IMPLEMENTASI VIRTUAL PRIVATE NETWORK - WAN DALAM DUNIA BISNIS

Directory of Open Access Journals (Sweden)

Erma Suryani

2007-01-01

Full Text Available Dalam dunia bisnis, biasanya sebuah organisasi ingin membangun Wide Area Network (WAN untuk menghubungkan beberapa kantor cabangnya. Sebelum munculnya Virtual Private Network (VPN, mereka umumnya menggunakan ” leased line” yang mahal sehingga hanya perusahaan besar yang dapat memilikinya.VPN - WAN memberi solusi alternatif karena dapat mengurangi biaya pembuatan infrastruktur jaringan dan memotong biaya operasional dengan memanfaatkan failitas internet sebagai media komunikasinya. Perusahaan cukup menghubungi  Internet Service Provider (ISP terdekat untuk mendapatkan layanan ini.Setiap paket informasi yang dikirim dapat diakses, diawasi atau bahkan dimanipulasi oleh pengguna. Supaya komunikasi berjalan aman maka diperlukan protokol tambahan khusus yang dirancang untuk mengamankan data yang dikirim.  Dewasa ini sudah banyak perusahaan seperti : perusahaan manufaktur, distribusi dan retail; pertambangan minyak dan gas, telekomunikasi, finansial, pemerintahan serta industri transportasi yang menggunakan VPN karena fasilitas –fasilitas yang ditawarkan berupa remote access client, internetworking LAN to LAN serta akses yang terkontrol dengan biaya yang murah.  Uji coba yang dilakukan Miercom(LAB penyedia testing kinerja perangkat keras terhadap  Cisco 1841 membuktikan bahwa Cisco 1841 dapat  menopang suatu komunikasi dua arah, interkoneksi IP WAN kapasitas E1 dengan enkripsi 3DES yang dapat menunjang throughput sampai dengan 2 Mbps dalam koneksi E1 IP-WAN. Penggunaan  VPN akan meningkatkan efektivitas, efisiensi kerja serta skalabilitas perusahaan. Keuntungan lain yang didapat dari VPN adalah pada biaya pulsa yang jauh lebih murah dibandingkan dengan menggunakan” leased line”.Kata Kunci: VPN, WAN,  paket informasi, ISP,  remote access client, skalabilitas.

Parental use of the term "Hot Qi" to describe symptoms in their children in Hong Kong: a cross sectional survey "Hot Qi" in children

Directory of Open Access Journals (Sweden)

Chan Danny

2006-01-01

Full Text Available Abstract Background The Chinese term "Hot Qi" is often used by parents to describe symptoms in their children. The current study was carried out to estimate the prevalence of using the Chinese term "Hot Qi" to describe symptoms in children by their parents and the symptomatology of "Hot Qi". Method A cross sectional survey by face-to-face interview with a semi-structured questionnaire was carried out in a public hospital and a private clinic in Hong Kong. The parental use of the term "Hot Qi", the symptoms of "Hot Qi" and the remedies used for "Hot Qi" were asked. Results 1060 pairs of children and parents were interviewed. 903 (85.1% of parents claimed that they had employed the term "Hot Qi" to describe their children's symptoms. Age of children and place of birth of parents were the predictors of parents using the term "Hot Qi". Eye discharge (37.2%, sore throat (33.9%, halitosis(32.8%, constipation(31.0%, and irritable (21.2% were the top five symptoms of "Hot Qi" in children. The top five remedies for "Hot Qi" were the increased consumption of water (86.8%, fruit (72.5%, soup (70.5%, and the use of herbal beverages "five-flower- tea" (a combination of several flowers such as Chrysanthemum morifolii, Lonicera japonica, Bombax malabaricum, Sophora japonica, and Plumeria rubra (57.6% or selfheal fruit spike (Prunella vulgaris (42.4%. Conclusion "Hot Qi" is often used by Chinese parents to describe symptoms in their children in Hong Kong. Place of birth of parents and age of the children are main factors for parents to apply the term "Hot Qi" to describe symptoms of their children. The common symptoms of "Hot Qi" suggest infections or allergy.

The Therapeutic Effect of Zuogui Wan in Gestational Diabetes Mellitus Rats

Science.gov (United States)

Feng, Qianjin; Niu, Xin; Liu, Xinshe; Xu, Kaixia; Yang, Xiangzhu; Wang, Huifeng

2014-01-01

In this experiment, we established an animal model of gestational diabetes mellitus rats using streptozotocin. Using the rat model of GDM, the pregnant rats in 1-19d were divided into three groups: (1) Zuogui Wan gestational diabetes mellitus group (group I, n = 12), (2) gestational diabetes mellitus rats as the control group (group II, n = 11), and (3) rats of normal pregnancy group (group III, n = 11). Compared with gestational diabetes mellitus rats as the control group, Zuogui Wan can change the indexes of fasting blood glucose, body weight, total cholesterol, insulin, and metabolism cage index significantly in Zuogui Wan gestational diabetes mellitus group. We can conclude that Zuogui Wan has the therapeutic effect on gestational diabetes mellitus. PMID:25136475

Three Identities of the Catalan-Qi Numbers

OpenAIRE

Mansour Mahmoud; Feng Qi

2016-01-01

In the paper, the authors find three new identities of the Catalan-Qi numbers and provide alternative proofs of two identities of the Catalan numbers. The three identities of the Catalan-Qi numbers generalize three identities of the Catalan numbers.

Three Identities of the Catalan-Qi Numbers

Directory of Open Access Journals (Sweden)

Mansour Mahmoud

2016-05-01

Full Text Available In the paper, the authors find three new identities of the Catalan-Qi numbers and provide alternative proofs of two identities of the Catalan numbers. The three identities of the Catalan-Qi numbers generalize three identities of the Catalan numbers.

Tai Chi and Qi Gong for Health and Well-Being

Science.gov (United States)

... Tai Chi and Qi Gong for Health and Well-Being Share: © Mariann Seriff The following video is intended ... Tai Chi and Qi Gong for Health and Well-Being Video › Tai Chi and Qi Gong for Health ...

Tai Chi and Qi Gong for Health and Well-Being

Medline Plus

Full Text Available ... Chi and Qi Gong for Health and Well-Being Share: © Mariann Seriff The following video is intended ... Chi and Qi Gong for Health and Well-Being Video › Tai Chi and Qi Gong for Health ...

[Comparative analysis on the biological basis of blood stasis syndrome induced by qi-stagnation and qi-deficiency in patients with unstable angina pectoris].

Science.gov (United States)

Ren, Jian-xun; Liu, Jian-xun; Lin, Cheng-ren

2010-04-01

To comparatively analyse the objective characteristics of different syndrome types of qi-disturbance-induced blood stasis syndrome (QDBS) in the pathogenetic evolution of unstable angina coronary heart disease (UA-CHD). Seventy-eight patients with UA-CHD of QDBS were differentiated into 2 groups: 55 in the qi-deficiency-induced blood-stasis syndrome group (A) and 23 in the qi-stagnation-induced blood-stasis syndrome group (B). The comparative analysis on them was carried out through comparing their blood pressure, glucose and lipid metabolisms, coagulation function, thyroid function and inflammation reaction changes, etc. In the pathogenetic process of qi-disturbance induced blood stasis, the initiating age, levels of HbA1c, TSH, PT and APTT between the two groups were significantly different (P emotional stress is possibly the essence of qi-stagnation induced blood stasis syndrome.

Tai Chi and Qi Gong for Health and Well-Being

Medline Plus

Full Text Available ... Tai Chi and Qi Gong for Health and Well-Being Share: © Mariann Seriff The following video is intended ... Tai Chi and Qi Gong for Health and Well-Being Video › Tai Chi and Qi Gong for Health ...

Scalability analysis of large-scale LoRaWAN networks in ns-3

OpenAIRE

Abeele, Floris Van den; Haxhibeqiri, Jetmir; Moerman, Ingrid; Hoebeke, Jeroen

2017-01-01

As LoRaWAN networks are actively being deployed in the field, it is important to comprehend the limitations of this Low Power Wide Area Network technology. Previous work has raised questions in terms of the scalability and capacity of LoRaWAN networks as the number of end devices grows to hundreds or thousands per gateway. Some works have modeled LoRaWAN networks as pure ALOHA networks, which fails to capture important characteristics such as the capture effect and the effects of interference...

Solución de conectividad ante fallos para una red WAN empresarial

OpenAIRE

Martín Manjón-Cabeza, José María

2014-01-01

El proyecto propone una solución bajo demanda y de bajo coste para poder mantener la disponibilidad de las comunicaciones de las distintas sedes de una empresa hacia el resto de la WAN corporativa ante un fallo de alguno de sus enlaces principales de la WAN contratada a la operadora. El projecte proposa una solució a la carta i de baix cost per poder mantenir la disponibilitat de les comunicacions de les diferents seus d'una empresa cap a la resta de la WAN corporativa davant una fallida d...

Using blockchain to build trusted LoRaWAN sharing server

Directory of Open Access Journals (Sweden)

Jun Lin

2017-09-01

Full Text Available Purpose – With the rapid growth of the Internet of Things (IoT market and requirement, low power wide area (LPWA technologies have become popular. In various LPWA technologies, Narrow Band IoT (NB-IoT and long range (LoRa are two main leading competitive technologies. Compared with NB-IoT networks, which are mainly built and managed by mobile network operators, LoRa wide area networks (LoRaWAN are mainly operated by private companies or organizations, which suggests two issues: trust of the private network operators and lack of network coverage. This study aims to propose a conceptual architecture design of a blockchain built-in solution for LoRaWAN network servers to solve these two issues for LoRaWAN IoT solution. Design/methodology/approach – The study proposed modeling, model analysis and architecture design. Findings – The proposed solution uses the blockchain technology to build an open, trusted, decentralized and tamper-proof system, which provides the indisputable mechanism to verify that the data of a transaction has existed at a specific time in the network. Originality/value – To the best of our knowledge, this is the first work that integrates blockchain technology and LoRaWAN IoT technology.

How to design some computer WAN

International Nuclear Information System (INIS)

Zhang Chengjun; Huang Hongmei

2001-01-01

The author introduces a way of how to construct computer WAN, depending on the present condition of enterprise, under the social surrounding in which the technology of internet is rapidly spread and developed at present, and gives a detailed dispose of main network equipment

How to design some computer WAN

International Nuclear Information System (INIS)

Zhang Chengjun; Huang Hongmei

2000-01-01

The authors introduce a way of how to construct computer WAN, depending on the present condition of enterprise, under the social surrounding in which the technology of internet is rapidly spread and developed at present. And gives the detailed dispose of main network equipment

Signal Propagation Delay as a Barrier to Control Applications in WAN

DEFF Research Database (Denmark)

Knudsen, Thomas Phillip; Patel, A.; Pedersen, Jens Myrup

With the advent in WAN of delay sensitive technical applications, such as remote control, signal propagation delay becomes a major problem. The extent of the problem is analysed by lower bounding the delay in relation to different transmission media. Requirements for reliability and bandwidth are...... are considered. The consequences of this bounding for communication network planning and provisioning are discussed in relation to mitigating the effects of signal propagation delay as a barrier to the penetration of control applications into WAN......With the advent in WAN of delay sensitive technical applications, such as remote control, signal propagation delay becomes a major problem. The extent of the problem is analysed by lower bounding the delay in relation to different transmission media. Requirements for reliability and bandwidth...

Thermography applied acupuncture and qi-gong

Science.gov (United States)

Qin, Yuwen; Ji, Hong-Wei; Chen, Jin-Long; Li, Hong-Qi

1997-04-01

Thermographic technique can be used to measure temperature distribution of body surface in real-time, non-contact and full-field, which has been successfully used in medical diagnosis, remote sensing, and NDT, etc. The authors have developed a thermographic experiment that can be applied to inspect the effect of action of acupuncture and qi-gong (a system of deep breathing exercises) by measuring the temperature of hand and arm. The observation is performed respectively by thermography for the dynamic changes of temperature of the arm and hand after acupuncture therapy and qi-gong therapy. Thermographic results show that the temperature on the collateral channels increases markedly. In the meantime, it can be seen that the above therapies of Chinese medicine can stimulate the channel collateral system. This also contributes a new basis to the effect of action of the therapies of Chinese medicine. The work shows that thermographic technique is a powerful tool for research in Chinese medicine. In this paper, some thermal images are obtained from the persons treated with acupuncture and qi- gong.

Requirement of histidine 217 for ubiquinone reductase activity (Qi site) in the cytochrome bc1 complex.

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Gray, K A; Dutton, P L; Daldal, F

1994-01-25

Folding models suggest that the highly conserved histidine 217 of the cytochrome b subunit from the cytochrome bc1 complex is close to the quinone reductase (Qi) site. This histidine (bH217) in the cytochrome b polypeptide of the photosynthetic bacterium Rhodobacter capsulatus has been replaced with three other residues, aspartate (D), arginine (R), and leucine (L). bH217D and bH217R are able to grow photoheterotrophically and contain active cytochrome bc1 complexes (60% of wild-type activity), whereas the bH217L mutant is photosynthetically incompetent and contains a cytochrome bc1 complex that has only 10% of the wild-type activity. Single-turnover flash-activated electron transfer experiments show that cytochrome bH is reduced via the Qo site with near native rates in the mutant strains but that electron transfer between cytochrome bH and quinone bound at the Qi site is greatly slowed. These results are consistent with redox midpoint potential (Em) measurements of the cytochrome b subunit hemes and the Qi site quinone. The Em values of cyt bL and bH are approximately the same in the mutants and wild type, although the mutant strains have a larger relative concentration of what may be the high-potential form of cytochrome bH, called cytochrome b150. However, the redox properties of the semiquinone at the Qi site are altered significantly. The Qi site semiquinone stability constant of bH217R is 10 times higher than in the wild type, while in the other two strains (bH217D and bH217L) the stability constant is much lower than in the wild type. Thus H217 appears to have major effects on the redox properties of the quinone bound at the Qi site. These data are incorporated into a suggestion that H217 forms part of the binding pocket of the Qi site in a manner reminiscent of the interaction between quinone bound at the Qb site and H190 of the L subunit of the bacterial photosynthetic reaction center.

Alteration of radiation-induced hematotoxicity by Bu-Zhong-Yi-Qi-Tang in mouse

International Nuclear Information System (INIS)

Jang, Jong Sik; Kim, Sung Ho

2008-01-01

The purpose of this study reported here was to investigate the ability of Bu-Zhong-Yi-Qi-Tang (BZYQT), known to elevate hematopoietic functions, to protect mice undergoing treatment with whole body single gamma-irradiation. BZYQT was given (25 mg/kg B.W.) intraperitoneally at 36 and 12 hours before irradiation and 30 minute and 24 hours after irradiation. Recovery of neutrophil and lymphocyte counts was significantly stimulated by extract of BZYQT. Stimulated recovery by the extract from the BZYQT was also observed in thrombocytes. However, the anti-radiation effect of erythrocyte, hemoglobin and hematocrit was not as significant as that of leukocyte. Further studies are needed to better characterize the protective nature of BZYQT extract and its ingredients

Alteration of radiation-induced hematotoxicity by Bu-Zhong-Yi-Qi-Tang in mouse

Energy Technology Data Exchange (ETDEWEB)

Jang, Jong Sik [Kyungpook National University, Daegu (Korea, Republic of); Kim, Sung Ho [Chonnam National University, Gwangju (Korea, Republic of)

2008-09-15

The purpose of this study reported here was to investigate the ability of Bu-Zhong-Yi-Qi-Tang (BZYQT), known to elevate hematopoietic functions, to protect mice undergoing treatment with whole body single gamma-irradiation. BZYQT was given (25 mg/kg B.W.) intraperitoneally at 36 and 12 hours before irradiation and 30 minute and 24 hours after irradiation. Recovery of neutrophil and lymphocyte counts was significantly stimulated by extract of BZYQT. Stimulated recovery by the extract from the BZYQT was also observed in thrombocytes. However, the anti-radiation effect of erythrocyte, hemoglobin and hematocrit was not as significant as that of leukocyte. Further studies are needed to better characterize the protective nature of BZYQT extract and its ingredients.

State of the Art in LP-WAN Solutions for Industrial IoT Services.

Science.gov (United States)

Sanchez-Iborra, Ramon; Cano, Maria-Dolores

2016-05-17

The emergence of low-cost connected devices is enabling a new wave of sensorization services. These services can be highly leveraged in industrial applications. However, the technologies employed so far for managing this kind of system do not fully cover the strict requirements of industrial networks, especially those regarding energy efficiency. In this article a novel paradigm, called Low-Power Wide Area Networking (LP-WAN), is explored. By means of a cellular-type architecture, LP-WAN-based solutions aim at fulfilling the reliability and efficiency challenges posed by long-term industrial networks. Thus, the most prominent LP-WAN solutions are reviewed, identifying and discussing the pros and cons of each of them. The focus is also on examining the current deployment state of these platforms in Spain. Although LP-WAN systems are at early stages of development, they represent a promising alternative for boosting future industrial IIoT (Industrial Internet of Things) networks and services.

Enhancing LoRaWAN Security through a Lightweight and Authenticated Key Management Approach.

Science.gov (United States)

Sanchez-Iborra, Ramon; Sánchez-Gómez, Jesús; Pérez, Salvador; Fernández, Pedro J; Santa, José; Hernández-Ramos, José L; Skarmeta, Antonio F

2018-06-05

Luckily, new communication technologies and protocols are nowadays designed considering security issues. A clear example of this can be found in the Internet of Things (IoT) field, a quite recent area where communication technologies such as ZigBee or IPv6 over Low power Wireless Personal Area Networks (6LoWPAN) already include security features to guarantee authentication, confidentiality and integrity. More recent technologies are Low-Power Wide-Area Networks (LP-WAN), which also consider security, but present initial approaches that can be further improved. An example of this can be found in Long Range (LoRa) and its layer-two supporter LoRa Wide Area Network (LoRaWAN), which include a security scheme based on pre-shared cryptographic material lacking flexibility when a key update is necessary. Because of this, in this work, we evaluate the security vulnerabilities of LoRaWAN in the area of key management and propose different alternative schemes. Concretely, the application of an approach based on the recently specified Ephemeral Diffie⁻Hellman Over COSE (EDHOC) is found as a convenient solution, given its flexibility in the update of session keys, its low computational cost and the limited message exchanges needed. A comparative conceptual analysis considering the overhead of different security schemes for LoRaWAN is carried out in order to evaluate their benefits in the challenging area of LP-WAN.

[Discussion on needling sensation, arrival of qi and needling response (Deqi)].

