systemic inflammation and MOF in ALF.

HMGB1 and Extracellular Histones Significantly Contribute to Systemic Inflammation and Multiple Organ Failure in Acute Liver Failure.

Science.gov (United States)

Yang, Runkuan; Zou, Xiaoping; Tenhunen, Jyrki; Tønnessen, Tor Inge

2017-01-01

Acute liver failure (ALF) is the culmination of severe liver cell injury from a variety of causes. ALF occurs when the extent of hepatocyte death exceeds the hepatic regenerative capacity. ALF has a high mortality that is associated with multiple organ failure (MOF) and sepsis; however, the underlying mechanisms are still not clear. Emerging evidence shows that ALF patients/animals have high concentrations of circulating HMGB1, which can contribute to multiple organ injuries and mediate gut bacterial translocation (BT). BT triggers/induces systemic inflammatory responses syndrome (SIRS), which can lead to MOF in ALF. Blockade of HMGB1 significantly decreases BT and improves hepatocyte regeneration in experimental acute fatal liver injury. Therefore, HMGB1 seems to be an important factor that links BT and systemic inflammation in ALF. ALF patients/animals also have high levels of circulating histones, which might be the major mediators of systemic inflammation in patients with ALF. Extracellular histones kill endothelial cells and elicit immunostimulatory effect to induce multiple organ injuries. Neutralization of histones can attenuate acute liver, lung, and brain injuries. In conclusion, HMGB1 and histones play a significant role in inducing systemic inflammation and MOF in ALF.

HMGB1 and Histones Play a Significant Role in Inducing Systemic Inflammation and Multiple Organ Dysfunctions in Severe Acute Pancreatitis

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Runkuan Yang

2017-01-01

Full Text Available Severe acute pancreatitis (SAP starts as a local inflammation of pancreatic tissue that induces the development of multiple extrapancreatic organs dysfunction; however, the underlying mechanisms are still not clear. Ischemia-reperfusion, circulating inflammatory cytokines, and possible bile cytokines significantly contribute to gut mucosal injury and intestinal bacterial translocation (BT during SAP. Circulating HMGB1 level is significantly increased in SAP patients and HMGB1 is an important factor that mediates (at least partly gut BT during SAP. Gut BT plays a critical role in triggering/inducing systemic inflammation/sepsis in critical illness, and profound systemic inflammatory response syndrome (SIRS can lead to multiple organ dysfunction syndrome (MODS during SAP, and systemic inflammation with multiorgan dysfunction is the cause of death in experimental SAP. Therefore, HMGB1 is an important factor that links gut BT and systemic inflammation. Furthermore, HMGB1 significantly contributes to multiple organ injuries. The SAP patients also have significantly increased circulating histones and cell-free DNAs levels, which can reflect the disease severity and contribute to multiple organ injuries in SAP. Hepatic Kupffer cells (KCs are the predominant source of circulating inflammatory cytokines in SAP, and new evidence indicates that hepatocyte is another important source of circulating HMGB1 in SAP; therefore, treating the liver injury is important in SAP.

Novel Control Strategy for Multiple Run-of-the-River Hydro Power Plants to Provide Grid Ancillary Services

Energy Technology Data Exchange (ETDEWEB)

Mohanpurkar, Manish; Luo, Yusheng; Hovsapian, Rob; Muljadi, Eduard; Gevorgian, Vahan; Koritarov, Vladimir

2017-05-01

Electricity generated by Hydropower Plants (HPPs) contributes a considerable portion of bulk electricity generation and delivers it with a low carbon footprint. In fact, HPP electricity generation provides the largest share from renewable energy resources, which includes solar and wind energy. The increasing penetration of wind and solar penetration leads to a lowered inertia in the grid and hence poses stability challenges. In recent years, breakthrough in energy storage technologies have demonstrated the economic and technical feasibility of extensive deployments in power grids. Multiple ROR HPPs if integrated with scalable, multi time-step energy storage so that the total output can be controlled. Although, the size of a single energy storage is far smaller than that of a typical reservoir, cohesively managing multiple sets of energy storage distributed in different locations is proposed. The ratings of storages and multiple ROR HPPs approximately equals the rating of a large, conventional HPP. The challenges associated with the system architecture and operation are described. Energy storage technologies such as supercapacitors, flywheels, batteries etc. can function as a dispatchable synthetic reservoir with a scalable size of energy storage will be integrated. Supercapacitors, flywheels, and battery are chosen to provide fast, medium, and slow responses to support grid requirements. Various dynamic and transient power grid conditions are simulated and performances of integrated ROR HPPs with energy storage is provided. The end goal of this research is to investigate the inertial equivalence of a large, conventional HPP with a unique set of multiple ROR HPPs and optimally rated energy storage systems.

Intramolecular 13C analysis of tree rings provides multiple plant ecophysiology signals covering decades.

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Wieloch, Thomas; Ehlers, Ina; Yu, Jun; Frank, David; Grabner, Michael; Gessler, Arthur; Schleucher, Jürgen

2018-03-22

Measurements of carbon isotope contents of plant organic matter provide important information in diverse fields such as plant breeding, ecophysiology, biogeochemistry and paleoclimatology. They are currently based on 13 C/ 12 C ratios of specific, whole metabolites, but we show here that intramolecular ratios provide higher resolution information. In the glucose units of tree-ring cellulose of 12 tree species, we detected large differences in 13 C/ 12 C ratios (>10‰) among carbon atoms, which provide isotopically distinct inputs to major global C pools, including wood and soil organic matter. Thus, considering position-specific differences can improve characterisation of soil-to-atmosphere carbon fluxes and soil metabolism. In a Pinus nigra tree-ring archive formed from 1961 to 1995, we found novel 13 C signals, and show that intramolecular analysis enables more comprehensive and precise signal extraction from tree rings, and thus higher resolution reconstruction of plants' responses to climate change. Moreover, we propose an ecophysiological mechanism for the introduction of a 13 C signal, which links an environmental shift to the triggered metabolic shift and its intramolecular 13 C signature. In conclusion, intramolecular 13 C analyses can provide valuable new information about long-term metabolic dynamics for numerous applications.

Long-term in vivo imaging of multiple organs at the single cell level.

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Benny J Chen

Full Text Available Two-photon microscopy has enabled the study of individual cell behavior in live animals. Many organs and tissues cannot be studied, especially longitudinally, because they are located too deep, behind bony structures or too close to the lung and heart. Here we report a novel mouse model that allows long-term single cell imaging of many organs. A wide variety of live tissues were successfully engrafted in the pinna of the mouse ear. Many of these engrafted tissues maintained the normal tissue histology. Using the heart and thymus as models, we further demonstrated that the engrafted tissues functioned as would be expected. Combining two-photon microscopy with fluorescent tracers, we successfully visualized the engrafted tissues at the single cell level in live mice over several months. Four dimensional (three-dimensional (3D plus time information of individual cells was obtained from this imaging. This model makes long-term high resolution 4D imaging of multiple organs possible.

Unusual fatal multiple-organ dysfunction and pancreatitis induced by a single wasp sting

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C Azad

2011-01-01

Full Text Available Acute onset of multiple organ dysfunction syndrome (MODS is a well-known complication following multiple wasp stings. However, MODS after a single wasp sting has been rarely reported in children and acute pancreatitis have probably never been observed before. Herein we describe the case of a 12-year-old boy who had urticaria and abdominal pain after a single wasp sting. The child gradually developed MODS while his abdominal complaints were worsening. Despite aggressive supportive management, the child did not survive. Afterward, the cause of the acute abdomen was finally diagnosed as acute pancreatitis. Both MODS and pancreatitis following a single wasp sting are very unusual. Thus, although pancreatitis is rarely manifested, it should be suspected after a wasp sting if there are predominant abdominal symptoms.

Federated or cached searches: providing expected performance from multiple invasive species databases

Science.gov (United States)

Graham, Jim; Jarnevich, Catherine S.; Simpson, Annie; Newman, Gregory J.; Stohlgren, Thomas J.

2011-01-01

Invasive species are a universal global problem, but the information to identify them, manage them, and prevent invasions is stored around the globe in a variety of formats. The Global Invasive Species Information Network is a consortium of organizations working toward providing seamless access to these disparate databases via the Internet. A distributed network of databases can be created using the Internet and a standard web service protocol. There are two options to provide this integration. First, federated searches are being proposed to allow users to search “deep” web documents such as databases for invasive species. A second method is to create a cache of data from the databases for searching. We compare these two methods, and show that federated searches will not provide the performance and flexibility required from users and a central cache of the datum are required to improve performance.

Financial risk sharing with providers in health maintenance organizations, 1999.

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Gold, Marsha R; Lake, Timothy; Hurley, Robert; Sinclair, Michael

2002-01-01

The transfer of financial risk from health maintenance organizations (HMOs) to providers is controversial. To provide timely national data on these practices, we conducted a telephone survey in 1999 of a multi-staged probability sample of HMOs in 20 of the nation's 60 largest markets, accounting for 86% of all HMO enrollees nationally. Among those sampled, 82% responded. We found that HMOs' provider networks with physicians, hospitals, skilled nursing homes, and home health agencies are complex and multi-tiered Seventy-six percent of HMOs in our study use contracts for their HMO products that involve global, professional services, or hospital risk capitation to intermediate entities. These arrangements account for between 24.5 million and 27.4 million of the 55.9 million commercial and Medicare HMO enrollees in the 60 largest markets. While capitation arrangements are particularly common in California, they are more common elsewhere than many assume. The complex layering of risk sharing and delegation of care management responsibility raise questions about accountability and administrative costs in managed care. Do complex structures provide a way to involve providers more directly in managed care, or do they diffuse authority and add to administrative costs?

Becoming a health literate organization: Formative research results from healthcare organizations providing care for undeserved communities.

Science.gov (United States)

Adsul, Prajakta; Wray, Ricardo; Gautam, Kanak; Jupka, Keri; Weaver, Nancy; Wilson, Kristin

2017-11-01

Background Integrating health literacy into primary care institutional policy and practice is critical to effective, patient centered health care. While attributes of health literate organizations have been proposed, approaches for strengthening them in healthcare systems with limited resources have not been fully detailed. Methods We conducted key informant interviews with individuals from 11 low resourced health care organizations serving uninsured, underinsured, and government-insured patients across Missouri. The qualitative inquiry explored concepts of impetus to transform, leadership commitment, engaging staff, alignment to organization wide goals, and integration of health literacy with current practices. Findings Several health care organizations reported carrying out health literacy related activities including implementing patient portals, selecting easy to read patient materials, offering community education and outreach programs, and improving discharge and medication distribution processes. The need for change presented itself through data or anecdotal staff experience. For any change to be undertaken, administrators and medical directors had to be supportive; most often a champion facilitated these changes in the organization. Staff and providers were often resistant to change and worried they would be saddled with additional work. Lack of time and funding were the most common barriers reported for integration and sustainability. To overcome these barriers, managers supported changes by working one on one with staff, seeking external funding, utilizing existing resources, planning for stepwise implementation, including members from all staff levels and clear communication. Conclusion Even though barriers exist, resource scarce clinical settings can successfully plan, implement, and sustain organizational changes to support health literacy.

The Activities of Community Organizations in Providing Assistance to Prisoners of World War I

OpenAIRE

Gulzhaukhar K. Kokebayeva; Ryskeldy S. Myrzabekova; Moldakhmet S. Myrzabekov

2016-01-01

The main purpose of this article is to examine the activities of the International Committee of the Red Cross and other community organizations in providing assistance to prisoners of the World War I. According to Article 15 of the Hague Convention of 1907, organizations that assist the prisoners of war, as well as their representatives can use all the benefits from the authorities of the warring countries. Representatives of these organizations are allowed to distribute benefits to places of...

Organ-specific gene expression: the bHLH protein Sage provides tissue specificity to Drosophila FoxA.

Science.gov (United States)

Fox, Rebecca M; Vaishnavi, Aria; Maruyama, Rika; Andrew, Deborah J

2013-05-01

FoxA transcription factors play major roles in organ-specific gene expression, regulating, for example, glucagon expression in the pancreas, GLUT2 expression in the liver, and tyrosine hydroxylase expression in dopaminergic neurons. Organ-specific gene regulation by FoxA proteins is achieved through cooperative regulation with a broad array of transcription factors with more limited expression domains. Fork head (Fkh), the sole Drosophila FoxA family member, is required for the development of multiple distinct organs, yet little is known regarding how Fkh regulates tissue-specific gene expression. Here, we characterize Sage, a bHLH transcription factor expressed exclusively in the Drosophila salivary gland (SG). We show that Sage is required for late SG survival and normal tube morphology. We find that many Sage targets, identified by microarray analysis, encode SG-specific secreted cargo, transmembrane proteins, and the enzymes that modify these proteins. We show that both Sage and Fkh are required for the expression of Sage target genes, and that co-expression of Sage and Fkh is sufficient to drive target gene expression in multiple cell types. Sage and Fkh drive expression of the bZip transcription factor Senseless (Sens), which boosts expression of Sage-Fkh targets, and Sage, Fkh and Sens colocalize on SG chromosomes. Importantly, expression of Sage-Fkh target genes appears to simply add to the tissue-specific gene expression programs already established in other cell types, and Sage and Fkh cannot alter the fate of most embryonic cell types even when expressed early and continuously.

Sleep loss and acute drug abuse can induce DNA damage in multiple organs of mice.

Science.gov (United States)

Alvarenga, T A; Ribeiro, D A; Araujo, P; Hirotsu, C; Mazaro-Costa, R; Costa, J L; Battisti, M C; Tufik, S; Andersen, M L

2011-09-01

The purpose of the present study was to characterize the genetic damage induced by paradoxical sleep deprivation (PSD) in combination with cocaine or ecstasy (3,4-methylenedioxymethamphetamine; MDMA) in multiple organs of male mice using the single cell gel (comet) assay. C57BL/6J mice were submitted to PSD by the platform technique for 72 hours, followed by drug administration and evaluation of DNA damage in peripheral blood, liver and brain tissues. Cocaine was able to induce genetic damage in the blood, brain and liver cells of sleep-deprived mice at the majority of the doses evaluated. Ecstasy also induced increased DNA migration in peripheral blood cells for all concentrations tested. Analysis of damaged cells by the tail moment data suggests that ecstasy is a genotoxic chemical at the highest concentrations tested, inducing damage in liver or brain cells after sleep deprivation in mice. Taken together, our results suggest that cocaine and ecstasy/MDMA act as potent genotoxins in multiple organs of mice when associated with sleep loss.

Multiple genetic interaction experiments provide complementary information useful for gene function prediction.

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Magali Michaut

Full Text Available Genetic interactions help map biological processes and their functional relationships. A genetic interaction is defined as a deviation from the expected phenotype when combining multiple genetic mutations. In Saccharomyces cerevisiae, most genetic interactions are measured under a single phenotype - growth rate in standard laboratory conditions. Recently genetic interactions have been collected under different phenotypic readouts and experimental conditions. How different are these networks and what can we learn from their differences? We conducted a systematic analysis of quantitative genetic interaction networks in yeast performed under different experimental conditions. We find that networks obtained using different phenotypic readouts, in different conditions and from different laboratories overlap less than expected and provide significant unique information. To exploit this information, we develop a novel method to combine individual genetic interaction data sets and show that the resulting network improves gene function prediction performance, demonstrating that individual networks provide complementary information. Our results support the notion that using diverse phenotypic readouts and experimental conditions will substantially increase the amount of gene function information produced by genetic interaction screens.

Patient-provider relationship as mediator between adult attachment and self-management in primary care patients with multiple chronic conditions.

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Brenk-Franz, Katja; Strauß, Bernhard; Tiesler, Fabian; Fleischhauer, Christian; Schneider, Nico; Gensichen, Jochen

2017-06-01

The conceptual model of attachment theory has been applied to understand the predispositions of patients in medical care and the patient-provider relationship. In patients with chronic conditions insecure attachment was connected to poorer self-management. The patient-provider relationship is associated with a range of health related outcomes and self-management skills. We determined whether the quality of the patient-provider relationship mediates the link between adult attachment and self-management among primary care patients with multiple chronic diseases. 209 patients with a minimum of three chronic diseases (including type II diabetes, hypertension and at least one other chronic condition) between the ages of 50 and 85 from eight general practices were included in the APRICARE cohort study. Adult attachment was measured via self-report (ECR-RD), self-management skills by the FERUS and the patient-provider relationship by the PRA-D. The health status and chronicity were assessed by the GP. Multiple mediation analyses were used to examine whether aspects of the patient-provider relationship (communication, information, affectivity) are a mediators of associations between adult attachment and self-management. The analysis revealed that the quality of the patient-provider relationship mediated the effect of attachment on self-management in patients with multiple chronic conditions. Particularly the quality of communication and information over the course of treatment has a significant mediating influence. A personalized, attachment-related approach that promotes active patient-provider communication and gives information about the treatment to the patient may improve self-management skills in patients. Copyright © 2017 Elsevier Inc. All rights reserved.

77 FR 33486 - Certain Integrated Circuit Packages Provided With Multiple Heat-Conducting Paths and Products...

Science.gov (United States)

2012-06-06

...Notice is hereby given that the U.S. International Trade Commission has received a complaint entitled Certain Integrated Circuit Packages Provided With Multiple Heat-Conducting Paths and Products Containing Same, DN 2899; the Commission is soliciting comments on any public interest issues raised by the complaint or complainant's filing under section 210.8(b) of the Commission's Rules of Practice and Procedure (19 CFR 210.8(b)).

Interconnection blocks: a method for providing reusable, rapid, multiple, aligned and planar microfluidic interconnections

International Nuclear Information System (INIS)

Sabourin, D; Snakenborg, D; Dufva, M

2009-01-01

In this paper a method is presented for creating 'interconnection blocks' that are re-usable and provide multiple, aligned and planar microfluidic interconnections. Interconnection blocks made from polydimethylsiloxane allow rapid testing of microfluidic chips and unobstructed microfluidic observation. The interconnection block method is scalable, flexible and supports high interconnection density. The average pressure limit of the interconnection block was near 5.5 bar and all individual results were well above the 2 bar threshold considered applicable to most microfluidic applications

Learning by Doing versus Learning by Viewing: Three Experimental Comparisons of Learner-Generated versus Author-Provided Graphic Organizers

Science.gov (United States)

Stull, Andrew T.; Mayer, Richard E.

2007-01-01

Do students learn more deeply from a passage when they attempt to construct their own graphic organizers (i.e., learning by doing) than when graphic organizers are provided (i.e., learning by viewing)? In 3 experiments, learners were tested on retention and transfer after reading a passage with author-provided graphic organizers or when asked to…

A case of multiple cancers in the pelvic organs after radiation for uterine cancer

International Nuclear Information System (INIS)

Miyake, Yasuhiro; Kurokawa, Eiji; Iijima, Shohei; Handa, Rio; Kato, Takeshi; Kikkawa, Nobuteru

2005-01-01

Patients who have undergone pelvic irradiation are reported to be at an increased risk of subsequently developing malignancies of the pelvic organs. We report a case of multiple cancers in the pelvic organs after radiation therapy for uterine cancer. The patient was a 76-year-old woman who had undergone a hysterectomy with radiation therapy for uterine cancer in 1960. Thereafter, she had undergone a total cystectomy for bladder cancer in 1989; an abdominoperineal resection for rectal cancer with radiation proctitis in February 1991; and a right hemicolectomy for cecum cancer in 1995. Then, in 2005, she was found to have early cancer of the sigmoid colon at the stoma, so that the colon was dissected from the periphery of the stoma, the sigmoid colon was removed, and an artificial anus was reconstructed again. The histopathological diagnosis was early well-differentiated adenocarcinoma. She had undergone three operations for multiple cancers of the large intestine in the pelvis at different times during 16 years since 1989 when the bladder cancer was detected and surgically treated. And she has been alive and well. Long-term follow-up would be mandatory for such patients undergone pelvic irradiation who might be able to survive for a long time with appropriate therapies like this patient. (author)

Cinteny: flexible analysis and visualization of synteny and genome rearrangements in multiple organisms

Directory of Open Access Journals (Sweden)

Meller Jaroslaw

2007-03-01

Full Text Available Abstract Background Identifying syntenic regions, i.e., blocks of genes or other markers with evolutionary conserved order, and quantifying evolutionary relatedness between genomes in terms of chromosomal rearrangements is one of the central goals in comparative genomics. However, the analysis of synteny and the resulting assessment of genome rearrangements are sensitive to the choice of a number of arbitrary parameters that affect the detection of synteny blocks. In particular, the choice of a set of markers and the effect of different aggregation strategies, which enable coarse graining of synteny blocks and exclusion of micro-rearrangements, need to be assessed. Therefore, existing tools and resources that facilitate identification, visualization and analysis of synteny need to be further improved to provide a flexible platform for such analysis, especially in the context of multiple genomes. Results We present a new tool, Cinteny, for fast identification and analysis of synteny with different sets of markers and various levels of coarse graining of syntenic blocks. Using Hannenhalli-Pevzner approach and its extensions, Cinteny also enables interactive determination of evolutionary relationships between genomes in terms of the number of rearrangements (the reversal distance. In particular, Cinteny provides: i integration of synteny browsing with assessment of evolutionary distances for multiple genomes; ii flexibility to adjust the parameters and re-compute the results on-the-fly; iii ability to work with user provided data, such as orthologous genes, sequence tags or other conserved markers. In addition, Cinteny provides many annotated mammalian, invertebrate and fungal genomes that are pre-loaded and available for analysis at http://cinteny.cchmc.org. Conclusion Cinteny allows one to automatically compare multiple genomes and perform sensitivity analysis for synteny block detection and for the subsequent computation of reversal distances

Assessing the quality of websites providing information on multiple sclerosis: evaluating tools and comparing sites.

Science.gov (United States)

Harland, Juliet; Bath, Peter

2007-09-01

The quality of health information available on the Internet has proved difficult to assess objectively. The Internet's growing popularity as a source of health information, accompanied by the lack of regulation of websites, has resulted in research that has developed and tested tools to evaluate health website quality. However, only a few studies have tested the validity and reliability of these tools. There is a lack of consensus about appropriate indicators with which to operationalize the concept of quality health information. This study aimed to contribute to this research by testing the validity and reliability of existing tools, through their application to websites that provided information about multiple sclerosis. Furthermore, a specific tool for evaluating multiple sclerosis information was developed, contributing to the debate about suitable criteria for measuring the ;quality' of health information on the web.

Testosterone Depletion by Castration May Protect Mice from Heat-Induced Multiple Organ Damage and Lethality

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Ruei-Tang Cheng

2010-01-01

Full Text Available When the vehicle-treated, sham-operated mice underwent heat stress, the fraction survival and core temperature at +4 h of body heating were found to be 5 of 15 and 34.4∘C±0.3∘C, respectively. Castration 2 weeks before the start of heat stress decreased the plasma levels of testosterone almost to zero, protected the mice from heat-induced death (fraction survival, 13/15 and reduced the hypothermia (core temperature, 37.3∘C. The beneficial effects of castration in ameliorating lethality and hypothermia can be significantly reduced by testosterone replacement. Heat-induced apoptosis, as indicated by terminal deoxynucleotidyl- transferase- mediatedαUDP-biotin nick end-labeling staining, were significantly prevented by castration. In addition, heat-induced neuronal damage, as indicated by cell shrinkage and pyknosis of nucleus, to the hypothalamus was also castration-prevented. Again, the beneficial effects of castration in reducing neuronal damage to the hypothalamus as well as apoptosis in multiple organs during heatstroke, were significantly reversed by testosterone replacement. The data indicate that testosterone depletion by castration may protect mice from heatstroke-induced multiple organ damage and lethality.

Clustering Multiple Sclerosis Subgroups with Multifractal Methods and Self-Organizing Map Algorithm

Science.gov (United States)

Karaca, Yeliz; Cattani, Carlo

Magnetic resonance imaging (MRI) is the most sensitive method to detect chronic nervous system diseases such as multiple sclerosis (MS). In this paper, Brownian motion Hölder regularity functions (polynomial, periodic (sine), exponential) for 2D image, such as multifractal methods were applied to MR brain images, aiming to easily identify distressed regions, in MS patients. With these regions, we have proposed an MS classification based on the multifractal method by using the Self-Organizing Map (SOM) algorithm. Thus, we obtained a cluster analysis by identifying pixels from distressed regions in MR images through multifractal methods and by diagnosing subgroups of MS patients through artificial neural networks.

Scavenging Circulating Mitochondrial DNA as a Potential Therapeutic Option for Multiple Organ Dysfunction in Trauma Hemorrhage.

Science.gov (United States)

Aswani, Andrew; Manson, Joanna; Itagaki, Kiyoshi; Chiazza, Fausto; Collino, Massimo; Wupeng, Winston Liao; Chan, Tze Khee; Wong, W S Fred; Hauser, Carl J; Thiemermann, Chris; Brohi, Karim

2018-01-01

Trauma is a leading cause of death worldwide with 5.8 million deaths occurring yearly. Almost 40% of trauma deaths are due to bleeding and occur in the first few hours after injury. Of the remaining severely injured patients up to 25% develop a dysregulated immune response leading to multiple organ dysfunction syndrome (MODS). Despite improvements in trauma care, the morbidity and mortality of this condition remains very high. Massive traumatic injury can overwhelm endogenous homeostatic mechanisms even with prompt treatment. The underlying mechanisms driving MODS are also not fully elucidated. As a result, successful therapies for trauma-related MODS are lacking. Trauma causes tissue damage that releases a large number of endogenous damage-associated molecular patterns (DAMPs). Mitochondrial DAMPs released in trauma, such as mitochondrial DNA (mtDNA), could help to explain part of the immune response in trauma given the structural similarities between mitochondria and bacteria. MtDNA, like bacterial DNA, contains an abundance of highly stimulatory unmethylated CpG DNA motifs that signal through toll-like receptor-9 to produce inflammation. MtDNA has been shown to be highly damaging when injected into healthy animals causing acute organ injury to develop. Elevated circulating levels of mtDNA have been reported in trauma patients but an association with clinically meaningful outcomes has not been established in a large cohort. We aimed to determine whether mtDNA released after clinical trauma hemorrhage is sufficient for the development of MODS. Secondly, we aimed to determine the extent of mtDNA release with varying degrees of tissue injury and hemorrhagic shock in a clinically relevant rodent model. Our final aim was to determine whether neutralizing mtDNA with the nucleic acid scavenging polymer, hexadimethrine bromide (HDMBr), at a clinically relevant time point in vivo would reduce the severity of organ injury in this model. We have shown that the release of mt

Scavenging Circulating Mitochondrial DNA as a Potential Therapeutic Option for Multiple Organ Dysfunction in Trauma Hemorrhage

Directory of Open Access Journals (Sweden)

Andrew Aswani

2018-05-01

Full Text Available Trauma is a leading cause of death worldwide with 5.8 million deaths occurring yearly. Almost 40% of trauma deaths are due to bleeding and occur in the first few hours after injury. Of the remaining severely injured patients up to 25% develop a dysregulated immune response leading to multiple organ dysfunction syndrome (MODS. Despite improvements in trauma care, the morbidity and mortality of this condition remains very high. Massive traumatic injury can overwhelm endogenous homeostatic mechanisms even with prompt treatment. The underlying mechanisms driving MODS are also not fully elucidated. As a result, successful therapies for trauma-related MODS are lacking. Trauma causes tissue damage that releases a large number of endogenous damage-associated molecular patterns (DAMPs. Mitochondrial DAMPs released in trauma, such as mitochondrial DNA (mtDNA, could help to explain part of the immune response in trauma given the structural similarities between mitochondria and bacteria. MtDNA, like bacterial DNA, contains an abundance of highly stimulatory unmethylated CpG DNA motifs that signal through toll-like receptor-9 to produce inflammation. MtDNA has been shown to be highly damaging when injected into healthy animals causing acute organ injury to develop. Elevated circulating levels of mtDNA have been reported in trauma patients but an association with clinically meaningful outcomes has not been established in a large cohort. We aimed to determine whether mtDNA released after clinical trauma hemorrhage is sufficient for the development of MODS. Secondly, we aimed to determine the extent of mtDNA release with varying degrees of tissue injury and hemorrhagic shock in a clinically relevant rodent model. Our final aim was to determine whether neutralizing mtDNA with the nucleic acid scavenging polymer, hexadimethrine bromide (HDMBr, at a clinically relevant time point in vivo would reduce the severity of organ injury in this model. Conclusions: We have

Plasma-polymerized films providing selective affinity to the polarity of vaporized organic solvents

International Nuclear Information System (INIS)

Akimoto, Takuo; Ikeshita, Yusuke; Terashima, Ryo; Karube, Isao

2009-01-01

Plasma-polymerized films (PPFs) were fabricated as recognition membranes for a vapor-sensing device, and their affinity to vaporized organic solvents was evaluated with surface plasmon resonance. The affinity we intended to create is the selective sorption of the vaporized organic solvents depending on their polarity. For this purpose, acetonitrile, ethylenediamine (EDA), styrene, hexamethyldisiloxane (HMDSO), and hexamethyldisilazane were used to fabricate PPFs. Vaporized methanol, ethanol, and 1-propanol were used as high-polar solvents to be analyzed. Hexane, toluene, and p-xylene were used as low-polar solvents. As a result, the HMDSO-PPF with 97.3 o of contact angle was found to provide affinity to the low-polar solvents. In contrast, the EDA-PPF with 7.1 o of contact angle provided affinity to the high-polar solvents. Observations of the surface morphology of the HMDSO- and EDA-PPFs with a scanning electron microscope revealed that they are composed of nano-scale islands.

Prognostic value of natriuretic peptides in severe trauma patients with multiple organ dysfunction syndrome

OpenAIRE

LI, NAN; SONG, ZHI; WANG, JING; TENG, YUE; CUI, YAN; JIN, HONGXU; GAO, YAN

2015-01-01

The aim of the present study was to evaluate the prognostic values of the N-terminal peptide of pro-atrial natriuretic peptide (NT-proANP) and the N-terminal fragment of B-type natriuretic peptide (NT-proBNP) in severe trauma patients developing multiple organ dysfunction syndrome (MODS). Out of the 126 severe trauma patients that were admitted to the Emergency Intensive Care Unit of the General Hospital of Shenyang Military Region between January 2009 and December 2011, 26 patients with mult...

Reframing cooperation: Challenges in overcoming tensions between professional services and volunteer organizations providing parenting support in immigrant communities

NARCIS (Netherlands)

Ponzoni, E.

2015-01-01

Volunteer organizations can potentially partner with mainstream professional services to provide better parenting support to immigrant parents. This qualitative study of cooperation between professional agencies and volunteer organizations known as migrant volunteer and community organizations

POSSIBILITIES OF ORGAN-PRESERVING TREATMENT OF PATIENTS WITH MULTIPLE RENAL TUMORS

Directory of Open Access Journals (Sweden)

B. Ya. Alekseev

2017-01-01

Full Text Available Renal cell carcinoma (RCC occupies one of the leading places in the world for morbidity among malignant neoplasms of the genitourinary system. The frequency of occurrence of bilateral RCC according to different authors is 2–6% of the total population of patients with RCC. Currently, the only effective method of treatment of bilateral RCC is surgical treatment. Patients with bilateral RCC are at high risk of dev eloping of local recurrence or progression of the disease after organ-preserving surgeries, which is why the surgeon is faced with a choice between a high risk of developing renal failure or relapse and/or progression of the disease, depending on the extent of the surgical intervention. According to the literature, in patients with bilateral RCC there was an increase in the incidence of papillary variant of RCC up to 19% and the presence of multifocal lesion. Surgical treatment of bilateral RCC is the only effective method to achieve satisfactory oncological results at a low incidence of complications. The m ost justified option for the treatment of bilateral RCC is the implementation of bilateral organ-preserving treatment, which allows achieving the optimal functional results. This article presents a clinical case of successful surgical treatment of a patient with bilateral RCC with multiple tumors.

Supplementation of Nigella sativa fixed and essential oil mediates potassium bromate induced oxidative stress and multiple organ toxicity.

Science.gov (United States)

Sultan, Muhammad Tauseef; Butt, Masood Sadiq; Ahmad, Rabia Shabeer; Pasha, Imran; Ahmad, Atif Nisar; Qayyum, Mir Muhammad Nasir

2012-01-01

The plants and their functional ingredients hold potential to cure various maladies and number of plants hold therapeutic potential. The present research was designed study the health promoting potential of black cumin (Nigella sativa) fixed oil (BCFO) and essential oil (BCEO) against oxidative stress with special reference to multiple organ toxicity. For the purpose, thirty rats (Strain: Sprague Dawley) were procured and divided into three groups (10 rats/group). The groups were fed on their respective diets i.e. D1 (control), D2 (BCFO @ 4.0%) and D3 (BCEO @ 0.30%) for a period of 56 days. Mild oxidative stress was induced with the help of potassium bromate injection @ 45 mg/Kg body weight. Furthermore, the levels of cardiac and liver enzymes were assayed. The results indicated that oxidative stress increased the activities of cardiac and liver enzymes. However, supplementation of BCFO and BCEO was effective in reducing the abnormal values of enzymes. Elevated levels of lactate dehydrogenase (LDH), CPK and CPK-MB were reduced from 456 to 231, 176 to 122 and 45 to 36mg/dL, respectively. Similarly, liver enzymes were also reduced. However, the results revealed that BCEO supplementation @ 0.30% is more effectual in ameliorating the multiple organ toxicity in oxidative stressed animal modelling. In the nutshell, it can be assumed that black cumin essential oil is more effective in reducing the extent of potassium bromate induced multiple organ toxicity (cardiac and liver enzymes imbalance) that will ultimately helpful in reducing the extent of myocardial and liver necrosis.

The Development of Multiple Intelligence Capabilities for Early Childhood Development Center, Local Administration Organization in Chaiyaphum Province

Science.gov (United States)

Siphai, Sunan; Supandee, Terdsak; Raksapuk, Chunpit; Poopayang, Piangkhae; Kratoorerk, Sangsan

2017-01-01

The aim of this research is to promote multiple intelligence capabilities for Early Childhood Care Center of a Sub-district Administration Organization in Chaiyaphum Province. The sample applied were 61 children aging between 3 and 5 years old at Child Development Center, Tambon Ban Kok, Amphoe Chaturus, Chaiyaphum Province, who were selected…

The state of multiple sclerosis: current insight into the patient/health care provider relationship, treatment challenges, and satisfaction

Directory of Open Access Journals (Sweden)

Tintoré M

2016-12-01

. Top challenges identified by patients in managing their DMT were cost, side effects/tolerability of treatment, and uncertainty if treatment was working. Half of the patients reported skipping doses, but only 68% told their health care provider that they did so. Conclusion: Several important differences in perception were identified between patients and neurologists concerning treatment selection, satisfaction, expectations, goals, and comfort discussing symptoms, as well as treatment challenges and skipped doses. The study results emphasize that patient/neurologist communication and patient input into the treatment decision-making process likely influence patient satisfaction with treatment. Keywords: health care provider survey, multiple sclerosis, patient-health care provider relationship, patient survey, treatment expectations, treatment satisfaction

Self-organizing sensing and actuation for automatic control

Science.gov (United States)

Cheng, George Shu-Xing

2017-07-04

A Self-Organizing Process Control Architecture is introduced with a Sensing Layer, Control Layer, Actuation Layer, Process Layer, as well as Self-Organizing Sensors (SOS) and Self-Organizing Actuators (SOA). A Self-Organizing Sensor for a process variable with one or multiple input variables is disclosed. An artificial neural network (ANN) based dynamic modeling mechanism as part of the Self-Organizing Sensor is described. As a case example, a Self-Organizing Soft-Sensor for CFB Boiler Bed Height is presented. Also provided is a method to develop a Self-Organizing Sensor.

The potential of the combination of CRISPR/Cas9 and pluripotent stem cells to provide human organs from chimaeric pigs.

Science.gov (United States)

Feng, Wanyou; Dai, Yifan; Mou, Lisha; Cooper, David K C; Shi, Deshun; Cai, Zhiming

2015-03-23

Clinical organ allotransplantation is limited by the availability of deceased human donors. However, the transplantation of human organs produced in other species would provide an unlimited number of organs. The pig has been identified as the most suitable source of organs for humans as organs of any size would be available. Genome editing by RNA-guided endonucleases, also known as clustered regularly interspaced short palindromic repeat (CRISPR/Cas9), in combination with induced pluripotent stem cells (iPSC), may have the potential to enable the creation of human organs from genetically-modified chimaeric pigs. These could potentially provide an unlimited supply of organs that would not be rejected by the recipient's immune system. However, substantial research is needed to prove that this approach will work. Genetic modification of chimaeric pigs could also provide useful models for developing therapies for various human diseases, especially in relation to drug development.

Performance evaluation of 2D and 3D deep learning approaches for automatic segmentation of multiple organs on CT images

Science.gov (United States)

Zhou, Xiangrong; Yamada, Kazuma; Kojima, Takuya; Takayama, Ryosuke; Wang, Song; Zhou, Xinxin; Hara, Takeshi; Fujita, Hiroshi

2018-02-01

The purpose of this study is to evaluate and compare the performance of modern deep learning techniques for automatically recognizing and segmenting multiple organ regions on 3D CT images. CT image segmentation is one of the important task in medical image analysis and is still very challenging. Deep learning approaches have demonstrated the capability of scene recognition and semantic segmentation on nature images and have been used to address segmentation problems of medical images. Although several works showed promising results of CT image segmentation by using deep learning approaches, there is no comprehensive evaluation of segmentation performance of the deep learning on segmenting multiple organs on different portions of CT scans. In this paper, we evaluated and compared the segmentation performance of two different deep learning approaches that used 2D- and 3D deep convolutional neural networks (CNN) without- and with a pre-processing step. A conventional approach that presents the state-of-the-art performance of CT image segmentation without deep learning was also used for comparison. A dataset that includes 240 CT images scanned on different portions of human bodies was used for performance evaluation. The maximum number of 17 types of organ regions in each CT scan were segmented automatically and compared to the human annotations by using ratio of intersection over union (IU) as the criterion. The experimental results demonstrated the IUs of the segmentation results had a mean value of 79% and 67% by averaging 17 types of organs that segmented by a 3D- and 2D deep CNN, respectively. All the results of the deep learning approaches showed a better accuracy and robustness than the conventional segmentation method that used probabilistic atlas and graph-cut methods. The effectiveness and the usefulness of deep learning approaches were demonstrated for solving multiple organs segmentation problem on 3D CT images.

Novel Control Strategy for Multiple Run-of-the-River Hydro Power Plants to Provide Grid Ancillary Services

Energy Technology Data Exchange (ETDEWEB)

Mohanpurkar, Manish; Luo, Yusheng; Hovsapian, Rob; Muljadi, Eduard; Gevorgian, Vahan; Koritarov, Vladimir

2017-07-12

Hydropower plant (HPP) generation comprises a considerable portion of bulk electricity generation and is delivered with a low-carbon footprint. In fact, HPP electricity generation provides the largest share from renewable energy resources, which include wind and solar. Increasing penetration levels of wind and solar lead to a lower inertia on the electric grid, which poses stability challenges. In recent years, breakthroughs in energy storage technologies have demonstrated the economic and technical feasibility of extensive deployments of renewable energy resources on electric grids. If integrated with scalable, multi-time-step energy storage so that the total output can be controlled, multiple run-of-the-river (ROR) HPPs can be deployed. Although the size of a single energy storage system is much smaller than that of a typical reservoir, the ratings of storages and multiple ROR HPPs approximately equal the rating of a large, conventional HPP. This paper proposes cohesively managing multiple sets of energy storage systems distributed in different locations. This paper also describes the challenges associated with ROR HPP system architecture and operation.

Artificial neural networks environmental forecasting in comparison with multiple linear regression technique: From heavy metals to organic micropollutants screening in agricultural soils

Science.gov (United States)

Bonelli, Maria Grazia; Ferrini, Mauro; Manni, Andrea

2016-12-01

The assessment of metals and organic micropollutants contamination in agricultural soils is a difficult challenge due to the extensive area used to collect and analyze a very large number of samples. With Dioxins and dioxin-like PCBs measurement methods and subsequent the treatment of data, the European Community advises the develop low-cost and fast methods allowing routing analysis of a great number of samples, providing rapid measurement of these compounds in the environment, feeds and food. The aim of the present work has been to find a method suitable to describe the relations occurring between organic and inorganic contaminants and use the value of the latter in order to forecast the former. In practice, the use of a metal portable soil analyzer coupled with an efficient statistical procedure enables the required objective to be achieved. Compared to Multiple Linear Regression, the Artificial Neural Networks technique has shown to be an excellent forecasting method, though there is no linear correlation between the variables to be analyzed.

European practices of providing of efficiency of self-organizations institutions of population in the context of public services

Directory of Open Access Journals (Sweden)

T. V. Serohina

2017-06-01

Full Text Available The research revealed that European countries devote sufficient attention to ensuring the effectiveness of the institutions of self-organization in the context of their public services. The most common areas where they operate are a system of health, education and assistance during emergencies. The study showed that in the development of public services, there were significant transformations in terms of subject-provider. Historically it was confessional organizations working on a voluntary basis, and linked their activity with the realization of Christian mission. Subsequently, when there had been formation of a «welfare state», the state took over responsibility for the area of public services. In favor of institutions of self-organization has been a change in the system when it became clear that they are best in the provide public services, especially in the social sphere, because they are the demonstrating of social needs. The main mechanisms of cooperation between institutions of self-organization and the public sector are, first, subsidies for statutory activities of the organization. Another mechanism is delegating services or outsourcing and in this case contracts mostly are for one year with possibility of further extension. In addition there is auxiliary element of providing of effectiveness institutions of self-organization, it consists in deprivation of their donors from taxes. Although institutions of self-organization are financed mainly by public authorities, they remain independent, because they have opportunity of funding from other sources. German experience showed that the starting point in the system of public services is the understanding of the necessity of paying taxes as acknowledgment of the rights of all members of society. That is why every taxpayer expects to receive public services at the appropriate level. This unwritten rule contributes to a very high level of provision of public services through an adequate

MODEL OF PROVIDING WITH DEVELOPMENT STRATEGY FOR INFORMATION TECHNOLOGIES IN AN ORGANIZATION

Directory of Open Access Journals (Sweden)

A. A. Kuzkin

2015-03-01

Full Text Available Subject of research. The paper presents research and instructional tools for assessment of providing with the development strategy for information technologies in an organization. Method. The corresponding assessment model is developed which takes into consideration IT-processes equilibrium according to selected efficiency factors of information technologies application. Basic results. The model peculiarity resides in applying neuro-fuzzy approximators where the conclusion is drawn upon fuzzy logic, and membership functions are adjusted through the use of neural networks. For the adequacy testing of the suggested model, due diligence result analysis has been carried out for the IT-strategy executed in the “Navigator” group of companies at the stage of implementation and support of new technologies and production methods. Data visualization with a circle diagram is applied for the comparative evaluation of the analysis results. The chosen model adequacy is proved by the agreement between predictive assessments for IT-strategy performance targets derived by means of the fuzzy cognitive model over 12 months planning horizon and the real values of these targets upon the expiry of the given planning term. Practical significance. The developed model application gives the possibility to solve the problem of sustainability assessment for the process of providing the required IT-strategy realization level based upon the fuzzy cognitive map analysis and to reveal IT-objectives changing tendencies for an organization over the stated planning interval.

The impact of conservation management on the community composition of multiple organism groups in eutrophic interconnected man-made ponds

NARCIS (Netherlands)

Lemmens, P.; Mergeay, J.; Van Wichelen, J.; De Meester, Luc; Declerck, S.A.J.

2015-01-01

Ponds throughout the world are subjected to a variety of management measures for purposes of biodiversity conservation. Current conservation efforts typically comprise a combination of multiple measures that directly and indirectly impact a wide range of organism groups. Knowledge of the relative

Dissolved organic matter cycling in eastern Mediterranean rivers experiencing multiple pressures. The case of the trans-boundary Evros River

Directory of Open Access Journals (Sweden)

E. PITTA

2014-07-01

Full Text Available The objective of our study was to provide a comprehensive evaluation on C, N, P cycling in medium sized Mediterranean rivers, such as the Evros, experiencing multiple pressures (intensive agriculture, industrial activities, population density. Our work aims also to contribute to the development of integrated management policies. Dissolved organic matter (DOM cycling were investigated, during a one-year study. It was shown that the organic component of N and P was comparable to those of large Mediterranean rivers (Rhone, Po. In the lower parts of the river where all point and non-point inputs converge, the high inorganic N input favour elevated assimilation rates by phytoplankton and result in increased chl-a concentrations and autochthonous dissolved organic matter (DOM production during the dry season with limited water flow. Moreover, carbohydrate distribution revealed that there is a constant background of soil derived mono-saccharides on top of which are superimposed impulses of poly-saccharides during blooms. During the dry season, inorganic nutrients and DOM are trapped in the lower parts of the river, whereas during high flow conditions DOM is flushed towards the sea and organic nitrogen forms can become an important TDN constituent (at least 40% transported to shelf waters. The co-existence of terrigenous material with autochthonous and some anthropogenic is supported by the relatively low DOC:DON and DOC:DOP ratios, the positive correlation of DOC vs chl-a and the decoupling between DOC and DON. Overall, this study showed that in medium size Mediterranean rivers, such as the Evros, intensive agriculture and pollution sources in combination with water management practices and climatic variability are important factors determining C, N, P dynamics and export to coastal seas. Also, it highlights the importance of the organic fraction of N and P when considering management practices.

Multiple Whole Genome Alignments Without a Reference Organism

Energy Technology Data Exchange (ETDEWEB)

Dubchak, Inna; Poliakov, Alexander; Kislyuk, Andrey; Brudno, Michael

2009-01-16

Multiple sequence alignments have become one of the most commonly used resources in genomics research. Most algorithms for multiple alignment of whole genomes rely either on a reference genome, against which all of the other sequences are laid out, or require a one-to-one mapping between the nucleotides of the genomes, preventing the alignment of recently duplicated regions. Both approaches have drawbacks for whole-genome comparisons. In this paper we present a novel symmetric alignment algorithm. The resulting alignments not only represent all of the genomes equally well, but also include all relevant duplications that occurred since the divergence from the last common ancestor. Our algorithm, implemented as a part of the VISTA Genome Pipeline (VGP), was used to align seven vertebrate and sixDrosophila genomes. The resulting whole-genome alignments demonstrate a higher sensitivity and specificity than the pairwise alignments previously available through the VGP and have higher exon alignment accuracy than comparable public whole-genome alignments. Of the multiple alignment methods tested, ours performed the best at aligning genes from multigene families?perhaps the most challenging test for whole-genome alignments. Our whole-genome multiple alignments are available through the VISTA Browser at http://genome.lbl.gov/vista/index.shtml.

Severe Leptospirosis with Multiple Organ Failure Successfully Treated by Plasma Exchange and High-Volume Hemofiltration

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Vincent Bourquin

2011-01-01

Full Text Available Background. Leptospirosis is a spirochetal zoonosis with complex clinical features including renal and liver failure. Case report. We report the case of a Swiss fisherman presenting with leptospirosis. After initial improvement, refractory septic shock and severe liver and kidney failure developed. The expected mortality was estimated at 90% with clinical scores. The patient underwent plasma exchanges and high-volume hemofiltration (HVHF with complete recovery of hepatic and kidney functions. Discussion. Plasma exchanges and HVHF may confer survival benefit on patients with severe leptospirosis, refractory septic shock, and multiple-organ failure.

Hanford Site Welding Program Successfully Providing A Single Site Function For Use By Multiple Contractors

International Nuclear Information System (INIS)

Cannell, G.R.

2009-01-01

The Department of Energy, Richland Operations (DOE-RL) recently restructured its Hanford work scope, awarding two new contracts over the past several months for a total of three contracts to manage the sites cleanup efforts. DOE-RL met with key contractor personnel prior to and during contract transition to ensure site welding activities had appropriate oversight and maintained code compliance. The transition also provided an opportunity to establish a single site-wide function that would provide welding and materials engineering services to the Hanford site contractors: CH2M HILL Plateau Remediation Company (CHPRC); Mission Support Alliance (MSA); Washington River Protection Solutions (WRPS); and Washington Closure Hanford (WCH). Over the years, multiple and separate welding programs (amongst the several contractors) existed at the Hanford site leading to inefficiencies resulting from duplication of administrative efforts, maintenance of welding procedures, welder performance certifications, etc. The new, single program eliminates these inefficiencies. The new program, co-managed by two of the sites' new contractors, the CHPRC ('owner' of the program and responsible for construction welding services) and the MSA (provides maintenance welding services), provides more than just the traditional construction and maintenance welding services. Also provided, are welding engineering, specialty welding development/qualification for the closure of radioactive materials containers and materials evaluation/failure analysis. The following describes the new Hanford site welding program.

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

Science.gov (United States)

Li, Hantao; Liu, Kai; Zhang, Jun

2005-11-01

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

The Gut as the Motor of Multiple Organ Dysfunction in Critical Illness.

Science.gov (United States)

Klingensmith, Nathan J; Coopersmith, Craig M

2016-04-01

All elements of the gut - the epithelium, the immune system, and the microbiome - are impacted by critical illness and can, in turn, propagate a pathologic host response leading to multiple organ dysfunction syndrome. Preclinical studies have demonstrated that this can occur by release of toxic gut-derived substances into the mesenteric lymph where they can cause distant damage. Further, intestinal integrity is compromised in critical illness with increases in apoptosis and permeability. There is also increasing recognition that microbes alter their behavior and can become virulent based upon host environmental cues. Gut failure is common in critically ill patients; however, therapeutics targeting the gut have proven to be challenging to implement at the bedside. Numerous strategies to manipulate the microbiome have recently been used with varying success in the ICU. Copyright © 2016 Elsevier Inc. All rights reserved.

Cooperative catalysis by silica-supported organic functional groups

OpenAIRE

Margelefsky, Eric L.; Zeidan, Ryan K.; Davis, Mark E.

2008-01-01

Hybrid inorganic–organic materials comprising organic functional groups tethered from silica surfaces are versatile, heterogeneous catalysts. Recent advances have led to the preparation of silica materials containing multiple, different functional groups that can show cooperative catalysis; that is, these functional groups can act together to provide catalytic activity and selectivity superior to what can be obtained from either monofunctional materials or homogeneous catalysts. This tutorial...

Quantitative measures of walking and strength provide insight into brain corticospinal tract pathology in multiple sclerosis

Directory of Open Access Journals (Sweden)

Nora E Fritz

2017-01-01

Quantitative measures of strength and walking are associated with brain corticospinal tract pathology. The addition of these quantitative measures to basic clinical information explains more of the variance in corticospinal tract fractional anisotropy and magnetization transfer ratio than the basic clinical information alone. Outcome measurement for multiple sclerosis clinical trials has been notoriously challenging; the use of quantitative measures of strength and walking along with tract-specific imaging methods may improve our ability to monitor disease change over time, with intervention, and provide needed guidelines for developing more effective targeted rehabilitation strategies.

Multiple trauma in children: critical care overview.

Science.gov (United States)

Wetzel, Randall C; Burns, R Cartland

2002-11-01

Multiple trauma is more than the sum of the injuries. Management not only of the physiologic injury but also of the pathophysiologic responses, along with integration of the child's emotional and developmental needs and the child's family, forms the basis of trauma care. Multiple trauma in children also elicits profound psychological responses from the healthcare providers involved with these children. This overview will address the pathophysiology of multiple trauma in children and the general principles of trauma management by an integrated trauma team. Trauma is a systemic disease. Multiple trauma stimulates the release of multiple inflammatory mediators. A lethal triad of hypothermia, acidosis, and coagulopathy is the direct result of trauma and secondary injury from the systemic response to trauma. Controlling and responding to the secondary pathophysiologic sequelae of trauma is the cornerstone of trauma management in the multiply injured, critically ill child. Damage control surgery is a new, rational approach to the child with multiple trauma. The selection of children for damage control surgery depends on the severity of injury. Major abdominal vascular injuries and multiple visceral injuries are best considered for this approach. The effective management of childhood multiple trauma requires a combined team approach, consideration of the child and family, an organized trauma system, and an effective quality assurance and improvement mechanism.

ORGANIZING OF MANAGERIAL ACCOUNTING IN THE FORMING OF INFORMATION BASE OF BUILDING ENTERPRISES PROVIDING DEVELOPMENT

Directory of Open Access Journals (Sweden)

Nadiia Pylypiv

2017-03-01

Full Text Available This article explores the impact of organization of managerial accounting on formation of informational base on the local (level of the individual enterprise, regional, disciplinary and national levels in the context of providing stable economic development for building enterprises. Based on our findings, we built a cognitive map of such an influence, which shows itself through different spheres, such as: economic, ecological and social, and will enjoy informational requests of management for improving of effectiveness of management system of such kind of  enterprises. Keywords: managerial accounting, organization, provision, stable economic development, building enterprises

BANANAS: providing child care services to a multi-ethnic community.

Science.gov (United States)

Vu, Catherine M; Schwartz, Sara L; Austin, Michael J

2011-01-01

BANANAS, Inc. is a nonprofit organization that has provided child care resource and referral services for over 35 years. BANANAS emerged as a grassroots effort initiated by a group of female volunteers who sought to build a network of women with children who needed childcare. As the organization developed, its leaders recognized and responded to additional needs, including resource and information sharing, workshops and classes, and political advocacy. Beginning as a collective, BANANAS has grown into a multifaceted service delivery and advocacy nonprofit operating with an annual budget of $12 million. This history of the agency reflects the development of a unique community-based effort, its challenges and rewards, and the multiple successes that this pioneering nonprofit has experienced.

Multiple sclerosis patients need and want information on exercise promotion from healthcare providers: a qualitative study.

Science.gov (United States)

Learmonth, Yvonne C; Adamson, Brynn C; Balto, Julia M; Chiu, Chung-Yi; Molina-Guzman, Isabel; Finlayson, Marcia; Riskin, Barry J; Motl, Robert W

2017-08-01

There is growing recognition of the benefits and safety of exercise and its importance in the comprehensive care of persons with multiple sclerosis (MS), yet uptake is low. We explored the needs and wants of patients with MS regarding exercise promotion through healthcare providers. Participants were adults with MS who had mild-or-moderate disability and a range of exercise levels. All participants lived in the Midwest of the United States. Fifty semi-structured interviews were conducted and analysed using thematic analysis. Two themes emerged, namely interactions between patients and healthcare providers and needs and wants of patients. Analysis of participant accounts illustrate that current exercise promotion by healthcare providers does not meet patient needs and wants. The identified needs and wants of persons with MS involved (i) information and knowledge on the benefits of exercise and exercise prescription, (ii) materials to allow home and community exercise and (iii) tools for initiating and maintaining exercise behaviour. Patients with MS frequently interact with healthcare providers and are generally unsatisfied with exercise promotion during interactions. Healthcare providers can address the low uptake of exercise among persons with MS by acting upon the identified unmet needs involving materials, knowledge and behaviour change strategies for exercise. © 2016 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Evaluation of Effective Factors on e-Loyalty in Organizations Providing Electronic Services using Fuzzy AHP Method

Directory of Open Access Journals (Sweden)

fatemeh mohammadi

2012-12-01

Full Text Available In today's business world, proper identification of customer’s requirements and a quick response to these requirements is a key to commercial success. Increasing customer loyalty affects the profitability and organizations can ensure their long-term interests by means of planning. In today's competitive world, the services provided by the competing company have to be more similar to each other and can be hard to surprise customers within completely new service in the long term, because the newest services are quickly imitated by competitors and marketed. Hence investment in customer loyalty is an effective and profitable investment for companies. One criticism that has entered into the e-service is customer loyalty. In order to study the causes of e-loyalty for organization providing e-services, this research identified the factors affecting customer loyalty in e-services and with questionnaire prepared and by using fuzzy hierarchical decision-making process acquires the weight of each factor and ultimately rank them. The results show that the quality of service provided to e-services customers is the most important factor in creating e-loyalty.

Proton-Controlled Organic Microlaser Switch.

Science.gov (United States)

Gao, Zhenhua; Zhang, Wei; Yan, Yongli; Yi, Jun; Dong, Haiyun; Wang, Kang; Yao, Jiannian; Zhao, Yong Sheng

2018-05-25

Microscale laser switches have been playing irreplaceable roles in the development of photonic devices with high integration levels. However, it remains a challenge to switch the lasing wavelengths across a wide range due to relatively fixed energy bands in traditional semiconductors. Here, we report a strategy to switch the lasing wavelengths among multiple states based on a proton-controlled intramolecular charge-transfer (ICT) process in organic dye-doped flexible microsphere resonant cavities. The protonic acids can effectively bind onto the ICT molecules, which thus enhance the ICT strength of the dyes and lead to a red-shifted gain behavior. On this basis, the gain region was effectively modulated by using acids with different proton-donating ability, and as a result, laser switching among multiple wavelengths was achieved. The results will provide guidance for the rational design of miniaturized lasers with performances based on the characteristic of organic optoelectronic materials.

Is environmental sustainability a strategic priority for logistics service providers?

Science.gov (United States)

Evangelista, Pietro; Colicchia, Claudia; Creazza, Alessandro

2017-08-01

Despite an increasing number of third-party logistics service providers (3PLs) regard environmental sustainability as a key area of management, there is still great uncertainty on how 3PLs implement environmental strategies and on how they translate green efforts into practice. Through a multiple case study analysis, this paper explores the environmental strategies of a sample of medium-sized 3PLs operating in Italy and the UK, in terms of environmental organizational culture, initiatives, and influencing factors. Our analysis shows that, notwithstanding environmental sustainability is generally recognised as a strategic priority, a certain degree of diversity in the deployment of environmental strategies still exists. This paper is original since the extant literature on green strategies of 3PLs provides findings predominantly from a single country perspective and mainly investigates large/multinational organizations. It also provides indications to help managers of medium-sized 3PLs in positioning their business. This is particularly meaningful in the 3PL industry, where medium-sized organizations significantly contribute to the generated turnover and market value. Copyright © 2017 Elsevier Ltd. All rights reserved.

Multiple Hierarchies and Organizational Control

Science.gov (United States)

Evans, Peter B.

1975-01-01

Uses a control-loss model to explore the effects of multiple channels in formal organizations, and presents an argument for the superior control properties of dual hierarchies. Two variant forms of multiple hierarchies are considered. (Author)

Successful treatment of severe sinusoidal obstruction syndrome despite multiple organ failure with defibrotide after allogeneic stem cell transplantation: a case report.

Science.gov (United States)

Behre, Gerhard; Theurich, Sebastian; Christopeit, Maximilian; Weber, Thomas

2009-03-10

We report a case of sinusoidal obstruction syndrome, a typical and life-threatening complication after allogeneic stem-cell transplantation, successfully treated with defibrotide despite massive multiple organ failure. A 64-year-old Caucasian woman underwent allogeneic peripheral blood stem-cell transplantation from her human leukocyte antigen-identical sister against aggressive lymphoplasmocytoid immunocytoma. Seven days later, the patient developed severe sinusoidal obstruction syndrome according to the modified Seattle criteria. We initiated treatment with defibrotide. Despite early treatment, multiple organ failure with kidney failure requiring dialysis and ventilator-dependent lung failure aggravated the clinical course. Furthermore, central nervous dysfunction occurred as well as transfusion refractory thrombocytopenia. As highlighted in our report, defibrotide is the most promising drug in the treatment of the formerly, almost lethal, severe sinusoidal obstruction syndrome to date. This is demonstrated very clearly in our patient. She improved completely, even after renal, cerebral and respiratory failure.

Irradiated Benzene Ice Provides Clues to Meteoritic Organic Chemistry

Science.gov (United States)

Callahan, Michael Patrick; Gerakines, Perry Alexander; Martin, Mildred G.; Hudson, Reggie L.; Peeters, Zan

2013-01-01

Aromatic hydrocarbons account for a significant portion of the organic matter in carbonaceous chondrite meteorites, as a component of both the low molecular weight, solvent-extractable compounds and the insoluble organic macromolecular material. Previous work has suggested that the aromatic compounds in carbonaceous chondrites may have originated in the radiation-processed icy mantles of interstellar dust grains. Here we report new studies of the organic residue made from benzene irradiated at 19 K by 0.8 MeV protons. Polyphenyls with up to four rings were unambiguously identified in the residue by gas chromatography-mass spectrometry. Atmospheric pressure photoionization Fourier transform mass spectrometry was used to determine molecular composition, and accurate mass measurements suggested the presence of polyphenyls, partially hydrogenated polyphenyls, and other complex aromatic compounds. The profile of low molecular weight compounds in the residue compared well with extracts from the Murchison and Orgueil meteorites. These results are consistent with the possibility that solid phase radiation chemistry of benzene produced some of the complex aromatics found in meteorites.

Association between resting-state brain network topological organization and creative ability: Evidence from a multiple linear regression model.

Science.gov (United States)

Jiao, Bingqing; Zhang, Delong; Liang, Aiying; Liang, Bishan; Wang, Zengjian; Li, Junchao; Cai, Yuxuan; Gao, Mengxia; Gao, Zhenni; Chang, Song; Huang, Ruiwang; Liu, Ming

2017-10-01

Previous studies have indicated a tight linkage between resting-state functional connectivity of the human brain and creative ability. This study aimed to further investigate the association between the topological organization of resting-state brain networks and creativity. Therefore, we acquired resting-state fMRI data from 22 high-creativity participants and 22 low-creativity participants (as determined by their Torrance Tests of Creative Thinking scores). We then constructed functional brain networks for each participant and assessed group differences in network topological properties before exploring the relationships between respective network topological properties and creative ability. We identified an optimized organization of intrinsic brain networks in both groups. However, compared with low-creativity participants, high-creativity participants exhibited increased global efficiency and substantially decreased path length, suggesting increased efficiency of information transmission across brain networks in creative individuals. Using a multiple linear regression model, we further demonstrated that regional functional integration properties (i.e., the betweenness centrality and global efficiency) of brain networks, particularly the default mode network (DMN) and sensorimotor network (SMN), significantly predicted the individual differences in creative ability. Furthermore, the associations between network regional properties and creative performance were creativity-level dependent, where the difference in the resource control component may be important in explaining individual difference in creative performance. These findings provide novel insights into the neural substrate of creativity and may facilitate objective identification of creative ability. Copyright © 2017 Elsevier B.V. All rights reserved.

Providing Family Planning Services at Primary Care Organizations after the Exclusion of Planned Parenthood from Publicly Funded Programs in Texas: Early Qualitative Evidence.

Science.gov (United States)

White, Kari; Hopkins, Kristine; Grossman, Daniel; Potter, Joseph E

2017-10-20

To explore organizations' experiences providing family planning during the first year of an expanded primary care program in Texas. Between November 2014 and February 2015, in-depth interviews were conducted with program administrators at 30 organizations: 7 women's health organizations, 13 established primary care contractors (e.g., community health centers, public health departments), and 10 new primary care contractors. Interviews addressed organizational capacities to expand family planning and integrate services with primary care. Interview transcripts were analyzed using a theme-based approach. Themes were compared across the three types of organizations. Established and new primary care contractors identified several challenges expanding family planning services, which were uncommon among women's health organizations. Clinicians often lacked training to provide intrauterine devices and contraceptive implants. Organizations often recruited existing clients into family planning services, rather than expanding their patient base, and new contractors found family planning difficult to integrate because of clients' other health needs. Primary care contractors frequently described contraceptive provision protocols that were not evidence-based. Many primary care organizations in Texas initially lacked the capacity to provide evidence-based family planning services that women's health organizations already provided. © Health Research and Educational Trust.

Ocean acidification in the coastal zone from an organism's perspective: multiple system parameters, frequency domains, and habitats.

Science.gov (United States)

Waldbusser, George G; Salisbury, Joseph E

2014-01-01

Multiple natural and anthropogenic processes alter the carbonate chemistry of the coastal zone in ways that either exacerbate or mitigate ocean acidification effects. Freshwater inputs and multiple acid-base reactions change carbonate chemistry conditions, sometimes synergistically. The shallow nature of these systems results in strong benthic-pelagic coupling, and marine invertebrates at different life history stages rely on both benthic and pelagic habitats. Carbonate chemistry in coastal systems can be highly variable, responding to processes with temporal modes ranging from seconds to centuries. Identifying scales of variability relevant to levels of biological organization requires a fuller characterization of both the frequency and magnitude domains of processes contributing to or reducing acidification in pelagic and benthic habitats. We review the processes that contribute to coastal acidification with attention to timescales of variability and habitats relevant to marine bivalves.

Successful Recovery and Transplantation of 11 Organs Including Face, Bilateral Upper Extremities, and Thoracic and Abdominal Organs From a Single Deceased Organ Donor.

Science.gov (United States)

Tullius, Stefan G; Pomahac, Bohdan; Kim, Heung Bae; Carty, Matthew J; Talbot, Simon G; Nelson, Helen M; Delmonico, Francis L

2016-10-01

We report on the to date largest recovery of 11 organs from a single deceased donor with the transplantation of face, bilateral upper extremities, heart, 1 lung, liver (split for 2 recipients), kidneys, pancreas, and intestine. Although logistically challenging, this case demonstrates the feasibility and safety of the recovery of multiple thoracic and abdominal organs with multiple vascular composite allotransplants and tissues. Our experience of 8 additional successful multiple vascular composite allotransplants, thoracic, and abdominal organ recoveries suggests that such procedures are readily accomplishable from the same deceased donor.

Accountable Care Organizations and Otolaryngology

Science.gov (United States)

Contrera, Kevin J.; Ishii, Lisa E.; Setzen, Gavin; Berkowitz, Scott A.

2016-01-01

Accountable Care Organizations represent a shift in health care delivery, while providing a significant potential for improved quality and coordination of care across multiple settings. Otolaryngologists have an opportunity to become leaders in this expanding arena. However, the field of otolaryngology-head and neck surgery currently lacks many of the tools necessary to implement value-based care, including performance-measurement, electronic health infrastructure and data management. These resources will become increasingly important for surgical specialists to be active participants in population health. This article reviews the fundamental issues that otolaryngologists should consider when pursuing new roles in Accountable Care Organizations. PMID:26044787

Combined Hydration and Antibiotics with Lisinopril to Mitigate Acute and Delayed High-dose Radiation Injuries to Multiple Organs.

Science.gov (United States)

Fish, Brian L; Gao, Feng; Narayanan, Jayashree; Bergom, Carmen; Jacobs, Elizabeth R; Cohen, Eric P; Moulder, John E; Orschell, Christie M; Medhora, Meetha

2016-11-01

The NIAID Radiation and Nuclear Countermeasures Program is developing medical agents to mitigate the acute and delayed effects of radiation that may occur from a radionuclear attack or accident. To date, most such medical countermeasures have been developed for single organ injuries. Angiotensin converting enzyme (ACE) inhibitors have been used to mitigate radiation-induced lung, skin, brain, and renal injuries in rats. ACE inhibitors have also been reported to decrease normal tissue complication in radiation oncology patients. In the current study, the authors have developed a rat partial-body irradiation (leg-out PBI) model with minimal bone marrow sparing (one leg shielded) that results in acute and late injuries to multiple organs. In this model, the ACE inhibitor lisinopril (at ~24 mg m d started orally in the drinking water at 7 d after irradiation and continued to ≥150 d) mitigated late effects in the lungs and kidneys after 12.5-Gy leg-out PBI. Also in this model, a short course of saline hydration and antibiotics mitigated acute radiation syndrome following doses as high as 13 Gy. Combining this supportive care with the lisinopril regimen mitigated overall morbidity for up to 150 d after 13-Gy leg-out PBI. Furthermore, lisinopril was an effective mitigator in the presence of the growth factor G-CSF (100 μg kg d from days 1-14), which is FDA-approved for use in a radionuclear event. In summary, by combining lisinopril (FDA-approved for other indications) with hydration and antibiotics, acute and delayed radiation injuries in multiple organs were mitigated.

Effectiveness of combining plasma exchange with continuous hemodiafiltration on acute Fatty liver of pregnancy complicated by multiple organ dysfunction.

Science.gov (United States)

Chu, Yu-Feng; Meng, Mei; Zeng, Juan; Zhou, Hai-Yan; Jiang, Jin-Jiao; Ren, Hong-Sheng; Zhang, Ji-Cheng; Zhu, Wen-Ying; Wang, Chun-Ting

2012-06-01

Acute fatty liver of pregnancy (AFLP) is a rare disease of progressive hepatic insufficiency and secondary systemic complications that induce significant maternal risk. The application of combining plasma exchange (PE) and continuous hemodiafiltration (CHDF) is a novel concept for patients with AFLP. Since 2002, we have utilized the combination of PE with CHDF as adjunctive medical therapy for 11 AFLP patients with multiple organ dysfunction. Before PE and CHDF initiation, four patients had signs and symptoms of encephalopathy, four required ventilatory support, and all 11 were developing liver failure, significant renal compromise, and coagulopathy. PE combined with CHDF for patients was initiated a mean of 2 days postpartum (range, days 0-3). Daily or every other day PE combined with CHDF was undertaken on two to eight occasions for each of the 11 patients. Ten patients responded with composite clinical and laboratory improvement and were discharged to the ward, then cured and discharged from hospital; one patient died of septic shock. Average duration of hospitalization was 17 days (range, days 9-38) from time of admission to discharge; the average duration of intensive care unit was 10 days (range, days 4-23). No significant PE- and CHDF-related complications occurred. These results indicate that combing PE and CHDF in a series-parallel circuit is an effective and safe treatment for patients with severe AFLP. This finding may have important implications for the development of an effective treatment for patients with AFLP suffering multiple organ dysfunction. © 2012, Copyright the Authors. Artificial Organs © 2012, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Genome organization, instabilities, stem cells, and cancer

Directory of Open Access Journals (Sweden)

Senthil Kumar Pazhanisamy

2009-01-01

Full Text Available It is now widely recognized that advances in exploring genome organization provide remarkable insights on the induction and progression of chromosome abnormalities. Much of what we know about how mutations evolve and consequently transform into genome instabilities has been characterized in the spatial organization context of chromatin. Nevertheless, many underlying concepts of impact of the chromatin organization on perpetuation of multiple mutations and on propagation of chromosomal aberrations remain to be investigated in detail. Genesis of genome instabilities from accumulation of multiple mutations that drive tumorigenesis is increasingly becoming a focal theme in cancer studies. This review focuses on structural alterations evolve to raise a variety of genome instabilities that are manifested at the nucleotide, gene or sub-chromosomal, and whole chromosome level of genome. Here we explore an underlying connection between genome instability and cancer in the light of genome architecture. This review is limited to studies directed towards spatial organizational aspects of origin and propagation of aberrations into genetically unstable tumors.

OSL Based Anthropomorphic Phantom and Real-Time Organ Dosimetry

Energy Technology Data Exchange (ETDEWEB)

David E. Hintenlang, Ph.D

2009-02-10

The overall objective of this project was the development of a dosimetry system that provides the direct measurement of organ does in real-time with a sensitivity that makes it an effective tool for applications in a wide variety of health physics applications. The system included the development of a real-time readout system for fiber optic coupled (FOC) dosimeters that is integrated with a state-of-art anthropomorphic phantom to provide instantaneous measures of organ doses throughout the phantom. The small size of the FOC detectors and optical fibers allow the sensitive volume of the detector to be located at organ centroids (or multiple locations distributed through the organ) within a tissue equivalent, anthropomorphic phantom without perturbing the tissue equivalent features of the phantom. The developed phantom/dosimetry system can be used in any environment where personnel may be exposed to gamma or x-ray radiations to provide the most accurate determinations of organ and effective doses possible to date.

OSL Based Anthropomorphic Phantom and Real-Time Organ Dosimetry

International Nuclear Information System (INIS)

Hintenlang, David E.

2009-01-01

The overall objective of this project was the development of a dosimetry system that provides the direct measurement of organ doses in real-time with a sensitivity that makes it an effective tool for applications in a wide variety of health physics applications. The system included the development of a real-time readout system for fiber optic coupled (FOC) dosimeters that is integrated with a state-of-art anthropomorphic phantom to provide instantaneous measures of organ doses throughout the phantom. The small size of the FOC detectors and optical fibers allow the sensitive volume of the detector to be located at organ centroids (or multiple locations distributed through the organ) within a tissue equivalent, anthropomorphic phantom without perturbing the tissue equivalent features of the phantom. The developed phantom/dosimetry system can be used in any environment where personnel may be exposed to gamma or x-ray radiations to provide the most accurate determinations of organ and effective doses possible to date

Immunological circumvention of multiple organ metastases of multidrug resistant human small cell lung cancer cells by mouse-human chimeric anti-ganglioside GM2 antibody KM966.

Science.gov (United States)

Hanibuchi, M; Yano, S; Nishioka, Y; Yanagawa, H; Miki, T; Sone, S

2000-01-01

serum against SBC-3/DOX cells to a similar extent compared with parental SBC-3 cells. Pretreatment of human effector cells with various cytokines induced further enhancement of the KM966-dependent ADCC against SBC-3/DOX cells. Intravenous injection of SBC-3 or SBC-3/DOX cells into natural killer (NK) cell-depleted severe combined immunodeficient (SCID) mice developed metastases in multiple organs (liver, kidneys and lymph nodes). Interestingly, SBC-3/DOX cells produced metastases more rapidly than SBC-3 cells, suggesting more aggressive phenotype of SBC-3/DOX cells than their parental cells in vivo. Systemic treatment with KM966, given on days 2 and 7, drastically inhibited the formation of multiple-organ metastases produced by both SBC-3 and SBC-3/DOX cells, indicating that KM966 can eradicate metastasis by SCLC cells irrespective of MDR phenotype. These findings suggest that the mouse-human chimeric KM966 targets the GM2 antigen, and might be useful for the immunological circumvention of multiple-organ metastases of refractory SCLC.

Multiple-endpoint assay provides a detailed mechanistic view of responses to herbicide exposure in Chlamydomonas reinhardtii

International Nuclear Information System (INIS)

Nestler, Holger; Groh, Ksenia J.; Schönenberger, René; Behra, Renata; Schirmer, Kristin; Eggen, Rik I.L.; Suter, Marc J.-F.

2012-01-01

The release of herbicides into the aquatic environment raises concerns about potential detrimental effects on ecologically important non-target species, such as unicellular algae, necessitating ecotoxicological risk assessment. Algal toxicity tests based on growth, a commonly assessed endpoint, are integrative, and hence do not provide information about underlying toxic mechanisms and effects. This limitation may be overcome by measuring more specific biochemical and physiological endpoints. In the present work, we developed and applied a novel multiple-endpoint assay, and analyzed the effects of the herbicides paraquat, diuron and norflurazon, each representing a specific mechanism of toxic action, on the single celled green alga Chlamydomonas reinhardtii. The endpoints added to assessment of growth were pigment content, maximum and effective photosystem II quantum yield, ATP content, esterase and oxidative activity. All parameters were measured at 2, 6 and 24 h of exposure, except for growth and pigment content, which were determined after 6 and 24 h only. Effective concentrations causing 50% of response (EC50s) and lowest observable effect concentrations (LOECs) were determined for all endpoints and exposure durations where possible. The assay provided a detailed picture of the concentration- and time-dependent development of effects elicited by the analyzed herbicides, thus improving the understanding of the underlying toxic mechanisms. Furthermore, the response patterns were unique to the respective herbicide and reflected the different mechanisms of toxicity. The comparison of the endpoint responses and sensitivities revealed that several physiological and biochemical parameters reacted earlier or stronger to disturbances than growth. Overall, the presented multiple-endpoint assay constitutes a promising basis for investigating stressor and toxicant effects in green algae.

Multiple-endpoint assay provides a detailed mechanistic view of responses to herbicide exposure in Chlamydomonas reinhardtii

Energy Technology Data Exchange (ETDEWEB)

Nestler, Holger [Eawag, Swiss Federal Institute of Aquatic Science and Technology, Ueberlandstrasse 133, 8600 Duebendorf (Switzerland); ETH Zurich, Swiss Federal Institute of Technology, Institute of Biogeochemistry and Pollutant Dynamics, Universitaetstrasse 16, 8092 Zurich (Switzerland); Groh, Ksenia J.; Schoenenberger, Rene; Behra, Renata [Eawag, Swiss Federal Institute of Aquatic Science and Technology, Ueberlandstrasse 133, 8600 Duebendorf (Switzerland); Schirmer, Kristin [Eawag, Swiss Federal Institute of Aquatic Science and Technology, Ueberlandstrasse 133, 8600 Duebendorf (Switzerland); ETH Zurich, Swiss Federal Institute of Technology, Institute of Biogeochemistry and Pollutant Dynamics, Universitaetstrasse 16, 8092 Zurich (Switzerland); EPF Lausanne, School of Architecture, Civil and Environmental Engineering, 1015 Lausanne (Switzerland); Eggen, Rik I.L. [Eawag, Swiss Federal Institute of Aquatic Science and Technology, Ueberlandstrasse 133, 8600 Duebendorf (Switzerland); ETH Zurich, Swiss Federal Institute of Technology, Institute of Biogeochemistry and Pollutant Dynamics, Universitaetstrasse 16, 8092 Zurich (Switzerland); Suter, Marc J.-F., E-mail: suter@eawag.ch [Eawag, Swiss Federal Institute of Aquatic Science and Technology, Ueberlandstrasse 133, 8600 Duebendorf (Switzerland); ETH Zurich, Swiss Federal Institute of Technology, Institute of Biogeochemistry and Pollutant Dynamics, Universitaetstrasse 16, 8092 Zurich (Switzerland)

2012-04-15

The release of herbicides into the aquatic environment raises concerns about potential detrimental effects on ecologically important non-target species, such as unicellular algae, necessitating ecotoxicological risk assessment. Algal toxicity tests based on growth, a commonly assessed endpoint, are integrative, and hence do not provide information about underlying toxic mechanisms and effects. This limitation may be overcome by measuring more specific biochemical and physiological endpoints. In the present work, we developed and applied a novel multiple-endpoint assay, and analyzed the effects of the herbicides paraquat, diuron and norflurazon, each representing a specific mechanism of toxic action, on the single celled green alga Chlamydomonas reinhardtii. The endpoints added to assessment of growth were pigment content, maximum and effective photosystem II quantum yield, ATP content, esterase and oxidative activity. All parameters were measured at 2, 6 and 24 h of exposure, except for growth and pigment content, which were determined after 6 and 24 h only. Effective concentrations causing 50% of response (EC50s) and lowest observable effect concentrations (LOECs) were determined for all endpoints and exposure durations where possible. The assay provided a detailed picture of the concentration- and time-dependent development of effects elicited by the analyzed herbicides, thus improving the understanding of the underlying toxic mechanisms. Furthermore, the response patterns were unique to the respective herbicide and reflected the different mechanisms of toxicity. The comparison of the endpoint responses and sensitivities revealed that several physiological and biochemical parameters reacted earlier or stronger to disturbances than growth. Overall, the presented multiple-endpoint assay constitutes a promising basis for investigating stressor and toxicant effects in green algae.

Opposition multiple objective symbiotic organisms search (OMOSOS for time, cost, quality and work continuity tradeoff in repetitive projects

Directory of Open Access Journals (Sweden)

Duc-Hoc Tran

2018-04-01

Full Text Available Construction managers often face with projects containing multiple units wherein activities repeat from unit to unit. Therefore effective resource management is crucial in terms of project duration, cost and quality. Accordingly, researchers have developed several models to aid planners in developing practical and near-optimal schedules for repetitive projects. Despite their undeniable benefits, such models lack the ability of pure simultaneous optimization because existing methodologies optimize the schedule with respect to a single factor, to achieve minimum duration, total cost, resource work breaks or various combinations, respectively. This study introduces a novel approach called “opposition multiple objective symbiotic organisms search” (OMOSOS for scheduling repetitive projects. The proposed algorithm used an opposition-based learning technique for population initialization and for generation jumping. Further, this study integrated a scheduling module (M1 to determine all project objectives including time, cost, quality and interruption. The proposed algorithm was implemented on two application examples in order to demonstrate its capabilities in optimizing the scheduling of repetitive construction projects. The results indicate that the OMOSOS approach is a powerful optimization technique and can assist project managers in selecting appropriate plan for project. Keywords: Symbiotic organisms search, Multi-objective analysis, Resource tradeoff, Schedules, Repetitive

Organic synthesis provides opportunities to transform drug discovery

Science.gov (United States)

Blakemore, David C.; Castro, Luis; Churcher, Ian; Rees, David C.; Thomas, Andrew W.; Wilson, David M.; Wood, Anthony

2018-03-01

Despite decades of ground-breaking research in academia, organic synthesis is still a rate-limiting factor in drug-discovery projects. Here we present some current challenges in synthetic organic chemistry from the perspective of the pharmaceutical industry and highlight problematic steps that, if overcome, would find extensive application in the discovery of transformational medicines. Significant synthesis challenges arise from the fact that drug molecules typically contain amines and N-heterocycles, as well as unprotected polar groups. There is also a need for new reactions that enable non-traditional disconnections, more C-H bond activation and late-stage functionalization, as well as stereoselectively substituted aliphatic heterocyclic ring synthesis, C-X or C-C bond formation. We also emphasize that syntheses compatible with biomacromolecules will find increasing use, while new technologies such as machine-assisted approaches and artificial intelligence for synthesis planning have the potential to dramatically accelerate the drug-discovery process. We believe that increasing collaboration between academic and industrial chemists is crucial to address the challenges outlined here.

Multiple Calcium Export Exchangers and Pumps Are a Prominent Feature of Enamel Organ Cells

Science.gov (United States)

Robertson, Sarah Y. T.; Wen, Xin; Yin, Kaifeng; Chen, Junjun; Smith, Charles E.; Paine, Michael L.

2017-01-01

Calcium export is a key function for the enamel organ during all stages of amelogenesis. Expression of a number of ATPase calcium transporting, plasma membrane genes (ATP2B1-4/PMCA1-4), solute carrier SLC8A genes (sodium/calcium exchanger or NCX1-3), and SLC24A gene family members (sodium/potassium/calcium exchanger or NCKX1-6) have been investigated in the developing enamel organ in earlier studies. This paper reviews the calcium export pathways that have been described and adds novel insights to the spatiotemporal expression patterns of PMCA1, PMCA4, and NCKX3 during amelogenesis. New data are presented to show the mRNA expression profiles for the four Atp2b1-4 gene family members (PMCA1-4) in secretory-stage and maturation-stage rat enamel organs. These data are compared to expression profiles for all Slc8a and Slc24a gene family members. PMCA1, PMCA4, and NCKX3 immunolocalization data is also presented. Gene expression profiles quantitated by real time PCR show that: (1) PMCA1, 3, and 4, and NCKX3 are most highly expressed during secretory-stage amelogenesis; (2) NCX1 and 3, and NCKX6 are expressed during secretory and maturation stages; (3) NCKX4 is most highly expressed during maturation-stage amelogenesis; and (4) expression levels of PMCA2, NCX2, NCKX1, NCKX2, and NCKX5 are negligible throughout amelogenesis. In the enamel organ PMCA1 localizes to the basolateral membrane of both secretory and maturation ameloblasts; PMCA4 expression is seen in the basolateral membrane of secretory and maturation ameloblasts, and also cells of the stratum intermedium and papillary layer; while NCKX3 expression is limited to Tomes' processes, and the apical membrane of maturation-stage ameloblasts. These new findings are discussed in the perspective of data already present in the literature, and highlight the multiplicity of calcium export systems in the enamel organ needed to regulate biomineralization. PMID:28588505

Multiple Calcium Export Exchangers and Pumps Are a Prominent Feature of Enamel Organ Cells

Directory of Open Access Journals (Sweden)

Sarah Y. T. Robertson

2017-05-01

Full Text Available Calcium export is a key function for the enamel organ during all stages of amelogenesis. Expression of a number of ATPase calcium transporting, plasma membrane genes (ATP2B1-4/PMCA1-4, solute carrier SLC8A genes (sodium/calcium exchanger or NCX1-3, and SLC24A gene family members (sodium/potassium/calcium exchanger or NCKX1-6 have been investigated in the developing enamel organ in earlier studies. This paper reviews the calcium export pathways that have been described and adds novel insights to the spatiotemporal expression patterns of PMCA1, PMCA4, and NCKX3 during amelogenesis. New data are presented to show the mRNA expression profiles for the four Atp2b1-4 gene family members (PMCA1-4 in secretory-stage and maturation-stage rat enamel organs. These data are compared to expression profiles for all Slc8a and Slc24a gene family members. PMCA1, PMCA4, and NCKX3 immunolocalization data is also presented. Gene expression profiles quantitated by real time PCR show that: (1 PMCA1, 3, and 4, and NCKX3 are most highly expressed during secretory-stage amelogenesis; (2 NCX1 and 3, and NCKX6 are expressed during secretory and maturation stages; (3 NCKX4 is most highly expressed during maturation-stage amelogenesis; and (4 expression levels of PMCA2, NCX2, NCKX1, NCKX2, and NCKX5 are negligible throughout amelogenesis. In the enamel organ PMCA1 localizes to the basolateral membrane of both secretory and maturation ameloblasts; PMCA4 expression is seen in the basolateral membrane of secretory and maturation ameloblasts, and also cells of the stratum intermedium and papillary layer; while NCKX3 expression is limited to Tomes' processes, and the apical membrane of maturation-stage ameloblasts. These new findings are discussed in the perspective of data already present in the literature, and highlight the multiplicity of calcium export systems in the enamel organ needed to regulate biomineralization.

A rare complication of ESWL: focal metastatic multiple organ abscesses in a horseshoe kidney.

Science.gov (United States)

Kuyumcuoglu, Ugur; Eryildirim, Bilal; Tuncer, Murat; Faydaci, Gokhan; Aktoz, Tevfik; Akdere, Hakan; Sarıca, Kemal

2014-06-30

Extracorporeal shock wave lithotripsy (ESWL) is an effective treatment modality in the minimal invasive management of urinary system stone disease. Although the majority of the complications occuring after ESWL are minor (most common ones are gross haematuria, pain, perinephritic hematoma); bacteriuria may also occur in some cases which sometimes can lead to sepsis and even metastatic abscess formation in a very rare part of the cases treated. In this rare situation infection agent spreads quickly via hematogenous route and causes abscess formation in different parts of the body. Majority of such cases usually have an underlying systemic disease like diabetes mellitus (DM), malignancy, HIV or steroid use which lead to disruption of immune system functions. Abscess formation following ESWL is extremely rare and usually limited with some case reports published in the literature. Herein, we present a diabetic case with formation of multiple abscess foci in kidney, as well as in lungs and liver following ESWL. The patient was first admitted to our emergency department with high fever and respiratory distress and misdiagnosed as metastatic tumor foci based on radiologic findings. To the best of our knowledge, our case is the first one in the literature in whom simultanous abscess formation in multiple organ systems has been documented following an otherwise uneventful ESWL.

Multi-slice echo-planar spectroscopic MR imaging provides both global and local metabolite measures in multiple sclerosis

DEFF Research Database (Denmark)

Mathiesen, Henrik Kahr; Tscherning, Thomas; Sorensen, Per Soelberg

2005-01-01

MR spectroscopy (MRS) provides information about neuronal loss or dysfunction by measuring decreases in N-acetyl aspartate (NAA), a metabolite widely believed to be a marker of neuronal viability. In multiple sclerosis (MS), whole-brain NAA (WBNAA) has been suggested as a marker of disease...... progression and treatment efficacy in treatment trials, and the ability to measure NAA loss in specific brain regions early in the evolution of this disease may have prognostic value. Most spectroscopic studies to date have been limited to single voxels or nonlocalized measurements of WBNAA only...

Successful treatment of severe sinusoidal obstruction syndrome despite multiple organ failure with defibrotide after allogeneic stem cell transplantation: a case report

Directory of Open Access Journals (Sweden)

Behre Gerhard

2009-03-01

Full Text Available Abstract Introduction We report a case of sinusoidal obstruction syndrome, a typical and life-threatening complication after allogeneic stem-cell transplantation, successfully treated with defibrotide despite massive multiple organ failure. Case presentation A 64-year-old Caucasian woman underwent allogeneic peripheral blood stem-cell transplantation from her human leukocyte antigen-identical sister against aggressive lymphoplasmocytoid immunocytoma. Seven days later, the patient developed severe sinusoidal obstruction syndrome according to the modified Seattle criteria. We initiated treatment with defibrotide. Despite early treatment, multiple organ failure with kidney failure requiring dialysis and ventilator-dependent lung failure aggravated the clinical course. Furthermore, central nervous dysfunction occurred as well as transfusion refractory thrombocytopenia. Conclusion As highlighted in our report, defibrotide is the most promising drug in the treatment of the formerly, almost lethal, severe sinusoidal obstruction syndrome to date. This is demonstrated very clearly in our patient. She improved completely, even after renal, cerebral and respiratory failure.

Performance Management in Healthcare Organizations: Concept and Practicum.

Science.gov (United States)

Dimitropoulos, Panagiotis E

2017-01-01

Organizational performance can create and sustain competitive advantages for corporations and even improve their sustainability and future prospects. Health care organizations present a sector where performance management is structured by multiple dimensions. The scope of this study is to analyze the issue of performance management in healthcare organizations and specifically the implementation of the Balanced Scorecard (BSC) methodology on organizations providing health services. The study provides a discussion on the BSC development process, the steps that management has to take in order to prepare the implementation of the BSC and finally discusses a practical example of a scorecard with specific strategic goals and performance indicators. Managers of healthcare organizations and specifically those providing services to the elderly and the general population could use the propositions of the study as a roadmap for processing, analyzing, evaluating and implementing the balanced scorecard approach in their organizations' daily operations. BSC methodology can give an advantage in terms of enhanced stakeholder management and preservation within a highly volatile and competitive economic environment.

Corporate culture and employment of people with disabilities: role of social workers and service provider organizations.

Science.gov (United States)

Samant, Deepti; Soffer, Michal; Hernandez, Brigida; Adya, Meera; Akinpelu, Omolara; Levy, Joel M; Repoli, Elizabeth; Kramer, Michael; Blanck, Peter

2009-01-01

Corporate culture reflects an organization's value system and impacts the recruitment, retention, and promotion of employees. Individuals with disabilities are positively impacted by a corporate culture that espouses and establishes a diverse workforce as a priority. This article provides an overview of corporate culture and the employment of individuals with disabilities, and presents a case example of the corporate culture of a large not-for-profit disability service organization. With an in-depth understanding of corporate culture and disability issues, social workers can be particularly helpful to applicants and employees with disabilities as well as employers.

"Coaching the Camp Coach: Leadership Development for Small Organizations" Resource Review

Directory of Open Access Journals (Sweden)

Jason Hedrick

2009-09-01

Full Text Available Coaching is an important component of successful professional growth for leaders within any organization. However, organizations with limited resources may have challenges providing such coaching opportunities. This can be especially true for small business, non profit organizations and summer camps. “Coaching the Camp Coach; Leadership Development for Small Organizations” by Shelton, M. (2003 provides a framework, both in theory and practice, for camp leaders to improve interpersonal and intrapersonal skills through self evaluation. Accompanying the book is a CD-ROM that has multiple worksheets to be used in conjunction with the text.

Provider and systems factors in diabetes quality of care.

Science.gov (United States)

Ghaznavi, Kimia; Malik, Shaista

2012-02-01

A gap exists in knowledge and the observed frequency with which patients with diabetes actually receive treatment for optimal cardiovascular risk reduction. Many interventions to improve quality of care have been targeted at the health systems level and provider organizations. Changes in several domains of care and investment in quality by organizational leaders are needed to make long-lasting improvements. In the studies reviewed, the most effective strategies often have multiple components, whereas the use of one single strategy, such as reminders only or an educational intervention, is less effective. More studies are needed to examine the effect of several care management strategies simultaneously, such as use of clinical information systems, provider financial incentives, and organizational model on processes of care and outcomes.

Detecting Renibacterium salmoninarum in wild brown trout by use of multiple organ samples and diagnostic methods

Science.gov (United States)

Guomundsdottir, S.; Applegate, Lynn M.; Arnason, I.O.; Kristmundsson, A.; Purcell, Maureen K.; Elliott, Diane G.

2017-01-01

Renibacterium salmoninarum, the causative agent of salmonid bacterial kidney disease (BKD), is endemic in many wild trout species in northerly regions. The aim of the present study was to determine the optimal R. salmoninarum sampling/testing strategy for wild brown trout (Salmo trutta L.) populations in Iceland. Fish were netted in a lake and multiple organs—kidney, spleen, gills, oesophagus and mid-gut—were sampled and subjected to five detection tests i.e. culture, polyclonal enzyme-linked immunosorbent assay (pELISA) and three different PCR tests. The results showed that each fish had encountered R. salmoninarum but there were marked differences between results obtained depending on organ and test. The bacterium was not cultured from any kidney sample while all kidney samples were positive by pELISA. At least one organ from 92.9% of the fish tested positive by PCR. The results demonstrated that the choice of tissue and diagnostic method can dramatically influence the outcome of R. salmoninarum surveys.

Research Needs Assessment in the Health Insurance Organization: Level of Health Care Provider

Directory of Open Access Journals (Sweden)

Mohammadkarim Bahadori

2011-12-01

Full Text Available Objective: Setting research priorities in the research management cycle is a key. It is important to set the research priorities to make optimal use of scarce resources. The aim of this research was to determine the research needs of Health Insurance Organization based on its health care centers research needs.Methods: This is a qualitative, descriptive and cross-sectional study that was conducted in 2011. A purposeful sample of 60 participants from 14 hospitals, seven dispensaries, five dental clinics, two rehabilitation centers, four radiology centers, six medical diagnostic laboratories, 12 pharmacies, and 20 medical offices that were contracted with the Health Insurance Organization in Iran was interviewed. The framework analysis method (a qualitative research method was used for analysis of interviews. Atlas-Ti software was used to analyze quantitative data, respectively. The topics were prioritized using the Analytical Hierarchy Process (AHP method through Expert Choice software.Results: Based on the problems extracted in our qualitative study, 12 research topics were proposed by the experts. Among these “Design of standard treatment protocols,” “Designing model of ranking the health care centers under contract,” and “Pathology of payment system” took the priority ranks of 1 to 3, earning the scores of 0.44, 0.42, and 0.37, respectively.Conclusion: Considering limited resources and unlimited needs and to prevent research resource wasting, conducting research related to health care providers in the Health Insurance Organization can help it achieve its goals.

Joint Segmentation of Multiple Thoracic Organs in CT Images with Two Collaborative Deep Architectures.

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Trullo, Roger; Petitjean, Caroline; Nie, Dong; Shen, Dinggang; Ruan, Su

2017-09-01

Computed Tomography (CT) is the standard imaging technique for radiotherapy planning. The delineation of Organs at Risk (OAR) in thoracic CT images is a necessary step before radiotherapy, for preventing irradiation of healthy organs. However, due to low contrast, multi-organ segmentation is a challenge. In this paper, we focus on developing a novel framework for automatic delineation of OARs. Different from previous works in OAR segmentation where each organ is segmented separately, we propose two collaborative deep architectures to jointly segment all organs, including esophagus, heart, aorta and trachea. Since most of the organ borders are ill-defined, we believe spatial relationships must be taken into account to overcome the lack of contrast. The aim of combining two networks is to learn anatomical constraints with the first network, which will be used in the second network, when each OAR is segmented in turn. Specifically, we use the first deep architecture, a deep SharpMask architecture, for providing an effective combination of low-level representations with deep high-level features, and then take into account the spatial relationships between organs by the use of Conditional Random Fields (CRF). Next, the second deep architecture is employed to refine the segmentation of each organ by using the maps obtained on the first deep architecture to learn anatomical constraints for guiding and refining the segmentations. Experimental results show superior performance on 30 CT scans, comparing with other state-of-the-art methods.

Unexpected Multiple Organ Infarctions in a Poisoned Patient

Directory of Open Access Journals (Sweden)

Sung-Wook Park

2015-08-01

Full Text Available Predisposing factors for venous thrombosis can be identified in the majority of patients with established venous thromboembolism (VTE. However, an obvious precipitant may not be identified during the initial evaluation of such patients. In the present case, a 47-year-old female presented to the emergency department of our hospital after ingesting multiple drugs. She had no VTE-related risk factors or previous episodes, nor any family history of VTE. After admission to the intensive care unit sudden hypoxemia developed, and during the evaluation cerebral, renal, and splenic infarctions with pulmonary embolisms were diagnosed. However, the sources of the emboli could not be identified by transthoracic echocardiography or computed tomography angiography. Protein C deficiency was identified several days later. We recommend that hypercoagulable states be taken into consideration, especially when unexplained thromboembolic events develop in multiple or unusual venous sites.

Molecular characterization of organic electronic films.

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DeLongchamp, Dean M; Kline, R Joseph; Fischer, Daniel A; Richter, Lee J; Toney, Michael F

2011-01-18

Organic electronics have emerged as a viable competitor to amorphous silicon for the active layer in low-cost electronics. The critical performance of organic electronic materials is closely related to their morphology and molecular packing. Unlike their inorganic counterparts, polymers combine complex repeat unit structure and crystalline disorder. This combination prevents any single technique from being able to uniquely solve the packing arrangement of the molecules. Here, a general methodology for combining multiple, complementary techniques that provide accurate unit cell dimensions and molecular orientation is described. The combination of measurements results in a nearly complete picture of the organic film morphology. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Providing Spark and Stability: The Role of Intermediary Organizations in Establishing School-Based Youth-Adult Partnerships

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Mitra, Dana L.; Sanders, Felicia C.; Perkins, Daniel F.

2010-01-01

The term "youth-adult partnership" increasingly is being used to define a relationship in which both youth and adults have the potential to contribute to decision making processes, to learn from one another, and to promote change. Establishing a relationship with an "intermediary organization" can provide much needed stability and sustainability…

TMVOC, simulator for multiple volatile organic chemicals

International Nuclear Information System (INIS)

Pruess, Karsten; Battistelli, Alfredo

2003-01-01

TMVOC is a numerical simulator for three-phase non-isothermal flow of water, soil gas, and a multicomponent mixture of volatile organic chemicals (VOCs) in multidimensional heterogeneous porous media. It is an extension of the TOUGH2 general-purpose simulation program developed at the Lawrence Berkeley National Laboratory. TMVOC is designed for applications to contamination problems that involve hydrocarbon fuel or organic solvent spills in saturated and unsaturated zones. It can model contaminant behavior under ''natural'' environmental conditions, as well as for engineered systems, such as soil vapor extraction, groundwater pumping, or steam-assisted source remediation. TMVOC is upwards compatible with T2VOC (Falta et al., 1995) and can be initialized from T2VOC-style initial conditions. The main enhancements in TMVOC relative to T2VOC are as follows: a multicomponent mixture of volatile organic chemicals can be modeled; any and all combinations of the three phases water-oil-gas are treated; several non-condensible gases may be present; diffusion is treated in all phases in a manner that is fully coupled with phase partitioning. This paper gives a brief summary of the methodology used in TMVOC as well as highlighting some implementation issues. Simulation of a NAPL spill and subsequent remediation is discussed for a 2-D vertical section of a saturated-unsaturated flow problem

A rare complication of ESWL: Focal metastatic multiple organ abscesses in a horseshoe kidney

Directory of Open Access Journals (Sweden)

Ugur Kuyumcuoglu

2014-06-01

Full Text Available Extracorporeal shock wave lithotripsy (ESWL is an effective treatment modality in the minimal invasive management of urinary system stone disease. Although the majority of the complications occuring after ESWL are minor (most common ones are gross haematuria, pain, perinephritic hematoma; bacteriuria may also occur in some cases which sometimes can lead to sepsis and even metastatic abscess formation in a very rare part of the cases treated. In this rare situation infection agent spreads quickly via hematogenous route and causes abscess formation in different parts of the body. Majority of such cases usually have an underlying systemic disease like diabetes mellitus (DM, malignancy, HIV or steroid use which lead to disruption of immune system functions. Abscess formation following ESWL is extremely rare and usually limited with some case reports published in the literature. Herein, we present a diabetic case with formation of multiple abscess foci in kidney, as well as in lungs and liver following ESWL. The patient was first admitted to our emergency department with high fever and respiratory distress and misdiagnosed as metastatic tumor foci based on radiologic findings. To the best of our knowledge, our case is the first one in the literature in whom simultanous abscess formation in multiple organ systems has been documented following an otherwise uneventful ESWL.

Can organic farming feed the world? : a contribution to the debate on the ability of organic farming systems to provide sustainable supplies of food

NARCIS (Netherlands)

Goulding, K.W.T.; Trewavas, A.J.; Giller, K.E.