Science.gov (United States)

Zhang, Fang; Wang, Hong-Du

2012-12-01

The current appointed teaching material of Science of Acupuncture and Moxibustion holds that there is no difference among the needling sensation, arrival of qi and needling response. However, the author has a different understanding. Therefore, Neijing (Internal Classic), its annotation, exposition and understandings of ancient and modern famous experts are cited to analyze their meanings. And the result indicates that the needling sensation is subjective feelings and perceived responses of doctors and patients. Arrival of qi is the healing process of the organ through activating the anti-pathogenic qi to expel the pathogens. The needling response is the final aim of acupuncture therapy. Thus, the meaning of needling sensation, arrival of qi, and needling response are different. And an accurate understanding can better guide acupuncture treatment.

Efficacy of an integrated continuing medical education (CME) and quality improvement (QI) program on radiation oncologist (RO) clinical practice

International Nuclear Information System (INIS)

Leong, Cheng Nang; Shakespeare, Thomas Philip; Mukherjee, Rahul K.; Back, Michael F.; Lee, Khai Mun; Lu, Jiade Jay; Wynne, Christopher J.; Lim, Keith; Tang, Johann; Zhang Xiaojian

2006-01-01

Purpose: There has been little radiation oncologist (RO)-specific research in continuing medical education (CME) or quality improvement (QI) program efficacy. Our aim was to evaluate a CME/QI program for changes in RO behavior, performance, and adherence to department protocols/studies over the first 12 months of the program. Methods and Materials: The CME/QI program combined chart audit with feedback (C-AWF), simulation review AWF (SR-AWF), reminder checklists, and targeted CME tutorials. Between April 2003 and March 2004, management of 75 patients was evaluated by chart audit with feedback (C-AWF) and 178 patients via simulation review audit (SR-AWF) using a validated instrument. Scores were presented, and case management was discussed with individualized educational feedback. RO behavior and performance was compared over the first year of the program. Results: Comparing the first and second 6 months, there was a significant improvement in mean behavior (12.7-13.6 of 14, p = 0.0005) and RO performance (7.6-7.9 of 8, p = 0.018) scores. Protocol/study adherence significantly improved from 90.3% to 96.6% (p = 0.005). A total of 50 actions were generated, including the identification of learning needs to direct CME tutorials, the systematic change of suboptimal RO practice, and the alteration of deficient management of 3% of patients audited during the program. Conclusion: An integrated CME/QI program combining C-AWF, SR-AWF, QI reminders, and targeted CME tutorials effectively improved targeted RO behavior and performance over a 12-month period. There was a corresponding increase in departmental protocol and study adherence

Enhancing LoRaWAN Security through a Lightweight and Authenticated Key Management Approach

Directory of Open Access Journals (Sweden)

Ramon Sanchez-Iborra

2018-06-01

Full Text Available Luckily, new communication technologies and protocols are nowadays designed considering security issues. A clear example of this can be found in the Internet of Things (IoT field, a quite recent area where communication technologies such as ZigBee or IPv6 over Low power Wireless Personal Area Networks (6LoWPAN already include security features to guarantee authentication, confidentiality and integrity. More recent technologies are Low-Power Wide-Area Networks (LP-WAN, which also consider security, but present initial approaches that can be further improved. An example of this can be found in Long Range (LoRa and its layer-two supporter LoRa Wide Area Network (LoRaWAN, which include a security scheme based on pre-shared cryptographic material lacking flexibility when a key update is necessary. Because of this, in this work, we evaluate the security vulnerabilities of LoRaWAN in the area of key management and propose different alternative schemes. Concretely, the application of an approach based on the recently specified Ephemeral Diffie–Hellman Over COSE (EDHOC is found as a convenient solution, given its flexibility in the update of session keys, its low computational cost and the limited message exchanges needed. A comparative conceptual analysis considering the overhead of different security schemes for LoRaWAN is carried out in order to evaluate their benefits in the challenging area of LP-WAN.

[Clinical observation on idiopathic tinnitus treated with acupuncture, buzhong yiqi tang and cizhu wan].

Science.gov (United States)

Chen, Surong; Tan, Xuming; Fei, Lanbo; Xiang, Xiande

2018-04-12

To observe the differences in the clinical therapeutic effects on idiopathic tinnitus between the combined therapy with acupuncture and the modified formula of buzhong yiqi tang and cizhu wan and the simple administration of the modified formula of buzhong yiqi tang and cizhu wan . A total of 60 patients were randomized into a combined treatment group and an herbal medicine group, 30 cases in each one and 2 cases dropped out in the herbal medicine group. In the combined treatment group, acupuncture was given at the local acupoints for tinnitus, such as Yifeng (TE 17), penetrating needling technique from Ermen (TE 21) to Tinggong (SI 19) and Tinghui (GB 2) combined with the scalp acupuncture [the vertigo-auditory area, Baihui (GV 20)] and the oral administration of the modified formula of buzhong yiqi tang and cizhu wan . In the herbal medicine group, the oral administration of the modified formula of buzhong yiqi tang and cizhu wan was only applied. The treatment was given once a day in each group, 5 times a week for acupuncture and 7 times a week for the oral administration of herbal medicine. Totally, the treatment for 6 weeks was required in the two groups. Before and after treatment, the tinnitus severity score (TSS) and the score of tinnitus handicap inventory (THI) were observed and the clinical therapeutic effects were compared between the two groups. After treatment, the TSS and THI scores reduced as compared with those before treatment in the two groups (all P tang and cizhu wan achieve the superior therapeutic effects on idiopathic tinnitus as compared with the simple oral administration of the modified formula of buzhong yiqi tang and cizhu wan .

Artemisiae Argyi Folium and its geo-authentic crude drug qi ai

Directory of Open Access Journals (Sweden)

Diangang Liu

2017-01-01

Conclusion: The superior quality of qi ai compared with general AAF may be due to relatively higher contents of bioactive components. This study provides basic information for further study and utilization of AAF and qi ai.

Qi Liu - Bulletin of Materials Science | Indian Academy of Sciences

Indian Academy of Sciences (India)

Home; Journals; Bulletin of Materials Science. QI LIU. Articles written in Bulletin of Materials Science. Volume 34 Issue 2 April 2011 pp 183-189. Study of structural transformations and phases formation upon calcination of Zn–Ni–Al hydrotalcite nanosheets · Zhanshuang Li Yanchao Song Jun Wang Qi Liu Piaoping Yang ...

[Qi as a materialist concept on the level of medical philosophy].

Science.gov (United States)

Su, Zhan-Qing

2005-03-01

This paper has made a distinction between the materialist concept of qi on the medical philosophical level and its substantial existence, and illustrated the materiality and multiplicity of qi. Materiality refers to the objective reality, a summation of various things or phenomena related to human beings; while multiplicity refers to diversity of specific substances, each holding its individual essence. Based on two essential conceptions "xiang" and "xiangji", and combining the theories of traditional Chinese medicine and Western medicine, this paper has also made a preliminary study on the substantial existence of qi at macro- and micro-levels, and on physiological (normal) and pathological (abnormal) aspects. It is the author's argument that studies of the substantial existence of qi from different aspects, micro-dimension in particular, will push the syndrome differentiation of traditional Chinese medicine to a more subtle sphere.

"Warming yang and invigorating qi" acupuncture alters acetylcholine receptor expression in the neuromuscular junction of rats with experimental autoimmune myasthenia gravis

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Hai-peng Huang

2016-01-01

Full Text Available Myasthenia gravis is an autoimmune disorder in which antibodies have been shown to form against the nicotinic acetylcholine nicotinic postsynaptic receptors located at the neuromuscular junction. "Warming yang and invigorating qi" acupuncture treatment has been shown to reduce serum inflammatory cytokine expression and increase transforming growth factor beta expression in rats with experimental autoimmune myasthenia gravis. However, few studies have addressed the effects of this type of acupuncture on the acetylcholine receptors at the neuromuscular junction. Here, we used confocal laser scanning microscopy to examine the area and density of immunoreactivity for an antibody to the nicotinic acetylcholine receptor at the neuromuscular junction in the phrenic nerve of rats with experimental autoimmune myasthenia gravis following "warming yang and invigorating qi" acupuncture therapy. Needles were inserted at acupressure points Shousanli (LI10, Zusanli (ST36, Pishu (BL20, and Shenshu (BL23 once daily for 7 consecutive days. The treatment was repeated after 1 day of rest. We found that area and the integrated optical density of the immunoreactivity for the acetylcholine receptor at the neuromuscular junction of the phrenic nerve was significantly increased following acupuncture treatment. This outcome of the acupuncture therapy was similar to that of the cholinesterase inhibitor pyridostigmine bromide. These findings suggest that "warming yang and invigorating qi" acupuncture treatment increases acetylcholine receptor expression at the neuromuscular junction in a rat model of autoimmune myasthenia gravis.

[Professor GAO Yuchun's experience on "sequential acupuncture leads to smooth movement of qi"].

Science.gov (United States)

Wang, Yanjun; Xing, Xiao; Cui, Linhua

2016-01-01

Professor GAO Yuchun is considered as the key successor of GAO's academic school of acupuncture and moxibustion in Yanzhao region. Professor GAO's clinical experience of, "sequential acupuncture" is introduced in details in this article. In Professor GAO's opinions, appropriate acupuncture sequence is the key to satisfactory clinical effects during treatment. Based on different acupoints, sequential acupuncture can achieve the aim of qi following needles and needles leading qi; based on different symptoms, sequential acupuncture can regulate qi movement; based on different body positions, sequential acupuncture can harmonize qi-blood and reinforcing deficiency and reducing excess. In all, according to the differences of disease condition and constitution, based on the accurate acupoint selection and appropriate manipulation, it is essential to capture the nature of diseases and make the order of acupuncture, which can achieve the aim of regulating qi movement and reinforcing deficiency and reducing excess.

Acupuncture phenomenon of the Qi energy complete awakening

Directory of Open Access Journals (Sweden)

Viktor N. Skakov

2013-11-01

Full Text Available Aims The aim is to study the phenomenon of the Qi energy complete awakening using the acupuncture method and the reactions appearing during this process that lead to recovery of the body and of the cardiovascular system first of all. Materials and methods The study is based on the classical acupuncture method using the unique technique of effecting the points by I-Ching. Results The result is the body recovering the pathologic diseases the patient has been suffering for decades. Conclusion The new method for acupuncture is the Qi energy complete awakening based on structuring the Qi energy in the acupoints according to the figures of gua (trigrams and hexagrams in the Chinese Canon of Changes and can be used for the treatment of almost any kind of the disease including cardiovascular. The given method allows not only balancing the Yin and Yang energy in the human body but also launching the generalized recovery program concentrated in the deepest layers of the human genetic memory. The given method allows treating many diseases considered to be incurable by the official medicine.

Current temporal asymmetry and the role of tides: Nan-Wan Bay vs. the Gulf of Elat

Science.gov (United States)

Ashkenazy, Yosef; Fredj, Erick; Gildor, Hezi; Gong, Gwo-Ching; Lee, Hung-Jen

2016-05-01

Nan-Wan Bay in Taiwan and the Gulf of Elat in Israel are two different coastal environments, and as such, their currents are expected to have different statistical properties. While Nan-Wan Bay is shallow, has three open boundaries, and is directly connected to the open ocean, the Gulf of Elat is deep, semi-enclosed, and connected to the Red Sea via the Straits of Tiran. Surface currents have been continuously measured with fine temporal (less than or equal to 1 h) and spatial resolution (less than or equal to 1 km) for more than a year in both environments using coastal radars (CODARs) that cover a domain of roughly 10 × 10 km. These measurements show that the currents in Nan-Wan Bay are much stronger than those in the Gulf of Elat and that the mean current field in Nan-Wan Bay exhibits cyclonic circulation, which is stronger in the summer; in the Gulf of Elat, the mean current field is directed southward and is also stronger during the summer. We have compared the statistical properties of the current speeds in both environments and found that both exhibit large spatial and seasonal variations in the shape parameter of the Weibull distribution. However, we have found fundamental and significant differences when comparing the temporal asymmetry of the current speed (i.e., the ratio between the time during which the current speed increases and the total time). While the Nan-Wan Bay currents are significantly asymmetric, those of the Gulf of Elat are not. We then extracted the tidal component of the Nan-Wan Bay currents and found that it is strongly asymmetric, while the asymmetry of tidally filtered currents is much weaker. We thus conclude that the temporal asymmetry of the Nan-Wan Bay currents reported here is due to the strong tides in the region. We show that the asymmetry ratio in Nan-Wan Bay varies spatially and seasonally: (i) the currents increase rapidly and decay slowly in the northern part of the domain and vice versa in the southern part, and (ii) the

Implementación de una red WAN en una escudería de F1

OpenAIRE

García Muñoz, Luis Eduardo

2013-01-01

TFC en el que se detalla la implementación de una red WAN en una escudería de Fórmula 1. TFC en què es detalla la implementació d'una xarxa WAN en una escuderia de Fórmula 1. Bachelor thesis for the Telecommunication Technologies program on Telematics.

Implantación de switching y ToIP sobre una red WAN

OpenAIRE

Pique Palacin, Ivan

2013-01-01

Este proyecto tiene como objeto el diseño y la implementación de servicios de comunicaciones de LAN (Switching) y Telefonía IP (ToIP), todos ellos integrados sobre una red WAN nacional ya existente y funcionando, gestionada por un ISP. Aquest projecte té com a objecte el disseny i la implementació de serveis de comunicacions de LAN (Switching) i telefonia IP (ToIP), tots ells integrats sobre una xarxa WAN nacional ja existent i funcionant, gestionada per un ISP. Bachelor thesis for the ...

Estudio de las características, funcionamiento, ventajas y técnicas utilizadas en los optimizadores WAN

OpenAIRE

Suarez Armijos, Javier Naufredo

2012-01-01

En la actualidad existe la necesidad de conectarse a redes de área amplia WAN, ya sea por parte de usuarios móviles o usuarios que se encuentran en sucursales remotas que lamentablemente no pueden acceder a la red WAN de forma eficiente ya que existe perdidas de paquetes por la interferencia, latencia entre otros factores que hacen que la red WAN tenga muchos inconvenientes, principalmente de velocidad. Muchos usuarios que no pueden trabajar desde sus oficinas o desde sus casas desean poderlo...

The Efficacy of Jing Wan Hong Ointment for Nerve Injury Diabetic Foot Ulcer and Its Mechanisms

Directory of Open Access Journals (Sweden)

Shumei Jin

2014-01-01

Full Text Available Jing Wan Hong ointment contains 30 kinds of Chinese herbs, with functions of activating blood circulation to disperse blood stasis, clearing heat, eliminating dampness, and reducing swelling by detoxification. Therefore, Jing Wan Hong ointment may facilitate the healing of ulcers. The aim of this study was to evaluate the efficacy and mechanisms of Jing Wan Hong ointment for healing diabetic foot ulceration in Wistar rats induced by streptozotocin and sciatic nerve damage. The results showed that Jing Wan Hong ointment had a marked effect on foot ulcers in diabetic rats induced by initial nerve injury. These effects were manifested by reducing the foot ulcer size and Wagner grade after seven days of treatment. The diabetic rats with foot ulcers were almost healed after 21 days of treatment. Moreover, the mechanisms of this effect seem to be dependent on increased expression of PDGF mRNA, but there was no influence on the expression of TGF-β, VEGF, and FLT-1 mRNA.

Making cognitive decision support work: Facilitating adoption, knowledge and behavior change through QI.

Science.gov (United States)

Weir, Charlene; Brunker, Cherie; Butler, Jorie; Supiano, Mark A

2017-07-01

This paper evaluates the role of facilitation in the successful implementation of Computerized Decision Support (CDS). Facilitation processes include education, specialized computerized decision support, and work process reengineering. These techniques, as well as modeling and feedback enhance self-efficacy, which we propose is one of the factors that mediate the effectiveness of any CDS. In this study, outpatient clinics implemented quality improvement (QI) projects focused on improving geriatric care. Quality Improvement is the systematic process of improving quality through continuous measurement and targeted actions. The program, entitled "Advancing Geriatric Education through Quality Improvement" (AGE QI), consisted of a 6-month, QI based, intervention: (1) 2h didactic session, (2) 1h QI planning session, (3) computerized decision support design and implementation, (4) QI facilitation activities, (5) outcome feedback, and (6) 20h of CME. Specifically, we examined the impact of the QI based program on clinician's perceived self-efficacy in caring for older adults and the relationship of implementation support and facilitation on perceived success. The intervention was implemented at 3 institutions, 27 community healthcare system clinics, and 134 providers. This study reports the results of pre/post surveys for the forty-nine clinicians who completed the full CME program. Self-efficacy ratings for specific clinical behaviors related to care of older adults were assessed using a Likert based instrument. Self-ratings of efficacy improved across the following domains (depression, falls, end-of-life, functional status and medication management) and specifically in QI targeted domains and were associated with overall clinic improvements. Published by Elsevier Inc.

State of the Art in LP-WAN Solutions for Industrial IoT Services

Directory of Open Access Journals (Sweden)

Ramon Sanchez-Iborra

2016-05-01

Full Text Available The emergence of low-cost connected devices is enabling a new wave of sensorization services. These services can be highly leveraged in industrial applications. However, the technologies employed so far for managing this kind of system do not fully cover the strict requirements of industrial networks, especially those regarding energy efficiency. In this article a novel paradigm, called Low-Power Wide Area Networking (LP-WAN, is explored. By means of a cellular-type architecture, LP-WAN–based solutions aim at fulfilling the reliability and efficiency challenges posed by long-term industrial networks. Thus, the most prominent LP-WAN solutions are reviewed, identifying and discussing the pros and cons of each of them. The focus is also on examining the current deployment state of these platforms in Spain. Although LP-WAN systems are at early stages of development, they represent a promising alternative for boosting future industrial IIoT (Industrial Internet of Things networks and services.

Qing-Qi Rickshaw : A Boon Or Bane For Public Transportation? A Study Of Road Traffic Injury Patterns Involving Qing-Qi Rickshaws In Karachi Pakistan.