2009-01-01

A recent paper Badgley et al. (2007) claimed that organic farming, if used worldwide, would provide sufficient food for a growing world population. The paper stimulated much critical response. Our paper makes a critical assessment of this claim for wheat, a major cereal crop and source of food

Size-specific dose estimate (SSDE) provides a simple method to calculate organ dose for pediatric CT examinations

Energy Technology Data Exchange (ETDEWEB)

Moore, Bria M.; Brady, Samuel L., E-mail: samuel.brady@stjude.org; Kaufman, Robert A. [Department of Radiological Sciences, St Jude Children' s Research Hospital, Memphis, Tennessee 38105 (United States); Mirro, Amy E. [Department of Biomedical Engineering, Washington University, St Louis, Missouri 63130 (United States)

2014-07-15

previously published pediatric patient doses that accounted for patient size in their dose calculation, and was found to agree in the chest to better than an average of 5% (27.6/26.2) and in the abdominopelvic region to better than 2% (73.4/75.0). Conclusions: For organs fully covered within the scan volume, the average correlation of SSDE and organ absolute dose was found to be better than ±10%. In addition, this study provides a complete list of organ dose correlation factors (CF{sub SSDE}{sup organ}) for the chest and abdominopelvic regions, and describes a simple methodology to estimate individual pediatric patient organ dose based on patient SSDE.

How organic carbon derived from multiple sources contributes to carbon sequestration processes in a shallow coastal system?

Science.gov (United States)

Watanabe, Kenta; Kuwae, Tomohiro

2015-04-16

Carbon captured by marine organisms helps sequester atmospheric CO 2 , especially in shallow coastal ecosystems, where rates of primary production and burial of organic carbon (OC) from multiple sources are high. However, linkages between the dynamics of OC derived from multiple sources and carbon sequestration are poorly understood. We investigated the origin (terrestrial, phytobenthos derived, and phytoplankton derived) of particulate OC (POC) and dissolved OC (DOC) in the water column and sedimentary OC using elemental, isotopic, and optical signatures in Furen Lagoon, Japan. Based on these data analysis, we explored how OC from multiple sources contributes to sequestration via storage in sediments, water column sequestration, and air-sea CO 2 exchanges, and analyzed how the contributions vary with salinity in a shallow seagrass meadow as well. The relative contribution of terrestrial POC in the water column decreased with increasing salinity, whereas autochthonous POC increased in the salinity range 10-30. Phytoplankton-derived POC dominated the water column POC (65-95%) within this salinity range; however, it was minor in the sediments (3-29%). In contrast, terrestrial and phytobenthos-derived POC were relatively minor contributors in the water column but were major contributors in the sediments (49-78% and 19-36%, respectively), indicating that terrestrial and phytobenthos-derived POC were selectively stored in the sediments. Autochthonous DOC, part of which can contribute to long-term carbon sequestration in the water column, accounted for >25% of the total water column DOC pool in the salinity range 15-30. Autochthonous OC production decreased the concentration of dissolved inorganic carbon in the water column and thereby contributed to atmospheric CO 2 uptake, except in the low-salinity zone. Our results indicate that shallow coastal ecosystems function not only as transition zones between land and ocean but also as carbon sequestration filters. They

3D Bioprinting for Organ Regeneration

Science.gov (United States)

Cui, Haitao; Nowicki, Margaret; Fisher, John P.; Zhang, Lijie Grace

2017-01-01

Regenerative medicine holds the promise of engineering functional tissues or organs to heal or replace abnormal and necrotic tissues/organs, offering hope for filling the gap between organ shortage and transplantation needs. Three-dimensional (3D) bioprinting is evolving into an unparalleled bio-manufacturing technology due to its high-integration potential for patient-specific designs, precise and rapid manufacturing capabilities with high resolution, and unprecedented versatility. It enables precise control over multiple compositions, spatial distributions, and architectural accuracy/complexity, therefore achieving effective recapitulation of microstructure, architecture, mechanical properties, and biological functions of target tissues and organs. Here we provide an overview of recent advances in 3D bioprinting technology, as well as design concepts of bioinks suitable for the bioprinting process. We focus on the applications of this technology for engineering living organs, focusing more specifically on vasculature, neural networks, the heart and liver. We conclude with current challenges and the technical perspective for further development of 3D organ bioprinting. PMID:27995751

Gene prediction using the Self-Organizing Map: automatic generation of multiple gene models.

Science.gov (United States)

Mahony, Shaun; McInerney, James O; Smith, Terry J; Golden, Aaron

2004-03-05

Many current gene prediction methods use only one model to represent protein-coding regions in a genome, and so are less likely to predict the location of genes that have an atypical sequence composition. It is likely that future improvements in gene finding will involve the development of methods that can adequately deal with intra-genomic compositional variation. This work explores a new approach to gene-prediction, based on the Self-Organizing Map, which has the ability to automatically identify multiple gene models within a genome. The current implementation, named RescueNet, uses relative synonymous codon usage as the indicator of protein-coding potential. While its raw accuracy rate can be less than other methods, RescueNet consistently identifies some genes that other methods do not, and should therefore be of interest to gene-prediction software developers and genome annotation teams alike. RescueNet is recommended for use in conjunction with, or as a complement to, other gene prediction methods.

Visual detection of multiple genetically modified organisms in a capillary array.

Science.gov (United States)

Shao, Ning; Chen, Jianwei; Hu, Jiaying; Li, Rong; Zhang, Dabing; Guo, Shujuan; Hui, Junhou; Liu, Peng; Yang, Litao; Tao, Sheng-Ce

2017-01-31

There is an urgent need for rapid, low-cost multiplex methodologies for the monitoring of genetically modified organisms (GMOs). Here, we report a C[combining low line]apillary A[combining low line]rray-based L[combining low line]oop-mediated isothermal amplification for M[combining low line]ultiplex visual detection of nucleic acids (CALM) platform for the simple and rapid monitoring of GMOs. In CALM, loop-mediated isothermal amplification (LAMP) primer sets are pre-fixed to the inner surface of capillaries. The surface of the capillary array is hydrophobic while the capillaries are hydrophilic, enabling the simultaneous loading and separation of the LAMP reaction mixtures into each capillary by capillary forces. LAMP reactions in the capillaries are then performed in parallel, and the results are visually detected by illumination with a hand-held UV device. Using CALM, we successfully detected seven frequently used transgenic genes/elements and five plant endogenous reference genes with high specificity and sensitivity. Moreover, we found that measurements of real-world blind samples by CALM are consistent with results obtained by independent real-time PCRs. Thus, with an ability to detect multiple nucleic acids in a single easy-to-operate test, we believe that CALM will become a widely applied technology in GMO monitoring.

Matching Organs

Science.gov (United States)

... to know FAQ Living donation What is living donation? Organs Types Being a living donor First steps Being ... brochures What Every Patient Needs to Know Living Donation Multiple Listing Visit UNOS Store Learn more How organs are matched How to become a living donor ...

Organ Facts

Science.gov (United States)

... to know FAQ Living donation What is living donation? Organs Types Being a living donor First steps Being ... brochures What Every Patient Needs to Know Living Donation Multiple Listing Visit UNOS Store Learn more How organs are matched How to become a living donor ...

One-pot engineering TiO2/graphene interface for enhanced adsorption and photocatalytic degradation of multiple organics.

Science.gov (United States)

Song, Jianhua; Ling, Yun; Xie, Yu; Liu, Lianjun; Zhu, Huihua

2018-06-13

It is challenging to design a multifunctional structure or composite for simultaneously adsorb and photocatalytic degrade organic pollutants in water. Towards this goal, this work innovatively engineered interfacial sites between TiO2 particles and reduced graphene oxide (RGO) sheets by employing in situ one-pot one-step solvothermal method. The interface was associated with the content of RGO, solvothermal time and solvent ratio of n-pentanol to n-hexane. It was found that when at a moderate amount of RGO (25%), TiO2 nanoparticles were well dispersed on the surface of RGO or wrapped by RGO, thus leading to a fully contact and strong interaction to form Ti - O - C interfacial structure. But when at a low content of RGO (6%), TiO2 aggregates were mixture of nanosheets, nanoparticles and nanorods. 25%RGO/TiO2 also had 175% higher surface area (146m2/g), 95% larger volume (0.339 cm3/g) and smaller band gap than 6%RGO/TiO2. More importantly, 25%RGO/TiO2 demonstrated higher adsorption efficiency (25%) and 4 times faster degradation rate than TiO2 (0%). It also exhibited good capability to eliminate multiple organics and stable long-term cycle performance (up to 93% retention after 30 cycles). Its superiority was attributed to the large surface area and unique interface between TiO2 and RGO, which not only provided more active sites to capture pollutants but also enhanced charge transfer (3 µA/cm2, 5 times higher than TiO2). This work offered a promising way to purify water through engineering new materials structure and integrating adsorption and photodegradation technologies. © 2018 IOP Publishing Ltd.

Multiple approaches for enhancing all-organic electronics photoluminescent sensors: simultaneous oxygen and pH monitoring.

Science.gov (United States)

Liu, Rui; Xiao, Teng; Cui, Weipan; Shinar, Joseph; Shinar, Ruth

2013-05-17

Key issues in using organic light emitting diodes (OLEDs) as excitation sources in structurally integrated photoluminescence (PL)-based sensors are the low forward light outcoupling, the OLEDs' broad electroluminescence (EL) bands, and the long-lived remnant EL that follows an EL pulse. The outcoupling issue limits the detection sensitivity (S) as only ~20% of the light generated within standard OLEDs can be forward outcoupled and used for sensor probe excitation. The EL broad band interferes with the analyte-sensitive PL, leading to a background that reduces S and dynamic range. In particular, these issues hinder designing compact sensors, potentially miniaturizable, that are devoid of optical filters and couplers. We address these shortcomings by introducing easy-to-employ multiple approaches for outcoupling improvement, PL enhancement, and background EL reduction leading to novel, compact all-organic device architectures demonstrated for simultaneous monitoring of oxygen and pH. The sensor comprises simply-fabricated, directionally-emitting, narrower-band, multicolor microcavity OLED excitation and small molecule- and polymer-based organic photodetectors (OPDs) with a more selective spectral response. Additionally, S and PL intensity for oxygen are enhanced by using polystyrene (PS):polyethylene glycol (PEG) blends as the sensing film matrix. By utilizing higher molecular weight PS, the ratio τ0/τ100 (PL decay time τ at 0% O2/τ at 100% O2) that is often used to express S increases ×1.9 to 20.7 relative to the lower molecular weight PS, where this ratio is 11.0. This increase reduces to ×1.7 when the PEG is added (τ0/τ100=18.2), but the latter results in an increase ×2.7 in the PL intensity. The sensor's response time is <10s in all cases. The microporous structure of these blended films, with PEG decorating PS pores, serves a dual purpose. It results in light scattering that reduces the EL that is waveguided in the substrate of the OLEDs and

77 FR 39735 - Certain Integrated Circuit Packages Provided With Multiple Heat-Conducting Paths and Products...

Science.gov (United States)

2012-07-05

...Notice is hereby given that a complaint was filed with the U.S. International Trade Commission on May 31, 2012, under section 337 of the Tariff Act of 1930, as amended, on behalf of Industrial Technology Research Institute of Taiwan and ITRI International of San Jose, California. The complaint alleges violations of section 337 based upon the importation into the United States, the sale for importation, and the sale within the United States after importation of certain integrated circuit packages provided with multiple heat-conducting paths and products containing same by reason of infringement of certain claims of U.S. Patent No. 5,710,459 (``the `459 patent''). The complaint further alleges that an industry in the United States exists as required by subsection (a)(2) of section 337. The complainants request that the Commission institute an investigation and, after the investigation, issue an exclusion order and cease and desist order.

Multiple approaches for enhancing all-organic electronics photoluminescent sensors: Simultaneous oxygen and pH monitoring

Energy Technology Data Exchange (ETDEWEB)

Liu, Rui; Xiao, Teng; Cui, Weipan [Ames Laboratory-USDOE and Department of Physics and Astronomy, Iowa State University, Ames, IA 50011 (United States); Shinar, Joseph, E-mail: jshinar@iastate.edu [Ames Laboratory-USDOE and Department of Physics and Astronomy, Iowa State University, Ames, IA 50011 (United States); Shinar, Ruth, E-mail: rshinar@iastate.edu [Microelectronics Research Center and Department of Electrical and Computer Engineering, Iowa State University, Ames, IA 50011 (United States)

2013-05-17

Graphical abstract: -- Highlights: •Novel simply-fabricated all-organic electronics pH and oxygen optical monitor. •Excitation sources: directionally emitting, narrowed multicolor microcavity OLEDs. •Photodetectors: small molecule- or polymer-based with selective spectral responses. •Sensor film: structured high molecular weight polystyrene:polyethylene glycol blend. •×1.9 sensitivity enhancement and ×2.7 increase in the photoluminescence for oxygen. -- Abstract: Key issues in using organic light emitting diodes (OLEDs) as excitation sources in structurally integrated photoluminescence (PL)-based sensors are the low forward light outcoupling, the OLEDs’ broad electroluminescence (EL) bands, and the long-lived remnant EL that follows an EL pulse. The outcoupling issue limits the detection sensitivity (S) as only ∼20% of the light generated within standard OLEDs can be forward outcoupled and used for sensor probe excitation. The EL broad band interferes with the analyte-sensitive PL, leading to a background that reduces S and dynamic range. In particular, these issues hinder designing compact sensors, potentially miniaturizable, that are devoid of optical filters and couplers. We address these shortcomings by introducing easy-to-employ multiple approaches for outcoupling improvement, PL enhancement, and background EL reduction leading to novel, compact all-organic device architectures demonstrated for simultaneous monitoring of oxygen and pH. The sensor comprises simply-fabricated, directionally-emitting, narrower-band, multicolor microcavity OLED excitation and small molecule- and polymer-based organic photodetectors (OPDs) with a more selective spectral response. Additionally, S and PL intensity for oxygen are enhanced by using polystyrene (PS):polyethylene glycol (PEG) blends as the sensing film matrix. By utilizing higher molecular weight PS, the ratio τ{sub 0}/τ{sub 100} (PL decay time τ at 0% O{sub 2}/τ at 100% O{sub 2}) that is often used

The role of non-governmental organizations in providing curative health services in North Darfur State, Sudan.

Science.gov (United States)

Yagub, Abdallah I A; Mtshali, Khondlo

2015-09-01

Conflict in North Darfur state, Western Sudan started in 2003, and the delivering of curative health services was becoming a greater challenge for the country's limited resources. NGOs have played an important role in providing curative health services. To examine the role that Non-Governmental Organizations (NGOs) have played in providing curative health services, as well as to identify the difficulties and challenges that affect NGOs in delivering curative health services. Secondary data was collected from different sources, including government offices and medical organizations in Sudan and in North Darfur state. Primary data was obtained through interviews with government and NGOs representatives. The interviews were conducted with (1) expatriates working for international NGOs (N=15) (2) health professionals and administrators working in health sector (N= 45) in the period from November 2010 to January 2011. The government in North Darfur state spent 70% of its financial budget on security, while it spent it less than 1% on providing health services. The international NGOs have been providing 70% of curative health services to the State's population by contributing 52.9% of the health budget and 1 390 health personnel. Since 2003 NGOs have provided technical assistance to the health staff. As a result, more than fifty nurses have been trained to provide care and treatment, more than twenty-three doctors have been trained in laboratory equipment operation, and approximately six senior doctors and hospital directors have received management training. NGOs have been managing and supporting 89 public health facilities, and established 24 health centres in IDP camps, and 20 health centres across all the districts in North Darfur state. The NGOs have played an important role in providing curative health services and in establishing good health facilities, but a future problem is how the government will run these health facilities after a peaceful settlement has been

[Multiple organ failure presumably due to alkylating agents used as preconditioning drugs for autologous peripheral blood stem cell transplantation in an acute promyelocytic leukemia].

Science.gov (United States)

Ida, Tori; Hashimoto, Shigeo; Suzuki, Nobuaki; Ebe, Yusuke; Yano, Toshio; Sato, Naoko; Koike, Tadashi

2016-01-01

A 52-year-old male was diagnosed as having acute promyelocytic leukemia (APL) in 2006. He received induction chemotherapy including all-trans retinoic acid and initially achieved a complete remission (CR). After several courses of consolidation therapy combining anthracyclines and cytarabine, he maintained CR. In 2009, an APL relapse was diagnosed, and he was treated with arsenic trioxide. Since he achieved a second CR, he underwent autologous peripheral blood stem cell transplantation (auto-PBSCT) with a conditioning regimen consisting of busulfan and melphalan. At four months after auto-PBSCT, he developed a pneumothorax and acute respiratory failure. He died despite intensive therapy. Autopsy findings included various atypical and apoptotic cells in his pulmonary tissue. These changes were confirmed in multiple organs throughout the body, suggesting them to be drug-induced. The findings in this case suggested multiple organ failure due to alkylating agents.

Provider-agency fit in substance abuse treatment organizations: implications for learning climate, morale, and evidence-based practice implementation.

Science.gov (United States)

Ramsey, Alex T; van den Berk-Clark, Carissa

2015-05-12

Substance abuse agencies have been slow to adopt and implement evidence-based practices (EBPs), due in part to poor provider morale and organizational climates that are not conducive to successful learning and integration of these practices. Person-organization fit theory suggests that alignment, or fit, between provider- and agency-level characteristics regarding the implementation of EBPs may influence provider morale and organizational learning climate and, thus, implementation success. The current study hypothesized that discrepancies, or lack of fit, between provider- and agency-level contextual factors would negatively predict provider morale and organizational learning climate, outcomes shown to be associated with successful EBP implementation. Direct service providers (n = 120) from four substance abuse treatment agencies responded to a survey involving provider morale, organizational learning climate, agency expectations for EBP use, agency resources for EBP use, and provider attitudes towards EBP use. Difference scores between combinations of provider- and agency-level factors were computed to model provider-agency fit. Quadratic regression analyses were conducted to more adequately and comprehensively model the level of the dependent variables across the entire "fit continuum". Discrepancies, or misfit, between agency expectations and provider attitudes and between agency resources and provider attitudes were associated with poorer provider morale and weaker organizational learning climate. For all hypotheses, the curvilinear model of provider-agency discrepancies significantly predicted provider morale and organizational learning climate, indicating that both directions of misfit (provider factors more favorable than agency factors, and vice-versa) were detrimental to morale and climate. However, outcomes were most negative when providers viewed EBPs favorably, but perceived that agency expectations and resources were less supportive of EBP use. The

A preferred provider organization (PPO) case study for mental health and substance abuse.

Science.gov (United States)

Gomillion, I; Self, D R

1988-01-01

The Preferred Provider Organization concept is quickly becoming more popular because of its relative cost-effectiveness and recent successes. Managed care through means of this mental health and substance abuse PPO may well serve as the prototype for the general health care cost containment efforts of the future for the self-insured insurance plans for Alabama state employees and teachers. The first year also revealed several problems in the original proposal especially with respect to the unintended attractiveness of inpatient/residential care. Consequently, copayment plans were added to dissuade unnecessary lengthy stays (see Table 2). Second, a new quality assurance mechanism has been added to further evaluate the need for admissions to facilities, as well as for the need for continued inpatient treatment. The Alabama Quality Assurance Foundation (AQAF) began on January 1, 1988, conducting the preadmission certification on all admissions based upon criteria established jointly by AQAF and the PPO providers. In addition, AQAF will conduct continuing stay reviews at predetermined time periods to ensure that continued treatment in an inpatient setting is indeed necessary.

Gendered Managerial Discourses in Sport Organizations: Multiplicity and Complexity

NARCIS (Netherlands)

Knoppers, Annelies; Anthonissen, A.

2007-01-01

The lack of women in senior management functions in sport may in part be attributed to dominant discursive managerial practices in sport organizations. The purpose of this study is to explore ways in which the discourses and their subtexts used by directors of Dutch national sport organizations

Efficient Adoption and Assessment of Multiple Process Improvement Reference Models

Directory of Open Access Journals (Sweden)

Simona Jeners

2013-06-01

Full Text Available A variety of reference models such as CMMI, COBIT or ITIL support IT organizations to improve their processes. These process improvement reference models (IRMs cover different domains such as IT development, IT Services or IT Governance but also share some similarities. As there are organizations that address multiple domains and need to coordinate their processes in their improvement we present MoSaIC, an approach to support organizations to efficiently adopt and conform to multiple IRMs. Our solution realizes a semantic integration of IRMs based on common meta-models. The resulting IRM integration model enables organizations to efficiently implement and asses multiple IRMs and to benefit from synergy effects.

A Flexible High-Performance Photoimaging Device Based on Bioinspired Hierarchical Multiple-Patterned Plasmonic Nanostructures.

Science.gov (United States)

Lee, Yoon Ho; Lee, Tae Kyung; Kim, Hongki; Song, Inho; Lee, Jiwon; Kang, Saewon; Ko, Hyunhyub; Kwak, Sang Kyu; Oh, Joon Hak

2018-03-01

In insect eyes, ommatidia with hierarchical structured cornea play a critical role in amplifying and transferring visual signals to the brain through optic nerves, enabling the perception of various visual signals. Here, inspired by the structure and functions of insect ommatidia, a flexible photoimaging device is reported that can simultaneously detect and record incoming photonic signals by vertically stacking an organic photodiode and resistive memory device. A single-layered, hierarchical multiple-patterned back reflector that can exhibit various plasmonic effects is incorporated into the organic photodiode. The multiple-patterned flexible organic photodiodes exhibit greatly enhanced photoresponsivity due to the increased light absorption in comparison with the flat systems. Moreover, the flexible photoimaging device shows a well-resolved spatiotemporal mapping of optical signals with excellent operational and mechanical stabilities at low driving voltages below half of the flat systems. Theoretical calculation and scanning near-field optical microscopy analyses clearly reveal that multiple-patterned electrodes have much stronger surface plasmon coupling than flat and single-patterned systems. The developed methodology provides a versatile and effective route for realizing high-performance optoelectronic and photonic systems. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Organizing and managing care in a changing health system.

Science.gov (United States)

Kohn, L T

2000-04-01

To examine ways in which the management and organization of medical care is changing in response to the shifting incentives created by managed care. Site visits conducted in 12 randomly selected communities in 1996/ 1997. Approximately 35-60 interviews were conducted per site with key informants in healthcare and community organizations; about half were with providers. A standardized interview protocol was implemented across all sites, enabling cross-site comparisons. Multiple respondents were interviewed on each issue. A great deal of experimentation and apparent duplication exist in efforts to develop programs to influence physician practice patterns. Responsibility for managing care is being contested by health plans, medical groups and hospitals, as each seeks to accrue the savings that can result from the more efficient delivery of care. To manage the financial and clinical risk, providers are aggressively consolidating and reorganizing. Most significant was the rapid formation of intermediary organizations, such as independent practice arrangements (IPAs), physician-hospital organizations (PHOs), or management services organizations (MSOs), for contracting with managed care organizations. Managed care appears to have only a modest effect on how healthcare organizations deliver medical care, despite the profound effect that managed care has on how providers are organized. Rather than improving the efficiency of healthcare organizations, provider efforts to build large systems and become indispensable to health plans are exacerbating problems of excess capacity. It is not clear if new organizational arrangements will help providers manage the changing incentives they face, or if their intent is to blunt the effects of the incentives by forming larger organizations to improve their bargaining power and resist change.

How do patients and providers react to different incentives in the Chinese multiple health security systems?

Science.gov (United States)

Zhang, Chun-Yu; Hashimoto, Hideki

2015-03-05

China has achieved universal health insurance coverage. This study examined how patients and hospitals react to the different designs of the plans and to monitoring of patients by the local authority in the Chinese multiple health security schemes. The sample for analysis consisted of 1006 orthopedic inpatients who were admitted between January and December 2011 at a tertiary teaching hospital located in Beijing. We conducted general linear regression analyses to investigate whether medical expenditure and length of stay differed according to the different incentives. Patients under plans with lower copayment rates consumed significantly more medication compared with those under plans with higher copayment rates. Under plans with an annual ceiling for insurance coverage, patients spent significantly more in the second half of the year than in the first half of the year. The length of stay was shorter among patients when there were government monitoring and a penalty to the hospital service provider. Our results indicate that the different designs and monitoring of the health security systems in China cause opportunistic behavior by patients and providers. Reformation is necessary to reduce those incentives, and improve equity and efficiency in healthcare use.

The Effects of Urban Sprawl on Birds at Multiple Levels of Biological Organization

Directory of Open Access Journals (Sweden)

Robert Blair

2004-12-01

Full Text Available Urban sprawl affects the environment in myriad ways and at multiple levels of biological organization. In this paper I explore the effects of sprawl on native bird communities by comparing the occurrence of birds along gradients of urban land use in southwestern Ohio and northern California and by examining patterns at the individual, species, community, landscape, and continental levels. I do this by assessing the distribution and abundance of all bird species occupying sites of differing land-use intensity in Ohio and California. Additionally, I conducted predation experiments using artificial nests, tracked the nest fate of American Robins and Northern Cardinals, and assessed land cover in these sites. At the individual level, predation on artificial nests decreased with urbanization; however, this trend was not reflected in the nesting success of robins and cardinals, which did not increase with urbanization. At the species level, sprawl affected local patterns of extinction and invasion; the density of different species peaked at different levels of urbanization. At the community level, species richness and diversity peaked at moderate levels of urbanization, and the number of low-nesting species and of species with multiple broods increased with urbanization. The community-level results may reflect both the species-level patterns of local extinction and invasion as well as broader landscape-level patterns. At the landscape level, a linear combination of spatial heterogeneity and density of woody patches accurately predicted both species richness and Shannon Diversity. At the continental level, local extinction of endemic species, followed by the invasion of ubiquitous weedy species, leads to faunal homogenization between ecoregions.

The availability and consistency of dengue surveillance data provided online by the World Health Organization.

Science.gov (United States)

Ruberto, Irene; Marques, Ernesto; Burke, Donald S; Van Panhuis, Willem G

2015-04-01

The use of high quality disease surveillance data has become increasingly important for public health action against new threats. In response, countries have developed a wide range of disease surveillance systems enabled by technological advancements. The heterogeneity and complexity of country data systems have caused a growing need for international organizations such as the World Health Organization (WHO) to coordinate the standardization, integration, and dissemination of country disease data at the global level for research and policy. The availability and consistency of currently available disease surveillance data at the global level are unclear. We investigated this for dengue surveillance data provided online by the WHO. We extracted all dengue surveillance data provided online by WHO Headquarters and Regional Offices (RO's). We assessed the availability and consistency of these data by comparing indicators within and between sources. We also assessed the consistency of dengue data provided online by two example countries (Brazil and Indonesia). Data were available from WHO for 100 countries since 1955 representing a total of 23 million dengue cases and 82 thousand deaths ever reported to WHO. The availability of data on DengueNet and some RO's declined dramatically after 2005. Consistency was lacking between sources (84% across all indicators representing a discrepancy of almost half a million cases). Within sources, data at high spatial resolution were often incomplete. The decline of publicly available, integrated dengue surveillance data at the global level will limit opportunities for research, policy, and advocacy. A new financial and operational framework will be necessary for innovation and for the continued availability of integrated country disease data at the global level.

Multiple Access Communications

DEFF Research Database (Denmark)

This book constitutes the proceedings of the 9th International Workshop on Multiple Access Communications, MACOM 2016, held in Aalborg, Denmark, in November 2016. The 10 full papers presented in this volume were carefully reviewed and selected from 12 submissions. They were organized in topical...

An integrated miRNA functional screening and target validation method for organ morphogenesis.

Science.gov (United States)

Rebustini, Ivan T; Vlahos, Maryann; Packer, Trevor; Kukuruzinska, Maria A; Maas, Richard L

2016-03-16

The relative ease of identifying microRNAs and their increasing recognition as important regulators of organogenesis motivate the development of methods to efficiently assess microRNA function during organ morphogenesis. In this context, embryonic organ explants provide a reliable and reproducible system that recapitulates some of the important early morphogenetic processes during organ development. Here we present a method to target microRNA function in explanted mouse embryonic organs. Our method combines the use of peptide-based nanoparticles to transfect specific microRNA inhibitors or activators into embryonic organ explants, with a microRNA pulldown assay that allows direct identification of microRNA targets. This method provides effective assessment of microRNA function during organ morphogenesis, allows prioritization of multiple microRNAs in parallel for subsequent genetic approaches, and can be applied to a variety of embryonic organs.

Glyphosate ingestion causing multiple organ failure: a near-fatal case report.

Science.gov (United States)

Picetti, Edoardo; Generali, Michela; Mensi, Francesca; Neri, Giampaolo; Damia, Roberta; Lippi, Giuseppe; Cervellin, Gianfranco

2018-01-16

A 55 years old man self-presented to our Emergency Department (ED) reporting an attempted suicide by cutting the left forearm veins and ingesting approximately 200 mL of an herbicide (Myrtos®, containing 36% of glyphosate as isopropylamine salt). Laboratory tests showed metabolic acidosis. Hydration with normal saline and alkalinization with sodium bicarbonate was started according to suggestion of the poison control center, since an antidote was unavailable. Cardiorespiratory condition gradually worsened, so that non-invasive positive pressure ventilation (NIPPV) was applied and infusion of fluids was established. Nevertheless, the patient deteriorated and he needed to be transferred to the Intensive Care Unit (ICU), where he underwent orotracheal intubation and invasive mechanical ventilation. Noradrenaline and adrenaline were infused and fluid resuscitation with crystalloids was incremented. An esophagogastroduodenoscopy (EGD) showed diffuse mucosal erosions of upper digestive tract. No signs of visceral perforation were found during ICU stay. In the following days, the clinical conditions improved and a new EGD showed marked improvement of erosive lesions. After 12 days of ICU stay, the patient was extubated and then transferred to the Psychiatric Unit, in good clinical conditions. Gliphosate ingestion is associated with rapid development of multiple organ failure (MOF). Since an effective antidote is unavailable, major attention should be placed to aggressive life-support care and careful monitoring of complications.

Multiple organ histopathological changes in broiler chickens fed on genetically modified organism.

Science.gov (United States)

Cîrnatu, Daniela; Jompan, A; Sin, Anca Ileana; Zugravu, Cornelia Aurelia

2011-01-01

Diet can influence the structural characteristics of internal organs. An experiment involving 130 meat broilers was conducted during 42 days (life term for a meat broiler) to study the effect of feed with protein from genetically modified soy. The 1-day-old birds were randomly allocated to five study groups, fed with soy, sunflower, wheat, fish flour, PC starter. In the diet of each group, an amount of protein from soy was replaced with genetically modified soy (I - 0%, II - 25%, III - 50%, IV - 75%, V - 100% protein from genetically modified soy). The level of protein in soy, either modified, or non-modified, was the same. Organs and carcass weights were measured at about 42 days of age of the birds and histopathology exams were performed during May-June 2009. No statistically significant differences were observed in mortality, growth performance variables or carcass and organ yields between broilers consuming diets produced with genetically modified soybean fractions and those consuming diets produced with near-isoline control soybean fractions. Inflammatory and degenerative liver lesions, muscle hypertrophy, hemorrhagic necrosis of bursa, kidney focal tubular necrosis, necrosis and superficial ulceration of bowel and pancreatic dystrophies were found in tissues from broilers fed on protein from genetically modified soy. Different types of lesions found in our study might be due to other causes (parasites, viral) superimposed but their presence exclusively in groups fed with modified soy raises some serious questions about the consequences of use of this type of feed.

Benthic macroinvertebrates and multiple stressors : quantification of the effects of multiple stressors in field, laboratory and model settings

NARCIS (Netherlands)

Peeters, E.T.H.M.

2001-01-01

Organisms are always exposed to several simultaneously operating stressors in nature. It appears that the combined effects of multiple stressors cannot be understood as a simple product of their individual effects. To understand how multiple stressors affect the composition and functioning

A common rejection module (CRM) for acute rejection across multiple organs identifies novel therapeutics for organ transplantation.

Science.gov (United States)

Khatri, Purvesh; Roedder, Silke; Kimura, Naoyuki; De Vusser, Katrien; Morgan, Alexander A; Gong, Yongquan; Fischbein, Michael P; Robbins, Robert C; Naesens, Maarten; Butte, Atul J; Sarwal, Minnie M

2013-10-21

Using meta-analysis of eight independent transplant datasets (236 graft biopsy samples) from four organs, we identified a common rejection module (CRM) consisting of 11 genes that were significantly overexpressed in acute rejection (AR) across all transplanted organs. The CRM genes could diagnose AR with high specificity and sensitivity in three additional independent cohorts (794 samples). In another two independent cohorts (151 renal transplant biopsies), the CRM genes correlated with the extent of graft injury and predicted future injury to a graft using protocol biopsies. Inferred drug mechanisms from the literature suggested that two FDA-approved drugs (atorvastatin and dasatinib), approved for nontransplant indications, could regulate specific CRM genes and reduce the number of graft-infiltrating cells during AR. We treated mice with HLA-mismatched mouse cardiac transplant with atorvastatin and dasatinib and showed reduction of the CRM genes, significant reduction of graft-infiltrating cells, and extended graft survival. We further validated the beneficial effect of atorvastatin on graft survival by retrospective analysis of electronic medical records of a single-center cohort of 2,515 renal transplant patients followed for up to 22 yr. In conclusion, we identified a CRM in transplantation that provides new opportunities for diagnosis, drug repositioning, and rational drug design.

3D Bioprinting for Organ Regeneration.

Science.gov (United States)

Cui, Haitao; Nowicki, Margaret; Fisher, John P; Zhang, Lijie Grace

2017-01-01

Regenerative medicine holds the promise of engineering functional tissues or organs to heal or replace abnormal and necrotic tissues/organs, offering hope for filling the gap between organ shortage and transplantation needs. Three-dimensional (3D) bioprinting is evolving into an unparalleled biomanufacturing technology due to its high-integration potential for patient-specific designs, precise and rapid manufacturing capabilities with high resolution, and unprecedented versatility. It enables precise control over multiple compositions, spatial distributions, and architectural accuracy/complexity, therefore achieving effective recapitulation of microstructure, architecture, mechanical properties, and biological functions of target tissues and organs. Here we provide an overview of recent advances in 3D bioprinting technology, as well as design concepts of bioinks suitable for the bioprinting process. We focus on the applications of this technology for engineering living organs, focusing more specifically on vasculature, neural networks, the heart and liver. We conclude with current challenges and the technical perspective for further development of 3D organ bioprinting. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

UK guidance on the management of personal dosimetry systems for healthcare staff working at multiple organizations.

Science.gov (United States)

Rogers, Andy; Chapple, Claire-Louise; Murray, Maria; Platton, David; Saunderson, John

2017-11-01

There has been concern expressed by the UK regulator, the Health & Safety Executive, regarding the management of occupation dose for healthcare radiation workers who work across multiple organizations. In response to this concern, the British Institute of Radiology led a working group of relevant professional bodies to develop guidance in this area. The guidance addresses issues of general system management that would apply to all personal dosimetry systems, regardless of whether or not the workers within that system work across organizational boundaries, along with exploring efficient strategies to comply with legislation where those workers do indeed work across organizational boundaries. For those specific instances, the guidance discusses both system requirements to enable organizations to co-operate (Ionising Radiation Regulations 1999 Regulation 15), as well as specific instances of staff exposure. This is broken down into three categories-low, medium and high risk. A suggested approach to each is given to guide employers and their radiation advisers in adopting sensible strategies for the monitoring of their staff and the subsequent sharing of dosimetry data to ensure overall compliance with both dose limits and optimization requirements.

Association of low non-invasive near-infrared spectroscopic measurements during initial trauma resuscitation with future development of multiple organ dysfunction.

Science.gov (United States)

Nicks, Bret A; Campons, Kevin M; Bozeman, William P

2015-01-01

Near-infrared spectroscopy (NIRS) non-invasively monitors muscle tissue oxygen saturation (StO2). It may provide a continuous noninvasive measurement to identify occult hypoperfusion, guide resuscitation, and predict the development of multiple organ dysfunction (MOD) after severe trauma. We evaluated the correlation between initial StO2 and the development of MOD in multi-trauma patients. Patients presenting to our urban, academic, Level I Trauma Center/Emergency Department and meeting standardized trauma-team activation criteria were enrolled in this prospective trial. NIRS monitoring was initiated immediately on arrival with collection of StO2 at the thenar eminence and continued up to 24 hours for those admitted to the Trauma Intensive Care Unit (TICU). Standardized resuscitation laboratory measures and clinical evaluation tools were collected. The primary outcome was the association between initial StO2 and the development of MOD within the first 24 hours based on a MOD score of 6 or greater. Descriptive statistical analyses were performed; numeric means, multivariate regression and rank sum comparisons were utilized. Clinicians were blinded from the StO2 values. Over a 14 month period, 78 patients were enrolled. Mean age was 40.9 years (SD 18.2), 84.4% were male, 76.9% had a blunt trauma mechanism and mean injury severity score (ISS) was 18.5 (SD 12.9). Of the 78 patients, 26 (33.3%) developed MOD within the first 24 hours. The MOD patients had mean initial StO2 values of 53.3 (SD 10.3), significantly lower than those of non-MOD patients 61.1 (SD 10.0); P=0.002. The mean ISS among MOD patients was 29.9 (SD 11.5), significantly higher than that of non-MODS patients, 12.1 (SD 9.1) (P<0.0001). The mean shock index (SI) among MOD patients was 0.92 (SD 0.28), also significantly higher than that of non-MODS patients, 0.73 (SD 0.19) (P=0.0007). Lactate values were not significantly different between groups. Non-invasive, continuous StO2 near-infrared spectroscopy

Multiple linear regression models for predicting chronic aluminum toxicity to freshwater aquatic organisms and developing water quality guidelines.

Science.gov (United States)

DeForest, David K; Brix, Kevin V; Tear, Lucinda M; Adams, William J

2018-01-01

The bioavailability of aluminum (Al) to freshwater aquatic organisms varies as a function of several water chemistry parameters, including pH, dissolved organic carbon (DOC), and water hardness. We evaluated the ability of multiple linear regression (MLR) models to predict chronic Al toxicity to a green alga (Pseudokirchneriella subcapitata), a cladoceran (Ceriodaphnia dubia), and a fish (Pimephales promelas) as a function of varying DOC, pH, and hardness conditions. The MLR models predicted toxicity values that were within a factor of 2 of observed values in 100% of the cases for P. subcapitata (10 and 20% effective concentrations [EC10s and EC20s]), 91% of the cases for C. dubia (EC10s and EC20s), and 95% (EC10s) and 91% (EC20s) of the cases for P. promelas. The MLR models were then applied to all species with Al toxicity data to derive species and genus sensitivity distributions that could be adjusted as a function of varying DOC, pH, and hardness conditions (the P. subcapitata model was applied to algae and macrophytes, the C. dubia model was applied to invertebrates, and the P. promelas model was applied to fish). Hazardous concentrations to 5% of the species or genera were then derived in 2 ways: 1) fitting a log-normal distribution to species-mean EC10s for all species (following the European Union methodology), and 2) fitting a triangular distribution to genus-mean EC20s for animals only (following the US Environmental Protection Agency methodology). Overall, MLR-based models provide a viable approach for deriving Al water quality guidelines that vary as a function of DOC, pH, and hardness conditions and are a significant improvement over bioavailability corrections based on single parameters. Environ Toxicol Chem 2018;37:80-90. © 2017 SETAC. © 2017 SETAC.

The ISWI chromatin remodeler organizes the hsrω ncRNA-containing omega speckle nuclear compartments.

Directory of Open Access Journals (Sweden)

Maria C Onorati

2011-05-01

Full Text Available The complexity in composition and function of the eukaryotic nucleus is achieved through its organization in specialized nuclear compartments. The Drosophila chromatin remodeling ATPase ISWI plays evolutionarily conserved roles in chromatin organization. Interestingly, ISWI genetically interacts with the hsrω gene, encoding multiple non-coding RNAs (ncRNA essential, among other functions, for the assembly and organization of the omega speckles. The nucleoplasmic omega speckles play important functions in RNA metabolism, in normal and stressed cells, by regulating availability of hnRNPs and some other RNA processing proteins. Chromatin remodelers, as well as nuclear speckles and their associated ncRNAs, are emerging as important components of gene regulatory networks, although their functional connections have remained poorly defined. Here we provide multiple lines of evidence showing that the hsrω ncRNA interacts in vivo and in vitro with ISWI, regulating its ATPase activity. Remarkably, we found that the organization of nucleoplasmic omega speckles depends on ISWI function. Our findings highlight a novel role for chromatin remodelers in organization of nucleoplasmic compartments, providing the first example of interaction between an ATP-dependent chromatin remodeler and a large ncRNA.

Does organic school food service provide more healthy eating environments than their non organic counterparts?

DEFF Research Database (Denmark)

He, Chen; Mikkelsen, Bent Egberg

Organic food strategies are increasingly developing within European school food services at the same time as these services are being involved in measures aiming at promoting healthy eating at school and counter acting obesity. Schools have an important role to play in teaching children fundamental...... as sustainable consumption strategies are contributing to shaping the future school food culture. It is therefore imperative to study how these changes in agendas influences each other and to study the associations between healthy eating and organic supply strategies at school....... life skills, including good food habits according to a number of authoritative policy papers from Council of Europe, the WHO and the EU platform. Although there are great national differences, European school food culture seems to be in a transitional state in which both healthy eating as well...

Provider-Payer Partnerships as an Engine for Continuous Quality Improvement.

Science.gov (United States)

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

2018-03-01

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.

The occurrence of single and multiple organ dysfunction in pediatric electrical versus other thermal burns.

Science.gov (United States)

Hundeshagen, Gabriel; Wurzer, Paul; Forbes, Abigail A; Voigt, Charles D; Collins, Vanessa N; Cambiaso-Daniel, Janos; Finnerty, Celeste C; Herndon, David N; Branski, Ludwik K

2017-05-01

Multiple organ failure (MOF) is a major contributor to morbidity and mortality in burned children. While various complications induced by electrical injuries have been described, the incidence and severity of single organ failure (SOF) and MOF associated with this type of injury are unknown. The study was undertaken to compare the incidence and severity of SOF and MOF as well as other complications between electrically and thermally burned children. Between 2001 and 2016, 288 pediatric patients with electrical burns (EB; n = 96) or thermal burns (CTR; n = 192) were analyzed in this study. Demographic data; length of hospitalization; and number and type of operations, amputations, and complications were statistically analyzed. Incidence of SOF and MOF was assessed using the DENVER2 classification in an additive mixed model over time. Compound scores and organ-specific scores for lung, heart, kidney, and liver were analyzed. Serum cytokine expression profiles of both groups were also compared over time. Significance was accepted at p in age (CTR, 11 ± 5 years, vs EB, 11 ± 5 years), percent total body surface area burned (CTR, 33% ± 25%, vs EB, 32 ± 25%), and length of hospitalization (CTR, 18 ± 26 days, vs EB, 18 ± 21 days). The percentage of high-voltage injury in the EB group was 64%. The incidence of MOF was lower in the EB group (2 of 96 [2.1%]) than the CTR group (20 of 192 [10.4%]; p The incidence of single organ failure was comparable between groups. Incidence of pulmonary failure was comparable in both groups, but incidence of inhalation injury was significantly higher in the CTR group (p in the EB group had more amputations (p the groups. Serum cytokine expression profiles were also comparable between the groups. In pediatric patients, electrical injury is associated with a lower incidence of MOF than other thermal burns. Early and radical debridement of nonviable tissue is crucial to improve outcomes in the electrical burn patient population

Cumulative effective and individual organ dose levels in paediatric patients undergoing multiple catheterizations for congenital heart disease

International Nuclear Information System (INIS)

Jones, T.P.; Brennan, P.C.; Ryan, E.

2017-01-01

This study examines the cumulative radiation dose levels received by a group of children who underwent multiple cardiac catheterisation procedures during the investigation and management of congenital heart disease (CHD). The purpose is to calculate cumulative doses, identify higher dose individuals, outline the inconsistencies with risk assessment and encourage the establishment of dose databases in order to facilitate the longitudinal research necessary to better understand health risks. A retrospective review of patient records for 117 paediatric patients who have undergone two or more cardiac catheterizations for the investigation of CHD was undertaken. This cohort consisted of patients who were catheterised over a period from September 2002 to August 2014. The age distribution was from newborn to 17 y. Archived kerma-area product (P KA ) and fluoroscopy time (T) readings were retrieved and analysed. Cumulative effective and individual organ doses were determined. The cumulative P KA levels ranged from 1.8 to 651.2 Gycm 2 , whilst cumulative effective dose levels varied from 2 to 259 mSv. The cumulative fluoroscopy time was shown to vary from 8.1 to 193.5 min. Median cumulative organ doses ranged from 3 to 94 mGy. Cumulative effective dose levels are highly variable but may exceed 250 mSv. Individual organ and effective dose measurements remain useful for comparison purposes between institutions although current methodologies used for determining lifetime risks are inadequate. (authors)

Primary care physicians' willingness to disclose oncology errors involving multiple providers to patients.

Science.gov (United States)

Mazor, Kathleen; Roblin, Douglas W; Greene, Sarah M; Fouayzi, Hassan; Gallagher, Thomas H

2016-10-01

Full disclosure of harmful errors to patients, including a statement of regret, an explanation, acceptance of responsibility and commitment to prevent recurrences is the current standard for physicians in the USA. To examine the extent to which primary care physicians' perceptions of event-level, physician-level and organisation-level factors influence intent to disclose a medical error in challenging situations. Cross-sectional survey containing two hypothetical vignettes: (1) delayed diagnosis of breast cancer, and (2) care coordination breakdown causing a delayed response to patient symptoms. In both cases, multiple physicians shared responsibility for the error, and both involved oncology diagnoses. The study was conducted in the context of the HMO Cancer Research Network Cancer Communication Research Center. Primary care physicians from three integrated healthcare delivery systems located in Washington, Massachusetts and Georgia; responses from 297 participants were included in these analyses. The dependent variable intent to disclose included intent to provide an apology, an explanation, information about the cause and plans for preventing recurrences. Independent variables included event-level factors (responsibility for the event, perceived seriousness of the event, predictions about a lawsuit); physician-level factors (value of patient-centred communication, communication self-efficacy and feelings about practice); organisation-level factors included perceived support for communication and time constraints. A majority of respondents would not fully disclose in either situation. The strongest predictors of disclosure were perceived personal responsibility, perceived seriousness of the event and perceived value of patient-centred communication. These variables were consistently associated with intent to disclose. To make meaningful progress towards improving disclosure; physicians, risk managers, organisational leaders, professional organisations and

Subjective Organization Calculator for Free Recall

Directory of Open Access Journals (Sweden)

Olesya Senkova

2015-11-01

Full Text Available The free recall measure has an advantage over other memory measures because the free recall measure can provide organization measures, which can reveal the strategies participants used to maximize recall. For instance, even when a study list does not show a clear organizational scheme, recall outputs are often far from random, evidenced by participants recalling the same two or more items together repeatedly across multiple test trials. Unfortunately, computing organizational measures is laborious. The present article introduces a calculator to compute subjective organization (SO measures. The calculator is based on a popular platform accessible to most researchers and is designed to compute commonly used SO measures for each participant.

Autodigestion: Proteolytic Degradation and Multiple Organ Failure in Shock

Science.gov (United States)

Altshuler, Angelina E.; Kistler, Erik B.; Schmid-Schönbein, Geert W.

2015-01-01

There is currently no effective treatment for multiorgan failure following shock other than alleviation supportive care. A better understanding of the pathogenesis of these sequelae to shock is required. The intestine plays a central role in multiorgan failure. It was previously suggested that bacteria and their toxins are responsible for the organ failure seen in circulatory shock, but clinical trials in septic patients have not confirmed this hypothesis. Instead, we review here evidence that the digestive enzymes, synthesized in the pancreas and discharged into the small intestine as requirement for normal digestion, may play a role in multi-organ failure. These powerful enzymes are non-specific, highly concentrated and fully activated in the lumen of the intestine. During normal digestion they are compartmentalized in the lumen of the intestine by the mucosal epithelial barrier. However, if this barrier becomes permeable, e.g. in an ischemic state, the digestive enzymes escape into the wall of the intestine. They digest tissues in the mucosa and generate small molecular weight cytotoxic fragments such as unbound free fatty acids. Digestive enzymes may also escape into the systemic circulation and activate other degrading proteases. These proteases have the ability to clip the ectodomain of surface receptors and compromise their function; for example cleaving the insulin receptor causing insulin resistance. The combination of digestive enzymes and cytotoxic fragments leaking into the central circulation causes cell and organ dysfunction, and ultimately may lead to complete organ failure and death. We summarize current evidence suggesting that enteral blockade of digestive enzymes inside the lumen of the intestine may serve to reduce acute cell and organ damage and improve survival in experimental shock. PMID:26717111

[Chaotic dynamic process of multiple organs dysfunction syndrome and the regulatory function of shenqin liquid on it].

Science.gov (United States)

Liang, Jun-Xiong; Weng, Shu-He; Chen, Jing-He

2008-07-01

To explore the chaotic dynamic process of multiple organs dysfunction syndrome (MODS) and the regulatory effect of Shenqin Liquid (SQL), a Chinese herbal liquid preparation with the action of purging and qi-tonifying. Eighty SD rats were divided into 4 groups, and were given suspension of zymosan A and paraffine (1 mL/kg) by peritoneal injection except for those in the blank control group to set up the multiple organs dysfunction syndrome (MODS) model. Low and high doses SQL were administered twice at the doses of 30 and 60 g/kg of SQL respectively at an interval of 8 h per day before modeling. Serum concentration of tumor necrosis factor alpha (TNF-alpha) and nitric oxide (NO) in MODS model animals were tested diachronically, eg. 12, 6 h before modeling, during modeling, 6 and 12 h after modeling, and then the mathematic models were built up with compartment analysis. Lyapunov exponents (LE) of the mathematic models were calculated to evaluate their chaotic characteristics of movement and the degree of chaos was ascertained with the correlation dimension (CD). The serum levels of TNF-alpha and NO were significantly higher than those in the bland control group at modeling, 6, and 12 h after modeling (P SQL were significantly lower than the model group (P SQL was significantly lower than that in the low dose group (P 0 respectively; in the low dose and high dose SQL treated groups, CD was 0.517 and 0.653 respectively and LE >0. CD of NO movement in the blank control group was 0.670 and with LE 0; in the low dose SQL group, 0.574 and in the high dose SQL group 0.850, and LE SQL can intervene the movement of TNF-alpha and NO, decrease the complexity of their chaotic movement, and make them return back to a stable state.

Multiple Objective Treatment Aspects of Bank Filtration

NARCIS (Netherlands)

Maeng, S.K.

2010-01-01

This study shows that BF is an effective multiple objective barrier for removal of different contaminants present in surface water sources including bulk organic matter and organic microplollutants (OMPs) like pharmaceutically active compounds and endocrine disrupting compounds. It was found that

Multiple objective treatment aspects of bank filtration

NARCIS (Netherlands)

Maeng, S.K.

2010-01-01

This study showed that BF is an effective multiple objective barrier for removal of different contaminants present in surface water sources including bulk organic matter and organic micropollutants (OMPs) like pharmaceutically active compounds and endocrine disrupting compounds. It was found that

Trust and altruism--organ distribution scandals: do they provide good reasons to refuse posthumous donation?

Science.gov (United States)

Dufner, Annette; Harris, John

2015-06-01

A recent organ distribution scandal in Germany raises questions of general importance on which many thousands of lives may well depend. The scandal in Germany has produced reactions that are likely to occur whenever and wherever distribution irregularities occur and become public knowledge. After it had become known that physicians in three German hospitals were in the habit of manipulating records in order to fast-track their patients' cases, the country experienced a decrease of available organs by a staggering 40% in October 2012. Even though this loss of trust by donors and their families is understandable, and potentially a legitimate form of protest against wrongful distribution, the withdrawal of agreement to serve as a posthumous donor in response to irregularities also inevitably results in avoidable poor outcomes for highly vulnerable individuals. In this paper, we provide a moral analysis of such dilemmas and make recommendations as to the way forward. © The Author 2015. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Provider Monitoring and Pay-for-Performance When Multiple Providers Affect Outcomes: An Application to Renal Dialysis

Science.gov (United States)

Hirth, Richard A; Turenne, Marc N; Wheeler, John RC; Pan, Qing; Ma, Yu; Messana, Joseph M

2009-01-01

Objective To characterize the influence of dialysis facilities and nephrologists on resource use and patient outcomes in the dialysis population and to illustrate how such information can be used to inform payment system design. Data Sources Medicare claims for all hemodialysis patients for whom Medicare was the primary payer in 2004, combined with the Medicare Enrollment Database and the CMS Medical Evidence Form (CMS Form 2728), which is completed at onset of renal replacement therapy. Study Design Resource use (mainly drugs and laboratory tests) per dialysis session and two clinical outcomes (achieving targets for anemia management and dose of dialysis) were modeled at the patient level with random effects for nephrologist and dialysis facility, controlling for patient characteristics. Results For each measure, both the physician and the facility had significant effects. However, facilities were more influential than physicians, as measured by the standard deviation of the random effects. Conclusions The success of tools such as P4P and provider profiling relies upon the identification of providers most able to enhance efficiency and quality. This paper demonstrates a method for determining the extent to which variation in health care costs and quality of care can be attributed to physicians and institutional providers. Because variation in quality and cost attributable to facilities is consistently larger than that attributable to physicians, if provider profiling or financial incentives are targeted to only one type of provider, the facility appears to be the appropriate locus. PMID:19555398

Unsupervised multiple kernel learning for heterogeneous data integration.

Science.gov (United States)

Mariette, Jérôme; Villa-Vialaneix, Nathalie

2018-03-15

Recent high-throughput sequencing advances have expanded the breadth of available omics datasets and the integrated analysis of multiple datasets obtained on the same samples has allowed to gain important insights in a wide range of applications. However, the integration of various sources of information remains a challenge for systems biology since produced datasets are often of heterogeneous types, with the need of developing generic methods to take their different specificities into account. We propose a multiple kernel framework that allows to integrate multiple datasets of various types into a single exploratory analysis. Several solutions are provided to learn either a consensus meta-kernel or a meta-kernel that preserves the original topology of the datasets. We applied our framework to analyse two public multi-omics datasets. First, the multiple metagenomic datasets, collected during the TARA Oceans expedition, was explored to demonstrate that our method is able to retrieve previous findings in a single kernel PCA as well as to provide a new image of the sample structures when a larger number of datasets are included in the analysis. To perform this analysis, a generic procedure is also proposed to improve the interpretability of the kernel PCA in regards with the original data. Second, the multi-omics breast cancer datasets, provided by The Cancer Genome Atlas, is analysed using a kernel Self-Organizing Maps with both single and multi-omics strategies. The comparison of these two approaches demonstrates the benefit of our integration method to improve the representation of the studied biological system. Proposed methods are available in the R package mixKernel, released on CRAN. It is fully compatible with the mixOmics package and a tutorial describing the approach can be found on mixOmics web site http://mixomics.org/mixkernel/. jerome.mariette@inra.fr or nathalie.villa-vialaneix@inra.fr. Supplementary data are available at Bioinformatics online.

Neutron Multiplicity Analysis

Energy Technology Data Exchange (ETDEWEB)

Frame, Katherine Chiyoko [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2017-06-28

Neutron multiplicity measurements are widely used for nondestructive assay (NDA) of special nuclear material (SNM). When combined with isotopic composition information, neutron multiplicity analysis can be used to estimate the spontaneous fission rate and leakage multiplication of SNM. When combined with isotopic information, the total mass of fissile material can also be determined. This presentation provides an overview of this technique.

Development of Monte Carlo simulations to provide scanner-specific organ dose coefficients for contemporary CT

Science.gov (United States)

Jansen, Jan T. M.; Shrimpton, Paul C.

2016-07-01

The ImPACT (imaging performance assessment of CT scanners) CT patient dosimetry calculator is still used world-wide to estimate organ and effective doses (E) for computed tomography (CT) examinations, although the tool is based on Monte Carlo calculations reflecting practice in the early 1990’s. Subsequent developments in CT scanners, definitions of E, anthropomorphic phantoms, computers and radiation transport codes, have all fuelled an urgent need for updated organ dose conversion factors for contemporary CT. A new system for such simulations has been developed and satisfactorily tested. Benchmark comparisons of normalised organ doses presently derived for three old scanners (General Electric 9800, Philips Tomoscan LX and Siemens Somatom DRH) are within 5% of published values. Moreover, calculated normalised values of CT Dose Index for these scanners are in reasonable agreement (within measurement and computational uncertainties of  ±6% and  ±1%, respectively) with reported standard measurements. Organ dose coefficients calculated for a contemporary CT scanner (Siemens Somatom Sensation 16) demonstrate potential deviations by up to around 30% from the surrogate values presently assumed (through a scanner matching process) when using the ImPACT CT Dosimetry tool for newer scanners. Also, illustrative estimates of E for some typical examinations and a range of anthropomorphic phantoms demonstrate the significant differences (by some 10’s of percent) that can arise when changing from the previously adopted stylised mathematical phantom to the voxel phantoms presently recommended by the International Commission on Radiological Protection (ICRP), and when following the 2007 ICRP recommendations (updated from 1990) concerning tissue weighting factors. Further simulations with the validated dosimetry system will provide updated series of dose coefficients for a wide range of contemporary scanners.

Organizational Learning in Health Care Organizations

Directory of Open Access Journals (Sweden)

Savithiri Ratnapalan

2014-02-01

Full Text Available The process of collective education in an organization that has the capacity to impact an organization’s operations, performance and outcomes is called organizational learning. In health care organizations, patient care is provided through one or more visible and invisible teams. These teams are composed of experts and novices from diverse backgrounds working together to provide coordinated care. The number of teams involved in providing care and the possibility of breakdowns in communication and coordinated care increases in direct proportion to sophisticated technology and treatment strategies of complex disease processes. Safe patient care is facilitated by individual professional learning; inter-professional team learning and system based organizational learning, which encompass modified context specific learning by multiple teams and team members in a health care organization. Organizational learning in health care systems is central to managing the learning requirements in complex interconnected dynamic systems where all have to know common background knowledge along with shared meta-knowledge of roles and responsibilities to execute their assigned functions, communicate and transfer the flow of pertinent information and collectively provide safe patient care. Organizational learning in health care is not a onetime intervention, but a continuing organizational phenomenon that occurs through formal and informal learning which has reciprocal association with organizational change. As such, organizational changes elicit organizational learning and organizational learning implements new knowledge and practices to create organizational changes.

Estimation of nutrients and organic matter in Korean swine slurry using multiple regression analysis of physical and chemical properties.

Science.gov (United States)

Suresh, Arumuganainar; Choi, Hong Lim

2011-10-01

Swine waste land application has increased due to organic fertilization, but excess application in an arable system can cause environmental risk. Therefore, in situ characterizations of such resources are important prior to application. To explore this, 41 swine slurry samples were collected from Korea, and wide differences were observed in the physico-biochemical properties. However, significant (Phydrometer, EC meter, drying oven and pH meter were found useful to estimate Mn, Fe, Ca, K, Al, Na, N and 5-day biochemical oxygen demands (BOD₅) at improved R² values of 0.83, 0.82, 0.77, 0.75, 0.67, 0.47, 0.88 and 0.70, respectively. The results from this study suggest that multiple property regressions can facilitate the prediction of micronutrients and organic matter much better than a single property regression for livestock waste. Copyright © 2011 Elsevier Ltd. All rights reserved.

Multi-slice echo-planar spectroscopic MR imaging provides both global and local metabolite measures in multiple sclerosis

DEFF Research Database (Denmark)

Mathiesen, Henrik Kahr; Tscherning, Thomas; Sorensen, Per Soelberg

2005-01-01

MR spectroscopy (MRS) provides information about neuronal loss or dysfunction by measuring decreases in N-acetyl aspartate (NAA), a metabolite widely believed to be a marker of neuronal viability. In multiple sclerosis (MS), whole-brain NAA (WBNAA) has been suggested as a marker of disease...... progression and treatment efficacy in treatment trials, and the ability to measure NAA loss in specific brain regions early in the evolution of this disease may have prognostic value. Most spectroscopic studies to date have been limited to single voxels or nonlocalized measurements of WBNAA only......, measurements of metabolites in specific brain areas chosen after image acquisition (e.g., normal-appearing white matter (NAWM), gray matter (GM), and lesions) can be obtained. The identification and exclusion of regions that are inadequate for spectroscopic evaluation in global assessments can significantly...

Glutathione provides a source of cysteine essential for intracellular multiplication of Francisella tularensis.

Directory of Open Access Journals (Sweden)

Khaled Alkhuder

2009-01-01

Full Text Available Francisella tularensis is a highly infectious bacterium causing the zoonotic disease tularemia. Its ability to multiply and survive in macrophages is critical for its virulence. By screening a bank of HimarFT transposon mutants of the F. tularensis live vaccine strain (LVS to isolate intracellular growth-deficient mutants, we selected one mutant in a gene encoding a putative gamma-glutamyl transpeptidase (GGT. This gene (FTL_0766 was hence designated ggt. The mutant strain showed impaired intracellular multiplication and was strongly attenuated for virulence in mice. Here we present evidence that the GGT activity of F. tularensis allows utilization of glutathione (GSH, gamma-glutamyl-cysteinyl-glycine and gamma-glutamyl-cysteine dipeptide as cysteine sources to ensure intracellular growth. This is the first demonstration of the essential role of a nutrient acquisition system in the intracellular multiplication of F. tularensis. GSH is the most abundant source of cysteine in the host cytosol. Thus, the capacity this intracellular bacterial pathogen has evolved to utilize the available GSH, as a source of cysteine in the host cytosol, constitutes a paradigm of bacteria-host adaptation.

Application of multiple geochemical markers to investigate organic pollution in a dynamic coastal zone.

Science.gov (United States)

Liu, Liang-Ying; Wang, Ji-Zhong; Wong, Charles S; Qiu, Jian-Wen; Zeng, Eddy Y

2013-02-01

Multiple geochemical markers, including aliphatic hydrocarbons (n-alkanes), linear alkylbenzenes (LABs), and polycyclic aromatic hydrocarbons (PAHs), were employed to relate sediment organic chemical pollution in the coastal zone off South China to socioeconomic development there. Concentrations of Σn-C(15-35) (n-alkanes with 15-35 carbon atoms), ΣLAB (sum of C(10) to C(13) LABs), and Σ(26) PAH (sum of 26 PAH compounds) ranged from 110 to 3,160, 11 to 160, and 26 to 600 ng/g, with medians of 730, 40, and 230 ng/g, respectively. Natural hydrocarbons were mainly derived from terrestrial higher plant waxes, and in minor amounts from aquatic plankton and bacteria. Compositions of LABs indicated that considerable amounts of poorly treated wastewater had been directly discharged or transported to the eastern and western coastal areas of Guangdong Province. In addition, anthropogenic hydrocarbons were derived largely from vehicular emissions and combustion of domestic coal and biomass and to a lesser extent from oil spills. Eastern and western coastal sediments contained higher levels of LABs but lower levels of PAHs than those of the Pearl River Estuary, a coastal area of the Pearl River Delta. This spatial pattern of organic pollution was consistent with chemical use patterns. The eastern and western regions of Guangdong Province are economically less developed than the Pearl River Delta region, where more domestic wastewater treatment plants have been built. However, greater amounts of energy are consumed in the latter region to produce more combustion-derived PAH contamination. Copyright © 2012 SETAC.

Quantifying the Stock of Soil Organic Carbon using Multiple ...

African Journals Online (AJOL)

The stepwise multiple regression model was employed to identify ecological variables that explained significant variation of carbon in fallow soils. Using fallow genealogical cycles of 1st, 2nd, 3rd, 4th and 5th generations, soil and vegetation variables from 30 sampling plots were collected and subjected to linear regression ...

Organizational Enablers for Project Governance and Governmentality in Project-based Organizations

DEFF Research Database (Denmark)

Pemsel, Sofia; Müller, Ralf; Shao, Jingting

for governmentality belong mainly to the cultural-cognitive pillar. Collectively these OEs provide for an ambidexterity of flexibility and stability, which allows organizations to align their internal characteristics with their organizational context. Managerial and theoretical implications of the results......This study identifies organizational enablers (OEs) for governance and governmentality in the realm of projects in project-based organizations (PBOs). We use a multiple case study design with six firms in Sweden and China to identify OEs. Institutional theory serves as theoretical perspective...

Organizational Enablers for Project Governance and Governmentality in Project-based Organizations

DEFF Research Database (Denmark)

Müller, Ralf; Pemsel, Sofia; Shao, Jingting

2015-01-01

for governmentality belong mainly to the cultural–cognitive pillar. Collectively these OEs provide for an ambidexterity of flexibility and stability, which allows organizations to align their internal characteristics with their organizational context. Managerial and theoretical implications of the results......This study identifies organizational enablers (OEs) for governance and governmentality in the realm of projects in project-based organizations (PBOs). We use a multiple case study design with six firms in Sweden and China to identify OEs. Institutional theory serves as theoretical perspective...

Thyroid storm with multiple organ failure, disseminated intravascular coagulation, and stroke with a normal serum FT3 level.

Science.gov (United States)

Harada, Yuko; Akiyama, Hisanao; Yoshimoto, Tatsuji; Urao, Yasuko; Ryuzaki, Munekazu; Handa, Michiko

2012-01-01

Thyroid storm is a rare disorder with a sudden onset, rapid progression and high mortality. We experienced a case of thyroid storm which had a devastating course, including multiple organ failure (MOF), severe hypoglycemia, disseminated intravascular coagulation (DIC), and stroke. It was difficult to make a diagnosis of thyroid storm in the present patient, because she did not have a history of thyroid disease and her serum FT3 level was normal. Clinicians should be aware that thyroid storm can occur even when there is an almost normal level of thyroid hormones, and that intensive anticoagulation is required for patients with atrial fibrillation to prevent stroke after thyroid storm.

Leiomyosarcoma: A rare soft tissue cancer arising from multiple organs

Directory of Open Access Journals (Sweden)

Zorawar Singh

2018-03-01

Full Text Available Leiomyosarcoma (LMS, a smooth muscle connective tissue tumor, is a rare form of cancer which accounts for 5–10% of soft tissue sarcomas. This type of cancer is highly unpredictable. LMS is a resistant type of cancer and can remain in the dormant state for long time. It can recur in the later stages of life. LMS has been reported in different animals including humans. A wide literature search was done. The PubMed database was used to search for journal articles on the occurrence of LMS in different organs from 1950 to 2016. LMS has been reported to be associated with different organs, including esophagus, stomach, intestine, anus and uterus. In this article, an attempt has been made to review the studies based on occurrence of LMS with respect to the organs affected and frequency of publications. Finding the organ-associated occurrence of LMS may be useful in assessing the overall risk and formulating future cancer preventive strategies.

Contraception and fertility awareness among women with solid organ transplants.

Science.gov (United States)

French, Valerie A; Davis, John S; Sayles, Harlan S; Wu, Serena S

2013-10-01

To assess the contraception and fertility counseling provided to women with solid organ transplants. A telephone survey of 309 women aged 19-49 years who had received a solid organ transplant at the University of Nebraska Medical Center was performed. Of the 309 eligible women, 183 responded. Patients were asked 19 questions regarding pretransplant and posttransplant fertility awareness and contraception counseling. Data were summarized using descriptive statistics. Patients had undergone a variety of solid organ transplantations: 40% kidney (n=73); 32% liver (n=59); 6% pancreas (n=11); 5% heart (n=9); 3% intestine (n=5); and 14% multiple organs (n=26). Before their transplantations, 79 women (44%) reported they were not aware that a woman could become pregnant after transplantation. Only 66 women aged 13 and older at the time of transplantation reported that a health care provider discussed contraception before transplantation. Approximately half of women surveyed were using a method of contraception. Oral contraceptive pills were the most commonly recommended method. Twenty-two of the 31 pregnancies after organ transplantation were planned, which is higher than that of the general population. Few women with transplants are educated regarding the effect of organ transplantation on fertility and are not routinely counseled about contraception or the potential for posttransplant pregnancy. Health care providers should incorporate contraceptive and fertility counseling as part of routine care for women with solid organ transplants. : II.

The US Network of Pediatric Multiple Sclerosis Centers: Development, Progress, and Next Steps

Science.gov (United States)

Casper, T. Charles; Rose, John W.; Roalstad, Shelly; Waubant, Emmanuelle; Aaen, Gregory; Belman, Anita; Chitnis, Tanuja; Gorman, Mark; Krupp, Lauren; Lotze, Timothy E.; Ness, Jayne; Patterson, Marc; Rodriguez, Moses; Weinstock-Guttman, Bianca; Browning, Brittan; Graves, Jennifer; Tillema, Jan-Mendelt; Benson, Leslie; Harris, Yolanda

2014-01-01

Multiple sclerosis and other demyelinating diseases in the pediatric population have received an increasing level of attention by clinicians and researchers. The low incidence of these diseases in children creates a need for the involvement of multiple clinical centers in research efforts. The Network of Pediatric Multiple Sclerosis Centers was created initially in 2006 to improve the diagnosis and care of children with demyelinating diseases. In 2010, the Network shifted its focus to multicenter research while continuing to advance the care of patients. The Network has obtained support from the National Multiple Sclerosis Society, the Guthy-Jackson Charitable Foundation, and the National Institutes of Health. The Network will continue to serve as a platform for conducting impactful research in pediatric demyelinating diseases of the central nervous system. This article provides a description of the history and development, organization, mission, research priorities, current studies, and future plans of the Network. PMID:25270659

Self-organized criticality: An interplay between stable and turbulent regimes of multiple anodic double layers in glow discharge plasma

Science.gov (United States)

Alex, Prince; Carreras, Benjamin Andres; Arumugam, Saravanan; Sinha, Suraj Kumar

2018-05-01

The role of self-organized criticality (SOC) in the transformation of multiple anodic double layers (MADLs) from the stable to turbulent regime has been investigated experimentally as the system approaches towards critical behavior. The experiment was performed in a modified glow discharge plasma setup, and the initial stable state of MADL comprising three concentric perceptible layers was produced when the drift velocity of electrons towards the anode exceeds the electron thermal velocity (νd ≥ 1.3νte). The macroscopic arrangement of both positive and negative charges in opposite layers of MADL is attributed to the self-organization scenario. Beyond νd ≥ 3νte, MADL begins to collapse and approaches critical and supercritical states through layer reduction which continue till the last remaining layer of the double layer is transformed into a highly unstable radiant anode glow. The avalanche resulting from the collapse of MADL leads to the rise of turbulence in the system. Long-range correlations, a key signature of SOC, have been explored in the turbulent floating potential fluctuations using the rescaled-range analysis technique. The result shows that the existence of the self-similarity regime with self-similarity parameter H varies between 0.55 and 0.91 for time lags longer than the decorrelation time. The power law tail in the rank function, slowly decaying tail of the autocorrelation function, and 1/f behavior of the power spectra of the fluctuations are consistent with the fact that SOC plays a conclusive role in the transformation of MADL from the stable to turbulent regime. Since the existence of SOC gives a measure of complexity in the system, the result provides the condition under which complexity arises in cold plasma.

Automatic anatomy partitioning of the torso region on CT images by using multiple organ localizations with a group-wise calibration technique

Science.gov (United States)

Zhou, Xiangrong; Morita, Syoichi; Zhou, Xinxin; Chen, Huayue; Hara, Takeshi; Yokoyama, Ryujiro; Kanematsu, Masayuki; Hoshi, Hiroaki; Fujita, Hiroshi

2015-03-01

This paper describes an automatic approach for anatomy partitioning on three-dimensional (3D) computedtomography (CT) images that divide the human torso into several volume-of-interesting (VOI) images based on anatomical definition. The proposed approach combines several individual detections of organ-location with a groupwise organ-location calibration and correction to achieve an automatic and robust multiple-organ localization task. The essence of the proposed method is to jointly detect the 3D minimum bounding box for each type of organ shown on CT images based on intra-organ-image-textures and inter-organ-spatial-relationship in the anatomy. Machine-learning-based template matching and generalized Hough transform-based point-distribution estimation are used in the detection and calibration processes. We apply this approach to the automatic partitioning of a torso region on CT images, which are divided into 35 VOIs presenting major organ regions and tissues required by routine diagnosis in clinical medicine. A database containing 4,300 patient cases of high-resolution 3D torso CT images is used for training and performance evaluations. We confirmed that the proposed method was successful in target organ localization on more than 95% of CT cases. Only two organs (gallbladder and pancreas) showed a lower success rate: 71 and 78% respectively. In addition, we applied this approach to another database that included 287 patient cases of whole-body CT images scanned for positron emission tomography (PET) studies and used for additional performance evaluation. The experimental results showed that no significant difference between the anatomy partitioning results from those two databases except regarding the spleen. All experimental results showed that the proposed approach was efficient and useful in accomplishing localization tasks for major organs and tissues on CT images scanned using different protocols.

Multiple Wins, Multiple Organizations—How to Manage Institutional Interaction in Financing Forest Landscape Restoration (FLR

Directory of Open Access Journals (Sweden)

Astrid Carrapatoso

2018-03-01

Full Text Available By restoring forest ecosystems and fostering resilient and sustainable land use practices, Forest Landscape Restoration (FLR contributes to climate change mitigation, adaptation and sustainable development as well as the protection of biological diversity and combating desertification. This integrative approach provides the opportunity for multiple wins, but it necessitates the management of complex institutional interactions arising from the involvement of multiple international organizations. Focusing on the pivotal aspect of financing, this article surveys the landscape of public international institutions supporting FLR and analyzes the effectiveness of existing mechanisms of inter-institutional coordination and harmonization. Methodologically, our research is based on a document analysis, complemented by participant observation of the two Bonn Climate Change Conferences in May and November 2017 as well as the Global Landscapes Forum in December 2017. We find that financial institutions have established fairly effective rules for the management of positive and negative externalities through the introduction of co-benefits and safeguards. The fact that each institution has their own safeguards provisions, however, leads to significant transaction costs for recipient countries. In the discussion, we thus recommend that institutions should refrain from an unnecessary duplication of standards and focus on best practice.

Three-dimensional tracking of small aquatic organisms using fluorescent nanoparticles.

Science.gov (United States)

Ekvall, Mikael T; Bianco, Giuseppe; Linse, Sara; Linke, Heiner; Bäckman, Johan; Hansson, Lars-Anders

2013-01-01

Tracking techniques are vital for the understanding of the biology and ecology of organisms. While such techniques have provided important information on the movement and migration of large animals, such as mammals and birds, scientific advances in understanding the individual behaviour and interactions of small (mm-scale) organisms have been hampered by constraints, such as the sizes of existing tracking devices, in existing tracking methods. By combining biology, chemistry and physics we here present a method that allows three-dimensional (3D) tracking of individual mm-sized aquatic organisms. The method is based on in-vivo labelling of the organisms with fluorescent nanoparticles, so-called quantum dots, and tracking of the organisms in 3D via the quantum-dot fluorescence using a synchronized multiple camera system. It allows for the efficient and simultaneous study of the behaviour of one as well as multiple individuals in large volumes of observation, thus enabling the study of behavioural interactions at the community scale. The method is non-perturbing - we demonstrate that the labelling is not affecting the behavioural response of the organisms - and is applicable over a wide range of taxa, including cladocerans as well as insects, suggesting that our methodological concept opens up for new research fields on individual behaviour of small animals. Hence, this offers opportunities to focus on important biological, ecological and behavioural questions never before possible to address.

An agent-based simulation model of patient choice of health care providers in accountable care organizations.

Science.gov (United States)

Alibrahim, Abdullah; Wu, Shinyi

2018-03-01

Accountable care organizations (ACO) in the United States show promise in controlling health care costs while preserving patients' choice of providers. Understanding the effects of patient choice is critical in novel payment and delivery models like ACO that depend on continuity of care and accountability. The financial, utilization, and behavioral implications associated with a patient's decision to forego local health care providers for more distant ones to access higher quality care remain unknown. To study this question, we used an agent-based simulation model of a health care market composed of providers able to form ACO serving patients and embedded it in a conditional logit decision model to examine patients capable of choosing their care providers. This simulation focuses on Medicare beneficiaries and their congestive heart failure (CHF) outcomes. We place the patient agents in an ACO delivery system model in which provider agents decide if they remain in an ACO and perform a quality improving CHF disease management intervention. Illustrative results show that allowing patients to choose their providers reduces the yearly payment per CHF patient by $320, reduces mortality rates by 0.12 percentage points and hospitalization rates by 0.44 percentage points, and marginally increases provider participation in ACO. This study demonstrates a model capable of quantifying the effects of patient choice in a theoretical ACO system and provides a potential tool for policymakers to understand implications of patient choice and assess potential policy controls.

Combination Treatment of People with Multiple Sclerosis based on Collaboration between Conventional Healthcare Providers and Alternative Practitioners

DEFF Research Database (Denmark)

Skovgaard, Lasse; Launsø, Laila; Pedersen, Inge Kryger

2011-01-01

The use of alternative and complementary medicine (CAM) is prevalent among People with Multiple Sclerosis (PwMS) in Denmark as well as in other Western countries. Many PwMS combine conventional treatments and CAM; however there is little research-based knowledge about the outcomes that PwMS achieve...... from combined treatments. The purpose of this article is to describe which outcomes PwMS have experienced from combination treatment based on collaboration between conventional healthcare providers and CAM practitioners. A second purpose is to identify and study aspects of the courses of treatment...... that have generally characterized the achieved outcomes. During the course of their treatment, 59 PwMS participated in semi-structured individual or group interviews. The analyses show that the participants’ experienced outcomes can be classified in four ways 1) short-term positive outcomes; 2) long...

Multiplicity: An Explorative Interview Study on Personal Experiences of People with Multiple Selves.

Science.gov (United States)

Ribáry, Gergő; Lajtai, László; Demetrovics, Zsolt; Maraz, Aniko

2017-01-01

Background and aims: Personality psychology research relies on the notion that humans have a single self that is the result of the individual's thoughts, feelings, and behaviors that can be reliably described (i.e., through traits). People who identify themselves as "multiple" have a system of multiple or alternative, selves, that share the same physical body. This is the first study to explore the phenomenon of multiplicity by assessing the experiences of people who identify themselves as "multiple." Methods: First, an Internet forum search was performed using the terms "multiplicity" and "multiple system." Based on that search, people who identified themselves as multiple were contacted. Interviews were conducted by a consultant psychiatrist, which produced six case vignettes. Results: Multiplicity is discussed on Twitter, Tumblr, Google+ and several other personal websites, blogs, and forums maintained by multiples. According to the study's estimates, there are 200-300 individuals who participate in these forums and believe they are multiple. Based on the six interviews, it appears that multiples have several selves who are relatively independent of each other and constitute the personality's system. Each "resident person" or self, has their own unique behavioral pattern, which is triggered by different situations. However, multiples are a heterogeneous group in terms of their system organization, memory functions, and control over switching between selves. Conclusions: Multiplicity can be placed along a continuum between identity disturbance and dissociative identity disorder (DID), although most systems function relatively well in everyday life. Further research is needed to explore this phenomenon, especially in terms of the extent to which multiplicity can be regarded as a healthy way of coping.

Efficient organ localization using multi-label convolutional neural networks in thorax-abdomen CT scans

Science.gov (United States)

Efrain Humpire-Mamani, Gabriel; Arindra Adiyoso Setio, Arnaud; van Ginneken, Bram; Jacobs, Colin

2018-04-01

Automatic localization of organs and other structures in medical images is an important preprocessing step that can improve and speed up other algorithms such as organ segmentation, lesion detection, and registration. This work presents an efficient method for simultaneous localization of multiple structures in 3D thorax-abdomen CT scans. Our approach predicts the location of multiple structures using a single multi-label convolutional neural network for each orthogonal view. Each network takes extra slices around the current slice as input to provide extra context. A sigmoid layer is used to perform multi-label classification. The output of the three networks is subsequently combined to compute a 3D bounding box for each structure. We used our approach to locate 11 structures of interest. The neural network was trained and evaluated on a large set of 1884 thorax-abdomen CT scans from patients undergoing oncological workup. Reference bounding boxes were annotated by human observers. The performance of our method was evaluated by computing the wall distance to the reference bounding boxes. The bounding boxes annotated by the first human observer were used as the reference standard for the test set. Using the best configuration, we obtained an average wall distance of 3.20~+/-~7.33 mm in the test set. The second human observer achieved 1.23~+/-~3.39 mm. For all structures, the results were better than those reported in previously published studies. In conclusion, we proposed an efficient method for the accurate localization of multiple organs. Our method uses multiple slices as input to provide more context around the slice under analysis, and we have shown that this improves performance. This method can easily be adapted to handle more organs.

Multiple approaches for enhancing all-organic electronics photoluminescent sensors: Simultaneous oxygen and pH monitoring

International Nuclear Information System (INIS)

Liu, Rui; Xiao, Teng; Cui, Weipan; Shinar, Joseph; Shinar, Ruth

2013-01-01

Graphical abstract: -- Highlights: •Novel simply-fabricated all-organic electronics pH and oxygen optical monitor. •Excitation sources: directionally emitting, narrowed multicolor microcavity OLEDs. •Photodetectors: small molecule- or polymer-based with selective spectral responses. •Sensor film: structured high molecular weight polystyrene:polyethylene glycol blend. •×1.9 sensitivity enhancement and ×2.7 increase in the photoluminescence for oxygen. -- Abstract: Key issues in using organic light emitting diodes (OLEDs) as excitation sources in structurally integrated photoluminescence (PL)-based sensors are the low forward light outcoupling, the OLEDs’ broad electroluminescence (EL) bands, and the long-lived remnant EL that follows an EL pulse. The outcoupling issue limits the detection sensitivity (S) as only ∼20% of the light generated within standard OLEDs can be forward outcoupled and used for sensor probe excitation. The EL broad band interferes with the analyte-sensitive PL, leading to a background that reduces S and dynamic range. In particular, these issues hinder designing compact sensors, potentially miniaturizable, that are devoid of optical filters and couplers. We address these shortcomings by introducing easy-to-employ multiple approaches for outcoupling improvement, PL enhancement, and background EL reduction leading to novel, compact all-organic device architectures demonstrated for simultaneous monitoring of oxygen and pH. The sensor comprises simply-fabricated, directionally-emitting, narrower-band, multicolor microcavity OLED excitation and small molecule- and polymer-based organic photodetectors (OPDs) with a more selective spectral response. Additionally, S and PL intensity for oxygen are enhanced by using polystyrene (PS):polyethylene glycol (PEG) blends as the sensing film matrix. By utilizing higher molecular weight PS, the ratio τ 0 /τ 100 (PL decay time τ at 0% O 2 /τ at 100% O 2 ) that is often used to express S

CO2 and nutrient-driven changes across multiple levels of organization in Zostera noltii ecosystems

Science.gov (United States)

Martínez-Crego, B.; Olivé, I.; Santos, R.

2014-12-01

Increasing evidence emphasizes that the effects of human impacts on ecosystems must be investigated using designs that incorporate the responses across levels of biological organization as well as the effects of multiple stressors. Here we implemented a mesocosm experiment to investigate how the individual and interactive effects of CO2 enrichment and eutrophication scale-up from changes in primary producers at the individual (biochemistry) or population level (production, reproduction, and/or abundance) to higher levels of community (macroalgae abundance, herbivory, and global metabolism), and ecosystem organization (detritus release and carbon sink capacity). The responses of Zostera noltii seagrass meadows growing in low- and high-nutrient field conditions were compared. In both meadows, the expected CO2 benefits on Z. noltii leaf production were suppressed by epiphyte overgrowth, with no direct CO2 effect on plant biochemistry or population-level traits. Multi-level meadow response to nutrients was faster and stronger than to CO2. Nutrient enrichment promoted the nutritional quality of Z. noltii (high N, low C : N and phenolics), the growth of epiphytic pennate diatoms and purple bacteria, and shoot mortality. In the low-nutrient meadow, individual effects of CO2 and nutrients separately resulted in reduced carbon storage in the sediment, probably due to enhanced microbial degradation of more labile organic matter. These changes, however, had no effect on herbivory or on community metabolism. Interestingly, individual effects of CO2 or nutrient addition on epiphytes, shoot mortality, and carbon storage were attenuated when nutrients and CO2 acted simultaneously. This suggests CO2-induced benefits on eutrophic meadows. In the high-nutrient meadow, a striking shoot decline caused by amphipod overgrazing masked the response to CO2 and nutrient additions. Our results reveal that under future scenarios of CO2, the responses of seagrass ecosystems will be complex and

Knowledge management performance methodology regarding manufacturing organizations

Science.gov (United States)

Istrate, C.; Herghiligiu, I. V.

2016-08-01

The current business situation is extremely complicated. Business must adapt to the changes in order (a) to survive on the increasingly dynamic markets, (b) to meet customers’ new request for complex, customized and innovative products. In modern manufacturing organizations it can be seen a substantial improvement regarding the management of knowledge. This occurs due to the fact that organizations realized that knowledge and an efficient management of knowledge generates the highest value. Even it could be said that the manufacturing organizations were and are the biggest beneficiary of KM science. Knowledge management performance (KMP) evaluation in manufacturing organizations can be considered as extremely important because without measuring it, they are unable to properly assess (a) what goals, targets and activities must have continuity, (b) what must be improved and (c) what must be completed. Therefore a proper KM will generate multiple competitive advantages for organizations. This paper presents a developed methodological framework regarding the KMP importance regarding manufacturing organizations. This methodological framework was developed using as research methods: bibliographical research and a panel of specialists. The purpose of this paper is to improve the evaluation process of KMP and to provide a viable tool for manufacturing organizations managers.

Data and Decision Making: Same Organization, Different Perceptions; Different Organizations, Different Perceptions

Science.gov (United States)

Maxwell, Nan L.; Rotz, Dana; Garcia, Christina

2016-01-01

This study examines the perceptions of data-driven decision making (DDDM) activities and culture in organizations driven by a social mission. Analysis of survey information from multiple stakeholders in each of eight social enterprises highlights the wide divergence in views of DDDM. Within an organization, managerial and nonmanagerial staff…

Prevention of triplets and higher order multiples: trends in reproductive medicine.

Science.gov (United States)

Armour, Kim L; Callister, Lynn Clark

2005-01-01

In the United States and throughout the world, today's healthcare providers are challenged by the risks of multiple gestation pregnancy. Assisted reproductive technologies (ARTs) often used to treat infertility raise ethical issues including informed consent, veracity, and nonmalificence. In the United States, there is the need to improve maternal and fetal/neonatal mortality and morbidity by proposing legislation regulating ART and supporting single embryo transfers with no more than 2 such transfers. Beginning with the diagnosis of infertility, providers have a responsibility to educate, inform, and treat infertile couples. From the moment pregnancy with multiples is confirmed, these families are faced with incredible stressors including decision making on multifetal or selective reduction. Full disclosure of risks involved throughout the course of care should be discussed and documented in the record and plan of care. Currently in the United States, legislation does not regulate ART, including ovulation induction/enhancement and in vitro fertilization. Although the United States does have self-regulation via limited reporting through their professional organization and the Centers for Disease Control and Prevention, an unlimited number of embryos may be transferred. Unfortunately, many healthcare providers have not recognized the responsibility and burden placed on families and society as a whole. Lack of regulation means women may become pregnant with high order multiples, which raises serious moral and ethical issues.

The Relationship between Environmental Turbulence, Management Support, Organizational Collaboration, Information Technology Solution Realization, and Process Performance, in Healthcare Provider Organizations

Science.gov (United States)

Muglia, Victor O.

2010-01-01

The Problem: The purpose of this study was to investigate relationships between environmental turbulence, management support, organizational collaboration, information technology solution realization, and process performance in healthcare provider organizations. Method: A descriptive/correlational study of Hospital medical services process…

Density dependence governs when population responses to multiple stressors are magnified or mitigated.

Science.gov (United States)

Hodgson, Emma E; Essington, Timothy E; Halpern, Benjamin S

2017-10-01

Population endangerment typically arises from multiple, potentially interacting anthropogenic stressors. Extensive research has investigated the consequences of multiple stressors on organisms, frequently focusing on individual life stages. Less is known about population-level consequences of exposure to multiple stressors, especially when exposure varies through life. We provide the first theoretical basis for identifying species at risk of magnified effects from multiple stressors across life history. By applying a population modeling framework, we reveal conditions under which population responses from stressors applied to distinct life stages are either magnified (synergistic) or mitigated. We find that magnification or mitigation critically depends on the shape of density dependence, but not the life stage in which it occurs. Stressors are always magnified when density dependence is linear or concave, and magnified or mitigated when it is convex. Using Bayesian numerical methods, we estimated the shape of density dependence for eight species across diverse taxa, finding support for all three shapes. © 2017 by the Ecological Society of America.

A Robust Two-Phase Pumped Loop With Multiple Evaporators and Multiple Radiators, Phase I

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National Aeronautics and Space Administration — NASA's future spacecraft require advanced thermal management technologies to provide effective cooling for multiple instruments and reject heat through multiple...

Multiplicity: An Explorative Interview Study on Personal Experiences of People with Multiple Selves

Directory of Open Access Journals (Sweden)

Gergő Ribáry

2017-06-01

Full Text Available Background and aims: Personality psychology research relies on the notion that humans have a single self that is the result of the individual's thoughts, feelings, and behaviors that can be reliably described (i.e., through traits. People who identify themselves as “multiple” have a system of multiple or alternative, selves, that share the same physical body. This is the first study to explore the phenomenon of multiplicity by assessing the experiences of people who identify themselves as “multiple.”Methods: First, an Internet forum search was performed using the terms “multiplicity” and “multiple system.” Based on that search, people who identified themselves as multiple were contacted. Interviews were conducted by a consultant psychiatrist, which produced six case vignettes.Results: Multiplicity is discussed on Twitter, Tumblr, Google+ and several other personal websites, blogs, and forums maintained by multiples. According to the study's estimates, there are 200–300 individuals who participate in these forums and believe they are multiple. Based on the six interviews, it appears that multiples have several selves who are relatively independent of each other and constitute the personality's system. Each “resident person” or self, has their own unique behavioral pattern, which is triggered by different situations. However, multiples are a heterogeneous group in terms of their system organization, memory functions, and control over switching between selves.Conclusions: Multiplicity can be placed along a continuum between identity disturbance and dissociative identity disorder (DID, although most systems function relatively well in everyday life. Further research is needed to explore this phenomenon, especially in terms of the extent to which multiplicity can be regarded as a healthy way of coping.

[Multiple emissions in organic electroluminescent device using a mixed layer as an emitter].

Science.gov (United States)

Zhu, Wen-qing; Wu, You-zhi; Zheng, Xin-you; Jiang, Xue-yin; Zhang, Zhi-lin; Sun, Run-guang; Xu, Shao-hong

2005-04-01

A organic electroluminescent device has been fabricated by using a mixed layer as an emitter. The configuration of the device is ITO/TPD/TPD: PBD(equimole)/PBD/A1, in which TPD (N,N'-diphenyl-N,N'-bis(3-methylphenyl)-1,1'-biphenyl-4,4'-diamine) and PBD (2-(4'-biphenyl)-5-(4''-tert-butylphenyl)-1,3,4-oxadiazole) are used as hole transport material and electron transport material, respectively. Broad and red-shifted electroluminescent spectra related to the fluorescence of constituent materials were observed. It is suggested that the monomer, exciplex and electroplex emissions are simultaneously involved in EL spectra by comparison of the EL with the PL spectra and decomposition of the EL spectrum. The type of exciplex is the interaction between the excited state TPD (TPD*) and PBD in the ground state, and the type of electroplex is a (D+-A-)* complex by cross-recombination of hole on the charged hole transport molecule (D+) and electron on the charged electron transport molecule (A-). All types of excited states show different formation mechanisms and recombination processes under electric field. The change of emission strengths from monomer and excited complexes lead to a blue-shift of the emissive spectra with an increasing electric field. The maximum luminance and external quantum efficiency of this device are 240 cd x (cm2)(-1) and 0.49%, respectively. The emissions from exciplex or electroplex formation at the organic solid interface generally present a broad and red-shifted emissive band, providing an effective method for tuning of emission color in organic electroluminescent devices.

[Assessment of financial performance improves the quality of healthcare provided by medical organizations].

Science.gov (United States)

Afek, Arnon; Meilik, Ahuva; Rotstein, Zeev

2009-01-01

Today, medical organizations have to contend with a highly competitive environment, an atmosphere saturated with a multitude of innovative new technologies and ever-increasing costs. The ability of these organizations to survive and to develop and expand their services mandates adoption of management guidelines based on the world of finance/commerce, adapted to make them relevant to the world of medical service. In this article the authors chose to present a management administration assessment which is a process that ensures that the management will effectively administer the organization's resources, and meet the goals set by the organization. The system demands that hospital "centers of responsibility" be defined, a management information system be set up, activities be priced, budget be defined and the expenses assessed. These processes make it possible to formulate a budget and assess any possible deviation between the budget and the actual running costs. An assessment of deviations will reveal any possible deviation of the most significant factor--efficiency. Medical organization managers, with the cooperation of the directors of the "centers of responsibility", can assess subunit activities and gain an understanding of the significance of management decisions and thus improve the quality of management, and the medical organization. The goal of this management system is not only to Lower costs and to meet the financial goals that were set; it is a tool that ensures quality. Decreasing expenditure is important in this case, but is only secondary in importance and will be a result of reducing the costs incurred by services lacking in quality.

Familial pseudoxanthoma elasticum associated with multiple comedones

OpenAIRE

Maarouf, Melody; Sharon, Victoria R; Sivamani, Raja K; Prakash, Neha; Bipin, TH; Davis, Tracy; Shi, Vivian Y

2017-01-01

Pseudoxanthoma elasticum (PXE) is an autosomal recessive disorder characterized by atypical elastic fibers that causes connective tissue abnormalities of the skin, eyes, and heart, among other organs. The disorder is rare, with a classic presentation of yellow-orange cobblestone-like papules on flexural areas, lax skin, ocular degeneration, and moribund vasculature in multiple organs. There is wide variability in the presentation of the affected organs [1]. We present two sisters with classic...

Sexual dysfunction in multiple myeloma: survivorship care plan of the International Myeloma Foundation Nurse Leadership Board.

Science.gov (United States)

Richards, Tiffany A; Bertolotti, Page A; Doss, Deborah; McCullagh, Emily J

2011-08-01

The World Health Organization describes sexuality as a "central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy, and reproduction. Sexuality is influenced by the interaction of biological, psychological, social, economic, political, cultural, ethical, legal, historical, religious, and spiritual factors." Currently, no research has been conducted regarding sexual dysfunction in patients with multiple myeloma; therefore, information related to the assessment and evaluation of sexual dysfunction is gleaned from other malignancies and diseases. In this article, members of the International Myeloma Foundation's Nurse Leadership Board discuss the definition, presentation, and causes of sexual dysfunction; provide recommendations for sexual assessment practices; and promote discussion among patients with multiple myeloma, their healthcare providers, and their partners.

Applying Multiple Intelligences

Science.gov (United States)

Christodoulou, Joanna A.

2009-01-01

The ideas of multiple intelligences introduced by Howard Gardner of Harvard University more than 25 years ago have taken form in many ways, both in schools and in other sometimes-surprising settings. The silver anniversary of Gardner's learning theory provides an opportunity to reflect on the ways multiple intelligences theory has taken form and…

Three-dimensional tracking of small aquatic organisms using fluorescent nanoparticles.

Directory of Open Access Journals (Sweden)

Mikael T Ekvall

Full Text Available Tracking techniques are vital for the understanding of the biology and ecology of organisms. While such techniques have provided important information on the movement and migration of large animals, such as mammals and birds, scientific advances in understanding the individual behaviour and interactions of small (mm-scale organisms have been hampered by constraints, such as the sizes of existing tracking devices, in existing tracking methods. By combining biology, chemistry and physics we here present a method that allows three-dimensional (3D tracking of individual mm-sized aquatic organisms. The method is based on in-vivo labelling of the organisms with fluorescent nanoparticles, so-called quantum dots, and tracking of the organisms in 3D via the quantum-dot fluorescence using a synchronized multiple camera system. It allows for the efficient and simultaneous study of the behaviour of one as well as multiple individuals in large volumes of observation, thus enabling the study of behavioural interactions at the community scale. The method is non-perturbing - we demonstrate that the labelling is not affecting the behavioural response of the organisms - and is applicable over a wide range of taxa, including cladocerans as well as insects, suggesting that our methodological concept opens up for new research fields on individual behaviour of small animals. Hence, this offers opportunities to focus on important biological, ecological and behavioural questions never before possible to address.

Experimental investigation of multiple self-organized structures in plasma

International Nuclear Information System (INIS)

Ivan, L. M.; Gaman, C.; Aflori, M.; Mihai-Plugaru, M.; Dimitriu, D.G.; Lozneanu, E.; Sanduloviciu, M.

2005-01-01

Complex space charge configuration emerges by self-organization in front of an electrode immersed in plasma when its potential is increased at a certain critical value. Consisting from a nucleus protected from the surrounding plasma by an electrical double layer, the complexity reveals an internal structure and behaviour which remind us primitive organisms. Thus the complexity is not static but stationary open system in which continuous decay is constantly compensated by substance and energy from the surrounding plasma. Endowed with a special kind of memory the complexity can work as an intelligent multifunctional system and consequently it is also able to perform innovations after selective interaction with an environment in evolution. Additionally, the complexity is able to replicate by division. (authors)

Oxidation of organic pollutants on BDD anodes using modulated current electrolysis

International Nuclear Information System (INIS)

Panizza, M.; Kapalka, Agnieszka; Comninellis, Ch.

2008-01-01

In this paper, a theoretical model is presented for organic pollutants mineralization at high current efficiency (close to 100%) and low energy consumption on boron-doped diamond electrodes. The model is formulated for a perfect mixed electrochemical reactor operated as a batch recirculation system under multiple current steps, in which the applied current is adjusted during the electrolysis to be close to the limiting value. An experimental validation with the anodic oxidation of 3,4,5-trihydroxybenzoic acid is also provided. The results have shown that multiple current steps electrolysis and continuous current control allowed obtaining high oxidation rate and current efficiency

Oxidation of organic pollutants on BDD anodes using modulated current electrolysis

Energy Technology Data Exchange (ETDEWEB)

Panizza, M. [Department of Chemical and Process Engineering, University of Genoa, P.le J.F. Kennedy 1, 16129 Genova (Italy)], E-mail: marco.panizza@unige.it; Kapalka, Agnieszka [Institute of Chemical Sciences and Engineering, Ecole Polytechnique Federale de Lausanne (EPFL), CH-1015 Lausanne (Switzerland); Comninellis, Ch. [Institute of Chemical Sciences and Engineering, Ecole Polytechnique Federale de Lausanne (EPFL), CH-1015 Lausanne (Switzerland)], E-mail: christos.comninellis@epfl.ch

2008-01-01

In this paper, a theoretical model is presented for organic pollutants mineralization at high current efficiency (close to 100%) and low energy consumption on boron-doped diamond electrodes. The model is formulated for a perfect mixed electrochemical reactor operated as a batch recirculation system under multiple current steps, in which the applied current is adjusted during the electrolysis to be close to the limiting value. An experimental validation with the anodic oxidation of 3,4,5-trihydroxybenzoic acid is also provided. The results have shown that multiple current steps electrolysis and continuous current control allowed obtaining high oxidation rate and current efficiency.

Multiple organ gigantism caused by mutation in VmPPD gene in blackgram (Vigna mungo).

Science.gov (United States)

Naito, Ken; Takahashi, Yu; Chaitieng, Bubpa; Hirano, Kumi; Kaga, Akito; Takagi, Kyoko; Ogiso-Tanaka, Eri; Thavarasook, Charaspon; Ishimoto, Masao; Tomooka, Norihiko

2017-03-01

Seed size is one of the most important traits in leguminous crops. We obtained a recessive mutant of blackgram that had greatly enlarged leaves, stems and seeds. The mutant produced 100% bigger leaves, 50% more biomass and 70% larger seeds though it produced 40% less number of seeds. We designated the mutant as multiple-organ-gigantism ( mog ) and found the mog phenotype was due to increase in cell numbers but not in cell size. We also found the mog mutant showed a rippled leaf ( rl ) phenotype, which was probably caused by a pleiotropic effect of the mutation. We performed a map-based cloning and successfully identified an 8 bp deletion in the coding sequence of VmPPD gene, an orthologue of Arabidopsis PEAPOD ( PPD ) that regulates arrest of cell divisions in meristematic cells . We found no other mutations in the neighboring genes between the mutant and the wild type. We also knocked down GmPPD genes and reproduced both the mog and rl phenotypes in soybean. Controlling PPD genes to produce the mog phenotype is highly valuable for breeding since larger seed size could directly increase the commercial values of grain legumes.

Endovascular interventions for multiple trauma

International Nuclear Information System (INIS)

Kinstner, C.; Funovics, M.