Science.gov (United States)

Muzzammil, Muhammad; Minhas, Muhammad Saeed; Effendi, Jahanzeb; Jahanzeb, Syed; Mughal, Ayesha; Qadir, Abdul

2017-01-01

The three-wheeler Qing-qi and Compressed Natural Gas (CNG) auto-rickshaws were introduced in Karachi to meet the transportation demand of the growing population. These vehicles have directly or indirectly been implicated in a number of road traffic violations as well as road accidents. This study aims to describe the crash characteristics and injury patterns for Qing-qi rickshaw occupants and other road users hit by Qing-qi rickshaw in Karachi, Pakistan. An Observational/ Descriptive study was conducted at Accident & Emergency and Orthopaedic Surgery Department, Jinnah Post Graduate Medical Centre, Karachi Pakistan from July 2014 to June 2015.All patients who came with Qing-qi rickshaw accident in Accident & Emergency (A&E) of JPMC were included. Crash characteristics, details of injuries, injury severity parameters and outcome were documented in detailed interviews. Four hundred and eighty-six rickshaw related injuries were noted in road traffic accidents by Qing-gi rickshaw. Age range was 2-85 (43.5±58.68). 350 injured victims were males and 136 were females. By occupation most victims were laborers and daily wage workers (45%) and students (21%). Overloading of vehicle with more than two passengers was found in (28.5%). The most common cause of injury was collision with a moving vehicle (56%), followed by fall from rickshaw. The most common contributing factor was the overloading of rickshaw and roll over on turning (61%). Injury severity on arrival were mild (49%), moderate were (32%), and severe were (19%). Injuries related to head and neck (26%), face (14%), thorax and abdomen (5%), lower extremity and pelvic girdle (31%) and upper extremity (23%) were observed. Qing-qi rickshaw injuries are common and these vehicles are vulnerable to road traffic accidents. Occupants and road users are both at risk of injuries.

Integración del sistema SoloWAN de optimización de tráfico en redes WAN como un servicio dentro de una plataforma IaaS basada en OpenStack

OpenAIRE

Vega García, Carlos

2016-01-01

El trabajo consiste en la integración del software SoloWAN de optimización de tráfico en redes WAN, desarrollado en el Center for Open Middleware (COM) de la UPM, como un servicio dentro de una plataforma IaaS basada en OpenStack. Para alcanzar este propósito, se ha llevado a cabo un proceso de desarrollo partiendo del estudio de la plataforma OpenStack, analizando sus características, entendiendo los nodos que de los que está compuesta, así como los diferentes servicios que ofrece. S...

Relationship between endogenous hydrogen sulfide and blood stasis syndrome based on the Qi-blood theory of Chinese medicine.

Science.gov (United States)

Li, Wei-wei; Guo, Hao; Wang, Xue-mei

2013-09-01

"Qi" and "blood" are two essential concepts in Chinese medicine (CM). As qi is intangible, the concept of qi is still controversial between CM and Western medicine. However, the endogenous hydrogen sulfide (H2S) and other gaseous signaling molecules provides a new approach for understanding the essence of qi in CM. Blood stasis syndrome is a common syndrome in CM. According to the CM theory, the incidence of blood stasis syndrome is closely correlated to the reckless movement of qi, as qi and blood are inseparable in regulating physiological functions. In recent years, more and more evidences suggest a close correlation between blood stasis syndrome and microcirculation dysfunction. In this paper, we discuss the relationship between endogenous H2S and blood stasis syndrome based on qi-blood theory of CM. We found that endogenous H2S maybe a material basis in concept of qi in CM, while dysfunctional microcirculation is the pathological basis of the blood stasis syndrome. As qi is closely associated with incidence and progression of blood stasis syndrome, endogenous H2S may play an important role in preventing and treating the blood stasis syndrome by improving the function of microcirculation.

Traditional Chinese medicine formula Bi-Qi capsule alleviates rheumatoid arthritis-induced inflammation, synovial hyperplasia, and cartilage destruction in rats.

Science.gov (United States)

Wang, Kai; Zhang, Dongmei; Liu, Yan; Wang, Xuan; Zhao, Jiantong; Sun, Tingting; Jin, Tingting; Li, Baoli; Pathak, Janak L

2018-03-14

Traditional Chinese medicine (TCM) formula Bi-Qi capsule (Bi-Qi) is a commonly prescribed drug to treat rheumatoid arthritis (RA). However, the mechanism of Bi-Qi-mediated amelioration of RA pathogenesis is still a mystery. Collagen induced arthritis (CIA) in rats is an established model that shares many similarities with RA in humans. In this study we investigated the effect of Bi-Qi on the pathogenesis of CIA in rats. CIA was developed in Sprague-Dawley (S.D) rats (n = 60, female) and used as a model resembling RA in humans. Rats were treated with a high or moderate dose of Bi-Qi, or methotrexate (MTX). Effects of the treatment on local joint and systemic inflammation, synovial hyperplasia, cartilage destruction, and other main features in the pathogenesis of CIA were analyzed. Inflamed and swollen ankles and joints were observed in arthritic rats, while Bi-Qi or MTX treatment alleviated these symptoms. Only the Bi-Qi moderate dose decreased RA-induced serum levels of tumor necrosis factor-alpha (TNF-α). Both Bi-Qi and MTX reduced the interleukin (IL)-18 serum level. Protein levels of cartilage oligomeric matrix protein and osteopontin in serum, synovium, and cartilage were elevated in arthritic rats, while Bi-Qi alleviated these effects. Synovial hyperplasia, inflammatory cell infiltration in synovium and a high degree of cartilage degradation was observed in RA, and Bi-Qi or MTX alleviated this effect. Bi-Qi at the moderate dose was the most effective in mitigating CIA-related clinical complications. Our findings showed that Bi-Qi alleviates CIA-induced inflammation, synovial hyperplasia, cartilage destruction, and the other main features in the pathogenesis of CIA. This provides fundamental evidence for the anti-arthritic properties of Bi-Qi and corroborates the use of Bi-Qi TCM formula for the treatment of RA.

Network Information Management: The Key To Providing High WAN Availability.

Science.gov (United States)

Tysdal, Craig

1996-01-01

Discusses problems associated with increasing corporate network complexity as a result of the proliferation of client/server applications at remote locations, and suggests the key to providing high WAN (wide area network) availability is relational databases used in an integrated management approach. (LRW)

Introduction of the WAN accelerator in JAEA network

International Nuclear Information System (INIS)

Hirayama, Takashi; Kannari, Masaaki; Sato, Tomohiko

2012-06-01

In pursuance of 'The Optimization Plan on the network of JAEA', which aims to ensure network reliability and information security and to improve convenience in using the network, we are engaged in the optimization of inter-institute/center network bandwidth. This is a record of an introduction of WAN Accelerator into the network to Ningyo-toge Environmental Engineering Center which bandwidth is limited due to a geographically constraint. (author)

Effect of Qi Ming Granule on the choroidal circulation in diabetic patients

Directory of Open Access Journals (Sweden)

Ke-Jun Li

2016-03-01

Full Text Available AIM:To investigate the effect of a Chinese medicine(Qi Ming granuleon the retinal and choroidal circulation in diabetes patients. METHODS: According to the results of fundus fluorescein angiography(FFA, all the 45 diabetes patients were divided into no diabetic retinopathy(NDRgroup and nonproliferative diabetic retinopathy(NPDRgroup. All subjects were examined by FFA and indocyanine green angiography(ICGAat the same time. After taken Qi Ming granule for 3mo, all subjects were examined by the same method. FFA and ICGA were used to evaluate the retinal and choroidal circulation and their features. The key points were filling time for the retinal and choroidal circulation before and after treatments. The accuracy data was used to evaluate the effect.RESULTS: After taken Qi Ming granule for 3mo, there were significant decrease of the retina and the choroid filling time in NDR and NPDR groups. The occurrence rate of various abnormal angiographic features were significantly decreased. CONCLUSION: Qi Ming granule can accelerate the blood flow of retina and choroid, improve the blood circulation in diabetes patients, and delay the occurrence and development of diabetic retinopathy.

Seamless live migration of virtual machines over the MAN/WAN

NARCIS (Netherlands)

Travostino, F.; Daspit, P.; Gommans, L.; Jog, C.; de Laat, C.; Mambretti, J.; Monga, I.; van Oudenaarde, B.; Raghunath, S.; Wang, P.Y.

2006-01-01

The “VM Turntable” demonstrator at iGRID 2005 pioneered the integration of Virtual Machines (VMs) with deterministic “lightpath” network services across a MAN/WAN. The results provide for a new stage of virtualization—one for which computation is no longer localized within a data center but rather

Neuroprotective effect of Zhen Tian Wan on pial strip-induced ...

African Journals Online (AJOL)

ZTW significantly reduced the level of free radicals in pial stripped rats. ZTW can improve learning and memory function and it possess anti-oxidant activity. ZTW may be beneficial in the treatment of vascular dementia. Keywords: Zhen Tian Wan; pial strip; lesion; Memory; Morris water maze; free radicals ...

Weaker cognitive control abilities of Pi (Spleen) qi-deficient individuals supported Chinese medicine diagnosis.

Science.gov (United States)

Lin, Hui-Yan; Zhao, Yan-Ping; Xu, Gui-Ping; Li, Yun-Si; Xie, Wei-Yun; Bai, Li-Hua; Jin, Hua

2017-07-28

To investigate whether Pi (Spleen) qi-deficiency affected psychological and neural responses in relevance to cognitive control. Pi qi-deficient and balanced participants were asked to perform the Stroop task, a classical cognitive control paradigm. In this paradigm, participants had to judge the color of the prompted word. The word's meaning indicated the color (the consistent condition) or not (the inconsistent condition), or were unrelated to the color (the neutral condition). Electroencephalograph (EEG) was recorded during the task. Event-related potential (ERP) results showed that Pi qi-deficient individuals failed to exhibit a normal Stroop effect as Balanced individuals did, such as the accuracy differences between the consistent and the inconsistent conditions as well as the N450 effect (P>0.05). Meanwhile, Pi qi-deficient individuals displayed larger P2 and P3 amplitudes than balanced individuals did during performing the cognitive control task (Pcognitive control aspect.

High-throughput LC-MS method for the rapid characterization of multiple chemical constituents and metabolites of Da-Bu-Yin-Wan.

Science.gov (United States)

Li, Xianna; Sun, Hui; Zhang, Aihua; Liu, Zhidong; Zou, Di; Song, Yanhua; Liu, Liang; Wang, Xijun

2017-11-01

Traditional Chinese medicine is the clinical experience accumulated by Chinese people against diseases. Da-Bu-Yin-Wan is a famous traditional Chinese medicine formula consisting of Phellodendri amurensis Rupr., Anemarrhenae asphodeloides Bge., Radix Rehmanniae Preparata and Chinemys reevesii. In this study, ultra high performance liquid chromatography with electrospray ionization quadrupole time-of-flight high-definition mass spectrometry with the control software of Masslynx (V4.1) was established for comprehensive screening and identification of the chemical constituents and serum metabolites of Da-Bu-Yin-Wan in vivo and in vitro. Consequently, 70 peaks in the methanol extract from Da-Bu-Yin-Wan and 38 peaks absorbed into rat blood were characterized. The 70 constituents in vitro included alkaloids, flavonoids, polysaccharide, limonoids, flavonoid, etc. And the 38 constituents consist of 22 absorbed prototypes and 16 metabolites of Da-Bu-Yin-Wan absorbed in vivo. We fully clarified the chemical constituents of Da-Bu-Yin-Wan and provided a scientific strategy for the screening and characterization of the chemical constituents and metabolites of traditional Chinese medicine in vitro and in vivo. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Development of the Quality Improvement Minimum Quality Criteria Set (QI-MQCS): a tool for critical appraisal of quality improvement intervention publications.

Science.gov (United States)

Hempel, Susanne; Shekelle, Paul G; Liu, Jodi L; Sherwood Danz, Margie; Foy, Robbie; Lim, Yee-Wei; Motala, Aneesa; Rubenstein, Lisa V

2015-12-01

Valid, reliable critical appraisal tools advance quality improvement (QI) intervention impacts by helping stakeholders identify higher quality studies. QI approaches are diverse and differ from clinical interventions. Widely used critical appraisal instruments do not take unique QI features into account and existing QI tools (eg, Standards for QI Reporting Excellence) are intended for publication guidance rather than critical appraisal. This study developed and psychometrically tested a critical appraisal instrument, the QI Minimum Quality Criteria Set (QI-MQCS) for assessing QI-specific features of QI publications. Approaches to developing the tool and ensuring validity included a literature review, in-person and online survey expert panel input, and application to empirical examples. We investigated psychometric properties in a set of diverse QI publications (N=54) by analysing reliability measures and item endorsement rates and explored sources of disagreement between reviewers. The QI-MQCS includes 16 content domains to evaluate QI intervention publications: Organisational Motivation, Intervention Rationale, Intervention Description, Organisational Characteristics, Implementation, Study Design, Comparator Description, Data Sources, Timing, Adherence/Fidelity, Health Outcomes, Organisational Readiness, Penetration/Reach, Sustainability, Spread and Limitations. Median inter-rater agreement for QI-MQCS items was κ 0.57 (83% agreement). Item statistics indicated sufficient ability to differentiate between publications (median quality criteria met 67%). Internal consistency measures indicated coherence without excessive conceptual overlap (absolute mean interitem correlation=0.19). The critical appraisal instrument is accompanied by a user manual detailing What to consider, Where to look and How to rate. We developed a ready-to-use, valid and reliable critical appraisal instrument applicable to healthcare QI intervention publications, but recognise scope for

GPS-free Geolocation using LoRa in Low-Power WANs

DEFF Research Database (Denmark)

Fargas, Bernat Carbones; Petersen, Martin Nordal

2017-01-01

Internet of Things (IoT) has been growing over the last few years in multiple applications and due to the high need GPS for tracking capabilities, an innovative opportunity arises. This paper reports on a design and implementation of a LoRaWAN tracking system which is capable exploiting transmitted...

Brain areas involved in acupuncture needling sensation of de qi: a single-photon emission computed tomography (SPECT) study.

Science.gov (United States)

Chen, Jia-Rong; Li, Gan-Long; Zhang, Gui-Feng; Huang, Yong; Wang, Shu-Xia; Lu, Na

2012-12-01

De qi is a sensory response elicited by acupuncture stimulation. According to traditional Chinese medicine (TCM), de qi is essential for clinical efficacy. However, the understanding of the neurobiological basis of de qi is still limited. To investigate the relationship between brain activation and de qi by taking a single-photon emission computed tomography (SPECT) scan while applying acupuncture at TE5. A total of 24 volunteers were randomly divided into 4 groups, and received verum or sham acupuncture at true acupuncture point TE5 or a nearby sham point according to grouping. All subjects then received a (99m)Tc-ethylcysteinate dimer (ECD) SPECT scan. All six subjects in the verum acupuncture at true acupuncture point group experienced de qi sensation; in contrast, all six subjects in the sham acupuncture at the sham point group responded with nothing other than non-sensation. Compared to the scan results from subjects who experienced non-sensation, SPECT scans from subjects with de qi sensation demonstrated significant activated points mainly located in brodmann areas 6, 8, 19, 21, 28, 33, 35, 37, 47, the parahippocampal gyrus, lentiform nucleus, claustrum and red nucleus; deactivated points were seen in brodmann areas 9 and 25. Verum acupuncture at true acupuncture points is more likely to elicit de qi sensation. De qi sensations mainly resulted in brain area activations, but not deactivations. These brain areas are related to the curative effect of Te5. The acupuncture needle sensations of de qi and sharp pain are associated with different patterns of activations and deactivations in the brain.

[Effect of Xinling Wan in treatment of stable angina pectoris: a randomized, double-blinded, placebo parallel-controlled, multicenter trial].

Science.gov (United States)

Gao, Jian-Wei; Gao, Xue-Min; Zou, Ting; Zhao, Tian-Meng; Wang, Dong-Hua; Wu, Zong-Gui; Ren, Chang-Jie; Wang, Xing; Geng, Nai-Zhi; Zhao, Ming-Jun; Liang, Qiu-Ming; Feng, Xing; Yang, Bai-Song; Shi, Jun-Ling; Hua, Qi

2018-03-01

To evaluate the effectiveness and safety of Xinling Wan on patients with stable angina pectoris, a randomized, double-blinded, placebo parallel-controlled, multicenter clinical trial was conducted. A total of 232 subjects were enrolled and randomly divided into experiment group and placebo group. The experiment group was treated with Xinling Wan (two pills each time, three times daily) for 4 weeks, and the placebo group was treated with placebo. The effectiveness evaluation showed that Xinling Wan could significantly increase the total duration of treadmill exercise among patients with stable angina pectoris. FAS analysis showed that the difference value of the total exercise duration was between experiment group (72.11±139.32) s and placebo group (31.25±108.32) s. Xinling Wan could remarkably increase the total effective rate of angina pectoris symptom score, and the analysis showed that the total effective rate was 78.95% in experiment group and 42.61% in placebo group. The reduction of nitroglycerin dose was (2.45±2.41) tablets in experiment group and (0.50±2.24) tablets in placebo group on the basis of FAS analysis. The decrease of symptom integral was (4.68±3.49) in experiment group and (3.19±3.31) in placebo group based on FAS analysis. Besides, Xinling Wan could decrease the weekly attack time and the duration of angina pectoris. PPS analysis results were similar to those of FAS analysis. In conclusion, Xinling Wan has an obvious therapeutic effect in treating stable angina pectoris, with a good safety and a low incidence of adverse event and adverse reaction in experiment group. Copyright© by the Chinese Pharmaceutical Association.

QiShenYiQi Pills, a Compound Chinese Medicine, Prevented Cisplatin Induced Acute Kidney Injury via Regulating Mitochondrial Function

Directory of Open Access Journals (Sweden)

Li Zhou

2017-12-01

Full Text Available Nephrotoxicity is a serious adverse effect of cisplatin chemotherapy that limits its clinical application, to deal with which no effective management is available so far. The present study was to investigate the potential protective effect of QiShenYiQi Pills (QSYQ, a compound Chinese medicine, against cisplatin induced nephrotoxicity in mice. Pretreatment with QSYQ significantly attenuated the cisplatin induced increase in plasma urea and creatinine, along with the histological damage, such as tubular necrosis, protein cast, and desquamation of epithelial cells, improved the renal microcirculation disturbance as indicated by renal blood flow, microvascular flow velocity, and the number of adherent leukocytes. Additionally, QSYQ prevented mitochondrial dysfunction by preventing the cisplatin induced downregulation of mitochondrial complex activity and the expression of NDUFA10, ATP5D, and Sirt3. Meanwhile, the cisplatin-increased renal thiobarbituric acid-reactive substances, caspase9, cleaved-caspase9, and cleaved-caspase3 were all diminished by QSYQ pretreatment. In summary, the pretreatment with QSYQ remarkably ameliorated the cisplatin induced nephrotoxicity in mice, possibly via the regulation of mitochondrial function, oxidative stress, and apoptosis.

Estudio de las aplicaciones de gestión de la red WAN de un operador de telecomunicaciones

OpenAIRE

González Medina, Mariano

2012-01-01

Este proyecto se basa en analizar y estudiar exhaustivamente las aplicaciones de gestión de la red WAN de un operador de telecomunicaciones (OdT). Dichas aplicaciones se dividen en dos fases importantes: provisión y mantenimiento. Aquest projecte es basa en analitzar i estudiar exhaustivament les aplicacions de gestió de la xarxa WAN d'un operador de telecomunicacions (OdT). Aquestes aplicacions es divideixen en dues fases importants: provisió i manteniment.