2014-01-01

In recent years interventional radiology has significantly changed the management of injured patients with multiple trauma. Currently nearly all vessels can be reached within a reasonably short time with the help of specially preshaped catheters and guide wires to achieve bleeding control of arterial und venous bleeding. Whereas bleeding control formerly required extensive open surgery, current interventional methods allow temporary vessel occlusion (occlusion balloons), permanent embolization and stenting. In injured patients with multiple trauma preinterventional procedural planning is performed with the help of multidetector computed tomography whenever possible. Interventional radiology not only allows minimization of therapeutic trauma but also a considerably shorter treatment time. Interventional bleeding control has developed into a standard method in the management of vascular trauma of the chest and abdomen as well as in vascular injuries of the upper and lower extremities when open surgical access is associated with increased risk. Additionally, pelvic trauma, vascular trauma of the superior thoracic aperture and parenchymal arterial lacerations of organs that can be at least partially preserved are primarily managed by interventional methods. In an interdisciplinary setting interventional radiology provides a safe and efficient means of rapid bleeding control in nearly all vascular territories in addition to open surgical access. (orig.) [de

Otalgia and eschar in the external auditory canal in scrub typhus complicated by acute respiratory distress syndrome and multiple organ failure

Directory of Open Access Journals (Sweden)

Hu Sung-Yuan

2011-03-01

Full Text Available Abstract Background Scrub typhus, a mite-transmitted zoonosis caused by Orientia tsutsugamushi, is an endemic disease in Taiwan and may be potentially fatal if diagnosis is delayed. Case presentations We encountered a 23-year-old previously healthy Taiwanese male soldier presenting with the right ear pain after training in the jungle and an eleven-day history of intermittent high fever up to 39°C. Amoxicillin/clavulanate was prescribed for otitis media at a local clinic. Skin rash over whole body and abdominal cramping pain with watery diarrhea appeared on the sixth day of fever. He was referred due to progressive dyspnea and cough for 4 days prior to admission in our institution. On physical examination, there were cardiopulmonary distress, icteric sclera, an eschar in the right external auditory canal and bilateral basal rales. Laboratory evaluation revealed thrombocytopenia, elevation of liver function and acute renal failure. Chest x-ray revealed bilateral diffuse infiltration. Doxycycline was prescribed for scrub typhus with acute respiratory distress syndrome and multiple organ failure. Fever subsided dramatically the next day and he was discharged on day 7 with oral tetracycline for 7 days. Conclusion Scrub typhus should be considered in acutely febrile patients with multiple organ involvement, particularly if there is an eschar or a history of environmental exposure in endemic areas. Rapid and accurate diagnosis, timely administration of antibiotics and intensive supportive care are necessary to decrease mortality of serious complications of scrub typhus.

Providing the Missing Link: the Exposure Science Ontology ...

Science.gov (United States)

Although knowledge-discovery tools are new to the exposure science community, these tools are critical for leveraging exposure information to design health studies and interpret results for improved public health decisions. Standardized ontologies define relationships, allow for automated reasoning, and facilitate meta-analyses. ExO will facilitate development of biologically relevant exposure metrics, design of in vitro toxicity tests, and incorporation of information on susceptibility and background exposures for risk assessment. In this approach, there are multiple levels of organization, from the global environment down through ecosystems, communities, indoor spaces, populations, organisms, tissues, and cells. We anticipate that the exposure science and environmental health community will adopt and contribute to this work, as wide acceptance is key to integration and federated searching of exposure data to support environmental and public health research. In particular, we anticipate acceptance of the concept that exposure science provides the spatial/temporal narrative about the intensity (concentration) of a stressor at the boundary between two systems: one functioning as an “environment” (stressor) and one functioning as a target (receptor). An agreed-upon exposure ontology with clear definitions and relationships should help to facilitate decision-making, study design and prioritization of research initiatives by enhancing the capacity for data colle

Social Media Mashups: The Ordering and Disordering Role of Social Media Technologies in Organizations

DEFF Research Database (Denmark)

Albu, Oana Brindusa; Etter, Michael

This study explores how mashups (disconnected and mutable interactions from multiple locales to merge into communicative events) and social media (SM) exhibit interdependent agency across technologies, spaces and times. This study draws on communication constitutes organization (CCO), affordances...... and ethnographic perspectives to investigate the hybrid use of multiple SM in two organizations. The contributions of the study are twofold: Firstly, the findings detect practices of cross-association (‘exporting’ data across platforms) and cross-integration (‘importing’ content across technologies......) that are specific to hybrid SM use. Secondly, the findings indicate how the uses across, and communication through, SM enable forms of agency that could not or would not otherwise exist. This study advances organizational research by providing analytical insights concerning how SM introduce interconnected...

The use of interest rate swaps by nonprofit organizations: evidence from nonprofit health care providers.

Science.gov (United States)

Stewart, Louis J; Trussel, John

2006-01-01

Although the use of derivatives, particularly interest rate swaps, has grown explosively over the past decade, derivative financial instrument use by nonprofits has received only limited attention in the research literature. Because little is known about the risk management activities of nonprofits, the impact of these instruments on the ability of nonprofits to raise capital may have significant public policy implications. The primary motivation of this study is to determine the types of derivatives used by nonprofits and estimate the frequency of their use among these organizations. Our study also extends contemporary finance theory by an empirical examination of the motivation for interest rate swap usage among nonprofits. Our empirical data came from 193 large nonprofit health care providers that issued debt to the public between 2000 and 2003. We used a univariate analysis and a multivariate analysis relying on logistic regression models to test alternative explanations of interest rate swaps usage by nonprofits, finding that more than 45 percent of our sample, 88 organizations, used interest rate swaps with an aggregate notional value in excess of $8.3 billion. Our empirical tests indicate the primary motive for nonprofits to use interest rate derivatives is to hedge their exposure to interest rate risk. Although these derivatives are a useful risk management tool, under conditions of falling bond market interest rates these derivatives may also expose a nonprofit swap user to the risk of a material unscheduled termination payment. Finally, we found considerable diversity in the informativeness of footnote disclosure among sample organizations that used interest rate swaps. Many nonprofits did not disclose these risks in their financial statements. In conclusion, we find financial managers in large nonprofits commonly use derivative financial instruments as risk management tools, but the use of interest rate swaps by nonprofits may expose them to other risks

Survey of Nongovernmental Organizations Providing Pediatric Cardiovascular Care in Low- and Middle-Income Countries

Science.gov (United States)

Nguyen, Nguyenvu; Jacobs, Jeffrey P.; Dearani, Joseph A.; Weinstein, Samuel; Novick, William M.; Jacobs, Marshall L.; Massey, Jeremy; Pasquali, Sara K.; Walters, Henry L.; Drullinsky, David; Stellin, Giovanni; Tchervenkov, Christo I.

2014-01-01

Background Nearly 90% of the children with heart disease in low- and middle-income countries (LMICs) cannot access cardiovascular (CV) services. Limitations include inadequate financial, human, and infrastructure resources. Nongovernmental organizations (NGOs) have played crucial roles in providing clinical services and infrastructure supports to LMICs CV programs; however, these outreach efforts are dispersed, inadequate, and lack coordination. Methods A survey was sent to members of the World Society for Pediatric and Congenital Heart Society and PediHeart. Results A clearinghouse was created to provide information on NGO structures, geographic reach, and scope of services. The survey identified 80 NGOs supporting CV programs in 92 LMICs. The largest outreach efforts were in South and Central America (42%), followed by Africa (18%), Europe (17%), Asia (17%), and Asia-Western Pacific (6%). Most NGOs (51%) supported two to five outreach missions per year. The majority (87%) of NGOs provided education, diagnostics, and surgical or catheter-based interventions. Working jointly with LMIC partners, 59% of the NGOs performed operations in children and infants; 41% performed nonbypass neonatal operations. Approximately a quarter (26%) reported that partner sites do not perform interventions in between missions. Conclusions Disparity and inadequacy in pediatric CV services remain an important problem for LMICs. A global consensus and coordinated efforts are needed to guide strategies on the development of regional centers of excellence, a global outcome database, and a CV program registry. Future efforts should be held accountable for impacts such as growth in the number of independent LMIC programs as well as reduction in mortality and patient waiting lists. PMID:24668973

The Spleen: A forgotten organ

International Nuclear Information System (INIS)

Castrillon German; Montoya Maria del Pilar; Echeverri Santiago

2010-01-01

The spleen has traditionally been regarded as an orphan organ. Its embryological development is described together with the digestive system, although it is not part of the gastrointestinal tract. Its main function is during the early fetal development when it produces both red and white blood cells, losing this function during the late fetal life. Nevertheless, the spleen continues to work as a filter for blood cells and also has important immune functions. As it is not necessary for the preservation of vital life functions, the spleen receives limited attention by both radiologists and clinicians. It is, however, an organ with multiple pathological conditions that have representation in the different diagnostic imaging modalities; radiologists, therefore, must be aware of these conditions and their radiological characteristics. This article provides a diagnostic approach to the most common diseases affecting the spleen using tomography and magnetic resonance.

Organic thermometry for chondritic parent bodies

Science.gov (United States)

Cody, G. D.; Alexander, C. M. O'D.; Yabuta, H.; Kilcoyne, A. L. D.; Araki, T.; Ade, H.; Dera, P.; Fogel, M.; Militzer, B.; Mysen, B. O.

2008-07-01

A unique spectroscopic feature has been identified in a study of twenty-five different samples of meteoritic insoluble organic matter (IOM) spanning multiple chemical classes, groups, and petrologic types, using carbon X-ray Absorption Near Edge Structure (XANES) spectroscopy. The intensity of this feature, a 1s - σ* exciton, appears to provide a precise measure of parent body metamorphism. The intensity of this exciton is also shown to correlate well with a large negative paramagnetic shift observed through solid state 13C NMR. Experiments reveal that upon heating primitive IOM is transformed into material that is indistinguishable from that in thermally processed chondrites, including the development of the 1s - σ* exciton. A thermo-kinetic expression is derived from the experimental data that allows the intensity of the 1s - σ* exciton to be used to estimated the effective temperature integrated over time. A good correlation is observed between the intensity of the 1s - σ* exciton and previously published microRaman spectral data. These data provide a self-consistent organic derived temperature scale for the purpose of calibrating Raman based thermometric expressions.

Diagnostic radiology on multiple injured patients: interdisciplinary management

International Nuclear Information System (INIS)

Linsenmaier, U.; Pfeifer, K.J.; Kanz, K.G.; Mutschler, W.

2001-01-01

The presence of a radiologist within the admitting area of an emergency department and his capability as a member of the trauma team have a major impact on the role of diagnostic radiology in trauma care. The knowledge of clinical decision criteria, algorithms, and standards of patient care are essential for the acceptance within a trauma team. We present an interdisciplinary management concept of diagnostic radiology for trauma patients, which comprises basic diagnosis, organ diagnosis, radiological ABC, and algorithms of early clinical care. It is the result of a prospective study comprising over 2000 documented multiple injured patients. The radiologist on a trauma team should support trauma surgery and anesthesia in diagnostic and clinical work-up. The radiological ABC provides a structured approach for diagnostic imaging in all steps of the early clinical care of the multiple injured patient. Radiological ABC requires a reevaluation in cases of equivocal findings or difficulties in the clinical course. Direct communication of radiological findings with the trauma team enables quick clinical decisions. In addition, the radiologist can priority-oriented influence the therapy by using interventional procedures. The clinical radiologist is an active member of the interdisciplinary trauma team, not only providing diagnostic imaging but also participating in clinical decisions. (orig.) [de

Generalized internal multiple imaging

KAUST Repository

Zuberi, Mohammad Akbar Hosain

2014-12-04

Various examples are provided for generalized internal multiple imaging (GIMI). In one example, among others, a method includes generating a higher order internal multiple image using a background Green\\'s function and rendering the higher order internal multiple image for presentation. In another example, a system includes a computing device and a generalized internal multiple imaging (GIMI) application executable in the computing device. The GIMI application includes logic that generates a higher order internal multiple image using a background Green\\'s function and logic that renders the higher order internal multiple image for display on a display device. In another example, a non-transitory computer readable medium has a program executable by processing circuitry that generates a higher order internal multiple image using a background Green\\'s function and renders the higher order internal multiple image for display on a display device.

Generalized internal multiple imaging

KAUST Repository

Zuberi, Mohammad Akbar Hosain; Alkhalifah, Tariq

2014-01-01

Various examples are provided for generalized internal multiple imaging (GIMI). In one example, among others, a method includes generating a higher order internal multiple image using a background Green's function and rendering the higher order internal multiple image for presentation. In another example, a system includes a computing device and a generalized internal multiple imaging (GIMI) application executable in the computing device. The GIMI application includes logic that generates a higher order internal multiple image using a background Green's function and logic that renders the higher order internal multiple image for display on a display device. In another example, a non-transitory computer readable medium has a program executable by processing circuitry that generates a higher order internal multiple image using a background Green's function and renders the higher order internal multiple image for display on a display device.

Development of a statistical shape model of multi-organ and its performance evaluation

International Nuclear Information System (INIS)

Nakada, Misaki; Shimizu, Akinobu; Kobatake, Hidefumi; Nawano, Shigeru

2010-01-01

Existing statistical shape modeling methods for an organ can not take into account the correlation between neighboring organs. This study focuses on a level set distribution model and proposes two modeling methods for multiple organs that can take into account the correlation between neighboring organs. The first method combines level set functions of multiple organs into a vector. Subsequently it analyses the distribution of the vectors of a training dataset by a principal component analysis and builds a multiple statistical shape model. Second method constructs a statistical shape model for each organ independently and assembles component scores of different organs in a training dataset so as to generate a vector. It analyses the distribution of the vectors of to build a statistical shape model of multiple organs. This paper shows results of applying the proposed methods trained by 15 abdominal CT volumes to unknown 8 CT volumes. (author)

The problem of multiple carcinomas

International Nuclear Information System (INIS)

Kegel, W.; Schmieder, A.

1982-01-01

This retrospective study reports on the occurrence of multiple carcinomas among the patients of our Department of Radiotherapy. Examination of 1290 patients during 1978 to 1980 showed in 76 cases (5.8%) simultaneously or successively secondary or tertiary tumours. These multiple tumours were most frequent in the mammary gland, in the female genital organs and in the respiratory system. Women had an incidence which was double of that displayed by men. Diagnosis and therapy of malignant tumours must always consider the possibility of multiplicity of carcinomas, either simultaneously or succesively, appearing spontaneously or as a result of iatrogenic influences. This applies in particular to the multicentric and bilateral occurrence of the early types of cancer of the female breast. (orig.) [de

Microfluidic-Based Multi-Organ Platforms for Drug Discovery

Directory of Open Access Journals (Sweden)

Ahmad Rezaei Kolahchi

2016-09-01

Full Text Available Development of predictive multi-organ models before implementing costly clinical trials is central for screening the toxicity, efficacy, and side effects of new therapeutic agents. Despite significant efforts that have been recently made to develop biomimetic in vitro tissue models, the clinical application of such platforms is still far from reality. Recent advances in physiologically-based pharmacokinetic and pharmacodynamic (PBPK-PD modeling, micro- and nanotechnology, and in silico modeling have enabled single- and multi-organ platforms for investigation of new chemical agents and tissue-tissue interactions. This review provides an overview of the principles of designing microfluidic-based organ-on-chip models for drug testing and highlights current state-of-the-art in developing predictive multi-organ models for studying the cross-talk of interconnected organs. We further discuss the challenges associated with establishing a predictive body-on-chip (BOC model such as the scaling, cell types, the common medium, and principles of the study design for characterizing the interaction of drugs with multiple targets.

The role of NIGMS P50 sponsored team science in our understanding of multiple organ failure.

Science.gov (United States)

Moore, Frederick A; Moore, Ernest E; Billiar, Timothy R; Vodovotz, Yoram; Banerjee, Anirban; Moldawer, Lyle L

2017-09-01

The history of the National Institute of General Medical Sciences (NIGMS) Research Centers in Peri-operative Sciences (RCIPS) is the history of clinical, translational, and basic science research into the etiology and treatment of posttraumatic multiple organ failure (MOF). Born out of the activism of trauma and burn surgeons after the Viet Nam War, the P50 trauma research centers have been a nidus of research advances in the field and the training of future academic physician-scientists in the fields of trauma, burns, sepsis, and critical illness. For over 40 years, research conducted under the aegis of this funding program has led to numerous contributions at both the bedside and at the bench. In fact, it has been this requirement for team science with a clinician-scientist working closely with basic scientists from multiple disciplines that has led the RCIPS to its unrivaled success in the field. This review will briefly highlight some of the major accomplishments of the RCIPS program since its inception, how they have both led and evolved as the field moved steadily forward, and how they are responsible for much of our current understanding of the etiology and pathology of MOF. This review is not intended to be all encompassing nor a historical reference. Rather, it serves as recognition to the foresight and support of many past and present individuals at the NIGMS and at academic institutions who have understood the cost of critical illness and MOF to the individual and to society.

Job satisfaction among multiple sclerosis certified nurses.

Science.gov (United States)

Gulick, Elsie E; Halper, June; Costello, Kathleen

2007-08-01

Several studies document high levels of job satisfaction among certified nurses, but no study has examined job satisfaction and factors influencing job satisfaction of certified multiple sclerosis (MS) nurses. This study tested a theoretical model proposing that two organizational factors, colleague relationships and benefits, will predict job satisfaction. Job satisfaction was represented by four factors: autonomy, professional status, professional growth, and time efficiency. Participants included MS nurses certified for 6 months or more practicing mostly in three countries (Canada, Great Britain, and the United States) who anonymously completed the Misener Nurse Practitioner Job Satisfaction Scale, an overall job satisfaction rating, and demographic information. Findings indicate that colleague relationships and benefits significantly estimated organization structure and that autonomy, professional status, professional growth, and time efficiency significantly estimated job satisfaction; furthermore, organization factors such as colleague relationships and benefits significantly predict job satisfaction. Among the countries, several statistically significant differences were observed between job satisfaction factors as well as items in both organization and job satisfaction subscales. Average factor scores among the countries were mostly rated satisfactory. The International Organization of Multiple Sclerosis Nurses Executive Board plans to use the study findings to see how it needs to focus efforts as an organization toward enhancing and standardizing MS care and develop MS nurse professionalism worldwide.

Organ Transplantation: Frequently Asked Questions

Science.gov (United States)

... to know FAQ Living donation What is living donation? Organs Types Being a living donor First steps Being ... brochures What Every Patient Needs to Know Living Donation Multiple Listing Visit UNOS Store Learn more How organs are matched How to become a living donor ...

Identifying preferred format and source of exercise information in persons with multiple sclerosis that can be delivered by health-care providers.

Science.gov (United States)

Learmonth, Yvonne C; Adamson, Brynn C; Balto, Julia M; Chiu, Chung-Yi; Molina-Guzman, Isabel M; Finlayson, Marcia; Riskin, Barry J; Motl, Robert W

2017-10-01

There is increasing recognition of the benefits of exercise in individuals with multiple sclerosis (MS), yet the MS population does not engage in sufficient amounts of exercise to accrue health benefits. There has been little qualitative inquiry to establish the preferred format and source for receiving exercise information from health-care providers among persons with MS. We sought to identify the desired and preferred format and source of exercise information for persons with MS that can be delivered through health-care providers. Participants were adults with MS who had mild or moderate disability and participated in a range of exercise levels. All participants lived in the Midwest of the United States. Fifty semi-structured interviews were conducted and analysed using thematic analysis. Two themes emerged, (i) approach for receiving exercise promotion and (ii) ideal person for promoting exercise. Persons with MS want to receive exercise information through in-person consultations with health-care providers, print media and electronic media. Persons with MS want to receive exercise promotion from health-care providers with expertise in MS (ie neurologists) and with expertise in exercise (eg physical therapists). These data support the importance of understanding how to provide exercise information to persons with MS and identifying that health-care providers including neurologists and physical therapists should be involved in exercise promotion. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Organizational resilience: Nonprofit organizations' response to change.

Science.gov (United States)

Witmer, Hope; Mellinger, Marcela Sarmiento

2016-05-24

Organizational resilience refers to the ability to respond productively to significant disruptive change and transform challenges into opportunities. There is a gap in the literature about resilient nonprofit organizations and its application for identifying organizational conditions for successful adaption to external variables that threaten their existence. The aim of this study was to identify organizational characteristics that point to the resilience of nonprofit behavioral healthcare organizations as they successfully adapt to funding changes. A multiple case study of two behavioral health nonprofit organizations was conducted. Data was collected through interviews and focus groups, and analyzed through a qualitative content analysis. Using the framework of resilience, six themes that equipped these organizations to successfully adapt to funding changes were identified. They included: commitment to the mission, improvisation, community reciprocity, servant and transformational leadership, hope and optimism, and fiscal transparency. The findings suggest that incorporating these qualities into an organizational system equips it to systematically adapt to funding changes and other disruptive challenges. Using resilience as a process and not simply an outcome after recovery, nonprofit organizations can have the capacity to continuously respond to challenges and provide uninterrupted and valuable services to society.

MULTIPLE PROJECT MANAGEMENT IN THE CONSTRUCTION INDSUTRY

Directory of Open Access Journals (Sweden)

Luciana Hazin Alencar

2010-06-01

Full Text Available The field of project management has historically focused on the administration of one project at a time, a focus that is insufficient given the growing need for organizations to manage multiple projects simultaneously. The requirements of Multiple Project Management (MPM involves demands and practices that are different from those of single projects. MPM poses a special need for coordination of shared resources across multiple projects in a way that can maintain the firm’s strategic focus and facilitate effective decision making. The construction industry is noteworthy for its frequent need for the management of multiple projects. This paper offers a review of the last five years of indexed literature related to multiple project management in the construction industry, identifies gaps and suggests promising new avenues of inquiry.

Simultaneous heat integration and techno-economic optimization of Organic Rankine Cycle (ORC) for multiple waste heat stream recovery

International Nuclear Information System (INIS)

Yu, Haoshui; Eason, John; Biegler, Lorenz T.; Feng, Xiao

2017-01-01

In the past decades, the Organic Rankine Cycle (ORC) has become a promising technology for low and medium temperature energy utilization. In refineries, there are usually multiple waste heat streams to be recovered. From a safety and controllability perspective, using an intermedium (hot water) to recover waste heat before releasing heat to the ORC system is more favorable than direct integration. The mass flowrate of the intermediate hot water stream determines the amount of waste heat recovered and the final hot water temperature affects the thermal efficiency of ORC. Both, in turn, exert great influence on the power output. Therefore, the hot water mass flowrate is a critical decision variable for the optimal design of the system. This study develops a model for techno-economic optimization of an ORC with simultaneous heat recovery and capital cost optimization. The ORC is modeled using rigorous thermodynamics with the concept of state points. The task of waste heat recovery using the hot water intermedium is modeled using the Duran-Grossmann model for simultaneous heat integration and process optimization. The combined model determines the optimal design of an ORC that recovers multiple waste heat streams in a large scale background process using an intermediate heat transfer stream. In particular, the model determines the optimal heat recovery approach temperature (HRAT), the utility load of the background process, and the optimal operating conditions of the ORC simultaneously. The effectiveness of this method is demonstrated with a case study that uses a refinery as the background process. Sensitivity of the optimal solution to the parameters (electricity price, utility cost) is quantified in this paper. - Highlights: • A new model for Organic Rankine cycle design optimization is presented. • Process heat integration and ORC are considered simultaneously. • Rigorous equation oriented models of the ORC are used for accurate results. • Impact of working

Multiple primary cancer

International Nuclear Information System (INIS)

Jung, Gyu Sik; Lee, Ouk; Kim, So Sun; Kim, Ho Joon; Chun, Byung Hee; Joh, Young Duck

1989-01-01

It is rare for one human being to be afflicted with more than one cancer. However with further advances in therapeutic regimens, histopathologic observation, diagnostic modalities, and increased curiosity, there are increasing number of case reports of multiple primary cancer. The present study evaluates 25 histologically confirmed cases of multiple primary cancer from 1974 to 1988 at Kosin Medical Center. The most frequent site of the first primary cancer in male was stomach and in female, uterine cervix. The first primary cancer in female occurred in endocrine-related organs (breast, uterus and thyroid) in 63.6 percent. Synchronous cancers are diagnosed simultaneously or within an interval of about six months and synchronous cancers were 16 out of 25 cases. Metachronous cancers are diagnosed at interval of more than six months. There were 9 metachronous cancers and average interval between the first and second primary cancer was 22.8 months. The incidence of multiple primary cancer was 0.11 percent. The average age was 51.9 years at the time of the first primary cancer (53.1 years in male and 50.3 years in female). CT scan was most helpful in early detection of multiple primary cancers facilitating biopsy and surgery. Multiple primary cancers are beyond the medical curiosity. Early diagnosis of the disease and careful follow-up study, based on an awareness of the possibility of second cancers, will substantially increase the survival of these patients

A Behavioral Framework for Managing Massive Airline Flight Disruptions through Crisis Management, Organization Development, and Organization Learning

Science.gov (United States)

Larsen, Tulinda Deegan

In this study the researcher provides a behavioral framework for managing massive airline flight disruptions (MAFD) in the United States. Under conditions of MAFD, multiple flights are disrupted throughout the airline's route network, customer service is negatively affected, additional costs are created for airlines, and governments intervene. This study is different from other studies relating to MAFD that have focused on the operational, technical, economic, financial, and customer service impacts. The researcher argues that airlines could improve the management of events that led to MAFD by applying the principles of crisis management where the entire organization is mobilized, rather than one department, adapting organization development (OD) interventions to implement change and organization learning (OL) processes to create culture of innovation, resulting in sustainable improvement in customer service, cost reductions, and mitigation of government intervention. At the intersection of crisis management, OD, and OL, the researcher has developed a new conceptual framework that enhances the resiliency of individuals and organizations in responding to unexpected-yet-recurring crises (e.g., MAFD) that impact operations. The researcher has adapted and augmented Lalonde's framework for managing crises through OD interventions by including OL processes. The OD interventions, coupled with OL, provide a framework for airline leaders to manage more effectively events that result in MAFD with the goal of improving passenger satisfaction, reducing costs, and preventing further government intervention. Further research is warranted to apply this conceptual framework to unexpected-yet-recurring crises that affect operations in other industries.

Multiple intelligences: Can they be measured?

OpenAIRE

Kirsi Tirri; Petri Nokelainen; Erkki Komulainen

2013-01-01

This paper is about issues relating to the assessment of multiple intelligences. The first section introduces the authors’ work on building measures of multiple intelligences and moral sensitivities. It also provides a conceptual definition of multiple intelligences based on Multiple Intelligences theory by Howard Gardner (1983). The second section discusses the context specificity of intelligences and alternative approaches to measuring multiple intelligences. The third section analyses the ...

Luminance mechanisms in green organic light-emitting devices fabricated utilizing tris(8-hydroxyquinoline)aluminum/4,7-diphenyl-1, 10-phenanthroline multiple heterostructures acting as an electron transport layer.

Science.gov (United States)

Choo, Dong Chul; Seo, Su Yul; Kim, Tae Whan; Jin, You Young; Seo, Ji Hyun; Kim, Young Kwan

2010-05-01

The electrical and the optical properties in green organic light-emitting devices (OLEDs) fabricated utilizing tris(8-hydroxyquinoline)aluminum (Alq3)/4,7-diphenyl-1,10-phenanthroline (BPhen) multiple heterostructures acting as an electron transport layer (ETL) were investigated. The operating voltage of the OLEDs with a multiple heterostructure ETL increased with increasing the number of the Alq3/BPhen heterostructures because more electrons were accumulated at the Alq3/BPhen heterointerfaces. The number of the leakage holes existing in the multiple heterostructure ETL of the OLEDs at a low voltage range slightly increased due to an increase of the internal electric field generated from the accumulated electrons at the Alq3/BPhen heterointerface. The luminance efficiency of the OLEDs with a multiple heterostructure ETL at a high voltage range became stabilized because the increase of the number of the heterointerface decreased the quantity of electrons accumulated at each heterointerface.

Management Challenges of Launching Multiple Payloads for Multiple Customers

OpenAIRE

Callen, Dave

1999-01-01

Orbital has provided launch services for multiple satellites as a means to provide greater economy for access to space. These include satellites from NASA, 000, commercial companies, universities, and foreign governments. While satellite customers view shared launches as a means to achieve reduced launch costs, this approach adds many complexities that a traditional launch service provider does not have to address for a dedicated launch. This paper will discuss some of the challenges associat...

Providing Students with Interdisciplinary Support to Improve Their Organic Chemistry Posters

Science.gov (United States)

Widanski, Bozena; Thompson, Jo Ann; Foran-Mulcahy, Katie; Abafo, Amy

2016-01-01

A two-semester-long interdisciplinary support effort to improve student posters in organic chemistry lab is described. In the first semester, students' literature search report is supported by a workshop conducted by an Instruction Librarian. During the subsequent semester, a second workshop is presented by the Instruction Librarian, an English…

Exponential Self-Organization and Moore’s Law: Measures and Mechanisms

Directory of Open Access Journals (Sweden)

Georgi Yordanov Georgiev

2017-01-01

Full Text Available The question of how complex systems become more organized and efficient with time is open. Examples are the formation of elementary particles from pure energy, the formation of atoms from particles, the formation of stars and galaxies, and the formation of molecules from atoms, of organisms, and of the society. In this sequence, order appears inside complex systems and randomness (entropy is expelled to their surroundings. Key features of self-organizing systems are that they are open and they are far away from equilibrium, with increasing energy flows through them. This work searches for global measures of such self-organizing systems, which are predictable and do not depend on the substrate of the system studied. Our results will help to understand the existence of complex systems and mechanisms of self-organization. In part we also provide insights, in this work, about the underlying physical essence of Moore’s law and the multiple logistic growth observed in technological progress.

Supporting children when providing services to families experiencing multiple problems : Perspectives and evidence on programmes

NARCIS (Netherlands)

Knorth, Erik J.; Knot-Dickscheit, Jana; Thoburn, June

2015-01-01

Recently, there has been growing interest amongst researchers, practitioners and policy-makers in approaches to understanding and ways of helping parents, children and the communities in which they live to respond to ‘families experiencing multiple problems’ (FEMPs). There is a strong need for

A higher-order generalized singular value decomposition for comparison of global mRNA expression from multiple organisms.

Directory of Open Access Journals (Sweden)

Sri Priya Ponnapalli

Full Text Available The number of high-dimensional datasets recording multiple aspects of a single phenomenon is increasing in many areas of science, accompanied by a need for mathematical frameworks that can compare multiple large-scale matrices with different row dimensions. The only such framework to date, the generalized singular value decomposition (GSVD, is limited to two matrices. We mathematically define a higher-order GSVD (HO GSVD for N≥2 matrices D(i∈R(m(i × n, each with full column rank. Each matrix is exactly factored as D(i=U(iΣ(iV(T, where V, identical in all factorizations, is obtained from the eigensystem SV=VΛ of the arithmetic mean S of all pairwise quotients A(iA(j(-1 of the matrices A(i=D(i(TD(i, i≠j. We prove that this decomposition extends to higher orders almost all of the mathematical properties of the GSVD. The matrix S is nondefective with V and Λ real. Its eigenvalues satisfy λ(k≥1. Equality holds if and only if the corresponding eigenvector v(k is a right basis vector of equal significance in all matrices D(i and D(j, that is σ(i,k/σ(j,k=1 for all i and j, and the corresponding left basis vector u(i,k is orthogonal to all other vectors in U(i for all i. The eigenvalues λ(k=1, therefore, define the "common HO GSVD subspace." We illustrate the HO GSVD with a comparison of genome-scale cell-cycle mRNA expression from S. pombe, S. cerevisiae and human. Unlike existing algorithms, a mapping among the genes of these disparate organisms is not required. We find that the approximately common HO GSVD subspace represents the cell-cycle mRNA expression oscillations, which are similar among the datasets. Simultaneous reconstruction in the common subspace, therefore, removes the experimental artifacts, which are dissimilar, from the datasets. In the simultaneous sequence-independent classification of the genes of the three organisms in this common subspace, genes of highly conserved sequences but significantly different cell

Interactions between multiple organizations responding to a reactor accident in Switzerland

International Nuclear Information System (INIS)

Baggenstos, M.; Isaak, H.P.

1987-01-01

The poster deals with the problems that emerge from the distribution of responsibilities in the case of a nuclear accident. It is demonstrated how clear and simple procedures and good co-ordination between the onsite and offsite emergency organizations are necessary for the smooth handling of such a situation. A good communications network is particularly essential. The special problem of co-ordination between different organizations performing measurements of the contaminated air, ground and food is also discussed. From the experience gained during the Chernobyl accident, it has been established that only those organizations, which are correctly trained and have a perspective over the complete accident situation, can perform valuable work. At the beginning of the accident for example, there was no organization responsible for taking samples covering the whole of Switzerland. A first quick assessment of the radiological situation could therefore only be made on the basis of measurements performed in the direct vicinity of the laboratories or from single samples which had to be transported over large distances

Geography of community health information organization activity in the United States: Implications for the effectiveness of health information exchange.

Science.gov (United States)

Vest, Joshua R

The United States has invested nearly a billion dollars in creating community health information organizations (HIOs) to foster health information exchange. Community HIOs provide exchange services to health care organizations within a distinct geographic area. While geography is a key organizing principle for community HIOs, it is unclear if geography is an effective method for organization or what challenges are created by a geography-based approach to health information exchange. This study describes the extent of reported community HIO coverage in the United States and explores the practical and policy implications of overlaps and gaps in HIO service areas. Furthermore, because self-reported service areas may not accurately reflect the true extent of HIOs activities, this study maps the actual markets for health services included in each HIO. An inventory of operational community HIOs that included self-reported geographic markets and participating organizations was face-validated using a crowd-sourcing approach. Aggregation of the participating hospitals' individual health care markets provided the total geographic market served by each community HIO. Mapping and overlay analyses using geographic information system methods described the extent of community HIO activity in the United States. Evidence suggests that community HIOs may be inefficiently distributed. Parts of the United States have multiple, overlapping HIOs, while others do not have any providing health information exchange services. In markets served by multiple community HIOs, 45% of hospitals were participants of only one HIO. The current geography of community HIO activity does not provide comprehensive patient information to providers, nor community-wide information for public health agencies. The discord between the self-reported and market geography of community HIOs raises concerns about the potential effectiveness of health information exchange, illustrates the limitations of geography as

Understanding spatial organizations of chromosomes via statistical analysis of Hi-C data

Science.gov (United States)

Hu, Ming; Deng, Ke; Qin, Zhaohui; Liu, Jun S.

2015-01-01

Understanding how chromosomes fold provides insights into the transcription regulation, hence, the functional state of the cell. Using the next generation sequencing technology, the recently developed Hi-C approach enables a global view of spatial chromatin organization in the nucleus, which substantially expands our knowledge about genome organization and function. However, due to multiple layers of biases, noises and uncertainties buried in the protocol of Hi-C experiments, analyzing and interpreting Hi-C data poses great challenges, and requires novel statistical methods to be developed. This article provides an overview of recent Hi-C studies and their impacts on biomedical research, describes major challenges in statistical analysis of Hi-C data, and discusses some perspectives for future research. PMID:26124977

Sustained multiple organ ischaemia after transarterial chemoembolization with drug-eluting beads for hepatocellular carcinoma.

Science.gov (United States)

Kim, Young Woon; Kwon, Jung Hyun; Nam, Soon Woo; Jang, Jeong Won; Jung, Hyun Suk; Shin, Yu Ri; Park, Eun Su; Shim, Dong Jae

2018-02-01

Transarterial chemoembolization (TACE) with drug-eluting beads (DC beads) may enhance drug delivery to tumours and reduce systemic toxicity. TACE with DC beads leads to significantly fewer serious side-effects compared with conventional TACE. A 66-year-old man with hepatocellular carcinoma (HCC) complained of continuous abdominal pain 1 month after TACE with DC beads. At the time of TACE, angiography revealed severe stenosis of both hepatic arteries. The diagnostic work up on admission suggested severe bile duct injury with regional bile duct dilatation, segmental liver and spleen infarction, necrotizing pancreatitis, as well as gastric and duodenal ulcers. The pathology specimens of the duodenum contained DC beads that had passed through small vessels in the connective tissue. The patient's condition appeared to improve after 2 weeks of antibiotic treatment and supportive care, but new multifocal liver and spleen infarction subsequently developed. After 2 months, he was well enough to be discharged. His HCC partially responded to the TACE with DC beads but eventually progressed and he died after 11 months. The present case report highlights unexpected ongoing multiple organ ischaemia in a 66-year-old man treated for HCC using TACE with DC beads. The use of TACE with DC beads should be carefully considered in patients with vascular strictures or aberrant blood supply.

Work of multiple organizations to improve seed potato health in U.S.A. and an example of change to reduce Potato virus Y in seed potato lots

Science.gov (United States)

Work of multiple organizations to improve seed potato health in U.S.A. and an example of change to reduce Potato virus Y in seed lots. In the United States, seed potato improvement starts with the individual seed potato grower. The seed grower also has resources that are available from university e...

Prediction of octanol-water partition coefficients of organic compounds by multiple linear regression, partial least squares, and artificial neural network.

Science.gov (United States)

Golmohammadi, Hassan

2009-11-30

A quantitative structure-property relationship (QSPR) study was performed to develop models those relate the structure of 141 organic compounds to their octanol-water partition coefficients (log P(o/w)). A genetic algorithm was applied as a variable selection tool. Modeling of log P(o/w) of these compounds as a function of theoretically derived descriptors was established by multiple linear regression (MLR), partial least squares (PLS), and artificial neural network (ANN). The best selected descriptors that appear in the models are: atomic charge weighted partial positively charged surface area (PPSA-3), fractional atomic charge weighted partial positive surface area (FPSA-3), minimum atomic partial charge (Qmin), molecular volume (MV), total dipole moment of molecule (mu), maximum antibonding contribution of a molecule orbital in the molecule (MAC), and maximum free valency of a C atom in the molecule (MFV). The result obtained showed the ability of developed artificial neural network to prediction of partition coefficients of organic compounds. Also, the results revealed the superiority of ANN over the MLR and PLS models. Copyright 2009 Wiley Periodicals, Inc.

MO-D-BRC-04: Multiple-Criteria Optimization Planning

International Nuclear Information System (INIS)

Donaghue, J.

2016-01-01

Treatment planning is a central part of radiation therapy, including delineation in tumor volumes and critical organs, setting treatment goals of prescription doses to the tumor targets and tolerance doses to the critical organs, and finally generation of treatment plans to meet the treatment goals. National groups like RTOG have led the effort to standardize treatment goals of the prescription doses to the tumor targets and tolerance doses to the critical organs based on accumulated knowledge from decades of abundant clinical trial experience. The challenge for each clinical department is how to achieve or surpass these set goals within the time constraints of clinical practice. Using fifteen testing cases from different treatment sites such as head and neck, prostate with and without pelvic lymph nodes, SBRT spine, we will present clinically utility of advanced planning tools, including knowledge based, automatic based, and multiple criteria based tools that are clinically implemented. The objectives of this session are: Understand differences among these three advanced planning tools Provide clinical assessments on the utility of the advanced planning tools Discuss clinical challenges of treatment planning with large variations in tumor volumes and their relationships with adjacent critical organs. Ping Xia received research grant from Philips. Jackie Wu received research grant from Varian; P. Xia, Research support by Philips and Varian; Q. Wu, NIH, Varian Medical

MO-D-BRC-04: Multiple-Criteria Optimization Planning

Energy Technology Data Exchange (ETDEWEB)

Donaghue, J. [Akron General Medical Center (United States)

2016-06-15

Treatment planning is a central part of radiation therapy, including delineation in tumor volumes and critical organs, setting treatment goals of prescription doses to the tumor targets and tolerance doses to the critical organs, and finally generation of treatment plans to meet the treatment goals. National groups like RTOG have led the effort to standardize treatment goals of the prescription doses to the tumor targets and tolerance doses to the critical organs based on accumulated knowledge from decades of abundant clinical trial experience. The challenge for each clinical department is how to achieve or surpass these set goals within the time constraints of clinical practice. Using fifteen testing cases from different treatment sites such as head and neck, prostate with and without pelvic lymph nodes, SBRT spine, we will present clinically utility of advanced planning tools, including knowledge based, automatic based, and multiple criteria based tools that are clinically implemented. The objectives of this session are: Understand differences among these three advanced planning tools Provide clinical assessments on the utility of the advanced planning tools Discuss clinical challenges of treatment planning with large variations in tumor volumes and their relationships with adjacent critical organs. Ping Xia received research grant from Philips. Jackie Wu received research grant from Varian; P. Xia, Research support by Philips and Varian; Q. Wu, NIH, Varian Medical.

Multiple Sclerosis and Vitamin D

Science.gov (United States)

... Editors David C. Spencer, MD Steven Karceski, MD Multiple sclerosis and vitamin D Andrew J. Solomon, MD WHAT ... caused by improper immune responses (autoimmune diseases), including multiple sclerosis (MS). A recent Patient Page in Neurology provided ...

The Nitrosocarbonyl Hetero-Diels–Alder Reaction as a Useful Tool for Organic Syntheses

Science.gov (United States)

Bodnar, Brian S.

2014-01-01

Organic transformations that result in the formation of multiple covalent bonds within the same reaction are some of the most powerful tools in synthetic organic chemistry. Nitrosocarbonyl hetero-Diels–Alder (HDA) reactions allow for the simultaneous stereospecific introduction of carbon–nitrogen and carbon–oxygen bonds in one synthetic step, and provide direct access to 3,6-dihydro-1,2-oxazines. This Review describes the development of the nitrosocarbonyl HDA reaction and the utility of the resulting oxazine ring in the synthesis of a variety of important, biologically active molecules. PMID:21520360

Self-reported changes in quality of life among people with multiple sclerosis who have participated in treatments based on collaboration between conventional healthcare providers and CAM practitioners

DEFF Research Database (Denmark)

Bjerre, Liv; Henningsen, Inge Biehl; Skovgaard, Lasse

2011-01-01

Aim of the study: This study assesses the changes in self-reported quality of life (QoL) from hospitalisation to 18 months later among people with multiple sclerosis (MS) who have participated in treatments based on collaboration between conventional healthcare providers and CAM practitioners...... interventions by a team of five healthcare providers and five CAM practitioners. The outcome measure was a change in QoL (measured as the difference in total score and sub-scores on the Functional Assessment of Multiple Sclerosis (FAMS) QoL scale). Results: From hospitalisation and through an 18-month period....... Materials and methods: A pre- and post-test evaluation design including an intervention group and a comparison group was employed in this study. 142 people with MS were analysed in the intervention group and 142 in the comparison group. Each person in the intervention group was treated with combined...

Strategy-Proof Assignment Of Multiple Resources

DEFF Research Database (Denmark)

Erlanson, Albin; Szwagrzak, Karol

2015-01-01

We examine the strategy-proof allocation of multiple resources; an application is the assignment of packages of tasks, workloads, and compensations among the members of an organization. In the domain of multidimensional single-peaked preferences, we find that any allocation mechanism obtained by ...

Recent Advances in Understanding Pelvic-Floor Tissue of Women With and Without Pelvic Organ Prolapse: Considerations for Physical Therapists.

Science.gov (United States)

Saunders, Kimberly

2017-04-01

Pelvic organ prolapse is a fairly common condition that imposes significant symptoms, diminished quality of life, social burden, financial expense, and surgical risk on women. As evidence supporting the benefit of pelvic-floor muscle training in nonsurgical management of pelvic organ prolapse grows, physical therapists are becoming a provider of choice interacting with women affected by pelvic organ prolapse. This perspective article will review recent research on tissue characteristics of 3 key components of pelvic organ support: skeletal muscle, ligament, and vaginal wall. This information will be summarized as implications for physical therapists. An improved understanding of pelvic-floor tissue in women with and without pelvic organ prolapse will provide a more comprehensive appreciation of the interaction of multiple systems in the disorder. © 2017 American Physical Therapy Association.

MO-E-17A-04: Size-Specific Dose Estimate (SSDE) Provides a Simple Method to Calculate Organ Dose for Pediatric CT Examinations

International Nuclear Information System (INIS)

Moore, B; Brady, S; Kaufman, R; Mirro, A

2014-01-01

Purpose: Investigate the correlation of SSDE with organ dose in a pediatric population. Methods: Four anthropomorphic phantoms, representing a range of pediatric body habitus, were scanned with MOSFET dosimeters placed at 23 organ locations to determine absolute organ dosimetry. Phantom organ dosimetry was divided by phantom SSDE to determine correlation between organ dose and SSDE. Correlation factors were then multiplied by patient SSDE to estimate patient organ dose. Patient demographics consisted of 352 chest and 241 abdominopelvic CT examinations, 22 ± 15 kg (range 5−55 kg) mean weight, and 6 ± 5 years (range 4 mon to 23 years) mean age. Patient organ dose estimates were compared to published pediatric Monte Carlo study results. Results: Phantom effective diameters were matched with patient population effective diameters to within 4 cm. 23 organ correlation factors were determined in the chest and abdominopelvic region across nine pediatric weight subcategories. For organs fully covered by the scan volume, correlation in the chest (average 1.1; range 0.7−1.4) and abdominopelvic (average 0.9; range 0.7−1.3) was near unity. For organs that extended beyond the scan volume (i.e., skin, bone marrow, and bone surface), correlation was determined to be poor (average 0.3; range: 0.1−0.4) for both the chest and abdominopelvic regions, respectively. Pediatric organ dosimetry was compared to published values and was found to agree in the chest to better than an average of 5% (27.6/26.2) and in the abdominopelvic region to better than 2% (73.4/75.0). Conclusion: Average correlation of SSDE and organ dosimetry was found to be better than ± 10% for fully covered organs within the scan volume. This study provides a list of organ dose correlation factors for the chest and abdominopelvic regions, and describes a simple methodology to estimate individual pediatric patient organ dose based on patient SSDE

MO-E-17A-04: Size-Specific Dose Estimate (SSDE) Provides a Simple Method to Calculate Organ Dose for Pediatric CT Examinations

Energy Technology Data Exchange (ETDEWEB)

Moore, B; Brady, S; Kaufman, R [St Jude Children' s Research Hospital, Memphis, TN (United States); Mirro, A [Washington University, St. Louis, MO (United States)

2014-06-15

Purpose: Investigate the correlation of SSDE with organ dose in a pediatric population. Methods: Four anthropomorphic phantoms, representing a range of pediatric body habitus, were scanned with MOSFET dosimeters placed at 23 organ locations to determine absolute organ dosimetry. Phantom organ dosimetry was divided by phantom SSDE to determine correlation between organ dose and SSDE. Correlation factors were then multiplied by patient SSDE to estimate patient organ dose. Patient demographics consisted of 352 chest and 241 abdominopelvic CT examinations, 22 ± 15 kg (range 5−55 kg) mean weight, and 6 ± 5 years (range 4 mon to 23 years) mean age. Patient organ dose estimates were compared to published pediatric Monte Carlo study results. Results: Phantom effective diameters were matched with patient population effective diameters to within 4 cm. 23 organ correlation factors were determined in the chest and abdominopelvic region across nine pediatric weight subcategories. For organs fully covered by the scan volume, correlation in the chest (average 1.1; range 0.7−1.4) and abdominopelvic (average 0.9; range 0.7−1.3) was near unity. For organs that extended beyond the scan volume (i.e., skin, bone marrow, and bone surface), correlation was determined to be poor (average 0.3; range: 0.1−0.4) for both the chest and abdominopelvic regions, respectively. Pediatric organ dosimetry was compared to published values and was found to agree in the chest to better than an average of 5% (27.6/26.2) and in the abdominopelvic region to better than 2% (73.4/75.0). Conclusion: Average correlation of SSDE and organ dosimetry was found to be better than ± 10% for fully covered organs within the scan volume. This study provides a list of organ dose correlation factors for the chest and abdominopelvic regions, and describes a simple methodology to estimate individual pediatric patient organ dose based on patient SSDE.

Childcare Providers: Work Stress and Personal Well-Being

Science.gov (United States)

Faulkner, Monica; Gerstenblatt, Paula; Lee, Ahyoung; Vallejo, Viana; Travis, Dnika

2016-01-01

Childcare providers face multiple work-related stressors. Small studies of childcare providers have suggested that providers have high levels of depression compared to the general population. However, unlike other caregiving professions, the research examining childcare providers is sparse, and there is little information to inform practices and…

Providing Memory Management Abstraction for Self-Reconfigurable Video Processing Platforms

Directory of Open Access Journals (Sweden)

Kurt Franz Ackermann

2009-01-01

Full Text Available This paper presents a concept for an SDRAM controller targeting video processing platforms with dynamically reconfigurable processing units (RPUs. A priority-arbitration algorithm provides the required QoS and supports high bit-rate data streaming of multiple clients. Conforming to common video data structures the controller organizes the memory in partitions, frames, lines, and pixels. The raised level of abstraction drastically reduces the complexity of clients' addressing logic. Its uniform interface structure facilitates instantiations in systems with various clients. In addition to SDRAM controllers for regular applications, special demands of reconfigurable platforms have to be satisfied. The aim of this work is to minimize the number of required bus macros leading to relaxed place and route constraints and reducing the number of critical design paths. A suitable interface protocol is presented, and fundamental implementation issues are outlined.

A new human (psycho)pharmacology tool: the multiple organs coincidences counter (MOCC).

Science.gov (United States)

Malizia, A; Forse, G; Haida, A; Gunn, R; Melichar, J; Poole, K; Bateman, D; Fahy, D; Schnorr, L; Brown, D; Rhodes, C; Nutt, D J; Jones, T

1995-01-01

We describe a novel instrument which is capable of measuring the uptake of radioligand in human organs in vivo with the administration of very small doses of positron-emitting radioligands. This technique readily detects the displacement or reduced uptake of radioligand when a competitive agonist or antagonist is administered. This system provides no tomographic information, but the small radioactive doses involved mean that investigations can be repeated at regular intervals and that female volunteers can also participate. We administered [(11) C]flumazenil, [(11)C]diprenorphine, [(11)C]meta -hydroxyephedrine (MHED) and [(11)C]RTI 55 to healthy male volunteers and performed control, pre-loading and displacement experiments. These demonstrate the feasibility of using this technique to investigate benzodiazepine and opiate receptor occupancy, as well as occupancy at dopamine, noradrenaline and serotonin (5-HT) re-uptake sites. This method is likely to be useful in pharmacokinetic/pharmacodynamic experiments, in drug development and discovery and in the development of novel imaging radioligands.

Highly sensitive photoelectrochemical biosensor for kinase activity detection and inhibition based on the surface defect recognition and multiple signal amplification of metal-organic frameworks.

Science.gov (United States)

Wang, Zonghua; Yan, Zhiyong; Wang, Feng; Cai, Jibao; Guo, Lei; Su, Jiakun; Liu, Yang

2017-11-15

A turn-on photoelectrochemical (PEC) biosensor based on the surface defect recognition and multiple signal amplification of metal-organic frameworks (MOFs) was proposed for highly sensitive protein kinase activity analysis and inhibitor evaluation. In this strategy, based on the phosphorylation reaction in the presence of protein kinase A (PKA), the Zr-based metal-organic frameworks (UiO-66) accommodated with [Ru(bpy) 3 ] 2+ photoactive dyes in the pores were linked to the phosphorylated kemptide modified TiO 2 /ITO electrode through the chelation between the Zr 4+ defects on the surface of UiO-66 and the phosphate groups in kemptide. Under visible light irradiation, the excited electrons from [Ru(bpy) 3 ] 2+ adsorbed in the pores of UiO-66 injected into the TiO 2 conduction band to generate photocurrent, which could be utilized for protein kinase activities detection. The large surface area and high porosities of UiO-66 facilitated a large number of [Ru(bpy) 3 ] 2+ that increased the photocurrent significantly, and afforded a highly sensitive PEC analysis of kinase activity. The detection limit of the as-proposed PEC biosensor was 0.0049UmL -1 (S/N!=!3). The biosensor was also applied for quantitative kinase inhibitor evaluation and PKA activities detection in MCF-7 cell lysates. The developed visible-light PEC biosensor provides a simple detection procedure and a cost-effective manner for PKA activity assays, and shows great potential in clinical diagnosis and drug discoveries. Copyright © 2017 Elsevier B.V. All rights reserved.

Exploring network organization in practice

DEFF Research Database (Denmark)

Hu, Yimei; Sørensen, Olav Jull

Constructing a network organization for global R&D is presented as a common sense practice in existing literature. However, there are still queries about the network organization, such as the persistence of hierarchies which make a network organization merely a “bureaucracy-lite” organization....... Furthermore, in practice, we rarely see radical organizational change towards a network organization that adopts an internal market. The co-existence of market, hierarchy and network triggered research interest. A multiple case study of three transnational corporations’ global R&D organization shows...... that there are different logical considerations when designing a network organization to facilitate innovation. I identify three types of network organizations: market-led, directed and culture-led network organizations. Different types of network organizations show that organizations are dual and even ternary systems...

A multiple multicomponent approach to chimeric peptide-peptoid podands.

Science.gov (United States)

Rivera, Daniel G; León, Fredy; Concepción, Odette; Morales, Fidel E; Wessjohann, Ludger A

2013-05-10

The success of multi-armed, peptide-based receptors in supramolecular chemistry traditionally is not only based on the sequence but equally on an appropriate positioning of various peptidic chains to create a multivalent array of binding elements. As a faster, more versatile and alternative access toward (pseudo)peptidic receptors, a new approach based on multiple Ugi four-component reactions (Ugi-4CR) is proposed as a means of simultaneously incorporating several binding and catalytic elements into organizing scaffolds. By employing α-amino acids either as the amino or acid components of the Ugi-4CRs, this multiple multicomponent process allows for the one-pot assembly of podands bearing chimeric peptide-peptoid chains as appended arms. Tripodal, bowl-shaped, and concave polyfunctional skeletons are employed as topologically varied platforms for positioning the multiple peptidic chains formed by Ugi-4CRs. In a similar approach, steroidal building blocks with several axially-oriented isocyano groups are synthesized and utilized to align the chimeric chains with conformational constrains, thus providing an alternative to the classical peptido-steroidal receptors. The branched and hybrid peptide-peptoid appendages allow new possibilities for both rational design and combinatorial production of synthetic receptors. The concept is also expandable to other multicomponent reactions. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Exploring the multiplicity of soil-human interactions: organic carbon content, agro-forest landscapes and the Italian local communities.

Science.gov (United States)

Salvati, Luca; Barone, Pier Matteo; Ferrara, Carlotta

2015-05-01

Topsoil organic carbon (TOC) and soil organic carbon (SOC) are fundamental in the carbon cycle influencing soil functions and attributes. Many factors have effects on soil carbon content such as climate, parent material, land topography and the human action including agriculture, which sometimes caused a severe loss in soil carbon content. This has resulted in a significant differentiation in TOC or SOC at the continental scale due to the different territorial and socioeconomic conditions. The present study proposes an exploratory data analysis assessing the relationship between the spatial distribution of soil organic carbon and selected socioeconomic attributes at the local scale in Italy with the aim to provide differentiated responses for a more sustainable use of land. A strengths, weaknesses, opportunities and threats (SWOT) analysis contributed to understand the effectiveness of local communities responses for an adequate comprehension of the role of soil as carbon sink.

Optimal information transmission in organizations: search and congestion

Energy Technology Data Exchange (ETDEWEB)

Arenas, A.; Cabrales, A.; Danon, L.; Diaz-Guilera, A.; Guimera, R.; Vega-Redondo, F.

2008-01-01

We propose a stylized model of a problem-solving organization whose internal communication structure is given by a fixed network. Problems arrive randomly anywhere in this network and must find their way to their respective specialized solvers by relying on local information alone. The organization handles multiple problems simultaneously. For this reason, the process may be subject to congestion. We provide a characterization of the threshold of collapse of the network and of the stock of floating problems (or average delay) that prevails below that threshold. We build upon this characterization to address a design problem: the determination of what kind of network architecture optimizes performance for any given problem arrival rate. We conclude that, for low arrival rates, the optimal network is very polarized (i.e. star-like or centralized), whereas it is largely homogeneous (or decentralized) for high arrival rates. These observations are in line with a common transformation experienced by information-intensive organizations as their work flow has risen in recent years.

Strategizing in multiple ways

DEFF Research Database (Denmark)

Larsen, Mette Vinther; Madsen, Charlotte Øland; Rasmussen, Jørgen Gulddahl

2013-01-01

Strategy processes are kinds of wayfaring where different actors interpret a formally defined strat-egy differently. In the everyday practice of organizations strategizing takes place in multiple ways through narratives and sensible actions. This forms a meshwork of polyphonic ways to enact one...... and the same strategy. The paper focusses on such processes as they develop in a Danish service company. It is done on the basis of an empirical and longitudinal study of a strategy process in the Service Company where the strategic purpose was to implement value-based management. The theme to be developed...... based on this development paper is whether one can understand these diver-gent strategic wayfaring processes as constructive for organizations....

Achieving health care cost containment through provider payment reform that engages patients and providers.

Science.gov (United States)

Ginsburg, Paul B

2013-05-01

The best opportunity to pursue cost containment in the next five to ten years is through reforming provider payment to gradually diminish the role of fee-for-service reimbursement. Public and private payers have launched many promising payment reform pilots aimed at blending fee-for-service with payment approaches based on broader units of care, such as an episode or patients' total needs over a period of time, a crucial first step. But meaningful cost containment from payment reform will not be achieved until Medicare and Medicaid establish stronger incentives for providers to contract in this way, with discouragement of nonparticipation increasing over time. In addition, the models need to evolve to engage beneficiaries, perhaps through incentives for patients to enroll in an accountable care organization and to seek care within that organization's network of providers.

Decree no 2013-496/PRN/ME/P from December 04, 2013 provides for the organization of the Ministry of Energy and Oil

International Nuclear Information System (INIS)

Issoufou, Mahamadou; Brigi, Rafini; Foumakoye, Gado

2013-01-01

This decree provides for the organization of the Ministry of Energy and Oil. Thus the Ministry of Energy and Oil is composed of: the central administration, deconcentrated services and piecing services, administrations and decentralized services, programs and public projects. [fr

Multiple-membrane multiple-electrolyte redox flow battery design

Science.gov (United States)

Yan, Yushan; Gu, Shuang; Gong, Ke

2017-05-02

A redox flow battery is provided. The redox flow battery involves multiple-membrane (at least one cation exchange membrane and at least one anion exchange membrane), multiple-electrolyte (one electrolyte in contact with the negative electrode, one electrolyte in contact with the positive electrode, and at least one electrolyte disposed between the two membranes) as the basic characteristic, such as a double-membrane, triple electrolyte (DMTE) configuration or a triple-membrane, quadruple electrolyte (TMQE) configuration. The cation exchange membrane is used to separate the negative or positive electrolyte and the middle electrolyte, and the anion exchange membrane is used to separate the middle electrolyte and the positive or negative electrolyte.

ORA: Organization Risk Analyzer

National Research Council Canada - National Science Library

Carley, Kathleen M; Reminga, Jeff

2004-01-01

.... Measures are also organized by input requirements and by output. ORA generates formatted reports viewable on screen or in log files, and reads and writes networks in multiple data formats to be interoperable...

4G/5G polymorphism of PAI-1 gene is associated with multiple organ dysfunction and septic shock in pneumonia induced severe sepsis: prospective, observational, genetic study

Science.gov (United States)

2010-01-01

Introduction Activation of inflammation and coagulation are closely related and mutually interdependent in sepsis. The acute-phase protein, plasminogen activator inhibitor-1 (PAI-1) is a key element in the inhibition of fibrinolysis. Elevated levels of PAI-1 have been related to worse outcome in pneumonia. We aimed to evaluate the effect of functionally relevant 4G/5G polymorphism of PAI-1 gene in pneumonia induced sepsis. Methods We enrolled 208 Caucasian patients with severe sepsis due to pneumonia admitted to an intensive care unit (ICU). Patients were followed up until ICU discharge or death. Clinical data were collected prospectively and the PAI-1 4G/5G polymorphism was genotyped by polymerase chain reaction-restriction fragment length polymorphism technique. Patients were stratified according to the occurrence of multiple organ dysfunction syndrome, septic shock or death. Results We found that carriers of the PAI-1 4G/4G and 4G/5G genotypes have a 2.74-fold higher risk for multiple organ dysfunction syndrome (odds ratio [OR] 95% confidence interval [CI] = 1.335 - 5.604; p = 0.006) and a 2.57-fold higher risk for septic shock (OR 95%CI = 1.180 - 5.615; p = 0.018) than 5G/5G carriers. The multivariate logistic regression analysis adjusted for independent predictors, such as age, nosocomial pneumonia and positive microbiological culture also supported that carriers of the 4G allele have a higher prevalence of multiple organ dysfunction syndrome (adjusted odds ratio [aOR] = 2.957; 95%CI = 1.306 -6.698; p = 0.009) and septic shock (aOR = 2.603; 95%CI = 1.137 - 5.959; p = 0.024). However, genotype and allele analyses have not shown any significant difference regarding mortality in models non-adjusted or adjusted for acute physiology and chronic health evaluation (APACHE) II. Patients bearing the 4G allele had higher disseminated intravascular coagulation (DIC) score at admission (p = 0.007) than 5G/5G carriers. Moreover, in 4G allele carriers the length of ICU stay

4G/5G polymorphism of PAI-1 gene is associated with multiple organ dysfunction and septic shock in pneumonia induced severe sepsis: prospective, observational, genetic study.

Science.gov (United States)

Madách, Krisztina; Aladzsity, István; Szilágyi, Agnes; Fust, George; Gál, János; Pénzes, István; Prohászka, Zoltán

2010-01-01

Activation of inflammation and coagulation are closely related and mutually interdependent in sepsis. The acute-phase protein, plasminogen activator inhibitor-1 (PAI-1) is a key element in the inhibition of fibrinolysis. Elevated levels of PAI-1 have been related to worse outcome in pneumonia. We aimed to evaluate the effect of functionally relevant 4G/5G polymorphism of PAI-1 gene in pneumonia induced sepsis. We enrolled 208 Caucasian patients with severe sepsis due to pneumonia admitted to an intensive care unit (ICU). Patients were followed up until ICU discharge or death. Clinical data were collected prospectively and the PAI-1 4G/5G polymorphism was genotyped by polymerase chain reaction-restriction fragment length polymorphism technique. Patients were stratified according to the occurrence of multiple organ dysfunction syndrome, septic shock or death. We found that carriers of the PAI-1 4G/4G and 4G/5G genotypes have a 2.74-fold higher risk for multiple organ dysfunction syndrome (odds ratio [OR] 95% confidence interval [CI] = 1.335 - 5.604; p = 0.006) and a 2.57-fold higher risk for septic shock (OR 95%CI = 1.180 - 5.615; p = 0.018) than 5G/5G carriers. The multivariate logistic regression analysis adjusted for independent predictors, such as age, nosocomial pneumonia and positive microbiological culture also supported that carriers of the 4G allele have a higher prevalence of multiple organ dysfunction syndrome (adjusted odds ratio [aOR] = 2.957; 95%CI = 1.306 -6.698; p = 0.009) and septic shock (aOR = 2.603; 95%CI = 1.137 - 5.959; p = 0.024). However, genotype and allele analyses have not shown any significant difference regarding mortality in models non-adjusted or adjusted for acute physiology and chronic health evaluation (APACHE) II. Patients bearing the 4G allele had higher disseminated intravascular coagulation (DIC) score at admission (p = 0.007) than 5G/5G carriers. Moreover, in 4G allele carriers the length of ICU stay of non-survivors was longer

Accelerated Cure Project for Multiple Sclerosis

Science.gov (United States)

... questions and enable an era of optimized MS treatment. Read more... The Accelerated Cure Project for MS is a non-profit, 501(c)(3) tax-exempt organization whose mission is to accelerate efforts toward a cure for multiple sclerosis by rapidly advancing research that determines its causes ...

An Evolutionary Game Theoretic Approach to Multi-Sector Coordination and Self-Organization

Directory of Open Access Journals (Sweden)

Fernando P. Santos

2016-04-01

Full Text Available Coordination games provide ubiquitous interaction paradigms to frame human behavioral features, such as information transmission, conventions and languages as well as socio-economic processes and institutions. By using a dynamical approach, such as Evolutionary Game Theory (EGT, one is able to follow, in detail, the self-organization process by which a population of individuals coordinates into a given behavior. Real socio-economic scenarios, however, often involve the interaction between multiple co-evolving sectors, with specific options of their own, that call for generalized and more sophisticated mathematical frameworks. In this paper, we explore a general EGT approach to deal with coordination dynamics in which individuals from multiple sectors interact. Starting from a two-sector, consumer/producer scenario, we investigate the effects of including a third co-evolving sector that we call public. We explore the changes in the self-organization process of all sectors, given the feedback that this new sector imparts on the other two.

Multiple Employer Welfare Arrangements

Science.gov (United States)

1992-01-01

Sponsors in the Private Nonfarm Sector in the United States, 1978-79," Volume IV, Description and Analysis of Plans and Plan Sponsors, NTIS # PB81-180366...Labor finds to be collectively bargained plans, and those organized by rural electrical cooperatives and rural telephone cooperatives. Thus, except for...their existence and generally higher cost than uninsured plans no doubt contributed to the development of other types of multiple employer

Enhanced life time and suppressed efficiency roll-off in phosphorescent organic light-emitting diodes with multiple quantum well structures

Directory of Open Access Journals (Sweden)

Ja-Ryong Koo

2012-03-01

Full Text Available We demonstrate red phosphorescent organic light-emitting diodes (OLEDs with multiple quantum well structures which confine triplet exciton inside an emitting layer (EML region. Five types of OLEDs, from a single to five quantum wells, are fabricated with charge control layers to produce high efficiencies, and the performance of the devices is investigated. The improved quantum efficiency and lifetime of the OLED with four quantum wells, and its suppressed quantum efficiency roll-off of 17.6%, can be described by the increased electron–hole charge balance owing to the bipolar property as well as the efficient triplet exciton confinement within each EML, and by prevention of serious triplet–triplet and/or triplet–polaron annihilation as well as the Förster self-quenching due to charge control layers.

Familial pseudoxanthoma elasticum associated with multiple comedones.

Science.gov (United States)

Maarouf, Melody; Sharon, Victoria R; Sivamani, Raja K; Prakash, Neha; Bipin, T H; Davis, Tracy; Shi, Vivian Y

2017-09-15

Pseudoxanthoma elasticum (PXE) is an autosomal recessive disorder characterized by atypical elastic fibers that causes connective tissue abnormalities of the skin, eyes, and heart, among other organs. The disorder is rare, with a classic presentation of yellow-orange cobblestone-like papules on flexural areas, lax skin, ocular degeneration, and moribund vasculature in multiple organs. There is wide variability in the presentation of the affected organs [1]. We present two sisters with classic cutaneous findings of PXE with the additional unusual findings of numerous open comedones on the neck. To our knowledge, this is the first report of numerous open comedones in familial PXE.

Thin film solar cells grown by organic vapor phase deposition

Science.gov (United States)

Yang, Fan

Organic solar cells have the potential to provide low-cost photovoltaic devices as a clean and renewable energy resource. In this thesis, we focus on understanding the energy conversion process in organic solar cells, and improving the power conversion efficiencies via controlled growth of organic nanostructures. First, we explain the unique optical and electrical properties of organic materials used for photovoltaics, and the excitonic energy conversion process in donor-acceptor heterojunction solar cells that place several limiting factors of their power conversion efficiency. Then, strategies for improving exciton diffusion and carrier collection are analyzed using dynamical Monte Carlo models for several nanostructure morphologies. Organic vapor phase deposition is used for controlling materials crystallization and film morphology. We improve the exciton diffusion efficiency while maintaining good carrier conduction in a bulk heterojunction solar cell. Further efficiency improvement is obtained in a novel nanocrystalline network structure with a thick absorbing layer, leading to the demonstration of an organic solar cell with 4.6% efficiency. In addition, solar cells using simultaneously active heterojunctions with broad spectral response are presented. We also analyze the efficiency limits of single and multiple junction organic solar cells, and discuss the challenges facing their practical implementations.

Evaluating the performance of business service providers : developing a model from multiple case studies

NARCIS (Netherlands)

Valk, van der W.; Weele, van A.J.; Kibbeling, M.I.; Baraldi, E.; Hadjikhani, A.; Waluszewski, A.

2008-01-01

Services have become an increasingly important part of many organizations' expenditures. At the same time, organizational buyers view the purchase of business services to be highly complex. The specific characteristics of services influence the purchasing process in the sense that certain steps in

Perspectives on leadership in organizations providing services to people with disabilities: an exploratory study.

Science.gov (United States)

Brady, Laura Thompson; Fong, Lisa; Waninger, Kendra N; Eidelman, Steven

2009-10-01

As leaders from the Baby Boomer generation prepare for retirement over the next decade, emerging leaders must be identified and supported in anticipation of a major organizational transition. Authentic leadership is a construct that informs the development of values-driven leaders who will bring organizations into the future, just as the previous generation of leaders oversaw the movement of services away from state institutions and into networks of community-based service delivery organizations. The purpose of this exploratory study was to examine executive and emerging leaders' opinions about the unique leadership values, skills, and challenges in organizations that serve individuals with intellectual and developmental disabilities. Themes of defining, developing, and sustaining leaders emerged from the data and are explored through an authentic leadership framework.

Experiences in simulating and testing coordinated voltage control provided by multiple wind power plants

Energy Technology Data Exchange (ETDEWEB)

Arlaban, T.; Alonso, O.; Ortiz, D. [Acciona Windpower S.A. (Spain); Peiro, J.; Rivas, R. [Red Electrica de Espana SAU (Spain); Quinonez-Varela, G.; Lorenzo, P. [Acciona Energia S.A. (Spain)

2011-07-01

This document presents some field tests performed in a transmission system node in order to check the adequacy of voltage control performance by multiple wind power plants, with an overall capacity of 395 MW. It briefly explains the Spanish TSO motivation towards new voltage control requirements and the necessity of performing such tests in order to set the most convenient voltage control parameters and to verify the stable operation. It presents how different the voltage control capability between modern wind turbines (DFIG) and older ones (SCIG) specifically retrofitted for voltage control is. (orig.)

Serving some and serving all: how providers navigate the challenges of providing racially targeted health services.

Science.gov (United States)

Zhou, Amy

2017-10-01

Racially targeted healthcare provides racial minorities with culturally and linguistically appropriate health services. This mandate, however, can conflict with the professional obligation of healthcare providers to serve patients based on their health needs. The dilemma between serving a particular population and serving all is heightened when the patients seeking care are racially diverse. This study examines how providers in a multi-racial context decide whom to include or exclude from health programs. This study draws on 12 months of ethnographic fieldwork at an Asian-specific HIV organization. Fieldwork included participant observation of HIV support groups, community outreach programs, and substance abuse recovery groups, as well as interviews with providers and clients. Providers managed the dilemma in different ways. While some programs in the organization focused on an Asian clientele, others de-emphasized race and served a predominantly Latino and African American clientele. Organizational structures shaped whether services were delivered according to racial categories. When funders examined client documents, providers prioritized finding Asian clients so that their documents reflected program goals to serve the Asian population. In contrast, when funders used qualitative methods, providers could construct an image of a program that targets Asians during evaluations while they included other racial minorities in their everyday practice. Program services were organized more broadly by health needs. Even within racially targeted programs, the meaning of race fluctuates and is contested. Patients' health needs cross cut racial boundaries, and in some circumstances, the boundaries of inclusion can expand beyond specific racial categories to include racial minorities and underserved populations more generally.

Multiple metachronous cancer of the esophagus

International Nuclear Information System (INIS)

Mamontov, A.S.; Shlakov, S.L.; Bitotskij, P.G.; Volchenko, N.N.

1996-01-01

Treatment of a patient with the most characteristics combination of primary multiple metachronous cancer of esophagus involving the esophagus tumor localization on the one hand and tumors in the head and neck organs, on the other hand is described. Remote radiation therapy has been applied in the area of the primary tumor ( 60 Co radiation - carrying needles) and interstitial cavitary therapy as been undertaken. According to the authors data in 1988-1995 in Moscow oncological institute named after Gertsen multiple metachronous cancer cases, esophagus being one of localizations were revealed in 7% of all the patients with esophagus cancer diagnosis [ru

A Novel Mechanism for Color Vision: Pupil Shape and Chromatic Aberration Can Provide Spectral Discrimination for Color Blind Organisms.

OpenAIRE

Stubbs, Christopher; Stubbs, Alexander

2015-01-01

We present a mechanism by which organisms with only a single photoreceptor, that have a monochromatic view of the world, can achieve color discrimination. The combination of an off axis pupil and the principle of chromatic aberration (where light of different colors focus at different distances behind a lens) can combine to provide color-blind animals with a way to distinguish colors. As a specific example we constructed a computer model of the visual system of cephalopods, (octopus, squid, a...

A Novel Mechanism for Color Vision: Pupil Shape and Chromatic Aberration Can Provide Spectral Discrimination for Color Blind Organisms.

OpenAIRE

Stubbs, Alexander L; Stubbs, Christopher William

2016-01-01

We present a mechanism by which organisms with only a single photoreceptor, that have a monochromatic view of the world, can achieve color discrimination. The combination of an off axis pupil and the principle of chromatic aberration (where light of different colors focus at different distances behind a lens) can combine to provide color-blind animals with a way to distinguish colors. As a specific example we constructed a computer model of the visual system of cephalopods, (octopus, squid, a...

Using matrix organization to manage health care delivery organizations.

Science.gov (United States)

Allcorn, S

1990-01-01

Matrix organization can provide health care organization managers enhanced information processing, faster response times, and more flexibility to cope with greater organization complexity and rapidly changing operating environments. A review of the literature informed by work experience reveals that the use of matrix organization creates hard-to-manage ambiguity and balances of power in addition to providing positive benefits for health care organization managers. Solutions to matrix operating problems generally rely on the use of superior information and decision support systems and extensive staff training to develop attitudes and behavior consistent with the more collegial matrix organization culture. Further improvement in understanding the suitability of matrix organization for managing health care delivery organizations will involve appreciating the impact of partial implementation of matrix organization, temporary versus permanent uses of matrix organization, and the impact of the ambiguity created by dual lines of authority upon the exercise of power and authority.

Stacking multiple connecting functional materials in tandem organic light-emitting diodes

Science.gov (United States)

Zhang, Tao; Wang, Deng-Ke; Jiang, Nan; Lu, Zheng-Hong

2017-02-01

Tandem device is an important architecture in fabricating high performance organic light-emitting diodes and organic photovoltaic cells. The key element in making a high performance tandem device is the connecting materials stack, which plays an important role in electric field distribution, charge generation and charge injection. For a tandem organic light-emitting diode (OLED) with a simple Liq/Al/MoO3 stack, we discovered that there is a significant current lateral spreading causing light emission over an extremely large area outside the OLED pixel when the Al thickness exceeds 2 nm. This spread light emission, caused by an inductive electric field over one of the device unit, limits one’s ability to fabricate high performance tandem devices. To resolve this issue, a new connecting materials stack with a C60 fullerene buffer layer is reported. This new structure permits optimization of the Al metal layer in the connecting stack and thus enables us to fabricate an efficient tandem OLED having a high 155.6 cd/A current efficiency and a low roll-off (or droop) in current efficiency.

Ethical criteria for procuring and distributing organs for transplantation.

Science.gov (United States)

Childress, J F

1989-01-01

This article provides an ethical analysis and assessment of various actual and proposed policies of organ procurement and distribution in light of moral principles already embedded in U.S. institutions, laws, policies, and practices. Evaluating different methods of acquisition of human body parts--donation (express and presumed), sales, abandonment, and expropriation--the author argues for laws and policies, including required request, to maintain and facilitate express donation of organs by individuals and their families. Such laws and policies need adequate time for a determination of their effectiveness before society moves to other major alternatives, such as a market. In organ allocation and distribution, which have close moral connections with organ procurement, the author defends the judgment of the federal Task Force on Organ Transplantation that the community should have dispositional authority over donated organs, that professionals should be viewed as trustees and stewards of donated organs, and that the public should be heavily involved in the formation of policies of allocation and distribution. Concentrating on policies being developed in the United Network for Organ Sharing, the author examines the point system for cadaveric kidneys, the access of foreign nationals to organs donated in the U.S., and the multiple listings of patients seeking transplants. He concludes by identifying two major problems of equitable access to donated organs that will have to be addressed by social institutions other than UNOS: access to the waiting list for donated organs and the role of ability to pay in extrarenal transplants.

Coordinating a Large, Amalgamated REU Program with Multiple Funding Sources

Science.gov (United States)

Fiorini, Eugene; Myers, Kellen; Naqvi, Yusra

2017-01-01

In this paper, we discuss the challenges of organizing a large REU program amalgamated from multiple funding sources, including diverse participants, mentors, and research projects. We detail the program's structure, activities, and recruitment, and we hope to demonstrate that the organization of this REU is not only beneficial to its…

Understanding the free energy barrier and multiple timescale dynamics of charge separation in organic photovoltaic cells.

Science.gov (United States)

Yan, Yaming; Song, Linze; Shi, Qiang

2018-02-28

By employing several lattice model systems, we investigate the free energy barrier and real-time dynamics of charge separation in organic photovoltaic (OPV) cells. It is found that the combined effects of the external electric field, entropy, and charge delocalization reduce the free energy barrier significantly. The dynamic disorder reduces charge carrier delocalization and results in the increased charge separation barrier, while the effect of static disorder is more complicated. Simulation of the real-time dynamics indicates that the free charge generation process involves multiple time scales, including an ultrafast component within hundreds of femtoseconds, an intermediate component related to the relaxation of the hot charge transfer (CT) state, and a slow component on the time scale of tens of picoseconds from the thermally equilibrated CT state. Effects of hot exciton dissociation as well as its dependence on the energy offset between the Frenkel exciton and the CT state are also analyzed. The current results indicate that only a small energy offset between the band gap and the lowest energy CT state is needed to achieve efficient free charge generation in OPV devices, which agrees with recent experimental findings.

Understanding the free energy barrier and multiple timescale dynamics of charge separation in organic photovoltaic cells

Science.gov (United States)

Yan, Yaming; Song, Linze; Shi, Qiang

2018-02-01

By employing several lattice model systems, we investigate the free energy barrier and real-time dynamics of charge separation in organic photovoltaic (OPV) cells. It is found that the combined effects of the external electric field, entropy, and charge delocalization reduce the free energy barrier significantly. The dynamic disorder reduces charge carrier delocalization and results in the increased charge separation barrier, while the effect of static disorder is more complicated. Simulation of the real-time dynamics indicates that the free charge generation process involves multiple time scales, including an ultrafast component within hundreds of femtoseconds, an intermediate component related to the relaxation of the hot charge transfer (CT) state, and a slow component on the time scale of tens of picoseconds from the thermally equilibrated CT state. Effects of hot exciton dissociation as well as its dependence on the energy offset between the Frenkel exciton and the CT state are also analyzed. The current results indicate that only a small energy offset between the band gap and the lowest energy CT state is needed to achieve efficient free charge generation in OPV devices, which agrees with recent experimental findings.

Kynurenine-3-monooxygenase inhibition prevents multiple organ failure in rodent models of acute pancreatitis.

Science.gov (United States)

Mole, Damian J; Webster, Scott P; Uings, Iain; Zheng, Xiaozhong; Binnie, Margaret; Wilson, Kris; Hutchinson, Jonathan P; Mirguet, Olivier; Walker, Ann; Beaufils, Benjamin; Ancellin, Nicolas; Trottet, Lionel; Bénéton, Véronique; Mowat, Christopher G; Wilkinson, Martin; Rowland, Paul; Haslam, Carl; McBride, Andrew; Homer, Natalie Z M; Baily, James E; Sharp, Matthew G F; Garden, O James; Hughes, Jeremy; Howie, Sarah E M; Holmes, Duncan S; Liddle, John; Iredale, John P

2016-02-01

Acute pancreatitis (AP) is a common and devastating inflammatory condition of the pancreas that is considered to be a paradigm of sterile inflammation leading to systemic multiple organ dysfunction syndrome (MODS) and death. Acute mortality from AP-MODS exceeds 20% (ref. 3), and the lifespans of those who survive the initial episode are typically shorter than those of the general population. There are no specific therapies available to protect individuals from AP-MODS. Here we show that kynurenine-3-monooxygenase (KMO), a key enzyme of tryptophan metabolism, is central to the pathogenesis of AP-MODS. We created a mouse strain that is deficient for Kmo (encoding KMO) and that has a robust biochemical phenotype that protects against extrapancreatic tissue injury to the lung, kidney and liver in experimental AP-MODS. A medicinal chemistry strategy based on modifications of the kynurenine substrate led to the discovery of the oxazolidinone GSK180 as a potent and specific inhibitor of KMO. The binding mode of the inhibitor in the active site was confirmed by X-ray co-crystallography at 3.2 Å resolution. Treatment with GSK180 resulted in rapid changes in the levels of kynurenine pathway metabolites in vivo, and it afforded therapeutic protection against MODS in a rat model of AP. Our findings establish KMO inhibition as a novel therapeutic strategy in the treatment of AP-MODS, and they open up a new area for drug discovery in critical illness.

Managing multiple funding streams and agendas to achieve local and global health and research objectives: lessons from the field.

Science.gov (United States)

Holmes, Charles B; Sikazwe, Izukanji; Raelly, Roselyne L; Freeman, Bethany L; Wambulawae, Inonge; Silwizya, Geoffrey; Topp, Stephanie M; Chilengi, Roma; Henostroza, German; Kapambwe, Sharon; Simbeye, Darius; Sibajene, Sheila; Chi, Harmony; Godfrey, Katy; Chi, Benjamin; Moore, Carolyn Bolton

2014-01-01

Multiple funding sources provide research and program implementation organizations a broader base of funding and facilitate synergy, but also entail challenges that include varying stakeholder expectations, unaligned grant cycles, and highly variable reporting requirements. Strong governance and strategic planning are essential to ensure alignment of goals and agendas. Systems to track budgets and outputs, as well as procurement and human resources are required. A major goal of funders is to transition leadership and operations to local ownership. This article details successful approaches used by the newly independent nongovernmental organization, the Centre for Infectious Disease Research in Zambia.

METHODOLOGIES FOR ASSESSING THE EFFECTIVENESS OF MEDICAL ORGANIZATIONS THAT PROVIDE OUTPATIENT CARE

Directory of Open Access Journals (Sweden)

Mikhail Georgievich Karailanov

2016-08-01

Full Text Available The aim of this study is to analyze the data in the literature, allows to define the basic methodological approaches to the assessment of the effectiveness of health care organizations, as well as important problems of studying the effectiveness of primary health care at the moment. Primary health care is an integral part of the national health system, as a basis for health care delivery system, and includes measures for prevention, diagnosis, treatment of diseases and conditions, medical rehabilitation, monitoring of pregnancy, healthy lifestyles, including reduce risk factors for disease. In the modern development of the health priority and remains the problem of assessing the effectiveness of the medical organization. Health Management is impossible without the identification of priority targets, indicators and parameters to achieve their efficient use of financial, material and human resources, which leads to the need for a methodology for assessing the effectiveness of health interventions that will ensure the relationship management processes and planning, as well as to solve practical problems of the industry.

Optically controlled multiple switching operations of DNA biopolymer devices

International Nuclear Information System (INIS)

Hung, Chao-You; Tu, Waan-Ting; Lin, Yi-Tzu; Fruk, Ljiljana; Hung, Yu-Chueh

2015-01-01

We present optically tunable operations of deoxyribonucleic acid (DNA) biopolymer devices, where a single high-resistance state, write-once read-many-times memory state, write-read-erase memory state, and single low-resistance state can be achieved by controlling UV irradiation time. The device is a simple sandwich structure with a spin-coated DNA biopolymer layer sandwiched by two electrodes. Upon irradiation, the electrical properties of the device are adjusted owing to a phototriggered synthesis of silver nanoparticles in DNA biopolymer, giving rise to multiple switching scenarios. This technique, distinct from the strategy of doping of pre-formed nanoparticles, enables a post-film fabrication process for achieving optically controlled memory device operations, which provides a more versatile platform to fabricate organic memory and optoelectronic devices

Optically controlled multiple switching operations of DNA biopolymer devices

Energy Technology Data Exchange (ETDEWEB)

Hung, Chao-You; Tu, Waan-Ting; Lin, Yi-Tzu [Institute of Photonics Technologies, National Tsing Hua University, Hsinchu 30013, Taiwan (China); Fruk, Ljiljana [Department of Chemical Engineering and Biotechnology, University of Cambridge, Pembroke Street, Cambridge CB2 3RA (United Kingdom); Hung, Yu-Chueh, E-mail: ychung@ee.nthu.edu.tw [Institute of Photonics Technologies, National Tsing Hua University, Hsinchu 30013, Taiwan (China); Department of Electrical Engineering, National Tsing Hua University, Hsinchu 30013, Taiwan (China)

2015-12-21

We present optically tunable operations of deoxyribonucleic acid (DNA) biopolymer devices, where a single high-resistance state, write-once read-many-times memory state, write-read-erase memory state, and single low-resistance state can be achieved by controlling UV irradiation time. The device is a simple sandwich structure with a spin-coated DNA biopolymer layer sandwiched by two electrodes. Upon irradiation, the electrical properties of the device are adjusted owing to a phototriggered synthesis of silver nanoparticles in DNA biopolymer, giving rise to multiple switching scenarios. This technique, distinct from the strategy of doping of pre-formed nanoparticles, enables a post-film fabrication process for achieving optically controlled memory device operations, which provides a more versatile platform to fabricate organic memory and optoelectronic devices.

Substrate-Integrated Waveguide PCB Leaky-Wave Antenna Design Providing Multiple Steerable Beams in the V-Band

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Matthias Steeg

2017-12-01

Full Text Available A periodic leaky-wave antenna (LWA design based on low loss substrate-integrated waveguide (SIW technology with inset half-wave microstrip antennas is presented. The developed LWA operates in the V-band between 50 and 70 GHz and has been fabricated using standard printed circuit board (PCB technology. The presented LWA is highly functional and very compact supporting 1D beam steering and multibeam operation with only a single radio frequency (RF feeding port. Within the operational 50–70 GHz bandwidth, the LWA scans through broadside, providing over 40° H-plane beam steering. When operated within the 57–66 GHz band, the maximum steering angle is 18.2°. The maximum gain of the fabricated LWAs is 15.4 dBi with only a small gain variation of +/−1.5 dB across the operational bandwidth. The beam steering and multibeam capability of the fabricated LWA is further utilized to support mobile users in a 60 GHz hot-spot. For a single user, a maximum wireless on-off keying (OOK data rate of 2.5 Gbit/s is demonstrated. Multibeam operation is achieved using the LWA in combination with multiple dense wavelength division multiplexing (WDM channels and remote optical heterodyning. Experimentally, multibeam operation supporting three users within a 57–66 GHz hot-spot with a total wireless cell capacity of 3 Gbit/s is achieved.

Organic/inorganic electrochromic nanocomposites with various interfacial interactions: A review

Energy Technology Data Exchange (ETDEWEB)

Xiong, Shanxin, E-mail: xiongsx@xust.edu.cn; Yin, Siyuan; Wang, Yuyun; Kong, Zhenzhen; Lan, Jinpeng; Zhang, Runlan; Gong, Ming; Wu, Bohua; Chu, Jia; Wang, Xiaoqin

2017-07-15

Highlights: • We review the effects of interfacial interactions in electrochromic nanocomposites. • Interfacial interactions are useful for film fabrication and property-enhancement. • The strong interaction can enhance the electron conduction and structural strength. • The weak interactions exist widely between organic and inorganic phases. • Multiple weak interactions can provide various performance-adjusting approaches. - Abstract: Electrochromic properties of organic or inorganic materials can be improved through preparing organic/inorganic electrochromic nanocomposites. In electrochromic nanocomposites, the interfacial interactions between the organic and inorganic phases play three important roles in preparation and application of the nanocomposites. Firstly, the interfacial interactions result in stable molecular structures. Secondly, they also improve the electron conduction and ion transport process in the nanocomposites. Thirdly, they enhance the electrochemical and electrochromic properties of the nanocomposites. In this paper, we review the common interfacial interactions including covalent bond, coordination bond, electrostatic interaction, hydrogen bond and π-π stacking interaction between the organic and inorganic phases in the electrochromic nanocomposites. The preparation method, the relationship between the structure and properties, and the mechanism of modulation of electrochromic effect in the nanocomposites with various interfacial interactions are surveyed. The strong interfacial interaction, e.g., covalent bond, is helpful for obtaining electrochromic nanocomposites with high electron conduction and high structural strength. However it is very complicated to construct covalent bond between the organic and inorganic phases. Another strong interfacial interaction, the coordination bond is mainly confined to preparation of electrochromic complex of metal ion and pyridine derivative. While, the weak interfacial interactions, e

Organic/inorganic electrochromic nanocomposites with various interfacial interactions: A review

International Nuclear Information System (INIS)

Xiong, Shanxin; Yin, Siyuan; Wang, Yuyun; Kong, Zhenzhen; Lan, Jinpeng; Zhang, Runlan; Gong, Ming; Wu, Bohua; Chu, Jia; Wang, Xiaoqin

2017-01-01

Highlights: • We review the effects of interfacial interactions in electrochromic nanocomposites. • Interfacial interactions are useful for film fabrication and property-enhancement. • The strong interaction can enhance the electron conduction and structural strength. • The weak interactions exist widely between organic and inorganic phases. • Multiple weak interactions can provide various performance-adjusting approaches. - Abstract: Electrochromic properties of organic or inorganic materials can be improved through preparing organic/inorganic electrochromic nanocomposites. In electrochromic nanocomposites, the interfacial interactions between the organic and inorganic phases play three important roles in preparation and application of the nanocomposites. Firstly, the interfacial interactions result in stable molecular structures. Secondly, they also improve the electron conduction and ion transport process in the nanocomposites. Thirdly, they enhance the electrochemical and electrochromic properties of the nanocomposites. In this paper, we review the common interfacial interactions including covalent bond, coordination bond, electrostatic interaction, hydrogen bond and π-π stacking interaction between the organic and inorganic phases in the electrochromic nanocomposites. The preparation method, the relationship between the structure and properties, and the mechanism of modulation of electrochromic effect in the nanocomposites with various interfacial interactions are surveyed. The strong interfacial interaction, e.g., covalent bond, is helpful for obtaining electrochromic nanocomposites with high electron conduction and high structural strength. However it is very complicated to construct covalent bond between the organic and inorganic phases. Another strong interfacial interaction, the coordination bond is mainly confined to preparation of electrochromic complex of metal ion and pyridine derivative. While, the weak interfacial interactions, e

How entorhinal grid cells may learn multiple spatial scales from a dorsoventral gradient of cell response rates in a self-organizing map.

Directory of Open Access Journals (Sweden)

Stephen Grossberg

Full Text Available Place cells in the hippocampus of higher mammals are critical for spatial navigation. Recent modeling clarifies how this may be achieved by how grid cells in the medial entorhinal cortex (MEC input to place cells. Grid cells exhibit hexagonal grid firing patterns across space in multiple spatial scales along the MEC dorsoventral axis. Signals from grid cells of multiple scales combine adaptively to activate place cells that represent much larger spaces than grid cells. But how do grid cells learn to fire at multiple positions that form a hexagonal grid, and with spatial scales that increase along the dorsoventral axis? In vitro recordings of medial entorhinal layer II stellate cells have revealed subthreshold membrane potential oscillations (MPOs whose temporal periods, and time constants of excitatory postsynaptic potentials (EPSPs, both increase along this axis. Slower (faster subthreshold MPOs and slower (faster EPSPs correlate with larger (smaller grid spacings and field widths. A self-organizing map neural model explains how the anatomical gradient of grid spatial scales can be learned by cells that respond more slowly along the gradient to their inputs from stripe cells of multiple scales, which perform linear velocity path integration. The model cells also exhibit MPO frequencies that covary with their response rates. The gradient in intrinsic rhythmicity is thus not compelling evidence for oscillatory interference as a mechanism of grid cell firing. A response rate gradient combined with input stripe cells that have normalized receptive fields can reproduce all known spatial and temporal properties of grid cells along the MEC dorsoventral axis. This spatial gradient mechanism is homologous to a gradient mechanism for temporal learning in the lateral entorhinal cortex and its hippocampal projections. Spatial and temporal representations may hereby arise from homologous mechanisms, thereby embodying a mechanistic "neural relativity" that

Syntenic block overlap multiplicities with a panel of reference genomes provide a signature of ancient polyploidization events.

Science.gov (United States)

Zheng, Chunfang; Santos Muñoz, Daniella; Albert, Victor A; Sankoff, David

2015-01-01

Following whole genome duplication (WGD), there is a compact distribution of gene similarities within the genome reflecting duplicate pairs of all the genes in the genome. With time, the distribution broadens and loses volume due to variable decay of duplicate gene similarity and to the process of duplicate gene loss. If there are two WGD, the older one becomes so reduced and broad that it merges with the tail of the distributions resulting from more recent events, and it becomes difficult to distinguish them. The goal of this paper is to advance statistical methods of identifying, or at least counting, the WGD events in the lineage of a given genome. For a set of 15 angiosperm genomes, we analyze all 15 × 14 = 210 ordered pairs of target genome versus reference genome, using SynMap to find syntenic blocks. We consider all sets of B ≥ 2 syntenic blocks in the target genome that overlap in the reference genome as evidence of WGD activity in the target, whether it be one event or several. We hypothesize that in fitting an exponential function to the tail of the empirical distribution f (B) of block multiplicities, the size of the exponent will reflect the amount of WGD in the history of the target genome. By amalgamating the results from all reference genomes, a range of values of SynMap parameters, and alternative cutoff points for the tail, we find a clear pattern whereby multiple-WGD core eudicots have the smallest (negative) exponents, followed by core eudicots with only the single "γ" triplication in their history, followed by a non-core eudicot with a single WGD, followed by the monocots, with a basal angiosperm, the WGD-free Amborella having the largest exponent. The hypothesis that the exponent of the fit to the tail of the multiplicity distribution is a signature of the amount of WGD is verified, but there is also a clear complicating factor in the monocot clade, where a history of multiple WGD is not reflected in a small exponent.

Extending Data Worth Analyses to Select Multiple Observations Targeting Multiple Forecasts

DEFF Research Database (Denmark)

Vilhelmsen, Troels Norvin; Ferre, Ty Paul

2017-01-01

. In the present study, we extend previous data worth analyses to include: simultaneous selection of multiple new measurements and consideration of multiple forecasts of interest. We show how the suggested approach can be used to optimize data collection. This can be used in a manner that suggests specific...... measurement sets or that produces probability maps indicating areas likely to be informative for specific forecasts. Moreover, we provide examples documenting that sequential measurement election approaches often lead to suboptimal designs and that estimates of data covariance should be included when...

The Development of Organized Rehearsal

Science.gov (United States)

Weist, Richard M.; Crawford, Jack

1977-01-01

In a study of development of organization strategies in rehearsal processes, children in the first, third, and fifth grades were exposed to a memory task which involved multiple overt rehearsal and recall phases. (SB)

Automatic plankton image classification combining multiple view features via multiple kernel learning.

Science.gov (United States)

Zheng, Haiyong; Wang, Ruchen; Yu, Zhibin; Wang, Nan; Gu, Zhaorui; Zheng, Bing

2017-12-28

Plankton, including phytoplankton and zooplankton, are the main source of food for organisms in the ocean and form the base of marine food chain. As the fundamental components of marine ecosystems, plankton is very sensitive to environment changes, and the study of plankton abundance and distribution is crucial, in order to understand environment changes and protect marine ecosystems. This study was carried out to develop an extensive applicable plankton classification system with high accuracy for the increasing number of various imaging devices. Literature shows that most plankton image classification systems were limited to only one specific imaging device and a relatively narrow taxonomic scope. The real practical system for automatic plankton classification is even non-existent and this study is partly to fill this gap. Inspired by the analysis of literature and development of technology, we focused on the requirements of practical application and proposed an automatic system for plankton image classification combining multiple view features via multiple kernel learning (MKL). For one thing, in order to describe the biomorphic characteristics of plankton more completely and comprehensively, we combined general features with robust features, especially by adding features like Inner-Distance Shape Context for morphological representation. For another, we divided all the features into different types from multiple views and feed them to multiple classifiers instead of only one by combining different kernel matrices computed from different types of features optimally via multiple kernel learning. Moreover, we also applied feature selection method to choose the optimal feature subsets from redundant features for satisfying different datasets from different imaging devices. We implemented our proposed classification system on three different datasets across more than 20 categories from phytoplankton to zooplankton. The experimental results validated that our system

Organ Donation and Transplantation: A Dialogue with American Indian Healers and Western Health-Care Providers

Science.gov (United States)

Hodge, Felicia Schanche; Bellanger, Patricia; Norman, Connie

2011-01-01

Surgically replacing organs in the human body has become an acceptable and successful procedure in Western medicine. In more recent years, replacing major organs in the human body with those procured from deceased or living donors has become commonplace. Disparities exist at the earliest stages in the donor and transplantation process in that…

Novel VEGF decoy receptor fusion protein conbercept targeting multiple VEGF isoforms provide remarkable anti-angiogenesis effect in vivo.

Directory of Open Access Journals (Sweden)

Qin Wang

Full Text Available VEGF family factors are known to be the principal stimulators of abnormal angiogenesis, which play a fundamental role in tumor and various ocular diseases. Inhibition of VEGF is widely applied in antiangiogenic therapy. Conbercept is a novel decoy receptor protein constructed by fusing VEGF receptor 1 and VEGF receptor 2 extracellular domains with the Fc region of human immunoglobulin. In this study, we systematically evaluated the binding affinity of conbercept with VEGF isoforms and PlGF by using anti-VEGF antibody (Avastin as reference. BIACORE and ELISA assay results indicated that conbercept could bind different VEGF-A isoforms with higher affinity than reference. Furthermore, conbercept could also bind VEGF-B and PlGF, whereas Avastin showed no binding. Oxygen-induced retinopathy model showed that conbercept could inhibit the formation of neovasularizations. In tumor-bearing nude mice, conbercept could also suppress tumor growth very effectively in vivo. Overall, our study have demonstrated that conbercept could bind with high affinity to multiple VEGF isoforms and consequently provide remarkable anti-angiogenic effect, suggesting the possibility to treat angiogenesis-related diseases such as cancer and wet AMD etc.

Consolidation of medical groups into physician practice management organizations.

Science.gov (United States)

Robinson, J C

1998-01-14

Medical groups are growing and merging to improve efficiency and bargaining leverage in the competitive managed care environment. An increasing number are affiliating with physician practice management (PPM) firms that offer capital financing, expertise in utilization management, and global capitation contracts with health insurance entities. These physician organizations provide an alternative to affiliation with a hospital system and to individual physician contracting with health plans. To describe the growth, structure, and strategy of PPM organizations that coordinate medical groups in multiple markets and contract with health maintenance organizations (HMOs). Case studies, including interviews with administrative and clinical leaders, review of company documents, and analysis of documents from investment bankers, the Securities and Exchange Commission, and industry observers. Medical groups and independent practice associations (IPAs) in California and New Jersey affiliated with MedPartners, FPA Medical Management, and UniMed. Growth in number of primary care and specialty care physicians employed by and contracting with affiliated medical groups; growth in patient enrollment from commercial, Medicare, and Medicaid HMOs; growth in capitation and noncapitation revenues; structure and governance of affiliated management service organizations and professional corporations; and contracting strategies with HMOs. Between 1994 and 1996, medical groups and IPAs affiliated with 3 PPMs grew from 3787 to 25763 physicians; 65% of employed physicians provide primary care, while the majority of contracting physicians provide specialty care. Patient enrollment in HMOs grew from 285503 to 3028881. Annual capitation revenues grew from $190 million to $2.1 billion. Medical groups affiliated with PPMs are capitated for most professional, hospital, and ancillary clinical services and are increasingly delegated responsibility by HMOs for utilization management and quality

Kynurenine–3–monooxygenase inhibition prevents multiple organ failure in rodent models of acute pancreatitis

Science.gov (United States)

Mole, Damian J; Webster, Scott P; Uings, Iain; Zheng, Xiaozhong; Binnie, Margaret; Wilson, Kris; Hutchinson, Jonathan P; Mirguet, Olivier; Walker, Ann; Beaufils, Benjamin; Ancellin, Nicolas; Trottet, Lionel; Bénéton, Véronique; Mowat, Christopher G; Wilkinson, Martin; Rowland, Paul; Haslam, Carl; McBride, Andrew; Homer, Natalie ZM; Baily, James E; Sharp, Matthew GF; Garden, O James; Hughes, Jeremy; Howie, Sarah EM; Holmes, Duncan S; Liddle, John; Iredale, John P

2015-01-01

Acute pancreatitis (AP) is a common and devastating inflammatory condition of the pancreas that is considered to be a paradigm of sterile inflammation leading to systemic multiple organ dysfunction syndrome (MODS) and death1,2 Acute mortality from AP-MODS exceeds 20%3 and for those who survive the initial episode, their lifespan is typically shorter than the general population4. There are no specific therapies available that protect individuals against AP-MODS. Here, we show that kynurenine-3-monooxygenase (KMO), a key enzyme of tryptophan metabolism5, is central to the pathogenesis of AP-MODS. We created a mouse strain deficient for Kmo with a robust biochemical phenotype that protected against extrapancreatic tissue injury to lung, kidney and liver in experimental AP-MODS. A medicinal chemistry strategy based on modifications of the kynurenine substrate led to the discovery of GSK180 as a potent and specific inhibitor of KMO. The binding mode of the inhibitor in the active site was confirmed by X-ray co-crystallography at 3.2 Å resolution. Treatment with GSK180 resulted in rapid changes in levels of kynurenine pathway metabolites in vivo and afforded therapeutic protection against AP-MODS in a rat model of AP. Our findings establish KMO inhibition as a novel therapeutic strategy in the treatment of AP-MODS and open up a new area for drug discovery in critical illness. PMID:26752518

Multiple Chemical Sensitivity

DEFF Research Database (Denmark)

Dantoft, Thomas Meinertz

Multiple chemical sensitivity (MCS) is a chronic disorder characterized by reports of symptoms from various organ systems attributed by the individuals to exposure to common odors and airborne chemicals in doses far below those known to induce toxic effects. There exists a general lack of knowledge......, significantly reduced levels of IL-13 in the MCS group and no group differences in the allergen specific IgE measures. The differences were independent of factors such as sex, age, Body Mass Index, asthma, smoking, depression, anxiety and allergen-specific IgE. In conclusion, the study identified a distinct...