Moessbauer studies on ancient pottery from a neolithic site in Tung Wan, Hong Kong

International Nuclear Information System (INIS)

Zheng Yufang; Tang Chung

1994-01-01

Twelve ceramic sherds unearthed from different archaeological layers at a neolithic site in Tung Wan, Hong Kong, were studied by means of X-ray diffraction (XRD) and Moessbauer spectroscopy. The results show that the firing techniques used for ancient pottery wares at different layers were very different. For the oldest sherds (4000-3000 B.C.) from layer No. 4, the original firing temperature was low and craftmanship was inferior. For the sherds (1650-250 B.C.) from layer No. 2, the original firing temperature was above 1000 C. In addition, the results indicate that the ancient pottery wares from the ruins might not have been manufactured in the Tung Wan region. (orig.)

Feasibility of a virtual learning collaborative to implement an obesity QI project in 29 pediatric practices.

Science.gov (United States)

John, Tamara; Morton, Michaela; Weissman, Mark; O'Brien, Ellen; Hamburger, Ellen; Hancock, Yolandra; Moon, Rachel Y

2014-04-01

Quality improvement (QI) activities are required to maintain board certification in pediatrics. However, because of lack of training and resources, pediatricians may feel overwhelmed by the need to implement QI activities. Pediatricians also face challenges when caring for overweight and obese children. To create a virtual (online) QI learning collaborative through which pediatric practices could easily develop and implement a continuous QI process. Prospective cohort. Pediatric practices that were part of the Children's National Health Network were invited to participate, with the option to receive continuing medical education and maintenance of certification credits. s) Practices conducted baseline and monthly chart audits, participated in educational webinars and selected monthly practice changes, using Plan-Do-Study-Act cycles. Practices reported activities monthly and periodic feedback was provided to practices about their performance. s) Improvement in (i) body mass index (BMI) percentile documentation, (ii) appropriate nutritional and activity counseling and (iii) follow-up management for high-risk patients. Twenty-nine practices (120 providers) participated, and 24 practices completed all program activities. Monthly chart audits demonstrated continuous improvement in documentation of BMI, abnormal weight diagnosis, nutrition and activity screening and counseling, weight-related health messages and follow-up management of overweight and obese patients. Impact of QI activities on visit duration and practice efficiency was minimal. A virtual learning collaborative was successful in providing a framework for pediatricians to implement a continuous QI process and achieve practice improvements. This format can be utilized to address multiple health issues.

Some properties of the Catalan-Qi function related to the Catalan numbers.

Science.gov (United States)

Qi, Feng; Mahmoud, Mansour; Shi, Xiao-Ting; Liu, Fang-Fang

2016-01-01

In the paper, the authors find some properties of the Catalan numbers, the Catalan function, and the Catalan-Qi function which is a generalization of the Catalan numbers. Concretely speaking, the authors present a new expression, asymptotic expansions, integral representations, logarithmic convexity, complete monotonicity, minimality, logarithmically complete monotonicity, a generating function, and inequalities of the Catalan numbers, the Catalan function, and the Catalan-Qi function. As by-products, an exponential expansion and a double inequality for the ratio of two gamma functions are derived.

The Chinese Herb Yi-Qi-Huo-Xue Protects Cardiomyocyte Function in Diabetic Cardiomyopathy

Directory of Open Access Journals (Sweden)

Xiangsheng Wang

2018-01-01

Full Text Available Aims. To study the effect of the Chinese herb Yi-qi-huo-xue on cardiomyopathy in diabetic rats. Methods. Rats were fed a high fat and high glucose diet and injected with 50 ml/kg streptozotocin (STZ to induce diabetic cardiomyopathy (DCM, followed by treatment with Yi-qi-huo-xue for 4 weeks. We measured the rats’ heart weight index, observed the myocardial morphology using hematoxylin eosin (HE staining, and determined the content of collagen types I and III in the myocardium using enzyme-linked immunosorbent assay (ELISA. We determined Bcl-2, Bax, and P53 protein expression by Western blot analysis and the cardiomyocyte apoptosis rate via a flow cytometry assay. Results. Compared with the rats in the control group, the diabetic rats gained weight and had increased blood sugar levels, an enhanced heart weight index, and increased myocardial pathophysiological damage. There was a decrease in their Bcl-2 expression, and their Bax and P53 expression increased. The Bcl-2/Bax ratio was enhanced, and there was an increase in the content of collagen types I and III in the myocardium. After treatment with Yi-qi-huo-xue, all levels listed above returned to normal. Conclusion. The Chinese herb Yi-qi-huo-xue degraded the myocardial interstitial collagen types I and III to protect the myocardium of the diabetic rats, thus delaying the role of myocardial fibrosis. Yi-qi-huo-xue could play an important role in protecting the myocardium of DCM rats by enhancing the expression of the Bcl-2 protein, inhibiting the expression of the Bax and P53 proteins, increasing the ratio of Bcl-2/Bax, and inhibiting the apoptosis of cardiomyocytes.

[Mechanism of tonifying Qi traditional Chinese medicines contained in Yiqi Qingwen Jiedu mixture against influenza immune inflammatory injury].

Science.gov (United States)

Xu, Hong-Ri; Wang, Cheng-Xiang; Wang, Lan; Zhou, Ping-An; Yin, Ren-Yi; Jiang, Liang-Duo; Wang, Hui-Fang

2014-10-01

To observe the impact of tonifying Qi traditional Chinese medicines contained in Yiqi Qingwen Jiedu mixture on mRNA expression of lung inflammatory cytokines and pulmonary pathological injury of mice infected by influenza virus, in order to discuss the mechanism of tonifying Qi traditional Chinese medicines against pulmonary immune inflammatory injury of infected mice. In different time phases after mice were infected with influenza virus FM1, the RT-PCR method was adopted to observe the impact of tonifying Qi traditional Chinese medicines contained in Yiqi Qingwen Jiedu mixture on five inflammatory cytokines TNF-α, IL-1, IL-6, IL-10 and IFN-γ, and the changes in pulmonary pathological injury of mice with viral pneumonia after intervention with tonifying qi traditional Chinese medicines. (1) Tonifying Qi traditional Chinese medicines significantly reduced the mRNA expression of TNF-α at 1-5 d and IL-1 mRNA expression at 7 d, may increase IL-1 mRNA expression in mouse lung at 3 d, significantly reduced IL-6 mRNA expression in mouse lung and increased IL-10 mRNA expression at 3-7 d, and significantly increased IFN-γ mRNA expression at 1 d. (2) Tonifying Qi traditional Chinese medicines could significantly inhibited and repaired pulmonary immune inflammatory injury of mice infected by FM1, which was most remarkable at 3-7 d after the infection with influenza virus FM1. Tonifying Qi traditional Chinese medicines contained in Yiqi Qingwen Jiedu mixture could resist pulmonary immune inflammatory injury and repair inflammatory injury by regulating the mRNA expression of imbalance inflammatory cytokines of organisms infected with influenza virus.

The Role of Rumination and Stressful Life Events in the Relationship between the Qi Stagnation Constitution and Depression in Women: A Moderated Mediation Model

Science.gov (United States)

Liu, Qiaosheng

2017-01-01

The qi stagnation constitution is associated with depression in traditional Chinese medicine. It is unclear how rumination and stressful life events affect the relationship between the qi stagnation constitution and depression. The Qi Stagnation Constitution Scale, Ruminative Response Scale, Center for Epidemiologic Studies Depression Scale, and Adolescent Self-Rating Life Events Checklist were used to assess this association in 1200 female college students. The results revealed that the qi stagnation constitution was positively associated with depression. Furthermore, rumination was a partial mediator of the relationship between the qi stagnation constitution and depression. In addition, stressful life events moderated the direct effect and mediating effect of the qi stagnation constitution on depression. These findings indicate that rumination and stressful life events may affect the relationship between the qi stagnation constitution and depression in women. PMID:28757889

Tai Chi and Qi Gong for Health and Well-Being

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Full Text Available ... tool that features tai chi and qi gong as an activity to enhance wellness. These exercise therapies ... care approaches used to promote a healthy lifestyle. As always, talk to your health care provider if ...

Efficacy and Safety of the TCM Qi-Supplementing Therapy in Patients with Myasthenia Gravis: A Systematic Review and Meta-Analysis

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Xi-qian Yang

2017-01-01

Full Text Available Background. The Traditional Chinese Medicine (TCM Qi-supplementing therapy has been used widely for treating myasthenia gravis (MG in China. The purpose of this meta-analysis was to evaluate the efficacy and safety of Qi-supplementing therapy as an adjunctive therapy in MG patients. Methods. Seven electronic databases were searched through June 2016. Randomized controlled trials (RCTs evaluating the add-on effect of Qi-supplementing therapy in MG patients were included. The outcome measures were the total effective rate, relapse rate, and adverse events. Results. Twenty-three RCTs involving 1,691 MG patients were included. The included studies were of low-to-moderate quality. Meta-analysis showed that Qi-supplementing therapy combined with Western medicine (WM significantly improved the total response rate and reduced the relapse risk during 6–24 months of follow-up. Subgroup analysis showed that Qi-supplementing therapy only affected the total response rate within the first 6 months of treatment. Moreover, the rate of adverse events was lower with the addition of Qi-supplementing therapy to WM than with WM only. Conclusions. Short-term Qi-supplementing therapy combined with WM appears to be superior to WM for improving the total response rate and reducing the relapse rate. However, more high-quality RCTs are warranted owing to methodological flaws of previous trials.

Tai Chi and Qi Gong for Health and Well-Being

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Full Text Available ... Legislation Advisory Council Job Opportunities All About NCCIH Health Topics A-Z # A B C D E ... Y Z Tai Chi and Qi Gong for Health and Well-Being Share: © Mariann Seriff The following ...

Validation of the qi blood yin yang deficiency questionnaire on chronic fatigue.

Science.gov (United States)

Kim, Jihye; Ku, Boncho; Kim, Keun Ho

2016-01-01

Chronic fatigue (CF) reflects an imbalance of inter-organ functions or of the four essential physiological components qi, blood (xue), yin, and yang. CF can be subdivided into different patterns. However, there are no diagnostic methods for CF. This study aimed to clinically validate a pattern identification method by identifying correlations between CF and responses to the qi blood yin yang deficiency questionnaire (QBYY-Q). Participants were recruited between May and June 2014 through the Kyung Hee University Korean Medicine hospital website and via posters and comprised 129 CF patients diagnosed with the United States Centers for Disease Control and Prevention (1994) criteria. Participants who had organic diseases that explained the CF were excluded. A total of 159 participants were asked to complete the QBYY-Q, the fatigue severity scale, and the Chalder fatigue scale. The latter two questionnaires were used to assess convergent validity with the QBYY-Q. Among the 129 CF participants, 70 and 59 had chronic fatigue syndrome and idiopathic chronic fatigue, respectively. Two Korean medical doctors independently assessed participants' qi, blood, yin, and yang deficiency patterns using QBYY deficiency pattern identification guidelines. Based on the results of a preliminary study of the QBYY-Q, we selected 32 reliable items for symptoms corresponding to each deficiency pattern. The items were used to estimate internal consistency and construct validity. Multinomial logistic regression analysis was performed for scores on each deficiency pattern. The data were means and standard deviations or numbers of participants and proportions for continuous and categorical variables, respectively. A statistical significance level of P yin, and yang deficiency were 45.1, 58.0, 52.2, and 63.4 %, respectively. Each QBYY-Q deficiency score was positively associated with each corresponding deficiency pattern. Qi deficiency was used as a reference category. Odds ratios of blood, yin

The Role of Rumination and Stressful Life Events in the Relationship between the Qi Stagnation Constitution and Depression in Women: A Moderated Mediation Model

Directory of Open Access Journals (Sweden)

Mingfan Liu

2017-01-01

Full Text Available The qi stagnation constitution is associated with depression in traditional Chinese medicine. It is unclear how rumination and stressful life events affect the relationship between the qi stagnation constitution and depression. The Qi Stagnation Constitution Scale, Ruminative Response Scale, Center for Epidemiologic Studies Depression Scale, and Adolescent Self-Rating Life Events Checklist were used to assess this association in 1200 female college students. The results revealed that the qi stagnation constitution was positively associated with depression. Furthermore, rumination was a partial mediator of the relationship between the qi stagnation constitution and depression. In addition, stressful life events moderated the direct effect and mediating effect of the qi stagnation constitution on depression. These findings indicate that rumination and stressful life events may affect the relationship between the qi stagnation constitution and depression in women.

Qi Gong exercises and Feldenkrais method from the perspective of Gestalt concept and humanistic psychology.

Science.gov (United States)

Posadzki, Paul; Stöckl, Andrea; Mucha, Dariusz

2010-07-01

This study describes two similar approaches to human movement: Qi Gong exercises and the Feldenkrais method. These systems are investigated in terms of Gestalt concepts and humanistic psychology. Moshe Feldenkrais created the concept known as Awareness Through Movement. This concept assumes that by becoming more aware of one's movements, one functions at a higher level. In similar ways to those using the Feldenkrais method, individuals may become more aware of their own movements by performing Qi Gong exercises: A therapeutic modality that facilitates mind-body integration. Qi Gong exercises commonly lead to increased personal awareness accompained by enhanced quality, fluency and smoothness of movement. These two methods of movement therapies are explored in terms of their relations with Gestalt concept and humanistic psychology. (c) 2008. Published by Elsevier Ltd. All rights reserved.

External Qi therapy to treat symptoms of Agent Orange Sequelae in Korean combat veterans of the Vietnam War.

Science.gov (United States)

Lee, Myeong Soo; Woo, Won-Hong; Lim, Hyun-Ja; Hong, Sung-Soo; Kim, Hye-Jung; Moon, Sun-Rock

2004-01-01

We investigated the efficacy of Qi therapy as a non-pharmacological treatment for various symptoms presented by Korean combat veterans of the Vietnam War with Agent Orange Sequelae. Nine subjects volunteered to receive 30 minutes of Qi therapy, twice per day for 7 days. There was marked improvement in 89% of the patients with impaired physical activity, 86% of those with psychological disorder, 78% of those with heavy drug use, and 67% of those with fatigue, indigestion and high blood glucose levels. This data suggests that Qi therapy combined with conventional treatment has positive effects in reducing and managing the pain, psychosomatic disorders, and substance abuse in patients with Agent Orange Sequelae. We cannot completely discount the possible influence of the placebo effect, and more objective, clinical measures are needed to study the long-term effects of Qi therapy.

Analysis of Latency and MAC-layer Performance for Class A LoRaWAN

DEFF Research Database (Denmark)

Sørensen, René Brandborg; Kim, Dong Min; Nielsen, Jimmy Jessen

2017-01-01

We propose analytical models that allow to investigate the performance of Long Range Wide Area Network (LoRaWAN) uplink in terms of latency, collision rate, and throughput under the constraints of the regulatory duty cycling, when assuming exponential inter-arrival times. Our models take into acc...

A Fair Adaptive Data Rate Algorithm for LoRaWAN

OpenAIRE

Abdelfadeel, Khaled Q.; Cionca, Victor; Pesch, Dirk

2018-01-01

LoRaWAN exhibits several characteristics that can lead to an unfair distribution of the Data Extracted Rate (DER) among nodes. Firstly, the capture effect leads to a strong signal suppressing a weaker signal at the gateway and secondly, the spreading codes used are not perfectly orthogonal, causing packet loss if an interfering signal is strong enough. In these conditions, nodes experiencing higher attenuation are less likely to see their packets received correctly. We develop FADR, a Fair Ad...

Network protocol changes can improve DisCom WAN performance : evaluating TCP modifications and SCTP in the ASC tri-lab environment.

Energy Technology Data Exchange (ETDEWEB)

Tolendino, Lawrence F.; Hu, Tan Chang

2005-06-01

The Advanced Simulation and Computing (ASC) Distance Computing (DisCom) Wide Area Network (WAN) is a high performance, long distance network environment that is based on the ubiquitous TCP/IP protocol set. However, the Transmission Control Protocol (TCP) and the algorithms that govern its operation were defined almost two decades ago for a network environment vastly different from the DisCom WAN. In this paper we explore and evaluate possible modifications to TCP that purport to improve TCP performance in environments like the DisCom WAN. We also examine a much newer protocol, SCTP (Stream Control Transmission Protocol) that claims to provide reliable network transport while also implementing multi-streaming, multi-homing capabilities that are appealing in the DisCom high performance network environment. We provide performance comparisons and recommendations for continued development that will lead to network communications protocol implementations capable of supporting the coming ASC Petaflop computing environments.

Education in Quality Improvement for Pediatric Practice: an online program to teach clinicians QI.

Science.gov (United States)

Bundy, David G; Morawski, Lori F; Lazorick, Suzanne; Bradbury, Scott; Kamachi, Karen; Suresh, Gautham K

2014-01-01

Education in Quality Improvement for Pediatric Practice (EQIPP) is an online program designed to improve evidence-based care delivery by teaching front-line clinicians quality improvement (QI) skills. Our objective was to evaluate EQIPP data to characterize 1) participant enrollment, use patterns, and demographics; 2) changes in performance in clinical QI measures from baseline to follow-up measurement; and 3) participant experience. We conducted an observational study of EQIPP participants utilizing 1 of 3 modules (asthma, immunizations, gastroesophageal reflux disease) from 2009 to 2013. Enrollment and use, demographic, and quality measure data were extracted directly from the EQIPP system; participant experience was assessed via an optional online survey. Study participants (n = 3501) were diverse in their gender, age, and race; most were board certified. Significant quality gaps were observed across many of the quality measures at baseline; sizable improvements were observed across most quality measures at follow-up. Participants were generally satisfied with their experience. The most influential module elements were collecting and analyzing data, creating and implementing aim statements and improvement plans, and completing "QI Basics." Online educational programs, such as EQIPP, hold promise for front-line clinicians to learn QI. The sustainability of the observed improvements in care processes and their linkage to improvements in health outcomes are unknown and are an essential topic for future study. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

A Dual Key-Based Activation Scheme for Secure LoRaWAN

Directory of Open Access Journals (Sweden)

Jaehyu Kim

2017-01-01

Full Text Available With the advent of the Internet of Things (IoT era, we are experiencing rapid technological progress. Billions of devices are connected to each other, and our homes, cities, hospitals, and schools are getting smarter and smarter. However, to realize the IoT, several challenging issues such as connecting resource-constrained devices to the Internet must be resolved. Recently introduced Low Power Wide Area Network (LPWAN technologies have been devised to resolve this issue. Among many LPWAN candidates, the Long Range (LoRa is one of the most promising technologies. The Long Range Wide Area Network (LoRaWAN is a communication protocol for LoRa that provides basic security mechanisms. However, some security loopholes exist in LoRaWAN’s key update and session key generation. In this paper, we propose a dual key-based activation scheme for LoRaWAN. It resolves the problem of key updates not being fully supported. In addition, our scheme facilitates each layer in generating its own session key directly, which ensures the independence of all layers. Real-world experimental results compared with the original scheme show that the proposed scheme is totally feasible in terms of delay and battery consumption.

78 FR 43857 - Order Relating to Yaming Nina Qi Hanson

Science.gov (United States)

2013-07-22

... Hanson shall not take any action or make or permit to be made any public statement, directly or... intention to initiate an administrative proceeding against Qi Hanson pursuant to Section 766.3 of the Export..., delivering, storing, disposing of, forwarding, transporting, financing, or otherwise servicing in any way...

Effect of GuiXiong Xiaoyi Wan in Treatment of Endometriosis on Rats

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Zhixing Jin

2015-01-01

Full Text Available Objective. To evaluate the effect of GuiXiong Xiaoyi Wan (GXXYW on the development of endometriosis in a rat model. Methods. Sprague-Dawley rats with surgically induced endometriosis were randomly treated with low-dose GXXYW, high-dose GXXYW, or vehicle (negative control for 28 days. Immunohistochemistry was used to assess cell proliferation in the lesions. The terminal deoxynucleotidyl transferase- (TdT- mediated dUTP biotin nick end labelling (TUNEL method was performed to analyse the apoptosis induced by GuiXiong Xiaoyi Wan. The percentages of CD3+ lymphocytes, CD4+ lymphocytes, and CD8+ lymphocytes in the spleens of the rats were evaluated using flow cytometric analysis. Results. Treatment with GXXYW significantly decreased the lesion size, inhibited cell proliferation, and induced apoptosis in endometriotic tissue. The spleens of GXXYW-treated rats also demonstrated a significant increase in the percentage of CD4+ lymphocytes and a significant decrease in the percentage of CD8+ lymphocytes. Conclusions. These results suggest that, in a rat model, GXXYW may be effective in the suppression of the growth of endometriosis, possibly through the inhibition of cell proliferation, the induction of apoptosis of endometriotic cells, and the regulation of the immune system.

Protocol for the evaluation and validation of Qi Blood Yin Yang deficiency pattern questionnaire: prospective observational study.

Science.gov (United States)

Kim, Jihye; Kim, Keun Ho

2015-12-01

The aim of this study is to validate the pattern identification standard of qi, blood, yin, and yang deficiency patterns diagnosis. The current study will investigate the usefulness of the Qi Blood Yin Yang deficiency pattern questionnaire as a diagnostic tool for qi, blood, yin, and yang deficiencies by assessing the agreement between the scores and a gold standard established by assessors. This protocol is for a single center, prospective, observational study. A total of 248 eligible patients with unexplained chronic fatigue will be assigned to four groups in a 1:1:1:1 ratio as the qi deficiency group, blood deficiency group, yin deficiency group, and yang deficiency group. The primary outcome will be measured using the score of the Qi Blood Yin Yang deficiency pattern questionnaire and the secondary outcomes will be measured using the fatigue severity scale, Korean-translated chalder fatigue scale, computerized tongue image analysis system, and three types of pattern identification questionnaires (cold-heat, food accumulation, and seven emotions patterns). The safety of the clinical study will be assessed after measurements at every visit. All statistical analysis will be performed using the R Statistics program. Statistics experts will analyze the relationship between clinical data using the Pearson's Chi-squared test and independent t -test. This study will provide reference data and good evidence that are applicable to future studies. Furthermore, the results of the present study are useful to improve the care of patients with unexplained chronic fatigue and unexplained chronic fatigue-related disorders.

Tai Chi and Qi Gong for Health and Well-Being

Medline Plus

Full Text Available ... The following video is intended to be an educational tool that features tai chi and qi gong as an activity to enhance wellness. These exercise therapies are generally considered safe, self-care approaches used to promote a healthy lifestyle. As always, talk to your health care provider if you are ...

[Guiding-qi acupuncture for dry eye syndrome].

Science.gov (United States)

Xie, Wenzhang; Zeng, Liang; Tao, Ying; Zhou, Yingfan; Zhao, Ran; Huang, Xinyun; Hou, Wenguang; Zhang, Ren; Zong, Lei

2018-02-12

To observe the clinical efficacy differences between different needling methods for dry eye syndrome. Sixty patients of dry eye syndrome were randomly divided into an observation group and a control group, 30 cases (60 eyes) in each group. Shangjingming (Extra), Xiajingming (Extra), Tongziliao (GB 1), Cuanzhu (BL 2), Fengchi (GB 20), Hegu (LI 4), Sanyinjiao (SP 6), Taixi (KI 3) and Taichong (LR 3) were selected in the two groups. The control group was treated with conventional acupuncture, while the observation group was treated with guiding- qi acupuncture. Electroacupuncture (EA) was used at bilateral Tongziliao (GB1) and Cuanzhu (BL 2), 30 min per treatment. The treatment was given three times per week. Totally 1-month treatment (12 treatments) was given. The eye symptom score, breakup time of tear film (BUT), Schirmer Ⅰ test (SⅠT) and visual analogue scale (VAS) score were compared before and after treatment in the two groups. The clinical efficacy was compared between the two groups. Compared before treatment, the eye symptom score, BUT, SⅠT and VAS score were improved after treatment in the two groups (all P eye symptom score and SⅠT in the observation group were superior to those in the control group (both P 0.05). The total effective rate was 86.7% (52/60) in the observation group, which was superior to 73.3% (44/60) in the control group ( P dry eye syndrome, and the efficacy of guiding- qi acupuncture combined with EA is superior to that of conventional EA.

Logarithmically complete monotonicity of a function related to the Catalan-Qi function

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Qi Feng

2016-08-01

Full Text Available In the paper, the authors find necessary and sufficient conditions such that a function related to the Catalan-Qi function, which is an alternative generalization of the Catalan numbers, is logarithmically complete monotonic.

The Contribution of Different Components in QiShenYiQi Pills® to Its Potential to Modulate Energy Metabolism in Protection of Ischemic Myocardial Injury

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Yuan-Chen Cui

2018-04-01

Full Text Available Ischemic heart diseases remain a challenge for clinicians. QiShenYiQi pills® (QSYQ has been reported to be curative during coronary heart diseases with modulation of energy metabolism as one of the underlying mechanisms. In this study, we detected the effect of QSYQ and its components on rat myocardial structure, mitochondrial respiratory chain complexes activity and energy metabolism, and heart function after 30 min of cardiac ischemia, with focusing on the contribution of each component to its potential to regulate energy metabolism. Results showed that treatment with QSYQ and all its five components protected myocardial structure from damage by ischemia. QSYQ also attenuated release of myocardial cTnI, and restored the production of ATP after cardiac ischemia. AS-IV and Rb1, but not Rg1, R1, and DLA, had similar effect as QSYQ in regulation of energy metabolism. These results indicate that QSYQ may prevent ischemia-induced cardiac injury via regulation of energy metabolism, to which each of its components contributes differently.

Optimizing the ASC WAN: evaluating network performance tools for comparing transport protocols.

Energy Technology Data Exchange (ETDEWEB)

Lydick, Christopher L.

2007-07-01

The Advanced Simulation & Computing Wide Area Network (ASC WAN), which is a high delay-bandwidth network connection between US Department of Energy National Laboratories, is constantly being examined and evaluated for efficiency. One of the current transport-layer protocols which is used, TCP, was developed for traffic demands which are different from that on the ASC WAN. The Stream Control Transport Protocol (SCTP), on the other hand, has shown characteristics which make it more appealing to networks such as these. Most important, before considering a replacement for TCP on any network, a testing tool that performs well against certain criteria needs to be found. In order to try to find such a tool, two popular networking tools (Netperf v.2.4.3 & v.2.4.6 (OpenSS7 STREAMS), and Iperf v.2.0.6) were tested. These tools implement both TCP and SCTP and were evaluated using four metrics: (1) How effectively can the tool reach a throughput near the bandwidth? (2) How much of the CPU does the tool utilize during operation? (3) Is the tool freely and widely available? And, (4) Is the tool actively developed? Following the analysis of those tools, this paper goes further into explaining some recommendations and ideas for future work.

[Analysis in pulmonary ventilatory function from 100 patients with ano-rectal diseases caused by deficiency of qi].

Science.gov (United States)

Wang, W

1999-03-01

To explore the pathogenesis of ano-rectal diseases caused by deficiency of Qi, which is correlated with obstruction of pulmonary ventilation. The pulmonary ventilatory function was measured in 100 patients with the internal piles, the interno-external hemorrhoid and prolapse of rectum, the prolapse of anus was the principal symptom of them. Data from the 100 patients showed that 67% of them were diagnosed with the obstruction of pulmonary ventilation, the ratio was far less in the health control group. FEV 1.0 (mean +/- s) (2011.65 +/- 875) ml, MMF (1.84 +/- 1.24) L/s and PEF (2.34 +/- 1.51) L/s in male patients, (1551.54 +/- 514) ml, (1.57 +/- 0.62) L/s and (1.85 +/- 0.92) L/s in female patients, but those values were higher in the control than in the patients. The statistical analysis was performed and the difference was significant between patients and the control group (P < 0.01). The patients with ano-rectal diseases caused by deficiency of Qi accompanied with obstruction of pulmonary ventilation in different degree and varied sorts, it confirmed that the pathogenesis of ano-rectal diseases caused by deficiency of Qi is related with "sinking of pectoral Qi".

Influence of de qi on the immediate analgesic effect of SP6 acupuncture in patients with primary dysmenorrhoea and cold and dampness stagnation: a multicentre randomised controlled trial.

Science.gov (United States)

Zhao, Min-Yi; Zhang, Peng; Li, Jing; Wang, Lin-Peng; Zhou, Wei; Wang, Yan-Xia; She, Yan-Fen; Ma, Liang-Xiao; Wang, Pei; Hu, Ni-Juan; Lin, Chi; Hu, Shang-Qin; Wu, Gui-Wen; Wang, Ya-Feng; Sun, Jun-Jun; Jiang, Si-Zhu; Zhu, Jiang

2017-10-01

The aim of this multicentre randomised controlled trial was to investigate the contribution of de qi to the immediate analgesic effect of acupuncture in patients with primary dysmenorrhoea and the specific traditional Chinese medicine diagnosis cold and dampness stagnation . Eighty-eight patients with primary dysmenorrhoea and cold and dampness stagnation were randomly assigned to de qi (n=43) or no de qi (n=45) groups and underwent 30 min of SP6 acupuncture. The de qi group received deep needling at SP6 with manipulation using thick needles; the no de qi group received shallow needling with no manipulation using thin needles. In both groups the pain scores and actual de qi sensation were evaluated using a visual analogue scale for pain (VAS-P) and the acupuncture de qi clinical assessment scale (ADCAS), respectively. Both groups showed reductions in VAS-P, with no signficant differences between groups. ADCAS scores showed 43/43 and 25/45 patients in de qi and no de qi groups, respectively, actually experienced de qi sensation. Independent of original group allocation, VAS-P reductions associated with actual de qi (n=68) were greater than those without (28.4±18.19 mm vs 14.6±12.28 mm, p=0.008). This study showed no significant difference in VAS-P scores in patients with primary dysmenorrhoea and cold and dampness stagnation immediately after SP6 acupuncture designed to induce or avoid de qi sensation. Both treatments significantly reduced VAS-P relative to baseline. Irrespective of group allocation, patients experiencing actual de qi sensation demonstrated larger reductions in pain score relative to those without, suggesting greater analgesic effects. Chinese Clinical Trial Registry (ChiCTR-TRC-13003086); Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Design and Smartphone-Based Implementation of a Chaotic Video Communication Scheme via WAN Remote Transmission

Science.gov (United States)

Lin, Zhuosheng; Yu, Simin; Li, Chengqing; Lü, Jinhu; Wang, Qianxue

This paper proposes a chaotic secure video remote communication scheme that can perform on real WAN networks, and implements it on a smartphone hardware platform. First, a joint encryption and compression scheme is designed by embedding a chaotic encryption scheme into the MJPG-Streamer source codes. Then, multiuser smartphone communications between the sender and the receiver are implemented via WAN remote transmission. Finally, the transmitted video data are received with the given IP address and port in an Android smartphone. It should be noted that, this is the first time that chaotic video encryption schemes are implemented on such a hardware platform. The experimental results demonstrate that the technical challenges on hardware implementation of secure video communication are successfully solved, reaching a balance amongst sufficient security level, real-time processing of massive video data, and utilization of available resources in the hardware environment. The proposed scheme can serve as a good application example of chaotic secure communications for smartphone and other mobile facilities in the future.

THE WAN-IFRA DISCOURSE: ADVICE, APPLICATION, AND DISQUALIFICATION OF ORGANISATIONAL MODELS IN MEDIA

Directory of Open Access Journals (Sweden)

Joël Langonné

2014-06-01

Full Text Available Among the multiple exhortations made on the liberating - even saviour-type - role of the digital era over the past ten years in the field of journalism, one constant has remained: criticism of managerial models and dialectic of economic ones in the media which have defined the spheres of action, resulting in these discourses without ever sealing their fate. A fate that for several years now has been marked by a process in which journalists are being cast aside in favour of a managerial standpoint that broadly integrates 'convergence' as a tool of governance. This paper aims to question (as one of many mediations instituting convergence as a structuring model WAN-IFRA's discursive and ideological materiality. This international organisation of newspapers and news publishers has set its sights on convincing the print media of the necessity to switching to multiformat; to convergence. This work investigates the stability and/or instability of the WAN-IFRA discourse, as well as its ability to absorb other discourses. Lastly, through a cloud of prescriptive discourse it will indicate those discourses enforced by some managers in the media business.

The WAN-IFRA discourse: advice, application, and disqualification of organisational models in media

Directory of Open Access Journals (Sweden)

Joël Langonné

2014-06-01

Full Text Available Among the multiple exhortations made on the liberating - even saviour-type - role of the digital era over the past ten years in the field of journalism, one constant has remained: criticism of managerial models and dialectic of economic ones in the media which have defined the spheres of action, resulting in these discourses without ever sealing their fate. A fate that for several years now has been marked by a process in which journalists are being cast aside in favour of a managerial standpoint that broadly integrates 'convergence' as a tool of governance. This paper aims to question (as one of many mediations instituting convergence as a structuring model WAN-IFRA's discursive and ideological materiality. This international organisation of newspapers and news publishers has set its sights on convincing the print media of the necessity to switching to multiformat; to convergence. This work investigates the stability and/or instability of the WAN-IFRA discourse, as well as its ability to absorb other discourses. Lastly, through a cloud of prescriptive discourse it will indicate those discourses enforced by some managers in the media business.

Construction Strategies of Social Security System for Wan-jiang Urban Belt’s Migrant Workers

Institute of Scientific and Technical Information of China (English)

2011-01-01

Theoretical debate and practice exploration on social security of migrant workers were introduced.The political direction and security layer on social security for migrant workers in Wan-jiang urban belt were analyzed:the first layer is to implement wage payment guarantee and employment injury insurance;the second layer is to emphasize serious disease insurance and endowment insurance;the third layer is unemployed insurance and social assistance.The primary strategy of building a social security system for migrant workers in Wan-jiang urban belt was put up:wage payment guarantee system that is united in certain regions should be promoted;employment injury insurance system that is undertaken by enterprises should be built;a social health care system for serious diseases should be set up;multi-layers endowment insurance system for migrant workers should be created;vocational training and training in how to start a business should be built as well as the unemployment insurance system;social assistant system based on the basic cost of living allowances should be set up.

Craniometric examination of Longxian and Qi Li Cun archaeological sites to assess population continuity in ancient northern China.

Science.gov (United States)

Gibbon, Victoria E; Porter, Tarun A; Wu, Xiujie; Liu, Wu

2016-10-01

In this paper, population continuity and discontinuity in northern China are explored using craniometric analyses from two archaeological sites, Longxian (Warring States) and Qi Li Cun (Han Dynasty). Neither population has been previously studied. Artefactual evidence shows the individuals from Qi Li Cun were Xianbei, descendants from Mongolia. Longxian is from further south in the central plains at an earlier time, thus, we expect to observe variability between these groups. In total, 24 cranial measurements were obtained on 66 crania from these sites. Howells's cranial measurements on Anyang (42 crania) and Hainan (83 crania) Chinese samples were included for comparative purposes. Less variability is expected between Longxian and Howells's Chinese data due to geographic and temporal similarity. With closer geographic and temporal affinity with Anyang, the expectation is for Longxian and Anyang to be similar. Few statistical differences exist between Longxian and Qi Li Cun; this was supported by the similarity found through principal components analysis (PCA). Regardless of sex, canonical discriminant analysis shows clustering of Longxian and Qi Li Cun separate from those of Anyang and Hainan. Their similarity indicates the people from Longxian and Qi Li Cun likely share Mongolian ancestry. Our results, supported by other studies, suggest that despite temporal differences, Mongolians living in China during the Warring States and Han dynasty retained their cultural and genetic Mongolian identity. These data add valuable bioarchaeological information regarding the peopling of northern China during a crucial period of cultural and political change in the Early Bronze Age and Iron Age. Copyright © 2016 Elsevier GmbH. All rights reserved.

Cardioprotection against ischemia/reperfusion injury by QiShenYiQi Pill® via ameliorate of multiple mitochondrial dysfunctions

Directory of Open Access Journals (Sweden)

Chen JR

2015-06-01

Full Text Available Jing Rui Chen,1–3 Jing Wei,1–3 Ling Yan Wang,1–3 Yan Zhu,1–3 Lan Li,1–3 Mary Akinyi Olunga,1–3 Xiu Mei Gao,1–3 Guan Wei Fan1–31Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin, People’s Republic of China; 2Key Laboratory of Pharmacology of Traditional Chinese Medicine Formulae, Ministry of Education, 3Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of ChinaAim: To investigate the potential cardioprotective effects of QiShenYiQi Pill® (QSYQ on myocardial ischemia/reperfusion (I/R injury through antioxidative stress and mitochondrial protection.Methods and results: Sprague Dawley rats were pretreated with QSYQ or saline for 7 days and subjected to ischemia (30 minutes occlusion of the left anterior descending coronary artery and reperfusion (120 minutes. Cardiac functions were evaluated by echocardiogram and hemodynamics. Myocardial mitochondria were obtained to evaluate changes in mitochondrial structure and function, immediately after 120 minutes reperfusion. Pretreatment with QSYQ protected against I/R-induced myocardial structural injury and improved cardiac hemodynamics, as demonstrated by normalized serum creatine kinase and suppressed oxidative stress. Moreover, the impaired myocardial mitochondrial structure and function decreased level of ATP (accompanied by reduction of ATP5D and increase in the expression of cytochrome C. Myocardial fiber rupture, interstitial edema, and infiltrated leukocytes were all significantly ameliorated by pretreatment with QSYQ.Conclusion: Pretreatment of QSYQ in Sprague Dawley rats improves ventricular function and energy metabolism and reduces oxidative stress via ameliorating multiple mitochondrial dysfunctions during I/R injury.Keywords: QSYQ, ischemia/reperfusion injury, energy metabolism, mitochondria

A QI Initiative to Reduce Hospitalization for Children With Isolated Skull Fractures.