SPECTRAL COLOR INDICES BASED GEOSPATIAL MODELING OF SOIL ORGANIC MATTER IN CHITWAN DISTRICT, NEPAL

Directory of Open Access Journals (Sweden)

U. K. Mandal

2016-06-01

Full Text Available Space Technology provides a resourceful-cost effective means to assess soil nutrients essential for soil management plan. Soil organic matter (SOM is one of valuable controlling productivity of crops by providing nutrient in farming systems. Geospatial modeling of soil organic matter is essential if there is unavailability of soil test laboratories and its strong spatial correlation. In the present analysis, soil organic matter is modeled from satellite image derived spectral color indices. Brightness Index (BI, Coloration Index (CI, Hue Index (HI, Redness Index (RI and Saturation Index (SI were calculated by converting DN value to radiance and radiance to reflectance from Thematic Mapper image. Geospatial model was developed by regressing SOM with color indices and producing multiple regression model using stepwise regression technique. The multiple regression equation between SOM and spectral indices was significant with R = 0. 56 at 95% confidence level. The resulting MLR equation was then used for the spatial prediction for the entire study area. Redness Index was found higher significance in estimating the SOM. It was used to predict SOM as auxiliary variables using cokringing spatial interpolation technique. It was tested in seven VDCs of Chitwan district of Nepal using Thematic Mapper remotely sensed data. SOM was found to be measured ranging from 0.15% to 4.75 %, with a mean of 2.24 %. Remotely sensed data derived spectral color indices have the potential as useful auxiliary variables for estimating SOM content to generate soil fertility management plans.

Cost effective tools for soil organic carbon monitoring

Science.gov (United States)

Shepherd, Keith; Aynekulu, Ermias

2013-04-01

There is increasing demand for data on soil properties at fine spatial resolution to support management and planning decisions. Measurement of soil organic carbon has attracted much interest because (i) soil organic carbon is widely cited as a useful indicator of soil condition and (ii) of the importance of soil carbon in the global carbon cycle and climate mitigation strategies. However in considering soil measurement designs there has been insufficient attention given to careful analysis of the specific decisions that the measurements are meant to support and on what measurements have high information value for decision-making. As a result, much measurement effort may be wasted or focused on the wrong variables. A cost-effective measurement is one that reduces risk in decisions and does not cost more than the societal returns to additional evidence. A key uncertainty in measuring soil carbon as a soil condition indicator is what constitutes a good or bad level of carbon on a given soil. A measure of soil organic carbon concentration may have limited value for informing management decisions without the additional information required to interpret it, and so expending further efforts on improving measurements to increase precision may then have no value to improving the decision. Measuring soil carbon stock changes for carbon trading purposes requires high levels of measurement precision but there is still large uncertainty on whether the costs of measurement exceed the benefits. Since the largest cost component in soil monitoring is often travel to the field and physically sampling soils, it is generally cost-effective to meet multiple objectives by analysing a number of properties on a soil sample. Diffuse reflectance infrared spectroscopy is playing a key role in allowing multiple soil properties to be determined rapidly and at low cost. The method provides estimation of multiple soil properties (e.g. soil carbon, texture and mineralogy) in one measurement

Quantitative analysis of oyster larval proteome provides new insights into the effects of multiple climate change stressors

KAUST Repository

Dineshram, Ramadoss; Chandramouli, Kondethimmanahalli; Ko, Ginger Wai Kuen; Zhang, Huoming; Qian, Pei-Yuan; Ravasi, Timothy; Thiyagarajan, Vengatesen

2016-01-01

might be affected in a future ocean, we examined changes in the proteome of metamorphosing larvae under multiple stressors: decreased pH (pH 7.4), increased temperature (30 °C), and reduced salinity (15 psu). Quantitative protein expression profiling

Genome complexity, robustness and genetic interactions in digital organisms

Science.gov (United States)

Lenski, Richard E.; Ofria, Charles; Collier, Travis C.; Adami, Christoph

1999-08-01

Digital organisms are computer programs that self-replicate, mutate and adapt by natural selection. They offer an opportunity to test generalizations about living systems that may extend beyond the organic life that biologists usually study. Here we have generated two classes of digital organism: simple programs selected solely for rapid replication, and complex programs selected to perform mathematical operations that accelerate replication through a set of defined `metabolic' rewards. To examine the differences in their genetic architecture, we introduced millions of single and multiple mutations into each organism and measured the effects on the organism's fitness. The complex organisms are more robust than the simple ones with respect to the average effects of single mutations. Interactions among mutations are common and usually yield higher fitness than predicted from the component mutations assuming multiplicative effects; such interactions are especially important in the complex organisms. Frequent interactions among mutations have also been seen in bacteria, fungi and fruitflies. Our findings support the view that interactions are a general feature of genetic systems.

The promise of organ and tissue preservation to transform medicine.

Science.gov (United States)

Giwa, Sebastian; Lewis, Jedediah K; Alvarez, Luis; Langer, Robert; Roth, Alvin E; Church, George M; Markmann, James F; Sachs, David H; Chandraker, Anil; Wertheim, Jason A; Rothblatt, Martine; Boyden, Edward S; Eidbo, Elling; Lee, W P Andrew; Pomahac, Bohdan; Brandacher, Gerald; Weinstock, David M; Elliott, Gloria; Nelson, David; Acker, Jason P; Uygun, Korkut; Schmalz, Boris; Weegman, Brad P; Tocchio, Alessandro; Fahy, Greg M; Storey, Kenneth B; Rubinsky, Boris; Bischof, John; Elliott, Janet A W; Woodruff, Teresa K; Morris, G John; Demirci, Utkan; Brockbank, Kelvin G M; Woods, Erik J; Ben, Robert N; Baust, John G; Gao, Dayong; Fuller, Barry; Rabin, Yoed; Kravitz, David C; Taylor, Michael J; Toner, Mehmet

2017-06-07

The ability to replace organs and tissues on demand could save or improve millions of lives each year globally and create public health benefits on par with curing cancer. Unmet needs for organ and tissue preservation place enormous logistical limitations on transplantation, regenerative medicine, drug discovery, and a variety of rapidly advancing areas spanning biomedicine. A growing coalition of researchers, clinicians, advocacy organizations, academic institutions, and other stakeholders has assembled to address the unmet need for preservation advances, outlining remaining challenges and identifying areas of underinvestment and untapped opportunities. Meanwhile, recent discoveries provide proofs of principle for breakthroughs in a family of research areas surrounding biopreservation. These developments indicate that a new paradigm, integrating multiple existing preservation approaches and new technologies that have flourished in the past 10 years, could transform preservation research. Capitalizing on these opportunities will require engagement across many research areas and stakeholder groups. A coordinated effort is needed to expedite preservation advances that can transform several areas of medicine and medical science.

Microbiology of Peritonitis in Peritoneal Dialysis Patients with Multiple Episodes

Science.gov (United States)

Nessim, Sharon J.; Nisenbaum, Rosane; Bargman, Joanne M.; Jassal, Sarbjit V.

2012-01-01

♦ Background: Peritoneal dialysis (PD)–associated peritonitis clusters within patients. Patient factors contribute to peritonitis risk, but there is also entrapment of organisms within the biofilm that forms on PD catheters. It is hypothesized that this biofilm may prevent complete eradication of organisms, predisposing to multiple infections with the same organism. ♦ Methods: Using data collected in the Canadian multicenter Baxter POET (Peritonitis, Organism, Exit sites, Tunnel infections) database from 1996 to 2005, we studied incident PD patients with 2 or more peritonitis episodes. We determined the proportion of patients with 2 or more episodes caused by the same organism. In addition, using a multivariate logistic regression model, we tested whether prior peritonitis with a given organism predicted the occurrence of a subsequent episode with the same organism. ♦ Results: During their time on PD, 558 patients experienced 2 or more peritonitis episodes. Of those 558 patients, 181 (32%) had at least 2 episodes with the same organism. The organism most commonly causing repeat infection was coagulase-negative Staphylococcus (CNS), accounting for 65.7% of cases. Compared with peritonitis caused by other organisms, a first CNS peritonitis episode was associated with an increased risk of subsequent CNS peritonitis within 1 year (odds ratio: 2.1; 95% confidence interval: 1.5 to 2.8; p peritonitis, 48% of repeat episodes occurred within 6 months of the earlier episode. ♦ Conclusions: In contrast to previous data, we did not find a high proportion of patients with multiple peritonitis episodes caused by the same organism. Coagulase-negative Staphylococcus was the organism most likely to cause peritonitis more than once in a given patient, and a prior CNS peritonitis was associated with an increased risk of CNS peritonitis within the subsequent year. PMID:22215659

Hadron multiplicities at COMPASS

Energy Technology Data Exchange (ETDEWEB)

Du Fresne von Hohenesche, Nicolas [Institut fuer Kernphysik, Universitaet Mainz, Johann-Joachim-Becher-Weg 45, 55128 Mainz (Germany); Collaboration: COMPASS Collaboration

2014-07-01

Quark fragmentation functions (FF) D{sub q}{sup h}(z,Q{sup 2}) describe final-state hadronization of quarks q into hadrons h. The FFs can be extracted from hadron multiplicities produced in semi-inclusive deep inelastic scattering. The COMPASS collaboration has recently measured charged hadron multiplicities for identified pions and kaons using a 160 GeV/c muon beam impinging on an iso-scalar target. The data cover a large kinematical range and provide an important input for global QCD analyses of world data at NLO, aiming at the determination of FFs in particular in the strange quark sector. The newest results from COMPASS on pion and kaon multiplicities will be presented.

SemanticOrganizer: A Customizable Semantic Repository for Distributed NASA Project Teams

Science.gov (United States)

Keller, Richard M.; Berrios, Daniel C.; Carvalho, Robert E.; Hall, David R.; Rich, Stephen J.; Sturken, Ian B.; Swanson, Keith J.; Wolfe, Shawn R.

2004-01-01

SemanticOrganizer is a collaborative knowledge management system designed to support distributed NASA projects, including diverse teams of scientists, engineers, and accident investigators. The system provides a customizable, semantically structured information repository that stores work products relevant to multiple projects of differing types. SemanticOrganizer is one of the earliest and largest semantic web applications deployed at NASA to date, and has been used in diverse contexts ranging from the investigation of Space Shuttle Columbia's accident to the search for life on other planets. Although the underlying repository employs a single unified ontology, access control and ontology customization mechanisms make the repository contents appear different for each project team. This paper describes SemanticOrganizer, its customization facilities, and a sampling of its applications. The paper also summarizes some key lessons learned from building and fielding a successful semantic web application across a wide-ranging set of domains with diverse users.

Multiple intelligence: ethical leadership feature consistent financial institutions.

Directory of Open Access Journals (Sweden)

Diamela Nava

2015-03-01

Full Text Available This study aims to make a theoretical underpinning contrast analysis on the multiple intelligences: consistent feature of Ethical Leadership in Financial Institutions. However, this research was conducted under a qualitative approach, a descriptive, using document analysis, which eventually might be considered that would support multiple intelligences to implement certain capabilities, to achieve the objectives with the purpose and from the rational point of view, to know how to establish significant changes in some ways it is, the way to assess the cognitive abilities of integrating human talent in organizations. Therefore, the role of the leader is to guide and support the development of human potential in their group as a community of interest in order to achieve the aspirations of the organization using intelligence as a strategic tool in different ways to not limit your imagination, judgment, and cooperative action.  

A Reference Architecture for Providing Tools as a Service to Support Global Software Development

DEFF Research Database (Denmark)

Chauhan, Aufeef

2014-01-01

-computing paradigm for addressing above-mentioned issues by providing a framework to select appropriate tools as well as associated services and reference architecture of the cloud-enabled middleware platform that allows on demand provisioning of software engineering Tools as a Service (TaaS) with focus......Global Software Development (GSD) teams encounter challenges that are associated with distribution of software development activities across multiple geographic regions. The limited support for performing collaborative development and engineering activities and lack of sufficient support......-based solutions. The restricted ability of the organizations to have desired alignment of tools with software engineering and development processes results in administrative and managerial overhead that incur increased development cost and poor product quality. Moreover, stakeholders involved in the projects have...

Multiple organ definition in CT using a Bayesian approach for 3D model fitting

Science.gov (United States)

Boes, Jennifer L.; Weymouth, Terry E.; Meyer, Charles R.

1995-08-01

Organ definition in computed tomography (CT) is of interest for treatment planning and response monitoring. We present a method for organ definition using a priori information about shape encoded in a set of biometric organ models--specifically for the liver and kidney-- that accurately represents patient population shape information. Each model is generated by averaging surfaces from a learning set of organ shapes previously registered into a standard space defined by a small set of landmarks. The model is placed in a specific patient's data set by identifying these landmarks and using them as the basis for model deformation; this preliminary representation is then iteratively fit to the patient's data based on a Bayesian formulation of the model's priors and CT edge information, yielding a complete organ surface. We demonstrate this technique using a set of fifteen abdominal CT data sets for liver surface definition both before and after the addition of a kidney model to the fitting; we demonstrate the effectiveness of this tool for organ surface definition in this low-contrast domain.

Magnetoresistance in hybrid organic spin valves at the onset of multiple-step tunneling.

Science.gov (United States)

Schoonus, J J H M; Lumens, P G E; Wagemans, W; Kohlhepp, J T; Bobbert, P A; Swagten, H J M; Koopmans, B

2009-10-02

By combining experiments with simple model calculations, we obtain new insight in spin transport through hybrid, CoFeB/Al2O3(1.5 nm)/tris(8-hydroxyquinoline)aluminium (Alq3)/Co spin valves. We have measured the characteristic changes in the I-V behavior as well as the intrinsic loss of magnetoresistance at the onset of multiple-step tunneling. In the regime of multiple-step tunneling, under the condition of low hopping rates, spin precession in the presence of hyperfine coupling is conjectured to be the relevant source of spin relaxation. A quantitative analysis leads to the prediction of a symmetric magnetoresistance around zero magnetic field in addition to the hysteretic magnetoresistance curves, which are indeed observed in our experiments.

Early changes within the lymphocyte population are associated with the development of multiple organ dysfunction syndrome in trauma patients.

Science.gov (United States)

Manson, Joanna; Cole, Elaine; De'Ath, Henry D; Vulliamy, Paul; Meier, Ute; Pennington, Dan; Brohi, Karim

2016-06-07

Early survival following severe injury has been improved with refined resuscitation strategies. Multiple organ dysfunction syndrome (MODS) is common among this fragile group of patients leading to prolonged hospital stay and late mortality. MODS after trauma is widely attributed to dysregulated inflammation but the precise mechanics of this response and its influence on organ injury are incompletely understood. This study was conducted to investigate the relationship between early lymphocyte responses and the development of MODS during admission. During a 24-month period, trauma patients were recruited from an urban major trauma centre to an ongoing, observational cohort study. Admission blood samples were obtained within 2 h of injury and before in-hospital intervention, including blood transfusion. The study population was predominantly male with a blunt mechanism of injury. Lymphocyte subset populations including T helper, cytotoxic T cells, NK cells and γδ T cells were identified using flow cytometry. Early cytokine release and lymphocyte count during the first 7 days of admission were also examined. This study demonstrated that trauma patients who developed MODS had an increased population of NK dim cells (MODS vs no MODS: 22 % vs 13 %, p < 0.01) and reduced γδ-low T cells (MODS vs no MODS: 0.02 (0.01-0.03) vs 0.09 (0.06-0.12) × 10^9/L, p < 0.01) at admission. Critically injured patients who developed MODS (n = 27) had higher interferon gamma (IFN-γ) concentrations at admission, compared with patients of matched injury severity and shock (n = 60) who did not develop MODS (MODS vs no MODS: 4.1 (1.8-9.0) vs 1.0 (0.6-1.8) pg/ml, p = 0.01). Lymphopenia was observed within 24 h of injury and was persistent in those who developed MODS. Patients with a lymphocyte count of 0.5 × 10(9)/L or less at 48 h, had a 45 % mortality rate. This study provides evidence of lymphocyte activation within 2 h of injury, as demonstrated by

Factors associated with contingency management adoption among opioid treatment providers receiving a comprehensive implementation strategy.

Science.gov (United States)

Becker, Sara J; Kelly, Lourah M; Kang, Augustine W; Escobar, Katherine I; Squires, Daniel D

2018-03-29

Contingency management (CM) is an evidence-based behavioral intervention for opioid use disorders (OUDs); however, CM adoption in OUD treatment centers remains low due to barriers at patient, provider, and organizational levels. In a recent trial, OUD treatment providers who received the Science to Service Laboratory (SSL), a multilevel implementation strategy developed by a federally funded addiction training center, had significantly greater odds of CM adoption than providers who received training as usual. This study examined whether CM adoption frequency varied as a function of provider sociodemographic characteristics (i.e., age, race/ethnicity, licensure) and perceived barriers to adoption (i.e., patient-, provider-, organization-level) among providers receiving the SSL in an opioid treatment program. Thirty-nine providers (67% female, 77% non-Hispanic white, 72% with specialty licensure, M age = 42 [SD = 11.46]) received the SSL, which consisted of didactic training, performance feedback, specialized training of internal change champions, and external coaching. Providers completed a comprehensive baseline assessment and reported on their adoption of CM biweekly for 52 weeks. Providers reported using CM an average of nine 2-week intervals (SD = 6.35). Hierarchical multiple regression found that providers identifying as younger, non-Hispanic white, and without addiction-related licensure all had higher levels of CM adoption frequency. Higher perceived patient-level barriers predicted lower levels of CM adoption frequency, whereas provider- and organization-level barriers were not significant predictors. The significant effect of age on CM adoption frequency was consistent with prior research on predictors of evidence-based practice adoption, whereas the effect of licensure was counter to prior research. The finding that CM adoption frequency was lower among racially/ethnically diverse providers was not expected and suggests that the SSL may require adaptation

Current status of multiple antigen-presenting peptide vaccine systems: Application of organic and inorganic nanoparticles

Directory of Open Access Journals (Sweden)

Taguchi Hiroaki

2011-08-01

Full Text Available Abstract Many studies are currently investigating the development of safe and effective vaccines to prevent various infectious diseases. Multiple antigen-presenting peptide vaccine systems have been developed to avoid the adverse effects associated with conventional vaccines (i.e., live-attenuated, killed or inactivated pathogens, carrier proteins and cytotoxic adjuvants. Recently, two main approaches have been used to develop multiple antigen-presenting peptide vaccine systems: (1 the addition of functional components, e.g., T-cell epitopes, cell-penetrating peptides, and lipophilic moieties; and (2 synthetic approaches using size-defined nanomaterials, e.g., self-assembling peptides, non-peptidic dendrimers, and gold nanoparticles, as antigen-displaying platforms. This review summarizes the recent experimental studies directed to the development of multiple antigen-presenting peptide vaccine systems.

Perception of space by multiple intrinsic frames of reference.

Directory of Open Access Journals (Sweden)

Yanlong Sun

Full Text Available It has been documented that when memorizing a physical space, the person's mental representation of that space is biased with distortion and segmentation. Two experiments reported here suggest that distortion and segmentation arise due to a hierarchical organization of the spatial representation. The spatial relations associated with salient landmarks are more strongly encoded and easier to recall than those associated with non-salient landmarks. In the presence of multiple salient landmarks, multiple intrinsic frames of reference are formed and spatial relations are anchored to each individual frame of reference. Multiple such representations may co-exist and interactively determine a person's spatial performance.

Cloud-based Virtual Organization Engineering

Directory of Open Access Journals (Sweden)

Liviu Gabriel CRETU

2012-01-01

Full Text Available Nowadays we may notice that SOA arrived to its maturity stage and Cloud Computing brings the next paradigm-shift regarding the software delivery business model. In such a context, we consider that there is a need for frameworks to guide the creation, execution and management of virtual organizations (VO based on services from different Clouds. This paper will introduce the main components of such a framework that will innovatively combine the principles of event-driven SOA, REST and ISO/IEC 42010:2007 multiple views and viewpoints in order to provide the required methodology for Cloud-based virtual organization (Cloud-VO engi-neering. The framework will consider the resource concept found in software architectures like REST or RDF as the basic building block of Cloud-VO. and will make use of resources’ URIs to create the Cloud-VO’s resource allocation matrix. While the matrix is used to declare activity-resources relationships, the resource catalogue concept will be introduced as a way to describe the resource in one place, using as many viewpoints as needed, and then to reuse that description for the creation or simulation of different VOs.

The metal-organic framework MIL-53(Al) constructed from multiple metal sources: alumina, aluminum hydroxide, and boehmite.

Science.gov (United States)

Li, Zehua; Wu, Yi-nan; Li, Jie; Zhang, Yiming; Zou, Xin; Li, Fengting

2015-04-27

Three aluminum compounds, namely alumina, aluminum hydroxide, and boehmite, are probed as the metal sources for the hydrothermal synthesis of a typical metal-organic framework MIL-53(Al). The process exhibits enhanced synthetic efficiency without the generation of strongly acidic byproducts. The time-course monitoring of conversion from different aluminum sources into MIL-53(Al) is achieved by multiple characterization that reveals a similar but differentiated crystallinity, porosity, and morphology relative to typical MIL-53(Al) prepared from water-soluble aluminum salts. Moreover, the prepared MIL-53(Al) constructed with the three insoluble aluminum sources exhibit an improved thermal stability of up to nearly 600 °C and enhanced yields. Alumina and boehmite are more preferable than aluminum hydroxide in terms of product porosity, yield, and reaction time. The adsorption performances of a typical environmental endocrine disruptor, dimethyl phthalate, on the prepared MIL-53(Al) samples are also investigated. The improved structural stability of MIL-53(Al) prepared from these alternative aluminum sources enables double-enhanced adsorption performance (up to 206 mg g(-1)) relative to the conventionally obtained MIL-53(Al). © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Ensuring comparability of data generated by multiple analytical laboratories for environmental decision making at the Fernald Environmental Management Project

International Nuclear Information System (INIS)

Sutton, C.; Campbell, B.A.; Danahy, R.J.; Dugan, T.A.; Tomlinson, F.K.

1994-01-01

The Fernald Environmental Management Project is a US Department of Energy (DOE)-owned facility located 17 miles northwest of Cincinnati, Ohio. From 1952 until 1989, the Fernald site provided high-purity uranium metal products to support US defense programs. In 1989 the mission of Fernald changed from one of uranium production to one of environmental restoration. At Fernald, multiple functional programs require analytical data. Inorganic and organic data for these programs are currently generated by seven laboratories, while radiochemical data are being obtained from six laboratories. Quality Assurance (QA) and Quality Control (QC) programs have been established to help ensure comparability of data generated by multiple laboratories at different times. The quality assurance program for organic and inorganic measurements specifies which analytical methodologies and sample preparation procedures are to be used based on analyte class, sample matrix, and data quality requirements. In contrast, performance specifications have been established for radiochemical analyses. A blind performance evaluation program for all laboratories, both on-site and subcontracted commercial laboratories, provides continuous feedback on data quality. The necessity for subcontractor laboratories to participate in the performance evaluation program is a contractual requirement. Similarly, subcontract laboratories are contractually required to generate data which meet radiochemical performance specifications. The Fernald on-site laboratory must also fulfill these requirements

Organizers.

Science.gov (United States)

Callison, Daniel

2000-01-01

Focuses on "organizers," tools or techniques that provide identification and classification along with possible relationships or connections among ideas, concepts, and issues. Discusses David Ausubel's research and ideas concerning advance organizers; the implications of Ausubel's theory to curriculum and teaching; "webbing," a…

Multiple Family Group Therapy: An Interpersonal/Postmodern Approach.

Science.gov (United States)

Thorngren, Jill M.; Kleist, David M.

2002-01-01

Multiple Family Group Therapy has been identified as a viable treatment model for a variety of client populations. A combination of family systems theories and therapeutic group factors provide the opportunity to explore multiple levels of intrapersonal and interpersonal relationships between families. This article depicts a Multiple Family Group…

Systems of Selves: the Construction of Meaning in Multiple Personality Disorder

Science.gov (United States)

Hughes, Dureen Jean

Current models for understanding both Multiple Personality Disorder and human mentation in general are both linear in nature and self-perpetuating insofar as most research in this area has been informed and shaped by extant psychological concepts, paradigms and methods. The research for this dissertation made use of anthropological concepts and methods in an attempt to gain a richer understanding of both multiple personality and fundamental universal processes of the mind. Intensive fieldwork using in-depth, open-ended interviewing techniques was conducted with people diagnosed with Multiple Personality Disorder with the purpose of mapping their personality systems in order to discover the nature of the relationships between the various alternate personalities and subsystems comprising the overall personality systems. These data were then analyzed in terms of dynamical systems theory ("Chaos Theory") as a way of understanding various phenomena of multiple personality disorder as well as the overall structure of each system. It was found that the application of the formal characteristics of nonlinear models and equations to multiple personality systems provided a number of new perspectives on mental phenomena. The underlying organizational structure of multiple personality systems can be understood as a phenomenon of spontaneous self-organization in far-from -equilibrium states which characterizes dissipative structures. Chaos Theory allows the perspective that the nature of the process of the self and the nature of relationship are one and the same, and that both can be conceived as ideas in struggle at a fractal boundary. Further, such application makes it possible to postulate an iterative process which would have as one of its consequences the formation of a processural self who is conscious of self as separate self. Finally, given that the iterative application of a few simple rules (or instructions) can result in complex systems, an attempt was made to discern

The adipose organ and multiple myeloma: Impact of adipokines on tumor growth and potential sites for therapeutic intervention.

Science.gov (United States)

Allegra, Alessandro; Innao, Vanessa; Gerace, Demetrio; Allegra, Andrea Gaetano; Vaddinelli, Doriana; Bianco, Oriana; Musolino, Caterina

2018-07-01

In addition to its capacity to store lipids the adipose tissue is now identified as a real organ with both endocrine and metabolic roles. Preclinical results indicate that modifying adipose tissue and bone marrow adipose tissue (BMAT) could be a successful multiple myeloma (MM) therapy. BMAT interrelates with bone marrow cells and other immune cells, and may influence MM disease progression. The BM adipocytes may have a role in MM progression, bone homing, chemoresistance, and relapse, due to local endocrine, paracrine, or metabolic factors. BM adipocytes isolated from MM subjects have been shown to increase myeloma growth in vitro and may preserve cells from chemotherapy-induced apoptosis. By producing free fatty acids and emitting signaling molecules such as growth factors and adipokines, BM adipocytes are both an energy font and an endocrine signaling factory. This review should suggest future research approaches toward developing novel treatments to target MM by targeting BMAT and its products. Copyright © 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Can branding by health care provider organizations drive the delivery of higher technical and service quality?

Science.gov (United States)

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

2009-01-01

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.

Healthcare provider relational quality is associated with better self-management and less treatment burden in people with multiple chronic conditions

Directory of Open Access Journals (Sweden)

Eton DT

2017-09-01

Full Text Available David T Eton,1,2 Jennifer L Ridgeway,1,2 Mark Linzer,3 Deborah H Boehm,4 Elizabeth A Rogers,5 Kathleen J Yost,1,2 Lila J Finney Rutten,1,2 Jennifer L St Sauver,1,2 Sara Poplau,4 Roger T Anderson6 1Department of Health Sciences Research, 2Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, 3Division of General Internal Medicine, Hennepin County Medical Center, 4Minneapolis Medical Research Foundation, 5Division of General Internal Medicine, University of Minnesota Medical School, Minneapolis, MN, 6Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA Purpose: Having multiple chronic conditions (MCCs can lead to appreciable treatment and self-management burden. Healthcare provider relational quality (HPRQ – the communicative and interpersonal skill of the provider – may mitigate treatment burden and promote self-management. The objectives of this study were to 1 identify the associations between HPRQ, treatment burden, and psychosocial outcomes in adults with MCCs, and 2 determine if certain indicators of HPRQ are more strongly associated than others with these outcomes.Patients and methods: This is a cross-sectional survey study of 332 people with MCCs. Patients completed a 7-item measure of HPRQ and measures of treatment and self-management burden, chronic condition distress, self-efficacy, provider satisfaction, medication adherence, and physical and mental health. Associations between HPRQ, treatment burden, and psychosocial outcomes were determined using correlational analyses and independent samples t-tests, which were repeated in item-level analyses to explore which indicators of HPRQ were most strongly associated with the outcomes.Results: Most respondents (69% were diagnosed with ≥3 chronic conditions. Better HPRQ was found to be associated with less treatment and self-management burden and better psychosocial outcomes (P<0

Enstore with Chimera namespace provider

International Nuclear Information System (INIS)

Litvintsev, Dmitry; Moibenko, Alexander; Oleynik, Gene; Zalokar, Michael

2012-01-01

Enstore is a mass storage system developed by Fermilab that provides distributed access and management of data stored on tapes. It uses a namespace service, PNFS, developed by DESY to provide a filesystem-like view of the stored data. PNFS is a legacy product and is being replaced by a new implementation, called Chimera, which is also developed by DESY. Chimera offers multiple advantages over PNFS in terms of performance and functionality. The Enstore client component, encp, has been modified to work with Chimera, as well as with any other namespace provider. We performed high load end-to-end acceptance test of Enstore with the Chimera namespace. This paper describes the modifications to Enstore, the test procedure and the results of the acceptance testing.

Multiple time scale dynamics

CERN Document Server

Kuehn, Christian

2015-01-01

This book provides an introduction to dynamical systems with multiple time scales. The approach it takes is to provide an overview of key areas, particularly topics that are less available in the introductory form.  The broad range of topics included makes it accessible for students and researchers new to the field to gain a quick and thorough overview. The first of its kind, this book merges a wide variety of different mathematical techniques into a more unified framework. The book is highly illustrated with many examples and exercises and an extensive bibliography. The target audience of this  book are senior undergraduates, graduate students as well as researchers interested in using the multiple time scale dynamics theory in nonlinear science, either from a theoretical or a mathematical modeling perspective. 

THE MULTIPLE CHOICE PROBLEM WITH INTERACTIONS BETWEEN CRITERIA

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Luiz Flavio Autran Monteiro Gomes

2015-12-01

Full Text Available ABSTRACT An important problem in Multi-Criteria Decision Analysis arises when one must select at least two alternatives at the same time. This can be denoted as a multiple choice problem. In other words, instead of evaluating each of the alternatives separately, they must be combined into groups of n alternatives, where n = 2. When the multiple choice problem must be solved under multiple criteria, the result is a multi-criteria, multiple choice problem. In this paper, it is shown through examples how this problemcan be tackled on a bipolar scale. The Choquet integral is used in this paper to take care of interactions between criteria. A numerical application example is conducted using data from SEBRAE-RJ, a non-profit private organization that has the mission of promoting competitiveness, sustainable developmentand entrepreneurship in the state of Rio de Janeiro, Brazil. The paper closes with suggestions for future research.

Organizing the National Guard to Provide Effective Domestic Operations

Science.gov (United States)

2011-12-01

Secretary of Defense PA Public Affairs PJ Pararescueman QDR Quadrennial Defense Review RAMZ Rigging Alternate Method – Zodiac (Inflatable Boat...National Guard Bureau, 2010, p. 12). This area has increased over the years with this being the most common status of all NG forces. As a sign of...safety of U.S. citizens and U.S. persons  Protecting critical U.S. infrastructure  Providing humanitarian assistance during disaster response and

Representations of Multiple-Valued Logic Functions

CERN Document Server

Stankovic, Radomir S

2012-01-01

Compared to binary switching functions, multiple-valued functions offer more compact representations of the information content of signals modeled by logic functions and, therefore, their use fits very well in the general settings of data compression attempts and approaches. The first task in dealing with such signals is to provide mathematical methods for their representation in a way that will make their application in practice feasible.Representation of Multiple-Valued Logic Functions is aimed at providing an accessible introduction to these mathematical techniques that are necessary for ap

Accounting for multiple climate components when estimating climate change exposure and velocity

Science.gov (United States)

Nadeau, Christopher P.; Fuller, Angela K.

2015-01-01

The effect of anthropogenic climate change on organisms will likely be related to climate change exposure and velocity at local and regional scales. However, common methods to estimate climate change exposure and velocity ignore important components of climate that are known to affect the ecology and evolution of organisms.We develop a novel index of climate change (climate overlap) that simultaneously estimates changes in the means, variation and correlation between multiple weather variables. Specifically, we estimate the overlap between multivariate normal probability distributions representing historical and current or projected future climates. We provide methods for estimating the statistical significance of climate overlap values and methods to estimate velocity using climate overlap.We show that climates have changed significantly across 80% of the continental United States in the last 32 years and that much of this change is due to changes in the variation and correlation between weather variables (two statistics that are rarely incorporated into climate change studies). We also show that projected future temperatures are predicted to be locally novel (using climate overlap compared to 1·4 km yr−1 when estimated using traditional methods.Our results suggest that accounting for changes in the means, variation and correlation between multiple weather variables can dramatically affect estimates of climate change exposure and velocity. These climate components are known to affect the ecology and evolution of organisms, but are ignored by most measures of climate change. We conclude with a set of future directions and recommend future work to determine which measures of climate change exposure and velocity are most related to biological responses to climate change.

The WSPC Reference on Organic Electronics: Organic Semiconductors

KAUST Repository

Bredas, Jean-Luc; Marder, Seth R

2015-01-01

In this chapter, we provide a basic theoretical perspective on charge-carrier transport in organic semiconductors, with a focus on organic molecular crystals. We introduce the microscopic parameters relevant to the intrinsic charge

SUMMIT (Serially Unified Multicenter Multiple Sclerosis Investigation): creating a repository of deeply phenotyped contemporary multiple sclerosis cohorts.

Science.gov (United States)

Bove, Riley; Chitnis, Tanuja; Cree, Bruce Ac; Tintoré, Mar; Naegelin, Yvonne; Uitdehaag, Bernard Mj; Kappos, Ludwig; Khoury, Samia J; Montalban, Xavier; Hauser, Stephen L; Weiner, Howard L

2017-08-01

There is a pressing need for robust longitudinal cohort studies in the modern treatment era of multiple sclerosis. Build a multiple sclerosis (MS) cohort repository to capture the variability of disability accumulation, as well as provide the depth of characterization (clinical, radiologic, genetic, biospecimens) required to adequately model and ultimately predict a patient's course. Serially Unified Multicenter Multiple Sclerosis Investigation (SUMMIT) is an international multi-center, prospectively enrolled cohort with over a decade of comprehensive follow-up on more than 1000 patients from two large North American academic MS Centers (Brigham and Women's Hospital (Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham and Women's Hospital (CLIMB; BWH)) and University of California, San Francisco (Expression/genomics, Proteomics, Imaging, and Clinical (EPIC))). It is bringing online more than 2500 patients from additional international MS Centers (Basel (Universitätsspital Basel (UHB)), VU University Medical Center MS Center Amsterdam (MSCA), Multiple Sclerosis Center of Catalonia-Vall d'Hebron Hospital (Barcelona clinically isolated syndrome (CIS) cohort), and American University of Beirut Medical Center (AUBMC-Multiple Sclerosis Interdisciplinary Research (AMIR)). We provide evidence for harmonization of two of the initial cohorts in terms of the characterization of demographics, disease, and treatment-related variables; demonstrate several proof-of-principle analyses examining genetic and radiologic predictors of disease progression; and discuss the steps involved in expanding SUMMIT into a repository accessible to the broader scientific community.

Exploring the Use of Enterprise Content Management Systems in Unification Types of Organizations

Directory of Open Access Journals (Sweden)

Arshad Noreen Izza

2014-03-01

Full Text Available The aim of this paper is to better understand how highly standardized and integrated businesses known as unification types of organizations use Enterprise Content Management Systems (ECMS to support their business processes. Multiple case study approach was used to study the ways two unification organizations use their ECMS in their daily work practices. Arising from these case studies are insights into the differing ways in which ECMS is used to support businesses. Based on the comparisons of the two cases, this study proposed that unification organizations may use ECMS in four ways, for: (1 collaboration, (2 information sharing that supports a standardized process structure, (3 building custom workflows that support integrated and standardized processes, and (4 providing links and access to information systems. These findings may guide organizations that are highly standardized and integrated in fashion, to achieve their intended ECMS-use, to understand reasons for ECMS failures and underutilization and to exploit technologies investments.

Evaluation of volumetric modulated arc therapy for cranial radiosurgery using multiple noncoplanar arcs

International Nuclear Information System (INIS)

Audet, Chantal; Poffenbarger, Brett A.; Chang, Pauling; Jackson, Paul S.; Lundahl, Robert E.; Ryu, Stephen I.; Ray, Gordon R.

2011-01-01

observed between an organ at risk and a target at the edge of a VMAT arc plane or plane of IMRT fields was 17%/mm. The average absolute percent difference between the measured and calculated central axis dose for all the VMAT plans was 3.6 ± 2.2%. The measured perpendicular profile widths and shifts were on average within 0.5 mm of planned values. The average total MUs for VMAT plans was double the DCA average and similar to the IMRT average. Conclusions: For the aforementioned planning and delivery system and cranial lesions greater than 7 mm in diameter, multiple noncoplanar arc VMAT consistently provides accurate and high quality cranial radiosurgery dose distributions with low doses to healthy brain tissue and high dose conformity to the target. These qualities may make multiple noncoplanar arc VMAT suitable for a greater range of prescription doses or larger and more irregular lesions. For smaller and/or rounder lesions there are other clinically acceptable treatment techniques that may involve fewer couch angles or arcs and reduce treatment times.

Multiple symbol differential detection

Science.gov (United States)

Divsalar, Dariush (Inventor); Simon, Marvin K. (Inventor)

1991-01-01

A differential detection technique for multiple phase shift keying (MPSK) signals is provided which uses a multiple symbol observation interval on the basis of which a joint decision is made regarding the phase of the received symbols. In accordance with the invention, a first difference phase is created between first and second received symbols. Next, the first difference phase is correlated with the possible values thereof to provide a first plurality of intermediate output signals. A second difference phase is next created between second and third received symbols. The second difference phase is correlated with plural possible values thereof to provide a second plurality of intermediate output signals. Next, a third difference phase is created between the first and third symbols. The third difference phase is correlated with plural possible values thereof to provide a third plurality of intermediate output signals. Each of the first plurality of intermediate outputs are combined with each of the second plurality of intermediate outputs and each of the third plurality of intermediate outputs to provide a plurality of possible output values. Finally, a joint decision is made by choosing from the plurality of possible output values the value which represents the best combined correlation of the first, second and third difference values with the possible values thereof.

PHENOMENON OF DEMIKHOV. "Transplantation of vital organs In experiment" (1960. Transplantation immunity, artifi cial circulation in organ transplantation

Directory of Open Access Journals (Sweden)

S. P. Glyantsev

2017-01-01

Full Text Available The article (the fourth of five presents the analysis of the 4th and 5th chapters from V.P.Demikhov's monograph "Transplantation of vital organs in experiment" (MedGIz Publisher, Moscow, 1960, where he described his studies of transplantation immunity in originally created models and his use of artificial blood-circulation systems in experimental organ transplantation. It has been shown that V.P.Demikhov changed his views on the tissue biological incompatibility in homoplastic transplants and turned from the Michurin-Pavlov's concepts (1946–1953 to natural-scientific views (1959. Meanwhile, his multiple attempts to study both the morphological and humoral immunological response to transplanted organs did not give conclusive results because of lacking the experience of such studies even in the country's leading scientists and due the imperfection of their techniques. Realizing that the retrieval of a beating heart from a human would have created further problems for its subsequent transplantation, V.P. Demikhov attempted to reanimate human hearts in corpses by means of extracorporeal devices to provide artificial circulation. Methodologically, those devices were based on S.S.Bryukhonenko's research and his "auto-injector" pump modified by V.P.Demikhov. However, by 1960, those studies had not come beyond the experiments.

Identification of Transgenic Organisms Based on Terahertz Spectroscopy and Hyper Sausage Neuron

Science.gov (United States)

Liu, J.; Li, Zh.; Hu, F.; Chen, T.; Du, Y.; Xin, H.

2015-03-01

This paper presents a novel approach for identifi cation of terahertz (THz) spectra of genetically modifi ed organisms (GMOs) based on hyper sausage neuron (HSN), and THz transmittance spectra of some typical transgenic sugarbeet samples are investigated to demonstrate its feasibility. Principal component analysis (PCA) is applied to extract features of the spectrum data, and instead of the original spectrum data, the feature signals are fed into the HSN pattern recognition, a new multiple weights neural network (MWNN). The experimental result shows that the HSN model not only can correctly classify different types of transgenic sugar-beets, but also can reject nonsimilar samples of the same type. The proposed approach provides a new effective method for detection and identification of genetically modified organisms by using THz spectroscopy.

Extending Data Worth Analyses to Select Multiple Observations Targeting Multiple Forecasts.

Science.gov (United States)

Vilhelmsen, Troels N; Ferré, Ty P A

2017-09-15

Hydrological models are often set up to provide specific forecasts of interest. Owing to the inherent uncertainty in data used to derive model structure and used to constrain parameter variations, the model forecasts will be uncertain. Additional data collection is often performed to minimize this forecast uncertainty. Given our common financial restrictions, it is critical that we identify data with maximal information content with respect to forecast of interest. In practice, this often devolves to qualitative decisions based on expert opinion. However, there is no assurance that this will lead to optimal design, especially for complex hydrogeological problems. Specifically, these complexities include considerations of multiple forecasts, shared information among potential observations, information content of existing data, and the assumptions and simplifications underlying model construction. In the present study, we extend previous data worth analyses to include: simultaneous selection of multiple new measurements and consideration of multiple forecasts of interest. We show how the suggested approach can be used to optimize data collection. This can be used in a manner that suggests specific measurement sets or that produces probability maps indicating areas likely to be informative for specific forecasts. Moreover, we provide examples documenting that sequential measurement election approaches often lead to suboptimal designs and that estimates of data covariance should be included when selecting future measurement sets. © 2017, National Ground Water Association.

Research utilization among children's mental health providers

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Ferguson H Bruce

2008-04-01

Full Text Available Abstract Background Children with emotional and behavioural disorders should be able to count on receiving care that meets their needs and is based on the best scientific evidence available, however, many do not receive these services. Implementation of evidence-based practice (EBP relies, in part, on the research utilization practices of mental health care providers. This study reports on a survey of research utilization practices among 80 children's mental health (CMH service provider organizations in Ontario, Canada. Methods A web-based survey was distributed to 80 CMH service provider organizations, to which 51 executive directors and 483 children's mental health practitioners responded. Research utilization was assessed using questions with Likert-type responses based on the Canadian Health Services Research Foundation's Four-A's approach: access, assess, adapt, apply. Results There was general agreement among executive directors and practitioners regarding the capacity of their organizations to use – access, assess, adapt, and apply – research evidence. Overall, both groups rated their organizations as using research information 'somewhat well.' The low response rate to the practitioner survey should be noted. Conclusion These findings provide a useful benchmark from which changes in reported research utilization in the Ontario CMH sector can be tracked over time, as a function of EBP training and implementation initiatives, for instance. The need to improve access to research evidence should be addressed because it relates to the eventual implementation and uptake of evidence-based practices. Communities of practice are recommended as a strategy that would enable practitioners to build capacity in their adaptation and application of research evidence.

Research utilization among children's mental health providers.

Science.gov (United States)

Barwick, Melanie A; Boydell, Katherine M; Stasiulis, Elaine; Ferguson, H Bruce; Blase, Karen; Fixsen, Dean

2008-04-09

Children with emotional and behavioural disorders should be able to count on receiving care that meets their needs and is based on the best scientific evidence available, however, many do not receive these services. Implementation of evidence-based practice (EBP) relies, in part, on the research utilization practices of mental health care providers. This study reports on a survey of research utilization practices among 80 children's mental health (CMH) service provider organizations in Ontario, Canada. A web-based survey was distributed to 80 CMH service provider organizations, to which 51 executive directors and 483 children's mental health practitioners responded. Research utilization was assessed using questions with Likert-type responses based on the Canadian Health Services Research Foundation's Four-A's approach: access, assess, adapt, apply. There was general agreement among executive directors and practitioners regarding the capacity of their organizations to use - access, assess, adapt, and apply - research evidence. Overall, both groups rated their organizations as using research information 'somewhat well.' The low response rate to the practitioner survey should be noted. These findings provide a useful benchmark from which changes in reported research utilization in the Ontario CMH sector can be tracked over time, as a function of EBP training and implementation initiatives, for instance. The need to improve access to research evidence should be addressed because it relates to the eventual implementation and uptake of evidence-based practices. Communities of practice are recommended as a strategy that would enable practitioners to build capacity in their adaptation and application of research evidence.

The Influence of Multiple Specializations on Economic Performance in U.S. Metropolitan Areas

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Saheum Hong

2016-09-01

Full Text Available Scholars have recently been debating how economic structure affects regional economic performance. Regional economic structure typically indicates how the industries in regions are organized. The attribute of industrial organization in regions is typically measured by how the employment in a region is distributed among various sectors. If the employment in a region is highly concentrated on a limited number of sectors, that region is industrially specialized. On the contrary, when the employment is more evenly distributed among various industries, that region is highly diversified in its industrial organization. In this context, some researchers recognized that diversity and specialization are not opposite concepts. Instead, they can coexist, for example in the form of diversified specializations. In this study, this body of literature was extended by formulating an indicator to measure the extent of multiple specializations in regional economies and by examining the effect of multiple specializations on regional economic performance. Empirical analysis showed that specializing in multiple industrial pursuits helped regions to achieve both faster and more stable economic growth.

Application of neutron multiplicity counting to waste assay

Energy Technology Data Exchange (ETDEWEB)

Pickrell, M.M.; Ensslin, N. [Los Alamos National Lab., NM (United States); Sharpe, T.J. [North Carolina State Univ., Raleigh, NC (United States)

1997-11-01

This paper describes the use of a new figure of merit code that calculates both bias and precision for coincidence and multiplicity counting, and determines the optimum regions for each in waste assay applications. A {open_quotes}tunable multiplicity{close_quotes} approach is developed that uses a combination of coincidence and multiplicity counting to minimize the total assay error. An example is shown where multiplicity analysis is used to solve for mass, alpha, and multiplication and tunable multiplicity is shown to work well. The approach provides a method for selecting coincidence, multiplicity, or tunable multiplicity counting to give the best assay with the lowest total error over a broad spectrum of assay conditions. 9 refs., 6 figs.

Deep transcriptome sequencing provides new insights into the structural and functional organization of the wheat genome.

Science.gov (United States)

Pingault, Lise; Choulet, Frédéric; Alberti, Adriana; Glover, Natasha; Wincker, Patrick; Feuillet, Catherine; Paux, Etienne

2015-02-10

Because of its size, allohexaploid nature, and high repeat content, the bread wheat genome is a good model to study the impact of the genome structure on gene organization, function, and regulation. However, because of the lack of a reference genome sequence, such studies have long been hampered and our knowledge of the wheat gene space is still limited. The access to the reference sequence of the wheat chromosome 3B provided us with an opportunity to study the wheat transcriptome and its relationships to genome and gene structure at a level that has never been reached before. By combining this sequence with RNA-seq data, we construct a fine transcriptome map of the chromosome 3B. More than 8,800 transcription sites are identified, that are distributed throughout the entire chromosome. Expression level, expression breadth, alternative splicing as well as several structural features of genes, including transcript length, number of exons, and cumulative intron length are investigated. Our analysis reveals a non-monotonic relationship between gene expression and structure and leads to the hypothesis that gene structure is determined by its function, whereas gene expression is subject to energetic cost. Moreover, we observe a recombination-based partitioning at the gene structure and function level. Our analysis provides new insights into the relationships between gene and genome structure and function. It reveals mechanisms conserved with other plant species as well as superimposed evolutionary forces that shaped the wheat gene space, likely participating in wheat adaptation.

Multiple sclerosis and other white matter diseases

International Nuclear Information System (INIS)

Zimmerman, R.A.

1991-01-01

The diagnosis of multiple sclerosis (MS) by computerized tomography and nuclear magnetic resonance are shown, including the examination of cerebral spinal fluid. Lymphocytic, foamy histiocytic perivascular cuffing, degenerated oligodendrocytes, and microglia proliferation with relative axonal sparing are presented. In the latter stage of the chronic MS plaque there is sclerosis with microcystic formation with complete demyelination and organization. (author)

Organ dosimetry

International Nuclear Information System (INIS)

Kaul, Dean C.; Egbert, Stephen D.; Otis, Mark D.; Kuhn, Thomas; Kerr, George D.; Eckerman, Keith F.; Cristy, Mark; Ryman, Jeffrey C.; Tang, Jabo S.; Maruyama, Takashi

1987-01-01

This chapter describes the technical approach, complicating factors, and sensitivities and uncertainties of calculations of doses to the organs of the A-bomb survivors. It is the object of the effort so described to provide data that enables the dosimetry system to determine the fluence, kerma, absorbed dose, and similar quantities in 14 organs and the fetus, specified as being of radiobiological interest. This object was accomplished through the use of adjoint Monte Carlo computations, which use a number of random particle histories to determine the relationship of incident neutrons and gamma rays to those transported to a target organ. The system uses these histories to correlate externally-incident energy- and angle-differential fluences with the fluence spectrum (energy differential only) within the target organ. In order for the system to work in the most efficient manner possible, two levels of data were provided. The first level, represented by approximately 6,000 random adjoint-particle histories, enables the computation of the fluence spectrum with sufficient precision to provide statistically reliable (± 6 %) mean doses within any given organ. With this limited history inventory, the system can be run rapidly for all survivors. Mean organ dose and dose uncertainty are obtainable in this mode. The second mode of operation enables the system to produce a good approximation to fluence spectrum within any organ or to produce the dose in each of an array of organ subvolumes. To be statistically reliable, this level of detail requires far more random histories, approximately 40,000 per organ. Thus, operation of the dosimetry system in this mode (i.e., with this data set) is intended to be on an as-needed, organ-specific basis, since the system run time is eight times that in the mean dose mode. (author)

How Does the Modular Organization of Entorhinal Grid Cells Develop?