Science.gov (United States)

Lyons, Todd W; Stack, Anne M; Monuteaux, Michael C; Parver, Stephanie L; Gordon, Catherine R; Gordon, Caroline D; Proctor, Mark R; Nigrovic, Lise E

2016-06-01

Although children with isolated skull fractures rarely require acute interventions, most are hospitalized. Our aim was to safely decrease the hospitalization rate for children with isolated skull fractures. We designed and executed this multifaceted quality improvement (QI) initiative between January 2008 and July 2015 to reduce hospitalization rates for children ≤21 years old with isolated skull fractures at a single tertiary care pediatric institution. We defined an isolated skull fracture as a skull fracture without intracranial injury. The QI intervention consisted of 2 steps: (1) development and implementation of an evidence-based guideline, and (2) dissemination of a provider survey designed to reinforce guideline awareness and adherence. Our primary outcome was hospitalization rate and our balancing measure was hospital readmission within 72 hours. We used standard statistical process control methodology to assess change over time. To assess for secular trends, we examined admission rates for children with an isolated skull fracture in the Pediatric Health Information System administrative database. We identified 321 children with an isolated skull fracture with a median age of 11 months (interquartile range 5-16 months). The baseline admission rate was 71% (179/249, 95% confidence interval, 66%-77%) and decreased to 46% (34/72, 95% confidence interval, 35%-60%) after implementation of our QI initiative. No child was readmitted after discharge. The admission rate in our secular trend control group remained unchanged at 78%. We safely reduced the hospitalization rate for children with isolated skull fractures without an increase in the readmissions. Copyright © 2016 by the American Academy of Pediatrics.

Technical Knowledge, Cultural Practices and Social Boundaries: Wan-Nan Scholars and the Recasting of Jesuit Astronomy, 1600-1800

Science.gov (United States)

Chu, Ping-Yi.

Taking four Wan-nan Confucian scholars--Yang Kuang -hsien, Mei Wen-ting, Chiang Yung and Tai Chen--as examples, this dissertation studies how an immigrant Jesuit scientific community built and defended itself in a specialized institutional niche located at the Ch'ing court and how a defeated Chinese scientific tradition successfully survived by occupying a broader cultural space, with the Manchu emperor in between. Special attention is paid to how these four Confucian scholars constructed social boundaries between the Chinese and the Westerners in their astronomical discourses and how they domesticated Western astronomy in order to fit the Chinese cultural conditions situated in the power structure built by the Manchus. This inquiry begins with a brief introduction of Wan-nan and the Wan-nan school. I then discuss how the Jesuits legitimated their knowledge during the Ming -Ch'ing transition, and how Jesuit astronomy was situated within the power nexus between the Confucian literati and the emperors. The next chapter focuses on Yang Kuang-hsien and his challenges to the Jesuits. I examine his strategies and the power structure in which Yang carried out his challenge to the Jesuits. The fourth and fifth chapters investigate how Mei Wen-ting restructured the relationship between Confucianism and astronomy. The former chapter focuses on Mei's social networking and his ambivalence towards the Ming and Ch'ing dynasties, on the one hand, and towards Chinese and Western learning on the other. The latter chapter deals with how Mei Wen-ting recast Chinese astronomical tradition and Confucianism. In the sixth chapter, I will compare the fame of Chiang Yung and Tai Chen in order to demonstrate how astronomy was practiced in evidential studies after Mei Wen-ting, and how evidential studies itself conveyed an ideological construction of the other. Through integrating Western astronomy with indigenous tradition while exorcising the otherness contained within the cultural package

Efficacy of integrative medicine in deficiency of both qi and yin in the rat model of type 2 diabetes

Directory of Open Access Journals (Sweden)

Jing Zhao

2015-10-01

Conclusions: A rat model of T2DM with both qi and yin deficiency was successfully replicated. CHF appeared to be more efficacious than IM and PIO in the rat model of qi and yin deficiency pattern of T2DM, though IM and PIO were each found to have their merits and drawbacks in attenuating T2DM indicators in the rat model.

Switched modified function projective synchronization of hyperchaotic Qi system with uncertain parameters

Science.gov (United States)

Sebastian Sudheer, K.; Sabir, M.

2010-12-01

This work is involved with switched modified function projective synchronization of two identical Qi hyperchaotic systems using adaptive control method. Switched synchronization of chaotic systems in which a state variable of the drive system synchronize with a different state variable of the response system is a promising type of synchronization as it provides greater security in secure communication. Modified function projective synchronization with the unpredictability of scaling functions can enhance security. Recently formulated hyperchaotic Qi system in the hyperchaotic mode has an extremely broad frequency bandwidth of high magnitudes, verifying its unusual random nature and indicating its great potential for some relevant engineering applications such as secure communications. By Lyapunove stability theory, the adaptive control law and the parameter update law are derived to make the state of two chaotic systems modified function projective synchronized. Synchronization under the effect of noise is also considered. Numerical simulations are presented to demonstrate the effectiveness of the proposed adaptive controllers.

Ensuring Support for Research and Quality Improvement (QI) Networks: Four Pillars of Sustainability-An Emerging Framework.

Science.gov (United States)

Holve, Erin

2013-01-01

Multi-institutional research and quality improvement (QI) projects using electronic clinical data (ECD) hold great promise for improving quality of care and patient outcomes but typically require significant infrastructure investments both to initiate and maintain the project over its duration. Consequently, it is important for these projects to think holistically about sustainability to ensure their long-term success. Four "pillars" of sustainability are discussed based on the experiences of EDM Forum grantees and other research and QI networks. These include trust and value, governance, management, and financial and administrative support. Two "foundational considerations," adaptive capacity and policy levers, are also discussed.

« Comme à l’époque de Suzie Wong ». Les mutations du red-light district de Wan Chai

OpenAIRE

Paris, Nicolas

2011-01-01

Le roman exotique Le monde de Suzie Wong et ses nombreuses adaptations immortalisent le red-light district de Wan Chai à Hong Kong à la fin des années 1950, mettant en scène marins américains, expatriés de l’Empire britannique et prostituées hongkongaises. Aujourd’hui, avec la mondialisation, Wan Chai est fréquenté par des migrantes de plusieurs pays d’Asie du Sud-Est. Pourtant, le red-light district est toujours associé dans la presse et les guides de voyage à « l’époque de Suzie Wong ». Ces...

State of the Art in LP-WAN Solutions for Industrial IoT Services

OpenAIRE

Sanchez-Iborra, Ramon; Cano, Maria-Dolores

2016-01-01

The emergence of low-cost connected devices is enabling a new wave of sensorization services. These services can be highly leveraged in industrial applications. However, the technologies employed so far for managing this kind of system do not fully cover the strict requirements of industrial networks, especially those regarding energy efficiency. In this article a novel paradigm, called Low-Power Wide Area Networking (LP-WAN), is explored. By means of a cellular-type architecture, LP-WAN–base...

VizieR Online Data Catalog: Follow-up of probable young star ASASSN-15qi (Herczeg+, 2016)

Science.gov (United States)

Herczeg, G. J.; Dong, S.; Shappee, B. J.; Chen, P.; Hillenbrand, L. A.; Jose, J.; Kochanek, C. S.; Prieto, J. L.; Stanek, K. Z.; Kaplan, K.; Holoien, T.-S.; Mairs, S.; Johnstone, D.; Gully-Santiago, M.; Zhu, Z.; Smith, M. C.; Bersier, D.; Mulders, G. D.; Filippenko, A. V.; Ayani, K.; Brimacombe, J.; Brown, J. S.; Connelley, M.; Harmanen, J.; Itoh, R.; Kawabata, K. S.; Maehara, H.; Takata, K.; Yuk, H.; Zheng, W.

2017-02-01

The outburst of ASASSN-15qi (2MASS J22560882+5831040) occurred on JD2457298 (2015 October 2; UTC dates are used herein). The All-Sky Automated Survey for Supernovae (ASAS-SN) is an all-sky V-band transient survey with a limiting magnitude of ~17. ASAS-SN photometry of ASASSN-15qi was obtained from two different telescopes on Haleakala, Hawaii with intervals of one to three days. ASAS-SN photometry is listed in Table 2. Archival photometry, ground-based optical photometry with Las Cumbres Observatory Global Telescope Network (LCOGT) 1m telescope at McDonald Observatory between 2015 October 23 and December 23 and at the Liverpool Telescope on 2016 April 26 and June 11, Swift/UVOT photometry on 2015 October 12 (ID 00034098001) and 2015 December 27 (ID 00034098002), NIR photometry with the NOTCam camera at the Nordic Optical Telescope (NOT) on 2015 December 22 and Spitzer/IRAC MIR photometry on 2006 December 29 (Program ID 30734, PI Donald Figer) and James Clerk Maxwell Telescope (JCMT) SCUBA2 submillimeter observations of ASASSN-15qi on 2015 November 5 and optical and NIR spectroscopy observations are also described in section 2. (1 data file).

Cardioprotective Effects of QiShenYiQi Dripping Pills on Transverse Aortic Constriction-Induced Heart Failure in Mice.

Science.gov (United States)

Ruan, Guoran; Ren, Haojin; Zhang, Chi; Zhu, Xiaogang; Xu, Chao; Wang, Liyue

2018-01-01

QiShenYiQi dripping pills (QSYQ), a traditional Chinese medicine, are commonly used to treat coronary heart disease, and QSYQ was recently approved as a complementary treatment for ischemic heart failure in China. However, only few studies reported on whether QSYQ exerts a protective effect on heart failure induced by pressure overload. In this study, we explored the role of QSYQ in a mouse model of heart failure induced by transverse aortic constriction (TAC). Twenty-eight C57BL/6J mice were divided into four groups: Sham + NS group, Sham + QSYQ group, TAC + NS group, and TAC + QSYQ group. QSYQ dissolved in normal saline (NS) was administered intragastrically (3.5 mg/100 g/day) in the Sham + QSYQ and TAC + QSYQ groups. In the Sham + NS and TAC + NS groups, NS was provided every day intragastrically. Eight weeks after TAC, echocardiography, and cardiac catheterization were performed to evaluate the cardiac function, and immunofluorescent staining with anti-actinin2 antibody was performed to determine the structure of the myocardial fibers. Moreover, TUNEL staining and Masson trichrome staining were employed to assess the effects of QSYQ on cardiac apoptosis and cardiac fibrosis. Western blots and real-time polymerase chain reaction (PCR) were used to measure the expression levels of vascular endothelial growth factor (VEGF) in the heart, and immunohistochemical staining with anti-CD31 antibody was performed to explore the role of QSYQ in cardiac angiogenesis. Results showed that TAC-induced cardiac dysfunction and disrupted structure of myocardial fibers significantly improved after QSYQ treatment. Moreover, QSYQ treatment also significantly improved cardiac apoptosis and cardiac fibrosis in TAC-induced heart failure, which was accompanied by an increase in VEGF expression levels and maintenance of microvessel density in the heart. In conclusion, QSYQ exerts a protective effect on TAC-induced heart failure, which could be attributed to enhanced cardiac angiogenesis

Fractal analysis of intraflow unidirectional delay over w-lan and w-wan environments

OpenAIRE

Pezaros, D. P.; Sifalakis, M.; Mathy, Laurent

2007-01-01

We have analysed unidirectional delay traces of a diverse set of IPv6 microflows routed over W-LAN and W-WAN environments. Using a number of time-domain and frequency-domain estimators we have examined the existence and intensity of long-range dependence in packet delay when viewed as time-series data. The correlation structures of packet delay on bulk TCP data path and UDP flows follow asymptotic decay while Hurst exponent estimates suggest from moderate to strong intensity(H->1).

Effect of Rat Medicated Serum Containing Zuo Gui Wan and/or You Gui Wan on the Differentiation of Stem Cells Derived from Human First Trimester Umbilical Cord into Oocyte-Like Cells In Vitro

Directory of Open Access Journals (Sweden)

Xiang Hu

2015-01-01

Full Text Available Zuo Gui Wan (ZGW and You Gui Wan (YGW are two classic formulas used in clinical treatment of infertility in traditional Chinese medicine (TCM. However, the actions of the formulas remain to be proven at the cellular and molecular levels. In this study, we investigate whether the two formulas have any effect on germ cell formation and differentiation by culturing rat medicated serums containing YGW or ZGW with stem cells derived from human first trimester umbilical cord. Our results showed that while the normal rat serums had no significant effects, the rat medicated serums had significant effects on the differentiation of the stem cells into oocyte-like cells (OLCs based on (1 cell morphological changes that resembled purative cumulus-oocyte complexes (COCs; (2 expressions of specific markers that were indicative of germ cell formation and oocyte development; and (3 estradiol production by the COC-like cells. Furthermore, ZGW medicated serums exhibited more obvious effects on specific gene expressions of germ cells, whereas YGW medicated serums showed stronger effects on estradiol production. Accordingly, our study provides evidence demonstrating for the first time that one of molecular and cellular actions of YGW or ZGW in treating human reproductive dysfunctions may be through an enhancement of neooogenesis.

Scalla/xrootd WAN globalization tools: where we are.

CERN Document Server

Furano, F; CERN. Geneva. IT Department

2010-01-01

The Scalla/Xrootd software suite is a set of tools and suggested methods useful to build scalable, fault tolerant and high performance storage systems for POSIX-like data access. One of the most important recent development efforts has been to implement technologies able to deal with the characteristics of Wide Area Networks, and find solutions in order to allow data analysis applications to directly access remote data repositories in an efficient way. This contribution describes the current status of the various features and mechanisms implemented in the Scalla/Xrootd software suite, which allow to create and efficiently access 'global' data repositories, obtained by aggregating multiple sites through Wide Area Networks. One of these mechanisms is the ability of the clients to efficiently exploit high-latency high-throughput WANs and access remote repositories in read/write mode for analysis-like tasks. We will also discuss the possibilities of making distant data sub-repositories cooperate. The aim is to gi...

Bifurcation Analysis of the QI 3-D Four-Wing Chaotic System

International Nuclear Information System (INIS)

Sun, Y.; Qi, G.; Wang, Z.; Wyk, B.J. van

2010-01-01

This paper analyzes the pitchfork and Hopf bifurcations of a new 3-D four-wing quadratic autonomous system proposed by Qi et al. The center manifold technique is used to reduce the dimensions of this system. The pitchfork and Hopf bifurcations of the system are theoretically analyzed. The influence of system parameters on other bifurcations are also investigated. The theoretical analysis and simulations demonstrate the rich dynamics of the system. (authors)

Effects of electroacupuncture and electroacupuncture plus Tao Hong Si Wu Wan in treating primary dysmenorrhea.

Science.gov (United States)

Miao, Edwin Yong; Miao, Miranda Yi-mo; Kildea, Daniel George; Lao, Yi-Wen

2014-02-01

This study investigated the efficacies of electroacupuncture and electroacupuncture combined with Tao Hong Si Wu Wan in treating primary dysmenorrhea and compared the results with those obtained using conventional medical treatment. One treatment group, group 1, was administered Tao Hong Si Wu Wan (2625 mg) while the other, group 2, was administered a placebo (2625 mg) twice daily for 3 months. Electroacupuncture was used in both treatment groups: two sessions per menstrual cycle for three menstrual cycles. The reference group, group 3, was administered ibuprofen, 600 mg, twice daily, for five menstrual cycles. Uses of the herb, placebo and ibuprofen were blinded. A ridit analysis was used for testing and interpreting the effects of treatment. Pain intensity was determined using a qualitative grading method in a blinded manner. The ridit scores in groups 1 and 2 were significantly higher than those in reference group immediately after treatment and three months later. Twelve months after the treatment, group 1 had a higher ridit score than group 2. In comparison to the reference group, groups 1 and 2 achieved better menstrual pain relief both immediately and 3 months after treatment. In addition, group 1 had better long-term pain relief than group 2. Copyright © 2014. Published by Elsevier B.V.

Fractal analysis of intraflow unidirectional\\ud delay over W-LAN and W-WAN environments

OpenAIRE

Pezaros, D.; Sifalakis, M.; Mathy, L.

2007-01-01

We have analysed unidirectional delay traces of a diverse\\ud set of IPv6 microflows routed over W-LAN and W-WAN\\ud environments. Using a number of time-domain and frequency-domain estimators we have examined the existence and intensity of long-range dependence in packet delay when viewed as time-series data. The correlation structures of packet delay on bulk TCP data path and UDP flows follow asymptotic decay while Hurst exponent estimates suggest from moderate to strong intensity(H->1).

On Chinese-English Translation of Tourist Attraction in Cross-cultural Perspective--Taking Qi Culture as An Example

Institute of Scientific and Technical Information of China (English)

张滕龙

2014-01-01

Tourist textsfeature vividness and distinctiveness and its translation is a typical cross-cultural activity.By applying cross-cultural consciousness to the tourist material's translation, foreigners can understand the cultural connotation easily. Therefore, cross-cultural consciousness plays an important role in the translation of tourist materials.This thesis, taking Qi culture as an exam-ple, explores some typical tourist attractions from perspectives of historical allusions and legend as well as traditional customs. The analysis of Qi cultural connotation concludes business culture, Pu culture and filial piety culture. So, in order to transmit the cul-tural information to foreign tourists accurately, it is necessary to apply inter-cultural consciousness to the translation of tourist texts.

Gene Expression Profiles of HIV/AIDS Patients with Qi-Yin Deficiency and Dampness-Heat Retention.

Science.gov (United States)

Liu, Sa; Chen, Yulong; Xie, Shiping; Xu, Qianlei; Chen, Jianshe; Wang, Changhai; Wang, Zhao; Ma, Suna; Wu, Xingwei; Zhang, Ning

2016-11-01

Traditional Chinese Medicine (TCM) applied in the clinic as a complementary and alternative therapy has helped improve immunity and reduce side effects and symptomatic treatment in patients with HIV/AIDS. However, the mechanisms of TCM syndromes are not clear. Transcriptomics enables the study of such TCM syndromes. This study compared the messenger RNA (mRNA) expressions of healthy persons and patients with HIV/AIDS who had two common TCM syndromes, qi-yin deficiency and dampness-heat retention, to find the difference in HIV/AIDS with TCM syndromes. Comparison with healthy persons identified 113 mRNAs-41 enhanced and 72 decreased-in the qi-yin deficiency group. Additionally, 76 mRNAs were found in the dampness-heat retention group: 14 increased and 62 decreased. Functional genetic analysis of the mRNAs indicated that two TCM syndromes were correlated with cell apoptosis, immunoinflammatory responses, and lymphocyte activation. Differentially expressed mRNAs in the qi-yin deficiency group were obviously associated with cellular activity, communication, protein localization, cellular ion homeostasis, and regulation of cell motion, whereas mRNAs in the dampness-heat retention group were associated with sequence-specific DNA binding, cellular response to stress, and hemopoietic or lymphoid organ development. These results suggest that the formation of different TCM syndromes in patients with HIV/AIDS were founded on biological transcriptomics, which reveal mechanisms of the formation of these syndromes in HIV/AIDS. Differentially expressed mRNAs in two TCM syndrome groups tended to normalize after TCM intervention, which indicates that TCM might remit symptoms by changing genetic expression.

Clinical Observation on Insomnia Treated by Wei-Defensive Qi-Regulating and Brain-Strengthening Needling Technique

Institute of Scientific and Technical Information of China (English)

GAO Xi-yan; LI Xing-rui; MA Qiao-lin; ZHAO Xin-ji; SHAO Su-ju; WEI Yu-long; SUN Wei-xia; HANG Guo-qi

2007-01-01

In order to make a report on 90 cases of insomnia treated by the Wei-defensive qi-regulating and brain-strengthening needling technique,as a clinical subject of the multiple center,for assessing the preliminary standardized indications and operating methods and making an initial summary for writing the draft of the technique operation.Methods:By ratio of 1:1,the patients in conformity with the criteria were randomly divided into the experimental group and control group.In the experimental group,45 cases were treated with the Wei-defensive qi-regulating and brain-strengthening needling technique on Baihui (GV 20),Dazhui(GV 14),Shenmai(BL 62),Zhaohai(KI 6),plus ear points.In the control group,45 cases were treated with routine acupuncture on Sishencong(Ex-HN 1),Shenmen (HT 7),Sanyinjiao(SP 6),etc.The therapeutic effects in the two groups were observed and assessed in comparison.Results:The results showed cure in 15 cases.remarkable effect in 27 cases,effect in 42 cases,failure in 6 cases,and the total eriective rate in 94.4% in 90 cases of insomnia.In the three centers,the statistic management was performed based upon PSQI integral and showed significant difference(P＜0.01),and no significant difference among various groups(P＞0.01).Conclusion:The therapeutic effect in the treatment of insomnia by Wei-defensive qi-regulating and brain-strengthening needling technique is better than the control group and the therapeutic effect and methods in various centers are stable.without any deviation.

Can Medical Herbs Stimulate Regeneration or Neuroprotection and Treat Neuropathic Pain in Chemotherapy-Induced Peripheral Neuropathy?

Directory of Open Access Journals (Sweden)

Sven Schröder

2013-01-01

Full Text Available Chemotherapy-induced neuropathy (CIPN has a relevant impact on the quality of life of cancer patients. There are no curative conventional treatments, so further options have to be investigated. We conducted a systematic review in English and Chinese language databases to illuminate the role of medical herbs. 26 relevant studies on 5 single herbs, one extract, one receptor-agonist, and 8 combinations of herbs were identified focusing on the single herbs Acorus calamus rhizoma, Cannabis sativa fructus, Chamomilla matricaria, Ginkgo biloba, Salvia officinalis, Sweet bee venom, Fritillaria cirrhosae bulbus, and the herbal combinations Bu Yang Huan Wu, modified Bu Yang Huan Wu plus Liuwei Di Huang, modified Chai Hu Long Gu Mu Li Wan, Geranii herba plus Aconiti lateralis praeparata radix , Niu Che Sen Qi Wan (Goshajinkigan, Gui Zhi Jia Shu Fu Tang (Keishikajutsubuto, Huang Qi Wu Wu Tang (Ogikeishigomotsuto, and Shao Yao Gan Cao Tang (Shakuyakukanzoto. The knowledge of mechanism of action is still limited, the quality of clinical trials needs further improvement, and studies have not yielded enough evidence to establish a standard practice, but a lot of promising substances have been identified. While CIPN has multiple mechanisms of neuronal degeneration, a combination of herbs or substances might deal with multiple targets for the aim of neuroprotection or neuroregeneration in CIPN.

CoralWatch Data Analysis at Hoi Ha Wan Marine Park, Hong Kong

Science.gov (United States)

Lau, A.; Hodgson, P.

2015-12-01

CoralWatch is a conservation organization that is based at the University of Queensland in Australia. Their development of the "Coral Health Chart" standardized the colour of corals for the further investigation of coral health and bleaching. The location of this project is in the NE part of Hong Kong in New Territories. The location faces ShenZhen, a heavily industrialized city, which is known for its pollution of the Pearl River. This area is protected by the Hong Kong Government and the WWF since 1996.Human activities have caused large amounts of greenhouse gasses to be released into the atmosphere. Carbon dioxide has caused the global temperature to rise and made ocean waters more acidic due to ocean respiration. The ocean is a carbon sink for mankind and the effect of severe acidification is negatively affecting marine life. The increase of temperature diminishes the amount of diversity of marine life; the decreasing acidity of the water has eliminated many species of shellfish and sea anemone; the increase of marine exploitation has decreased the diversity of marine life. The release of toxic waste, mainly mercury, waste and plastic products has also polluted the oceans which negatively impact coral reefs and endanger marine life.The data has been collected by observing the colours and discolouration (bleaching) of the corals of approximately 40 colonies per month. The species of coral in Hoi Ha Wan include, Favites flexuosa, Goniopora columna,Leptastrea purpurea, Lithophyllon undulatum, Pavona decussata. and Platygyra acuta (AFCD,1). The evaluation of four years of coralwatch data has shown the bleaching of hard boulder corals in Hoi Ha Wan, Hong Kong, has halted and the reefs are being to show signs of regeneration. Local marine biologists credited the improved situation of the corals to protected status of the area.

Theory of sinking of qi in treating chronic disease and its clinical application%从大气下陷论治慢性病经验举隅

Institute of Scientific and Technical Information of China (English)

范逸品

2012-01-01

Chronic diseases are usually occult in onset, complicated, recur repeatedly and long-term, treatment-resistant and so on. With the development of the society, environmental and social changes, chronic diseases has been the most dangerous threats to human health. This paper detailed the concept about qi and sinking of qi and pathogenesis, and holds that sinking of qi is closely related to chronic disease. Through the successful case in the treatment of sequela of myocarditis and progressive muscular dystrophy(PMD), we demonstrate the curative effect about theory of sinking of qi in treating chronic diseases, and analysis the advantages about therapy of invigorating qi and ascending qi collapse.%慢性病具有起病隐匿、病因复杂、反复发作、迁延难愈等特点.随着社会发展、环境因素及生活方式的变化,慢性病已逐渐成为威胁人类健康的首要原因.文章叙述了大气和大气下陷概念及病机特点,提出大气下陷与慢性病密切相关,以病毒性心肌炎后遗症与进行性肌营养不良治疗为例,证实了从大气下陷论治慢性病的疗效并分析了益气升陷法的优势作用.

Improving Quality of Service and Reducing Power Consumption with WAN accelerator in Cloud Computing Environments

OpenAIRE

Shin-ichi Kuribayashi

2013-01-01

The widespread use of cloud computing services is expected to deteriorate a Quality of Service and toincrease the power consumption of ICT devices, since the distance to a server becomes longer than before. Migration of virtual machines over a wide area can solve many problems such as load balancing and power saving in cloud computing environments. This paper proposes to dynamically apply WAN accelerator within the network when a virtual machine is moved to a distant center, in order to preve...

The ENET WAN of ENEA`S geographical network: Present situation and optimization; La rete geografica ENET dell`ENEA: Situazione attuale e proposte di ottimizzazione

Energy Technology Data Exchange (ETDEWEB)

Bongiovanni, Giancarlo [Rome, Univ. La Sapienza (Italy); Di Marco, Roberto Antonio [ENEA, Rome (Italy). Funzione Centrale Informatica; Marocco, Glaudio

1997-10-01

The wide area networks for data transmission are submitting to evolution process by technological progress and unrelated process to the network. The evolution process can be originated by the bottom up integration of different networks that were born to solve specific problems (i.e.: scientific calculations and business administration). The ENET WAN of ENEA had been submitted to the same evolution progress. In this thesis the author analyze all the problems about WAN with emphasis in ENET WAN. The purpose of this research is the analysis of the present situation in particularly links, efficiency, expenses and throughput. The goal is to suggest alternative solutions to optimized the network and to amplify the throughput by new technology. The research suggests in particularly two new wide area networks: ENET{sub C}-LAN95 e ENET{sub S}ERV96. The first one is a mix interconnection solution, that is basis on the public network C-LAN, with the transportation protocol Frame Relay, and on the private links Numerical Direct Channels (CDN). The second one is also a mix interconnection solution, but it is based on two new network services that are supplied by two new public networks just introduce in Italian telecommunications market since `96. Frame Relay and ATM are the transportation protocol employed.

Scalla/xrootd WAN globalization tools: Where we are

International Nuclear Information System (INIS)

Furano, Fabrizio; Hanushevsky, Andrew

2010-01-01

The Scalla/Xrootd software suite is a set of tools and suggested methods useful to build scalable, fault tolerant and high performance storage systems for POSIX-like data access. One of the most important recent development efforts has been to implement technologies able to deal with the characteristics of Wide Area Networks, and find solutions in order to allow data analysis applications to directly access remote data repositories in an efficient way. This contribution describes the current status of the various features and mechanisms implemented in the Scalla/Xrootd software suite, which allow to create and efficiently access 'global' data repositories, obtained by aggregating multiple sites through Wide Area Networks. One of these mechanisms is the ability of the clients to efficiently exploit high-latency high-throughput WANs and access remote repositories in read/write mode for analysis-like tasks. We will also discuss the possibilities of making distant data sub-repositories cooperate. The aim is to give a unique view of their content, and eventually allow external systems to coordinate and trigger data movements among them. Experience in using Scalla/Xrootd remote data repositories is also reported.

Scalla/xrootd WAN globalization tools: Where we are

Science.gov (United States)

Furano, Fabrizio; Hanushevsky, Andrew

2010-04-01

The Scalla/Xrootd software suite is a set of tools and suggested methods useful to build scalable, fault tolerant and high performance storage systems for POSIX-like data access. One of the most important recent development efforts has been to implement technologies able to deal with the characteristics of Wide Area Networks, and find solutions in order to allow data analysis applications to directly access remote data repositories in an efficient way. This contribution describes the current status of the various features and mechanisms implemented in the Scalla/Xrootd software suite, which allow to create and efficiently access 'global' data repositories, obtained by aggregating multiple sites through Wide Area Networks. One of these mechanisms is the ability of the clients to efficiently exploit high-latency high-throughput WANs and access remote repositories in read/write mode for analysis-like tasks. We will also discuss the possibilities of making distant data sub-repositories cooperate. The aim is to give a unique view of their content, and eventually allow external systems to coordinate and trigger data movements among them. Experience in using Scalla/Xrootd remote data repositories is also reported.

Scalla/xrootd WAN globalization tools: Where we are

Energy Technology Data Exchange (ETDEWEB)

Furano, Fabrizio [Conseil Europeen Recherche Nucl. (CERN) (Switzerland); Hanushevsky, Andrew, E-mail: furano@cern.c, E-mail: abh@slac.stanford.ed [SLAC National Accelerator Laboratory, CA (United States)

2010-04-01

The Scalla/Xrootd software suite is a set of tools and suggested methods useful to build scalable, fault tolerant and high performance storage systems for POSIX-like data access. One of the most important recent development efforts has been to implement technologies able to deal with the characteristics of Wide Area Networks, and find solutions in order to allow data analysis applications to directly access remote data repositories in an efficient way. This contribution describes the current status of the various features and mechanisms implemented in the Scalla/Xrootd software suite, which allow to create and efficiently access 'global' data repositories, obtained by aggregating multiple sites through Wide Area Networks. One of these mechanisms is the ability of the clients to efficiently exploit high-latency high-throughput WANs and access remote repositories in read/write mode for analysis-like tasks. We will also discuss the possibilities of making distant data sub-repositories cooperate. The aim is to give a unique view of their content, and eventually allow external systems to coordinate and trigger data movements among them. Experience in using Scalla/Xrootd remote data repositories is also reported.

The effectiveness of a multidisciplinary QI activity for accidental fall prevention: Staff compliance is critical

Directory of Open Access Journals (Sweden)

Ohde Sachiko

2012-07-01

Full Text Available Abstract Background Accidental falls among inpatients are a substantial cause of hospital injury. A number of successful experimental studies on fall prevention have shown the importance and efficacy of multifactorial intervention, though success rates vary. However, the importance of staff compliance with these effective, but often time-consuming, multifactorial interventions has not been fully investigated in a routine clinical setting. The purpose of this observational study was to describe the effectiveness of a multidisciplinary quality improvement (QI activity for accidental fall prevention, with particular focus on staff compliance in a non-experimental clinical setting. Methods This observational study was conducted from July 2004 through December 2010 at St. Luke’s International Hospital in Tokyo, Japan. The QI activity for in-patient falls prevention consisted of: 1 the fall risk assessment tool, 2 an intervention protocol to prevent in-patient falls, 3 specific environmental safety interventions, 4 staff education, and 5 multidisciplinary healthcare staff compliance monitoring and feedback mechanisms. Results The overall fall rate was 2.13 falls per 1000 patient days (350/164331 in 2004 versus 1.53 falls per 1000 patient days (263/172325 in 2010, representing a significant decrease (p = 0.039. In the first 6 months, compliance with use of the falling risk assessment tool at admission was 91.5% in 2007 (3998/4368, increasing to 97.6% in 2010 (10564/10828. The staff compliance rate of implementing an appropriate intervention plan was 85.9% in 2007, increasing to 95.3% in 2010. Conclusion In our study we observed a substantial decrease in patient fall rates and an increase of staff compliance with a newly implemented falls prevention program. A systematized QI approach that closely involves, encourages, and educates healthcare staff at multiple levels is effective.

[Correlation between spirit-qi acupuncture and lifting-thrusting twirling method for spirit in Huangdi Neijing].

Science.gov (United States)

Wang, Feng; Qin, Yuge; Qin, Yuheng; Li, Li; Li, Mei

2016-03-01

By analyzing the articles in Huangdi Neijing (Inner Canon of Yellow Emperor), combined with the verification of consciousness in vitro in clinic and modern science, it is found Huangdi Neijing has made special requirements of treating spirit for physicians using spirit-qi acupuncture. The physicians consciously use different methods to motivate the spirit of physician and patients, especially patients, to transform it to the physiological effect of patients, which could minimize the psychological factors that make negative influence on treatment; also the psychotherapy is considered as the most important principle of treating spirit. The reinforcing and reducing methods in later generations, mainly lifting-thrusting twirling method, unintentionally lead patients into a basic or strong status of treating spirit or keeping spirit during the process of achieving stimulation and needle sensation. To partially perform the special role of treating spirit for physicians in Huangdi Neijing on patients could cause the chages including patient-based using spirit to move qi. It not only inspires the body's natural resistance to disease and self-healing, but also motivates the self-protection mechanism of keeping spirit.

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

Science.gov (United States)

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

2018-06-08

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

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

Directory of Open Access Journals (Sweden)

Ilsun You

2018-06-01

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

[Efficacy of Qilin Pills combined with sertraline in the treatment of secondary non-consolidated kidney qi premature ejaculation].

Science.gov (United States)

Li, Jian-xin; Lu, Qing-ge

2015-05-01

To observe the clinical effectiveness of Qilin Pills combined with sertraline in the treatment of secondary non-consolidated kidney qi premature ejaculation (PE). A total of 120 patients with secondary non-consolidated kidney qi PE were randomly assigned to groups A (aged [35.5 ± 5.4] yr), B (aged [36.2 ± 5.7] yr), and C (aged [35.2 ± 5.3] yr) in the ratio of 1:1:1 to receive Qilin Pills (once 6 g, bid), sertraline (once 50 mg, qd), and Qilin Pills plus sertraline, respectively, all for 4 weeks. The intravaginal ejaculatory latency time (IELT) and PE diagnostic tool (PEDT) scores were obtained before and after medication and at 1 month after drug withdrawal, and comparative analyses were made among the three groups of patients. The IELT was dramatically prolonged in groups A, B, and C after treatment ([3.23 ± 1.84], [3.87 ± 2.43], and [5.92 ± 3.11] min) and at 1 month after drug withdrawal ([1.85 ± 1.27], [1.52 ± 1.06], and [ 4.26 ± 1.88 ] min) as compared with the baseline ([0.88 ± 0.45], [0.84 ± 0.47], and [0.85 ± 0.50] min) (P Pills combined with sertraline has a definite efficacy in the treatment of secondary non-consolidated kidney qi PE and therefore deserves wide clinical application.

The Effects of Yin, Yang and Qi in the Skin on Pain.

Science.gov (United States)

Adams, James David

2016-01-29

The most effective and safe treatment site for pain is in the skin. This chapter discusses the reasons to treat pain in the skin. Pain is sensed in the skin through transient receptor potential cation channels and other receptors. These receptors have endogenous agonists (yang) and antagonists (yin) that help the body control pain. Acupuncture works through modulation of these receptor activities (qi) in the skin; as do moxibustion and liniments. The treatment of pain in the skin has the potential to save many lives and improve pain therapy in most patients.

The Effects of Yin, Yang and Qi in the Skin on Pain

Directory of Open Access Journals (Sweden)

James David Adams

2016-01-01

Full Text Available The most effective and safe treatment site for pain is in the skin. This chapter discusses the reasons to treat pain in the skin. Pain is sensed in the skin through transient receptor potential cation channels and other receptors. These receptors have endogenous agonists (yang and antagonists (yin that help the body control pain. Acupuncture works through modulation of these receptor activities (qi in the skin; as do moxibustion and liniments. The treatment of pain in the skin has the potential to save many lives and improve pain therapy in most patients.

Research on the modern clinical herbal administration rules in TCM treatment of ovarian cysts based on data mining

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Ya'nan Song

2017-04-01

Conclusion: Medicinal herbs for promoting blood circulation to remove blood stasis, resolve hard lumps, for strengthening the spleen, eliminating phlegm, and relieving liver qi stagnation were highly used in the treatment of OCs; Herbs attributed to the Liver Meridian, the Spleen Meridian and the Heart Meridian were highly used in OCs; The compatibility of herbs for promoting blood circulation to remove blood stasis and resolve hard lumps were highly used; Guizhi Fuling Wan (GFW was often used and combined with other herbs in the treatment of OCs.