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Stephen eGrossberg

2014-06-01

Full Text Available The entorhinal-hippocampal system plays a crucial role in spatial cognition and navigation. Since the discovery of grid cells in layer II of medial entorhinal cortex (MEC, several types of models have been proposed to explain their development and operation; namely, continuous attractor network models, oscillatory interference models, and self-organizing map (SOM models. Recent experiments revealing the in vivo intracellular signatures of grid cells (Domnisoru et al., 2013; Schmidt-Heiber & Hausser, 2013, the primarily inhibitory recurrent connectivity of grid cells (Couey et al., 2013; Pastoll et al., 2013, and the topographic organization of grid cells within anatomically overlapping modules of multiple spatial scales along the dorsoventral axis of MEC (Stensola et al., 2012 provide strong constraints and challenges to existing grid cell models. This article provides a computational explanation for how MEC cells can emerge through learning with grid cell properties in modular structures. Within this SOM model, grid cells with different rates of temporal integration learn modular properties with different spatial scales. Model grid cells learn in response to inputs from multiple scales of directionally-selective stripe cells (Krupic et al., 2012; Mhatre et al., 2012 that perform path integration of the linear velocities that are experienced during navigation. Slower rates of grid cell temporal integration support learned associations with stripe cells of larger scales. The explanatory and predictive capabilities of the three types of grid cell models are comparatively analyzed in light of recent data to illustrate how the SOM model overcomes problems that other types of models have not yet handled.

Electronic Processes at Organic−Organic Interfaces: Insight from Modeling and Implications for Opto-electronic Devices †

KAUST Repository

Beljonne, David

2011-02-08

We report on the recent progress achieved in modeling the electronic processes that take place at interfaces between π-conjugated materials in organic opto-electronic devices. First, we provide a critical overview of the current computational techniques used to assess the morphology of organic: organic heterojunctions; we highlight the compromises that are necessary to handle large systems and multiple time scales while preserving the atomistic details required for subsequent computations of the electronic and optical properties. We then review some recent theoretical advances in describing the ground-state electronic structure at heterojunctions between donor and acceptor materials and highlight the role played by charge-transfer and long-range polarization effects. Finally, we discuss the modeling of the excited-state electronic structure at organic:organic interfaces, which is a key aspect in the understanding of the dynamics of photoinduced electron-transfer processes. © 2010 American Chemical Society.

Antibacterial activity of combined medicinal plants extract against multiple drug resistant strains

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Rafiqul Islam

2015-06-01

Full Text Available Objective: To find out the combined antibacterial efficacy of Aegle marmelos, Aphanamixis polystachya, Cuscuta reflexa and Aesclynomene indica against bacterial pathogens. Methods: Antibacterial potency of combined plant extracts has been tested against Bacillus subtilis IFO 3026, Sarcina lutea IFO 3232, Xanthomonas campestris IAM 1671, Escherichia coli IFO 3007, Klebsiella pneumoniae ATTC 10031, Proteus vulgaris MTCC 321 and Pseudomonas denitrificans KACC 32026 by disc diffusion assay. Commercially available standard antibiotic discs were also used to find out antibiotic resistance pattern of test organisms. Results: Among the test organisms, Escherichia coli, Proteus vulgaris, Klebsiella pneumoniae and Proteus denitrificans showed resistance against multiple commercially available antibiotics. On the other hand, these multiple drug resistant organisms showed susceptibility against combined plant extracts. Conclusions: These combined plants extracts showed synergistic antibacterial activity and could lead to new antibacterial drug designing.

Assembly, Structure, and Functionality of Metal-Organic Networks and Organic Semiconductor Layers at Surfaces

Science.gov (United States)

Tempas, Christopher D.

Self-assembled nanostructures at surfaces show promise for the development of next generation technologies including organic electronic devices and heterogeneous catalysis. In many cases, the functionality of these nanostructures is not well understood. This thesis presents strategies for the structural design of new on-surface metal-organic networks and probes their chemical reactivity. It is shown that creating uniform metal sites greatly increases selectivity when compared to ligand-free metal islands. When O2 reacts with single-site vanadium centers, in redox-active self-assembled coordination networks on the Au(100) surface, it forms one product. When O2 reacts with vanadium metal islands on the same surface, multiple products are formed. Other metal-organic networks described in this thesis include a mixed valence network containing Pt0 and PtII and a network where two Fe centers reside in close proximity. This structure is stable to temperatures >450 °C. These new on-surface assemblies may offer the ability to perform reactions of increasing complexity as future heterogeneous catalysts. The functionalization of organic semiconductor molecules is also shown. When a few molecular layers are grown on the surface, it is seen that the addition of functional groups changes both the film's structure and charge transport properties. This is due to changes in both first layer packing structure and the pi-electron distribution in the functionalized molecules compared to the original molecule. The systems described in this thesis were studied using high-resolution scanning tunneling microscopy, non-contact atomic force microscopy, and X-ray photoelectron spectroscopy. Overall, this work provides strategies for the creation of new, well-defined on-surface nanostructures and adds additional chemical insight into their properties.

HAL: a hierarchical format for storing and analyzing multiple genome alignments.

Science.gov (United States)

Hickey, Glenn; Paten, Benedict; Earl, Dent; Zerbino, Daniel; Haussler, David

2013-05-15

Large multiple genome alignments and inferred ancestral genomes are ideal resources for comparative studies of molecular evolution, and advances in sequencing and computing technology are making them increasingly obtainable. These structures can provide a rich understanding of the genetic relationships between all subsets of species they contain. Current formats for storing genomic alignments, such as XMFA and MAF, are all indexed or ordered using a single reference genome, however, which limits the information that can be queried with respect to other species and clades. This loss of information grows with the number of species under comparison, as well as their phylogenetic distance. We present HAL, a compressed, graph-based hierarchical alignment format for storing multiple genome alignments and ancestral reconstructions. HAL graphs are indexed on all genomes they contain. Furthermore, they are organized phylogenetically, which allows for modular and parallel access to arbitrary subclades without fragmentation because of rearrangements that have occurred in other lineages. HAL graphs can be created or read with a comprehensive C++ API. A set of tools is also provided to perform basic operations, such as importing and exporting data, identifying mutations and coordinate mapping (liftover). All documentation and source code for the HAL API and tools are freely available at http://github.com/glennhickey/hal. hickey@soe.ucsc.edu or haussler@soe.ucsc.edu Supplementary data are available at Bioinformatics online.

An Insoluble Benzoquinone-Based Organic Cathode for Use in Rechargeable Lithium-Ion Batteries.

Science.gov (United States)

Luo, Zhiqiang; Liu, Luojia; Zhao, Qing; Li, Fujun; Chen, Jun

2017-10-02

Application of organic electrode materials in rechargeable batteries has attracted great interest because such materials contain abundant carbon, hydrogen, and oxygen elements. However, organic electrodes are highly soluble in organic electrolytes. An organic electrode of 2,3,5,6-tetraphthalimido-1,4-benzoquinone (TPB) is reported in which rigid groups coordinate to a molecular benzoquinone skeleton. The material is insoluble in aprotic electrolyte, and demonstrates a high capacity retention of 91.4 % (204 mA h g -1 ) over 100 cycles at 0.2 C. The extended π-conjugation of the material contributes to enhancement of the electrochemical performance (155 mA h g -1 at 10 C). Moreover, density functional theory calculations suggest that favorable synergistic reactions between multiple carbonyl groups and lithium ions can enhance the initial lithium ion intercalation potential. The described approach may provide a novel entry to next-generation organic electrode materials with relevance to lithium-ion batteries. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

The Synthesis Map Is a Multidimensional Educational Tool That Provides Insight into Students’ Mental Models and Promotes Students’ Synthetic Knowledge Generation

Science.gov (United States)

Ortega, Ryan A.; Brame, Cynthia J.

2015-01-01

Concept mapping was developed as a method of displaying and organizing hierarchical knowledge structures. Using the new, multidimensional presentation software Prezi, we have developed a new teaching technique designed to engage higher-level skills in the cognitive domain. This tool, synthesis mapping, is a natural evolution of concept mapping, which utilizes embedding to layer information within concepts. Prezi’s zooming user interface lets the author of the presentation use both depth as well as distance to show connections between data, ideas, and concepts. Students in the class Biology of Cancer created synthesis maps to illustrate their knowledge of tumorigenesis. Students used multiple organizational schemes to build their maps. We present an analysis of student work, placing special emphasis on organization within student maps and how the organization of knowledge structures in student maps can reveal strengths and weaknesses in student understanding or instruction. We also provide a discussion of best practices for instructors who would like to implement synthesis mapping in their classrooms. PMID:25917385

Stakeholders and Apart Hotels: Multiple Case Study

Directory of Open Access Journals (Sweden)

Elizabeth Kyoko Wada

2012-09-01

Full Text Available Means of accommodation involve a wide range of social actors and agents, as well as different business models. Management strategies in this sector have been increasingly important for long-term sustainability and competitiveness of business organizations. This study aims to analyze the interactions between apart-hotels and their stakeholders to foster an improvement of services provided, aligning the interface of strategic management from the point of view of managers and their key stakeholders. It is an exploratory study, with qualitative chacter, along with multiple case studies of the following establishments: Travel Inn, Hotels Slaviero and Etoile george v. Brazilian enterprises, which manage lodging facilities with apart-hotel concepts, combining features that enable comparative analysis of the study. For conceptual understanding, this study was based on literature about stakeholders, taking the work of Freeman (1984 and Freeman et al (2010 as main references. The research was conducted through semi-structured interviews with managers of lodging facilities and their key stakeholders and through direct observation and documentation. We found that not all groups of influence are considered in the planning of service flats. However, the organizations surveyed indicated that the market has realized the importance of the groups that exert influence and are influenced by their goals, and are therefore increasingly alert for integration of such groups in their strategic planning.

Virtual Organizations: Beyond Network Organization

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Liviu Gabriel CRETU

2006-01-01

Full Text Available One of the most used buzz-words in (e-business literature of the last decade is virtual organization. The term "virtual" can be identified in all sorts of combinations regarding the business world. From virtual products to virtual processes or virtual teams, everything that is “touched” by the computer’s processing power instantly becomes virtual. Moreover, most of the literature treats virtual and network organizations as being synonyms. This paper aims to draw a much more distinctive line between the two concepts. Providing a more coherent description of what virtual organization might be is also one of our intentions.

Published GMO studies find no evidence of harm when corrected for multiple comparisons.

Science.gov (United States)

Panchin, Alexander Y; Tuzhikov, Alexander I

2017-03-01

A number of widely debated research articles claiming possible technology-related health concerns have influenced the public opinion on genetically modified food safety. We performed a statistical reanalysis and review of experimental data presented in some of these studies and found that quite often in contradiction with the authors' conclusions the data actually provides weak evidence of harm that cannot be differentiated from chance. In our opinion the problem of statistically unaccounted multiple comparisons has led to some of the most cited anti-genetically modified organism health claims in history. We hope this analysis puts the original results of these studies into proper context.

Selfish cellular networks and the evolution of complex organisms.

Science.gov (United States)

Kourilsky, Philippe

2012-03-01

Human gametogenesis takes years and involves many cellular divisions, particularly in males. Consequently, gametogenesis provides the opportunity to acquire multiple de novo mutations. A significant portion of these is likely to impact the cellular networks linking genes, proteins, RNA and metabolites, which constitute the functional units of cells. A wealth of literature shows that these individual cellular networks are complex, robust and evolvable. To some extent, they are able to monitor their own performance, and display sufficient autonomy to be termed "selfish". Their robustness is linked to quality control mechanisms which are embedded in and act upon the individual networks, thereby providing a basis for selection during gametogenesis. These selective processes are equally likely to affect cellular functions that are not gamete-specific, and the evolution of the most complex organisms, including man, is therefore likely to occur via two pathways: essential housekeeping functions would be regulated and evolve during gametogenesis within the parents before being transmitted to their progeny, while classical selection would operate on other traits of the organisms that shape their fitness with respect to the environment. Copyright © 2012 Académie des sciences. Published by Elsevier SAS. All rights reserved.

Nature and nature values in organic agriculture

DEFF Research Database (Denmark)

Hansen, Lene; Noe, Egon; Højring, Katrine

2006-01-01

The relationship between agriculture and nature is a centra issue in the current agricultural debate. Organic farming has ambitions and a special potential in relation to nature. Consideration for nature is part of the guiding principals of organic farming and many organic farmers are committed...... to protecting natural qualities. However, the issue of nature, landscape, and land use is not straightforward. Nature is an ambiguous concept that involves multiple interests and actors reaching far beyond farmers. The Danish research project ......

Towards Increased Relevance: Context-Adapted Models of the Learning Organization

Science.gov (United States)

Örtenblad, Anders

2015-01-01

Purpose: The purposes of this paper are to take a closer look at the relevance of the idea of the learning organization for organizations in different generalized organizational contexts; to open up for the existence of multiple, context-adapted models of the learning organization; and to suggest a number of such models.…

Multiple Primary Cancer Monograph

Science.gov (United States)

To identify groups of cancer survivors that are at increased risk for multiple primary cancers, investigators led an effort to provide the first comprehensive population-based analysis of the risk of subsequent cancer in the U.S., resulting in a monograph.

Learning achievements of farmers during the transition to market-oriented organic agriculture in rural Uganda

Directory of Open Access Journals (Sweden)

Amos Owamani

2010-04-01

Full Text Available Organic agriculture requires farmers with the ability to develop profitable agro-enterprises on their own. By drawing on four years of experiences with the Enabling Rural Innovation approach in Uganda, we outline how smallholder farmers transition to organic agriculture and, at the same time, increase their entrepreneurial skills and competences through learning. In order to document this learning we operationalised the Kirkpatrick learning evaluation model, which subsequently informed the collection of qualitative data in two study sites. Our analysis suggests that the Enabling Rural Innovation approach helps farmers to develop essential capabilities for identifying organic markets and new organic commodities, for testing these organic commodities under varying organic farm management scenarios, and for negotiating contracts with organic traders. We also observed several obstacles that confront farmers’ transition to organic agriculture when using the Enabling Rural Innovation approach. These include the long duration of agronomic experimentation and seed multiplication, expensive organic certification procedures and the absence of adequate mechanism for farmers to access crop finance services. Despite prevailing obstacles we conclude that the Enabling Rural Innovation approach provides a starting point for farmers to develop entrepreneurial competences and profitable agro-enterprises on their own.

Inventory verification measurements using neutron multiplicity counting

International Nuclear Information System (INIS)

Ensslin, N.; Foster, L.A.; Harker, W.C.; Krick, M.S.; Langner, D.G.

1998-01-01

This paper describes a series of neutron multiplicity measurements of large plutonium samples at the Los Alamos Plutonium Facility. The measurements were corrected for bias caused by neutron energy spectrum shifts and nonuniform multiplication, and are compared with calorimetry/isotopics. The results show that multiplicity counting can increase measurement throughput and yield good verification results for some inventory categories. The authors provide recommendations on the future application of the technique to inventory verification

Methodical approaches to providing sustainable development of the transport industry management system based on self-organization

Science.gov (United States)

Belyantseva, Oksana; Panenkov, Andrey; Safonova, Nataliya

2017-10-01

Current conditions of the cognitive economy formation demand to take into account the leading role of information, knowledge and human capital in the development of the transport industry management system. The article substantiates the conceptual approach to the self-organization of a management system on the basis of innovative changes. Human capital is the key aspect of self-organization, so the directions of improving the workforce quality are justified. Basing on the information-innovative genesis of the process of self-organization, the authors justified the necessity of preventing asymmetric information. For this pupose the actions against the resistance to innovations were proposed. The implementation of certain measures contributes to the effective development of the transport management system.

Semantic Web Compatible Names and Descriptions for Organisms

Science.gov (United States)

Wang, H.; Wilson, N.; McGuinness, D. L.

2012-12-01

Modern scientific names are critical for understanding the biological literature and provide a valuable way to understand evolutionary relationships. To validly publish a name, a description is required to separate the described group of organisms from those described by other names at the same level of the taxonomic hierarchy. The frequent revision of descriptions due to new evolutionary evidence has lead to situations where a single given scientific name may over time have multiple descriptions associated with it and a given published description may apply to multiple scientific names. Because of these many-to-many relationships between scientific names and descriptions, the usage of scientific names as a proxy for descriptions is inevitably ambiguous. Another issue lies in the fact that the precise application of scientific names often requires careful microscopic work, or increasingly, genetic sequencing, as scientific names are focused on the evolutionary relatedness between and within named groups such as species, genera, families, etc. This is problematic to many audiences, especially field biologists, who often do not have access to the instruments and tools required to make identifications on a microscopic or genetic basis. To better connect scientific names to descriptions and find a more convenient way to support computer assisted identification, we proposed the Semantic Vernacular System, a novel naming system that creates named, machine-interpretable descriptions for groups of organisms, and is compatible with the Semantic Web. Unlike the evolutionary relationship based scientific naming system, it emphasizes the observable features of organisms. By independently naming the descriptions composed of sets of observational features, as well as maintaining connections to scientific names, it preserves the observational data used to identify organisms. The system is designed to support a peer-review mechanism for creating new names, and uses a controlled

Decentralized Formation Flying Control in a Multiple-Team Hierarchy

Science.gov (United States)

Mueller, Joseph .; Thomas, Stephanie J.

2005-01-01

This paper presents the prototype of a system that addresses these objectives-a decentralized guidance and control system that is distributed across spacecraft using a multiple-team framework. The objective is to divide large clusters into teams of manageable size, so that the communication and computational demands driven by N decentralized units are related to the number of satellites in a team rather than the entire cluster. The system is designed to provide a high-level of autonomy, to support clusters with large numbers of satellites, to enable the number of spacecraft in the cluster to change post-launch, and to provide for on-orbit software modification. The distributed guidance and control system will be implemented in an object-oriented style using MANTA (Messaging Architecture for Networking and Threaded Applications). In this architecture, tasks may be remotely added, removed or replaced post-launch to increase mission flexibility and robustness. This built-in adaptability will allow software modifications to be made on-orbit in a robust manner. The prototype system, which is implemented in MATLAB, emulates the object-oriented and message-passing features of the MANTA software. In this paper, the multiple-team organization of the cluster is described, and the modular software architecture is presented. The relative dynamics in eccentric reference orbits is reviewed, and families of periodic, relative trajectories are identified, expressed as sets of static geometric parameters. The guidance law design is presented, and an example reconfiguration scenario is used to illustrate the distributed process of assigning geometric goals to the cluster. Next, a decentralized maneuver planning approach is presented that utilizes linear-programming methods to enact reconfiguration and coarse formation keeping maneuvers. Finally, a method for performing online collision avoidance is discussed, and an example is provided to gauge its performance.

Mechanisms of multiple production processes

International Nuclear Information System (INIS)

Dremin, I.M.

1977-01-01

Theoretical approaches to multiple production processes are discussed. A large number of models proceeds from the notion about common excited system produced by colliding hadrons. This class of models includes the hydrodynamical, statistical, thermodynamical and statistical bootstrap models. Sometimes the production process is due to excitation and decay of two colliding particles. The fragmentation bremsstrahlung and inelastic diffraction models belong to this group. The largest group of models describes the multiple production process as a result of formation of many excited centers. The typical example is the multiperipheral model. An interesting direction is given by the attempts to interrelate the mechanism of multiple production with internal structure of particles that is with their constituents (C-group)'-quarks, gluons, etc. Besides the models there are phenomenological (p group) attempts to connect different features of multiple production. Experimental data indicate the existence of leading and pionization particles thus giving an evidence for applications of different models. The data about increase of total and inclusive cross sections, the behaviour of the mean multiplicity and correlations at high energies provide a clue for further development of multiple production theory

The promise of organ and tissue preservation to transform medicine

Science.gov (United States)

Giwa, Sebastian; Lewis, Jedediah K; Alvarez, Luis; Langer, Robert; Roth, Alvin E; Church, George M; Markmann, James F; Sachs, David H; Chandraker, Anil; Wertheim, Jason A; Rothblatt, Martine; Boyden, Edward S; Eidbo, Elling; Lee, W P Andrew; Pomahac, Bohdan; Brandacher, Gerald; Weinstock, David M; Elliott, Gloria; Nelson, David; Acker, Jason P; Uygun, Korkut; Schmalz, Boris; Weegman, Brad P; Tocchio, Alessandro; Fahy, Greg M; Storey, Kenneth B; Rubinsky, Boris; Bischof, John; Elliott, Janet A W; Woodruff, Teresa K; Morris, G John; Demirci, Utkan; Brockbank, Kelvin G M; Woods, Erik J; Ben, Robert N; Baust, John G; Gao, Dayong; Fuller, Barry; Rabin, Yoed; Kravitz, David C; Taylor, Michael J; Toner, Mehmet

2017-01-01

The ability to replace organs and tissues on demand could save or improve millions of lives each year globally and create public health benefits on par with curing cancer. Unmet needs for organ and tissue preservation place enormous logistical limitations on transplantation, regenerative medicine, drug discovery, and a variety of rapidly advancing areas spanning biomedicine. A growing coalition of researchers, clinicians, advocacy organizations, academic institutions, and other stakeholders has assembled to address the unmet need for preservation advances, outlining remaining challenges and identifying areas of underinvestment and untapped opportunities. Meanwhile, recent discoveries provide proofs of principle for breakthroughs in a family of research areas surrounding biopreservation. These developments indicate that a new paradigm, integrating multiple existing preservation approaches and new technologies that have flourished in the past 10 years, could transform preservation research. Capitalizing on these opportunities will require engagement across many research areas and stakeholder groups. A coordinated effort is needed to expedite preservation advances that can transform several areas of medicine and medical science. PMID:28591112

Artesunate Protects Against the Organ Injury and Dysfunction Induced by Severe Hemorrhage and Resuscitation.

Science.gov (United States)

Sordi, Regina; Nandra, Kiran K; Chiazza, Fausto; Johnson, Florence L; Cabrera, Claudia P; Torrance, Hew D; Yamada, Noriaki; Patel, Nimesh S A; Barnes, Michael R; Brohi, Karim; Collino, Massimo; Thiemermann, Christoph

2017-02-01

To evaluate the effects of artesunate on organ injury and dysfunction associated with hemorrhagic shock (HS) in the rat. HS is still a common cause of death in severely injured patients and is characterized by impairment of organ perfusion, systemic inflammatory response, and multiple organ failure. There is no specific therapy that reduces organ injury/dysfunction. Artesunate exhibits pharmacological actions beyond its antimalarial activity, such as anticancer, antiviral, and anti-inflammatory effects. Rats were submitted to HS. Mean arterial pressure was reduced to 30 mm Hg for 90 minutes, followed by resuscitation. Rats were randomly treated with artesunate (2.4 or 4.8 mg/kg i.v.) or vehicle upon resuscitation. Four hours later, parameters of organ injury and dysfunction were assessed. Artesunate attenuated the multiple organ injury and dysfunction caused by HS. Pathway analysis of RNA sequencing provided good evidence to support an effect of artesunate on the Akt-survival pathway, leading to downregulation of interleukin-1 receptor-associated kinase 1. Using Western blot analysis, we confirmed that treatment of HS rats with artesunate enhanced the phosphorylation (activation) of Protein kinase B (Akt) and endothelial nitric oxide synthase and the phosphorylation (inhibition) of glycogen synthase kinase-3β (GSK-3β). Moreover, artesunate attenuated the HS-induced activation of nuclear factor kappa B and reduced the expression of proinflammatory proteins (inducible nitric oxide synthase, tumor necrosis factor-α, and interleukin 6). Artesunate attenuated the organ injury/dysfunction associated with HS by a mechanism that involves the activation of the Akt-endothelial nitric oxide synthase survival pathway, and the inhibition of glycogen synthase kinase-3β and nuclear factor kappa B. A phase II clinical trial evaluating the effects of good manufacturing practice-artesunate in patients with trauma and severe hemorrhage is planned.

Anaesthetic management of a patient with multiple system atrophy ...

African Journals Online (AJOL)

Multiple system atrophy (MSA) is a rare adult-onset neurodegenerative disease. Symptoms vary from autonomic dysfunction to Parkinsonism and cerebellar ataxia, in any combination. MSA affects many organ systems with many possible complications and makes perioperative management of a patient with this condition ...

Myelomatous ascites as an initial manifestation of extramedullary involvement of multiple myeloma

Energy Technology Data Exchange (ETDEWEB)

Choi, Seo Youn; Lee, Hae Kyung; Yi, Boem Ha; Lee, Min Hee; Kim, Hee Kyung; Park, Seong Kyu [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

2017-03-15

Multiple myeloma is a common hematological malignancy. Aggressive myeloma invades the organs outside the bone marrow, lymph, or reticuloendothelial systems. Among the extramedullary involvements of multiple myeloma, myelomatous ascites are extremely rare and are associated with a poor prognosis. We describe a case of myelomatous ascites as an initial manifestation of extramedullary involvement of multiple myeloma in 39-year-old patient. The patient was treated with high-dose chemotherapy, but extensive extramedullary involvement progressed, and the patient expired approximately five months after the initial detection of ascites.

The WSPC Reference on Organic Electronics: Organic Semiconductors

KAUST Repository

Bredas, Jean-Luc

2015-05-12

In this chapter, we provide a basic theoretical perspective on charge-carrier transport in organic semiconductors, with a focus on organic molecular crystals. We introduce the microscopic parameters relevant to the intrinsic charge-transport properties of these materials and describe some of the common quantum-chemical approaches used for their evaluation. We also discuss the nature of the possible charge-transport mechanisms in organic molecular crystals.

Mechanisms for cytoplasmic organization: an overview.

Science.gov (United States)

Pagliaro, L

2000-01-01

One of the basic characteristics of life is the intrinsic organization of cytoplasm, yet we know surprisingly little about the manner in which cytoplasmic macromolecules are arranged. It is clear that cytoplasm is not the homogeneous "soup" it was once envisioned to be, but a comprehensive model for cytoplasmic organization is not available in modern cell biology. The premise of this volume is that phase separation in cytoplasm may play a role in organization at the subcellular level. Other mechanisms for non-membrane-bounded intracellular organization have previously been proposed. Some of these will be reviewed in this chapter. Multiple mechanisms, involving phase separation, specific intracellular targeting, formation of macromolecular complexes, and channeling, all could well contribute to cytoplasmic organization. Temporal and spatial organization, as well as composition, are likely to be important in defining the characteristics of cytoplasm.

Using National Drug Codes and drug knowledge bases to organize prescription records from multiple sources.

Science.gov (United States)

Simonaitis, Linas; McDonald, Clement J

2009-10-01

The utility of National Drug Codes (NDCs) and drug knowledge bases (DKBs) in the organization of prescription records from multiple sources was studied. The master files of most pharmacy systems include NDCs and local codes to identify the products they dispense. We obtained a large sample of prescription records from seven different sources. These records carried a national product code or a local code that could be translated into a national product code via their formulary master. We obtained mapping tables from five DKBs. We measured the degree to which the DKB mapping tables covered the national product codes carried in or associated with the sample of prescription records. Considering the total prescription volume, DKBs covered 93.0-99.8% of the product codes from three outpatient sources and 77.4-97.0% of the product codes from four inpatient sources. Among the in-patient sources, invented codes explained 36-94% of the noncoverage. Outpatient pharmacy sources rarely invented codes, which comprised only 0.11-0.21% of their total prescription volume, compared with inpatient pharmacy sources for which invented codes comprised 1.7-7.4% of their prescription volume. The distribution of prescribed products was highly skewed, with 1.4-4.4% of codes accounting for 50% of the message volume and 10.7-34.5% accounting for 90% of the message volume. DKBs cover the product codes used by outpatient sources sufficiently well to permit automatic mapping. Changes in policies and standards could increase coverage of product codes used by inpatient sources.

The Long Road from the Kidney Bazaar: A Commentary on Pakistan’s Progress Towards Self-sufficiency in Organ Transplantation

Directory of Open Access Journals (Sweden)

Dominique E. Martin

2011-09-01

Full Text Available The dark history of transplant tourism in Pakistan demonstrates the hazards of unregulated cross-border markets in human organs. Trading on existing national and international social inequities, ‘transplant tourism’ offers dubious benefits for transplant recipients and attractive profits to those facilitating the industry at the expense of the world’s poor. The impact of Pakistan’s 2007 Transplantation of Human Organs and Tissue Ordinance and the sustained efforts of transplant professionals and societal groups led by the Sindh Institute of Urology and Transplantation, show that organ trading can be effectively discouraged and equitable programs of organ procurement and transplantation pursued despite multiple challenges. In this paper, the factors that have contributed to Pakistan’s progress towards self-sufficiency in organ transplantation are identified and discussed. The case of Pakistan highlights the need for countries to protect their own organ and tissue providers who may be vulnerable in the global healthcare market. Pakistan provides an excellent example for other countries in the region and throughout the world to consider when regulating their own transplantation programs and considering the pursuit of national self-sufficiency.

Structured diagnostic imaging in patients with multiple trauma

International Nuclear Information System (INIS)

Linsenmaier, U.; Rieger, J.; Rock, C.; Pfeifer, K.J.; Reiser, M.; Kanz, K.G.

2002-01-01

Purpose. Development of a concept for structured diagnostic imaging in patients with multiple trauma.Material and methods. Evaluation of data from a prospective trial with over 2400 documented patients with multiple trauma. All diagnostic and therapeutic steps, primary and secondary death and the 90 days lethality were documented.Structured diagnostic imaging of multiple injured patients requires the integration of an experienced radiologist in an interdisciplinary trauma team consisting of anesthesia, radiology and trauma surgery. Radiology itself deserves standardized concepts for equipment, personnel and logistics to perform diagnostic imaging for a 24-h-coverage with constant quality.Results. This paper describes criteria for initiation of a shock room or emergency room treatment, strategies for documentation and interdisciplinary algorithms for the early clinical care coordinating diagnostic imaging and therapeutic procedures following standardized guidelines. Diagnostic imaging consists of basic diagnosis, radiological ABC-rule, radiological follow-up and structured organ diagnosis using CT. Radiological trauma scoring allows improved quality control of diagnosis and therapy of multiple injured patients.Conclusion. Structured diagnostic imaging of multiple injured patients leads to a standardization of diagnosis and therapy and ensures constant process quality. (orig.) [de

Effect of continuous blood purification in treatment of patients with severe acute pancreatitis and multiple organ dysfunction syndrome

Directory of Open Access Journals (Sweden)

ZHANG Yong

2016-02-01

Full Text Available ObjectiveTo observe the effect of continuous blood purification (CBP on serum inflammatory mediators in patients with severe acute pancreatitis (SAP and multiple organ dysfunction syndrome (MODS. MethodsSixty-five SAP patients with MODS who were treated in General Hospital of Chengdu Command Area of Chinese PLA from April 2008 to December 2013 were enrolled and divided into two groups. The 33 patients in the control group received comprehensive internal medicine treatment, and the 32 patients in the treatment group received comprehensive internal medicine treatment and CBP. Changes in APACHE II score, MODS score, and the serum levels of tumor necrosis factor α (TNFα, C-reactive protein (CRP, interleukin 6 (IL-6, IL-18, platelet-activating factor (PAF, and nitric oxide (NO after treatment were observed. Independent-samples t test was applied for comparison of continuous data between the two groups, and paired t test was applied for before-after comparison within the same group; chi-squared test was applied for comparison of categorical data between the two groups. ResultsIn both groups, APACHE II score, MODS score, and the serum levels of TNFα, CRP, IL-6, IL-18, PAF, and NO decreased significantly after treatment (all P＜0.05, and the treatment group had significantly greater decreases in these values than the control group (all P＜0.001; the survival rates in the treatment group and the control group were 90.6% (29/32 and 78.8% (26/33, respectively, with no significant difference between the two groups (χ2=1.749, P=0.186. ConclusionIn SAP patients with MODS, CBP can effectively clear the serum inflammatory mediators to block systemic inflammatory response and improve organ function, and, therefore, it is an effective method to treat SAP.

Photodegradation in multiple-dye luminescent solar concentrators

International Nuclear Information System (INIS)

Mooney, Alex M.; Warner, Kathryn E.; Fontecchio, Paul J.; Zhang, Yu-Zhong; Wittmershaus, Bruce P.

2013-01-01

Combining multiple organic dyes to form a fluorescence resonance energy transfer (FRET) network is a useful strategy for extending the spectral range of sunlight absorbed by a luminescent solar concentrator (LSC). Excitation transfer out of the higher energy level dyes in the transfer series competes effectively with their photodegradation rates. Improvements in photostability up to a factor of 18 are observed for the first dye in the FRET series. FRET networks are shown to be a viable means of decreasing the rate of photodegradation of organic dyes used in LSCs. This comes at the expense of the final dye in the network; the depository of most of the excitations created by absorbing sunlight. The photostability and performance of an efficient FRET LSC rest heavily on the photostability and fluorescence quantum yield of the final dye. -- Highlights: • Photodegradation kinetics of multiple-dye FRET LSCs are reported. • The FRET network decreased the first dye's photodegradation rate by a factor of 18. • The final dye in the FRET LSC protects other dyes at its own expense. • The final dye must have excellent photostability and fluorescence quantum yield

Crocodylians evolved scattered multi-sensory micro-organs

Science.gov (United States)

2013-01-01

Background During their evolution towards a complete life cycle on land, stem reptiles developed both an impermeable multi-layered keratinized epidermis and skin appendages (scales) providing mechanical, thermal, and chemical protection. Previous studies have demonstrated that, despite the presence of a particularly armored skin, crocodylians have exquisite mechanosensory abilities thanks to the presence of small integumentary sensory organs (ISOs) distributed on postcranial and/or cranial scales. Results Here, we analyze and compare the structure, innervation, embryonic morphogenesis and sensory functions of postcranial, cranial, and lingual sensory organs of the Nile crocodile (Crocodylus niloticus) and the spectacled caiman (Caiman crocodilus). Our molecular analyses indicate that sensory neurons of crocodylian ISOs express a large repertoire of transduction channels involved in mechano-, thermo-, and chemosensory functions, and our electrophysiological analyses confirm that each ISO exhibits a combined sensitivity to mechanical, thermal and pH stimuli (but not hyper-osmotic salinity), making them remarkable multi-sensorial micro-organs with no equivalent in the sensory systems of other vertebrate lineages. We also show that ISOs all exhibit similar morphologies and modes of development, despite forming at different stages of scale morphogenesis across the body. Conclusions The ancestral vertebrate diffused sensory system of the skin was transformed in the crocodylian lineages into an array of discrete multi-sensory micro-organs innervated by multiple pools of sensory neurons. This discretization of skin sensory expression sites is unique among vertebrates and allowed crocodylians to develop a highly-armored, but very sensitive, skin. PMID:23819918

Collective Identity Formation in Hybrid Organizations

DEFF Research Database (Denmark)

Boulongne, Romain; Boxenbaum, Eva

The present article examines the process of collective identity formation in the context of hybrid organizing. Empirically, we investigate hybrid organizing in a collaborative structure at the interface of two heterogeneous organizations in the domain of new renewable energies. We draw...... on the literature on knowledge sharing across organizational boundaries, particularly the notions of transfer, translation and transformation, to examine in real time how knowledge sharing in a hybrid setting contributes (or not) to the emergence of a new collective identity at the interface of two heterogeneous...... organizations. Our findings point to two factors that limit knowledge sharing and hence to new collective identity formation in a hybrid space: 1) ambiguous or multiple organizational roles and 2) strong identities of the collaborating organizations. These findings contribute to illuminating the initial...

Development of Multiple Capsule Robots in Pipe

Directory of Open Access Journals (Sweden)

Shuxiang Guo

2018-05-01

Full Text Available Swallowable capsule robots which travel in body cavities to implement drug delivery, minimally invasive surgery, and diagnosis have provided great potential for medical applications. However, the space constraints of the internal environment and the size limitations of the robots are great challenges to practical application. To address the fundamental challenges of narrow body cavities, a different-frequency driven approach for multiple capsule robots with screw structure manipulated by external electromagnetic field is proposed in this paper. The multiple capsule robots are composed of driven permanent magnets, joint permanent magnets, and a screw body. The screw body generates a propulsive force in a fluidic environment. Moreover, robots can form new constructions via mutual docking and release. To provide manipulation guidelines for active locomotion, a dynamic model of axial propulsion and circumferential torque is established. The multiple start and step-out frequencies for multiple robots are defined theoretically. Moreover, the different-frequency driven approach based on geometrical parameters of screw structure and the overlap angles of magnetic polarities is proposed to drive multiple robots in an identical electromagnetic field. Finally, two capsule robots were prototyped and experiments in a narrow pipe were conducted to verify the different motions such as docking, release, and cooperative locomotion. The experimental results demonstrated the validity of the driven approach for multiple capsule robots in narrow body cavities.

Imaging of first-order surface-related multiples by reverse-time migration

Science.gov (United States)

Liu, Xuejian; Liu, Yike; Hu, Hao; Li, Peng; Khan, Majid

2017-02-01

Surface-related multiples have been utilized in the reverse-time migration (RTM) procedures, and additional illumination for subsurface can be provided. Meanwhile, many cross-talks are generated from undesired interactions between forward- and backward-propagated seismic waves. In this paper, subsequent to analysing and categorizing these cross-talks, we propose RTM of first-order multiples to avoid most undesired interactions in RTM of all-order multiples, where only primaries are forward-propagated and crosscorrelated with the backward-propagated first-order multiples. With primaries and multiples separated during regular seismic data processing as the input data, first-order multiples can be obtained by a two-step scheme: (1) the dual-prediction of higher-order multiples; and (2) the adaptive subtraction of predicted higher-order multiples from all-order multiples within local offset-time windows. In numerical experiments, two synthetic and a marine field data sets are used, where different cross-talks generated by RTM of all-order multiples can be identified and the proposed RTM of first-order multiples can provide a very interpretable image with a few cross-talks.

Neutron source multiplication method

International Nuclear Information System (INIS)

Clayton, E.D.

1985-01-01

Extensive use has been made of neutron source multiplication in thousands of measurements of critical masses and configurations and in subcritical neutron-multiplication measurements in situ that provide data for criticality prevention and control in nuclear materials operations. There is continuing interest in developing reliable methods for monitoring the reactivity, or k/sub eff/, of plant operations, but the required measurements are difficult to carry out and interpret on the far subcritical configurations usually encountered. The relationship between neutron multiplication and reactivity is briefly discussed and data presented to illustrate problems associated with the absolute measurement of neutron multiplication and reactivity in subcritical systems. A number of curves of inverse multiplication have been selected from a variety of experiments showing variations observed in multiplication during the course of critical and subcritical experiments where different methods of reactivity addition were used, with different neutron source detector position locations. Concern is raised regarding the meaning and interpretation of k/sub eff/ as might be measured in a far subcritical system because of the modal effects and spectrum differences that exist between the subcritical and critical systems. Because of this, the calculation of k/sub eff/ identical with unity for the critical assembly, although necessary, may not be sufficient to assure safety margins in calculations pertaining to far subcritical systems. Further study is needed on the interpretation and meaning of k/sub eff/ in the far subcritical system

Mixed methods for implementation research: application to evidence-based practice implementation and staff turnover in community-based organizations providing child welfare services.

Science.gov (United States)

Aarons, Gregory A; Fettes, Danielle L; Sommerfeld, David H; Palinkas, Lawrence A

2012-02-01

Many public sector service systems and provider organizations are in some phase of learning about or implementing evidence-based interventions. Child welfare service systems represent a context where implementation spans system, management, and organizational concerns. Research utilizing mixed methods that combine qualitative and quantitative design, data collection, and analytic approaches are particularly well suited to understanding both the process and outcomes of dissemination and implementation efforts in child welfare systems. This article describes the process of using mixed methods in implementation research and provides an applied example of an examination of factors impacting staff retention during an evidence-based intervention implementation in a statewide child welfare system. The authors integrate qualitative data with previously published quantitative analyses of job autonomy and staff turnover during this statewide implementation project in order to illustrate the utility of mixed method approaches in providing a more comprehensive understanding of opportunities and challenges in implementation research.

Why is the Bond Multiplicity in C2 so Elusive?

Czech Academy of Sciences Publication Activity Database

Cooper, D.L.; Penotti, F.E.; Ponec, Robert

2015-01-01

Roč. 1053, SI (2015), s. 189-194 ISSN 2210-271X Institutional support: RVO:67985858 Keywords : bond multiplicity in C2 * spin correlation matrices * full GVB and spin-coupled Subject RIV: CC - Organic Chemistry Impact factor: 1.403, year: 2015

Surveying multiple health professional team members within institutional settings: an example from the nursing home industry.

Science.gov (United States)

Clark, Melissa A; Roman, Anthony; Rogers, Michelle L; Tyler, Denise A; Mor, Vincent

2014-09-01

Quality improvement and cost containment initiatives in health care increasingly involve interdisciplinary teams of providers. To understand organizational functioning, information is often needed from multiple members of a leadership team since no one person may have sufficient knowledge of all aspects of the organization. To minimize survey burden, it is ideal to ask unique questions of each member of the leadership team in areas of their expertise. However, this risks substantial missing data if all eligible members of the organization do not respond to the survey. Nursing home administrators (NHA) and directors of nursing (DoN) play important roles in the leadership of long-term care facilities. Surveys were administered to NHAs and DoNs from a random, nationally representative sample of U.S. nursing homes about the impact of state policies, market forces, and organizational factors that impact provider performance and residents' outcomes. Responses were obtained from a total of 2,686 facilities (response rate [RR] = 66.6%) in which at least one individual completed the questionnaire and 1,693 facilities (RR = 42.0%) in which both providers participated. No evidence of nonresponse bias was detected. A high-quality representative sample of two providers in a long-term care facility can be obtained. It is possible to optimize data collection by obtaining unique information about the organization from each provider while minimizing the number of items asked of each individual. However, sufficient resources must be available for follow-up to nonresponders with particular attention paid to lower resourced, lower quality facilities caring for higher acuity residents in highly competitive nursing home markets. © The Author(s) 2014.

Specificity and multiplicity in the recognition of individuals: implications for the evolution of social behaviour.

Science.gov (United States)

Wiley, R H

2013-02-01

Recognition of conspecifics occurs when individuals classify sets of conspecifics based on sensory input from them and associate these sets with different responses. Classification of conspecifics can vary in specificity (the number of individuals included in a set) and multiplicity (the number of sets differentiated). In other words, the information transmitted varies in complexity. Although recognition of conspecifics has been reported in a wide variety of organisms, few reports have addressed the specificity or multiplicity of this capability. This review discusses examples of these patterns, the mechanisms that can produce them, and the evolution of these mechanisms. Individual recognition is one end of a spectrum of specificity, and binary classification of conspecifics is one end of a spectrum of multiplicity. In some cases, recognition requires no more than simple forms of learning, such as habituation, yet results in individually specific recognition. In other cases, recognition of individuals involves complex associations of multiple cues with multiple previous experiences in particular contexts. Complex mechanisms for recognition are expected to evolve only when simpler mechanisms do not provide sufficient specificity and multiplicity to obtain the available advantages. In particular, the evolution of cooperation and deception is always promoted by specificity and multiplicity in recognition. Nevertheless, there is only one demonstration that recognition of specific individuals contributes to cooperation in animals other than primates. Human capacities for individual recognition probably have a central role in the evolution of complex forms of human cooperation and deception. Although relatively little studied, this capability probably rivals cognitive abilities for language. © 2012 The Author. Biological Reviews © 2012 Cambridge Philosophical Society.

Immunotherapeutical role of Flt3 ligand amplification of pulmonary dendritic cells in murine multiple organ dysfunction syndrome in vivo

Directory of Open Access Journals (Sweden)

Hong-wei WANG

2012-08-01

Full Text Available Objective To explore the therapeutic effect of Flt3 ligand (Flt3L on multiple organ dysfunction syndrome (MODS model via amplification of lung dendritic cells. Methods Animal model of MODS was replicated by injecting zymosan into the peritoneal cavity of BALB/c mice, and then the mice were randomly divided into Flt3L treatment group, MODS group, Flt3L group and control group. Mortality rate was observed. After 12 days, lung mononuclear cells were isolated by density gradient centrifugation and analyzed with flow cytometry. Blood AST, ALT, creatinine, lipase, amylase and glucose were determined by automatic biochemical analyzer. Pathological changes in lung tissue were observed under light microscope. Results Mortality in Flt3L treatment group decreased dramatically compared with MODS group. The proportions of myeloid, plasmacytoid and I-Ad+ DCs in Flt3L group were remarkably increased compared with control group, and the proportion of the three DC subsets in MODS group was much lower than that in control group. Howerver, Flt3L treatment dramatically increased the proportion of them in MODS group. In MODS group, the level of ALT, AST, lipase, amylase and creatinine remarkably increased and blood glucose decreased compared with that of Flt3L and control groups; but in Flt3L treatment group, the level of ALT, AST, lipase, amylase and creatinine decreased and blood glucose increased dramatically, and lung injury mitigated obviously compared with MODS group. Conclusion Flt3L could attenuate lung tissue injury in MODS model, improve organ function, and lower the mortality of experimental animals, thus exerting its immunotherapeutic effects by in vivo amplification of lung dendritic cells.

Multiple-Stage Structure Transformation of Organic-Inorganic Hybrid Perovskite CH3NH3PbI3

Science.gov (United States)

Chen, Qiong; Liu, Henan; Kim, Hui-Seon; Liu, Yucheng; Yang, Mengjin; Yue, Naili; Ren, Gang; Zhu, Kai; Liu, Shengzhong; Park, Nam-Gyu; Zhang, Yong

2016-07-01

By performing spatially resolved Raman and photoluminescence spectroscopy with varying excitation wavelength, density, and data acquisition parameters, we achieve a unified understanding towards the spectroscopy signatures of the organic-inorganic hybrid perovskite, transforming from the pristine state (CH3NH3PbI3 ) to the fully degraded state (i.e., PbI2 ) for samples with varying crystalline domain size from mesoscopic scale (approximately 100 nm) to macroscopic size (centimeters), synthesized by three different techniques. We show that the hybrid perovskite exhibits multiple stages of structure transformation occurring either spontaneously or under light illumination, with exceptionally high sensitivity to the illumination conditions (e.g., power, illumination time, and interruption pattern). We highlight four transformation stages (stages I-IV, with stage I being the pristine state) along either the spontaneous or photoinduced degradation path exhibiting distinctly different Raman spectroscopy features at each stage, and point out that previously reported Raman spectra in the literature reflect highly degraded structures of either stage III or stage IV. Additional characteristic optical features of partially degraded materials under the joint action of spontaneous and photodegradation are also given. This study offers reliable benchmark results for understanding the intrinsic material properties and structure transformation of this unique category of hybrid materials, and the findings are pertinently important to a wide range of potential applications where the hybrid material is expected to function in greatly different environment and light-matter interaction conditions.

Multiple current peaks in room-temperature atmospheric pressure homogenous dielectric barrier discharge plasma excited by high-voltage tunable nanosecond pulse in air

Energy Technology Data Exchange (ETDEWEB)

Yang, De-Zheng; Wang, Wen-Chun; Zhang, Shuai; Tang, Kai; Liu, Zhi-jie; Wang, Sen [Key Lab of Materials Modification, Dalian University of Technology, Ministry of Education, Dalian 116024 (China)

2013-05-13

Room temperature homogenous dielectric barrier discharge plasma with high instantaneous energy efficiency is acquired by using nanosecond pulse voltage with 20-200 ns tunable pulse width. Increasing the voltage pulse width can lead to the generation of regular and stable multiple current peaks in each discharge sequence. When the voltage pulse width is 200 ns, more than 5 organized current peaks can be observed under 26 kV peak voltage. Investigation also shows that the organized multiple current peaks only appear in homogenous discharge mode. When the discharge is filament mode, organized multiple current peaks are replaced by chaotic filament current peaks.

Multiscale digital Arabidopsis predicts individual organ and whole-organism growth.

Science.gov (United States)

Chew, Yin Hoon; Wenden, Bénédicte; Flis, Anna; Mengin, Virginie; Taylor, Jasper; Davey, Christopher L; Tindal, Christopher; Thomas, Howard; Ougham, Helen J; de Reffye, Philippe; Stitt, Mark; Williams, Mathew; Muetzelfeldt, Robert; Halliday, Karen J; Millar, Andrew J

2014-09-30

Understanding how dynamic molecular networks affect whole-organism physiology, analogous to mapping genotype to phenotype, remains a key challenge in biology. Quantitative models that represent processes at multiple scales and link understanding from several research domains can help to tackle this problem. Such integrated models are more common in crop science and ecophysiology than in the research communities that elucidate molecular networks. Several laboratories have modeled particular aspects of growth in Arabidopsis thaliana, but it was unclear whether these existing models could productively be combined. We test this approach by constructing a multiscale model of Arabidopsis rosette growth. Four existing models were integrated with minimal parameter modification (leaf water content and one flowering parameter used measured data). The resulting framework model links genetic regulation and biochemical dynamics to events at the organ and whole-plant levels, helping to understand the combined effects of endogenous and environmental regulators on Arabidopsis growth. The framework model was validated and tested with metabolic, physiological, and biomass data from two laboratories, for five photoperiods, three accessions, and a transgenic line, highlighting the plasticity of plant growth strategies. The model was extended to include stochastic development. Model simulations gave insight into the developmental control of leaf production and provided a quantitative explanation for the pleiotropic developmental phenotype caused by overexpression of miR156, which was an open question. Modular, multiscale models, assembling knowledge from systems biology to ecophysiology, will help to understand and to engineer plant behavior from the genome to the field.

Abdominal multi-organ CT segmentation using organ correlation graph and prediction-based shape and location priors.

Science.gov (United States)

Okada, Toshiyuki; Linguraru, Marius George; Hori, Masatoshi; Summers, Ronald M; Tomiyama, Noriyuki; Sato, Yoshinobu

2013-01-01