LoRaWAN-Based Energy-Efficient Surveillance by Drones for Intelligent Transportation Systems

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Vishal Sharma

2018-03-01

Full Text Available Urban networks aim at facilitating users for better experience and services through smart platforms such as the Intelligent Transportation System (ITS. ITS focuses on information acquisition, sensing, contrivance control, data processing and forwarding to ground devices via user-specific application-interfaces. The utility of ITS is further improved via the Internet of Things (IoT, which supports “Connectivity to All”. One of the key applications of IoT-ITS is urban surveillance. Current surveillance in IoT-ITS is performed via fixed infrastructure-based sensing applications which consume an excessive amount of energy leading to several overheads and failures in the network. Such issues can be overcome by the utilization of on-demand nodes, such as drones, etc. However, drones-assisted surveillance requires efficient communication setup as drones are battery operated and any extemporaneous maneuver during monitoring may result in loss of drone or complete failure of the network. The novelty in terms of network layout can be procured by the utilization of drones with LoRaWAN, which is the protocol designated for Low-Power Wide Area Networks (LPWAN. However, even this architectural novelty alone cannot ascertain the formation of fail-safe, highly resilient, low-overhead, and non-redundant network, which is additionally the problem considered in this paper. To resolve such problem, this paper uses drones as LoRaWAN gateway and proposes a communication strategy based on the area stress, resilient factor, and energy consumption that avail in the efficient localization, improved coverage and energy-efficient surveillance with lower overheads, lower redundancy, and almost zero-isolations. The proposed approach is numerically simulated and the results show that the proposed approach can conserve a maximum of 39.2% and a minimum of 12.6% of the total network energy along with an improvement in the area stress between 89.7% and 53.0% for varying

The Cause of WanXi Folk Songs and music Characteristic%皖西民歌的成因及音乐特征

Institute of Scientific and Technical Information of China (English)

黄梅

2014-01-01

WanXi folk songs ,as an important branch of the Dabie Mountains , have distinct characteristics : both folk songs ,minor , and chant , chanting the words , rhythm and speed is relatively free . In the use of tuning , the symptoms of Pentatonic tuning is the most common ,following is five sound feather tuning and pentatonic Palace tuning , business transfer type , angle tuning barely , six sound and seven - tone style is rare . It different in pitch change and volume processing of each branches of WanXi folk songs . This form of music characterized and the body ,mainly due to the spread of WanXi folk songs birthplace and the main characteristics of the popular area .%皖西民歌作为大别山民歌的重要分支，具有鲜明的音乐特色：不论是山歌、小调，还是号子、诵词，音乐的节奏和速度都比较自由；在调式使用方面，最常见的为五声徵调式，其次是五声羽调式，再次是五声宫调式，商调式使用较少，而角调式几乎没有，六声及七声调式也很少见；在音高变化和音量处理方面，皖西民歌的各个支系皆有不同。这种音乐本体特征的形成，主要是受皖西民歌发源地和主要流传地的地域特征影响。

78 FR 56264 - Big Bear Mining Corp., Four Rivers BioEnergy, Inc., Mainland Resources, Inc., QI Systems Inc...

Science.gov (United States)

2013-09-12

... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] Big Bear Mining Corp., Four Rivers BioEnergy, Inc., Mainland Resources, Inc., QI Systems Inc., South Texas Oil Co., and Synova Healthcare Group, Inc... that there is a lack of current and accurate information concerning the securities of Big Bear Mining...

[Plasma metabonomics of Guifu Dihuang Wan in the treatment of yang deficiency].

Science.gov (United States)

Xiao, Ya; Jing, Yuan; Chen, Jie-Yu; Li, Fei; Cheng, Jing-Ru; Bi, Jian-Lu; Luo, Ren; Zhao, Xiao-Shan

2016-11-20

To assess the effect of Guifu Dihuang Wan (GFDHW) in the treatment of yang deficiency and explore the underlying molecular mechanism. Sixty-two participants without diseases were randomized into control group (n=31) and experimental group (n=31) and were given lifestyle intervention additional GFDHW treatment for a month. NMR technology was used for metabonomics analysis. Intervention with GFDHW resulted in significantly decreased conversion scores of yang deficiency in the experimental group compared with the control group (P<0.005). The concentrations of lactate, valine, proline, arginine and 3-hydroxybutyrate were increased in the plasma of yang-deficient subjects after lifestyle intervention. GFDHW treatment with lifestyle intervention significantly increased the concentrations of lactate, valine, proline, arginine and 3-hydroxybutyrate and also the levels of alanine, glutamine, alpha glucose, isoleucine, betaine and propylene glycol. GFDHW treatment improves yang deficiency possibly by increasing the concentrations of alanine, glutamine, alpha glucose, isoleucine, betaine and propylene glycol and promoting energy metabolism of the body.

Ensuring Support for Research and Quality Improvement (QI) Networks: Four Pillars of Sustainability?An Emerging Framework

OpenAIRE

Holve, Erin

2013-01-01

Multi-institutional research and quality improvement (QI) projects using electronic clinical data (ECD) hold great promise for improving quality of care and patient outcomes but typically require significant infrastructure investments both to initiate and maintain the project over its duration. Consequently, it is important for these projects to think holistically about sustainability to ensure their long-term success. Four ?pillars? of sustainability are discussed based on the experiences of...

[Effect of protein intervention on amino acid metabolism spectrum of Qi and Yin deficiency type 2 diabetic rats].

Science.gov (United States)

Ma, Li-Na; Mao, Xin-Min; Ma, Xiao-Li; Li, Lin-Lin; Wang, Ye; Tao, Yi-Cun; Wang, Jing-Wei; Guo, Jia-Jia; Lan, Yi

2016-11-01

To study the effect of plant protein and animal protein on amino acid metabolism spectrum of Qi and Yin deficiency type 2 diabetic rats. 110 male SD rats were randomly divided into blank group (n=10), diabetic model group (n=20), disease-symptoms group (n=80). The rats of blank group received ordinary feeding, while other groups were fed with high sugar and fat diets. During the whole process of feeding, rats of disease-symptoms group were given with Qingpi-Fuzi (15.75 g•kg⁻¹) once a day through oral administration. Five weeks later, the rats were given with a low dose of STZ (40 mg•kg⁻¹) by intraperitoneal injection to establish experimental diabetic models. Then the models were randomly divided into disease-symptoms group 1 (Qi and Yin deficiency diabetic group, 15.75 g•kg⁻¹), disease-symptoms group 2 (plant protein group, 0.5 g•kg⁻¹), disease-symptoms group 3 (animal protein group, 0.5 g•kg⁻¹), disease-symptoms group 4 (berberine group, 0.1 g•kg⁻¹). The drugs were given for 4 weeks by gavage administration. After 4 weeks of protein intervention, the abdominal aortic blood was collected and serum was isolated to analyze its free amino acid by using AQC pre-column derivatization HPLC and fluorescence detector. Four weeks after the protein intervention, plant protein, animal protein and berberine had no obvious effect on body weight and blood sugar in type 2 diabetic rats. As compared with animal protein group, histidine and proline（PYin deficiency type 2 diabetic SD rats. Symbolic differential compounds could be found through metabonomics technology, providing experimental basis for early warning of type 2 diabetes and diagnosis of Qi and Yin deficiency syndrome. Copyright© by the Chinese Pharmaceutical Association.

Oral Astragalus (Huang qi) for preventing frequent episodes of acute respiratory tract infection in children.

Science.gov (United States)

Su, Guobin; Chen, Xiankun; Liu, Zhuangzhu; Yang, Lihong; Zhang, La; Stålsby Lundborg, Cecilia; Wen, Zehuai; Guo, Xinfeng; Qin, Xindong; Liang, Jueyao; Liu, Xusheng

2016-12-01

Acute respiratory tract infections (ARTIs) are common in children and can involve both upper and lower airways. Many children experience frequent ARTI episodes or recurrent respiratory tract infections (RRTIs) in early life, which creates challenges for paediatricians, primary care physicians, parents and carers of children.In China, Astragalus (Huang qi), alone or in combination with other herbs, is used by Traditional Chinese Medicine (TCM) practitioners in the form of a water extract, to reduce the risk of ARTIs; it is believed to stimulate the immune system. Better understanding of the therapeutic mechanisms of Astragalus may provide insights into ARTI prevention, and consequently reduced antibiotic use. To assess the effectiveness and safety of oral Astragalus for preventing frequent episodes of acute respiratory tract infections (ARTIs) in children in community settings. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 12, 2015), MEDLINE (Ovid) (1946 to 31 December 2015), Embase (Elsevier) (1974 to 31 December 2015), AMED (Ovid) (1985 to 31 December 2015), Chinese National Knowledge Infrastructure (CNKI) (1979 to 31 December 2015) and Chinese Scientific Journals full text database (CQVIP) (1989 to 31 December 2015), China Biology Medicine disc (CBM 1976 to 31 December 2015) and Wanfang Data Knowledge Service Platform (WanFang) (1998 to 31 December 2015). We included randomised controlled trials (RCTs) comparing oral Astragalus as a sole Chinese herbal preparation with placebo to prevent frequent episodes of ARTIs in children. We used standard Cochrane methodological procedures for this review. We assessed search results to identify relevant studies. We planned to extract data using standardised forms. Disagreements were to be resolved through discussion. Risk of bias was to be assessed using the Cochrane 'Risk of bias' tool. We planned to use mean difference (MD) or standardised mean difference (SMD) for continuous data and risk

KOHESI GRAMATIKAL PENGACUAN DALAM CERPEN PEMBELAAN BAH BELA KARYA MOH. WAN ANWAR

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Asep Muhyidin

2016-08-01

  Referent Cohesion in Pembelaan Bah Bela a Short Story by Moh. Anwar. From the prespective of oral communication discourse is understood as a communication process between an addresser and an addressee. From written communication perspective, on the other hand, discourse is thought as the expression of the addresser. An integrated discourse is the one that is cohesive and coherent. It is complete when the sentenses constituting it support the topic, and integrated when the sentences are systematic and well-structured. Well structured idea is indicated by the use of cohesive devices. A short story has been chosen to investigate as it is short yet requires a high level of cohesion and coherence to allow it to be a complete reading. This article investigate “Pembelaan Bah Bela” one of best short stories by Moh. Wan Anwar. It tells about a Jawara culture in Banten. All the sentences in the short stories are analyzed. The investigation serves to show how cohesive devices work to construct a discourse Keywords: referent cohesion, text analysis, short story

Improving cachectic symptoms and immune strength of tumour-bearing mice in chemotherapy by a combination of Scutellaria baicalensis and Qing-Shu-Yi-Qi-Tang.

Science.gov (United States)

Wang, Hang; Chan, Yi-Lin; Li, Tsung-Lin; Wu, Chang-Jer

2012-05-01

Cancer cachexia is characterised by the loss of body mass and directly compromises immune response and the quality of life of cancer patients. In the present study, we set out to investigate the role of Chinese herbs as anticancer medicines and/or chemotherapeutic adjuvants to increase therapeutic efficacy and/or ameliorate given side-effects in animal model. Twelve kinds of herbs were chosen from the ingredients of major Chinese herbal medicines, and their effects on the antioxidant activity were investigated. To obtain the anticancer effects of 5-fluorouracil (5-FU) when consumed with minimal side-effects, we investigated the combination effect of Scutellaria baicalensis and Qing-Shu-Yi-Qi-Tang that may enhance the anticancer activity of 5-FU on subcutaneous tumour growth in C57BL/6 mice challenged with Lewis lung carcinoma cells. Qing-Shu-Yi-Qi-Tang, a multiple-component herbal extract, was shown to have high anti-oxidation activity, while S. baicalensis (Chinese skullcap) was demonstrated to have high tumour-growth inhibition activity. Thus, S. baicalensis and Qing-Shu-Yi-Qi-Tang were evaluated for their combinaton effects on the cancer-induced cachectic murine upon receiving 5-FU chemotherapy. As a result, tumour masses and losses of carcass and/or gastrocnemius muscle were found to be significantly decreased. This combination otherwise increased both Th1/Th2 ratio and NK cytotoxicity. In the mice receiving with or without 5-FU, the serum levels of monocyte chemoattractant protein-1 (MCP-1) increased by all means but otherwise decreased when the herbal combination was administrated. Additionally, the expressions of nuclear factor-kappa B (NF-κB) and muscle RING finger protein-1 (MuRF-1) decreased in the gastrocnemius muscle when the herbal combination was applied. Our results revealed that the combination of S. baicalensis and Qing-Shu-Yi-Qi-Tang is able to ameliorate cachectic symptoms and positively stimulate anti-tumour immunity while undergoing

Viabilidade da estimativa de QI a partir dos subtestes Vocabulário e Cubos da WAIS-III Viability of IQ estimates based on Vocabulary and Block Design WAIS-III subtests

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Flávia Wagner

2010-08-01

Full Text Available Objetivou-se avaliar a viabilidade de estimar o Quociente de Inteligência (QI de adultos por meio de duas estratégias que utilizam uma forma curta constituída pelos subtestes Vocabulário e Cubos da Escala Wechsler de Inteligência para Adultos (WAIS-III. Participaram do estudo 77 homens e mulheres, com idade média de 39,1 anos (dp=13,4. Foi aplicada a WAIS-III e questionários para cumprir os critérios de inclusão dos participantes sem prejuízos neurológicos e psiquiátricos. Para avaliar a concordância entre as duas estratégias de estimar o QI, utilizou-se o método estatístico proposto por Bland e Altman. Como resultado, encontrou-se que as estimativas de QI geradas pelas duas estratégias apresentam concordância com a medida do QI realizada pela aplicação da escala completa apenas em alguns dos casos avaliados. Sugere-se cautela na utilização dessas estratégias para estimar o QI de adultos.The aim of this study was to evaluate the feasibility of estimating the Intelligence Quotient (IQ in adults based on two strategies that use Vocabulary and Block Design subtests of Wechsler Adult Intelligence Scale (WAIS-III. Seventy-seven men and women participated of the study, with mean age of 39.1 (sd=13.4. WAIS-III subtests were administered and questionnaires were used to verify inclusion criteria for participants without neurological or psychiatric impairments. A statistical method proposed by Bland and Altman was used to evaluate the agreement between both strategies to estimate IQ. Results suggest that IQ estimates derived from both strategies only agree with the IQ derived from the full battery in a few cases of the sample. Considering these findings, caution is suggested when using these strategies to estimate adults' IQ.

Demand Side Management Using the Internet of Energy Based on LoRaWAN Technology

DEFF Research Database (Denmark)

Shahryari, Kolsoom; Anvari-Moghaddam, Amjad; Shahryari, Shadi

2017-01-01

into cloud because of a long range, low power, wide area and low bit rate wireless telecommunication system which is called LoRaWAN. All devices in fog domain are connected by long range wide area network (LoRa) into a smart gateway. The gateway which bridges fog domain and cloud, is introduced......The smart grid, as a communication network, allows numerous connected devices such as sensors, relays and actuators to interact and cooperate with each other. An Internet-based solution for electricity that provides bidirectional flow of information and power is internet of energy (IoE) which...... is an extension of smart grid concept. A large number of connected devices and the huge amount of data generated by IoE and issues related to data transmission, process and storage, force IoE to be integrated by cloud computing. Furthermore, in order to enhance the performance and reduce the volume of transmitted...

The Immunomodulatory Effect of You-Gui-Wan on Dermatogoides-pteronyssinus-Induced Asthma

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Li-Jen Lin

2012-01-01

Full Text Available The traditional Chinese medicine You-Gui-Wan (YGW contains ten species of medicinal plants and has been used to improve health in remissive states of asthma for hundreds of years in Asia. However, little is known about the immunomodulatory mechanisms in vivo. Therefore, this study investigated the pathologic and immunologic responses to YGW in mice that had been repeatedly exposed to Dermatogoides-pteronyssinus (Der p. YGW reduced Der-p-induced airway hyperresponsiveness and total IgE in serum. It also inhibited eosinophil infiltration by downregulating the protein expression of IL-5 in serum and changed the Th2-bios in BALF by upregulating IL-12. Results of the collagen assay and histopathologic examination showed that YGW reduced airway remodeling in the lung. In addition, after YGW treatment there was a relative decrease in mRNA expression of TGF-β1, IL-13, eotaxin, RANTES, and MCP-1 in lung in the YGW group. The results of EMSA and immunohistochemistry revealed that YGW inhibited NF-κB expression in epithelial lung cells. YGW exerts its regulative effects in chronic allergic asthmatic mice via its anti-inflammatory activity and by inhibiting the progression of airway remodeling.

A ginástica terapêutica e preventiva chinesa Lian Gong/Qi Gong como um dos instrumentos na prevenção e reabilitação da LER/DORT

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Gutembergue Livramento

Full Text Available Este ensaio traz elementos da medicina ocidental, da medicina tradicional chinesa e da sociologia do trabalho para reflexão sobre o Qi Gong - exercícios terapêuticos, um dos pilares da Medicina Tradicional Chinesa (MTC - como importante meio de prevenção da LER/DORT e recuperação da saúde. Considerando a natureza interdisciplinar e diversos níveis de prevenção, aborda aspectos sociológicos sobre as condições de trabalho frequentemente relacionadas com este tipo de adoecimento e categorias de trabalhadores mais acometidos. Focaliza aspectos médicos sobre a LER/DORT e as Síndromes de Bloqueio na MTC, estabelecendo canais de articulação e contribuição entre esses campos de conhecimento sobre a saúde humana. Ressalta o Qi Gong como importante prática terapêutica e preventiva na MTC e sua adequação à LER/DORT. No âmbito do Qi Gong, focaliza o Lian Gong Shi Ba Fa - Lian Gong em 18 Terapias, já amplamente experimentado na China e divulgado, inclusive no Brasil, para tratar e prevenir síndromes de dor em região cervical, ombros, membros superiores, membros inferiores e região lombar. À guisa de conclusão, são apresentadas algumas reflexões sobre a propriedade e a importância do Qi Gong na reabilitação e na prevenção da LER/DORT.

Estudio de la arquitectura y el nivel de desarrollo de la red LoRaWAN y de los dispositivos LoRa.

OpenAIRE

Ordóñez Monfort, Ignacio

2017-01-01

Es realitza un estudi sobre les diverses definicions del IoT que es concreta en una sèrie de requisits essencials del IoT i les característiques de les xarxes de connexió sobre les que sustentar-lo. Es realitza posteriorment un estudi en profunditat de les característiques de LoRA/LoRaWAN, que poden limitar o afavorir el seu ús com xarxa d'implementació del IoT, valorant de manera individualitzada cadascuna d'elles. Finalment, es realitza una analisi sobre el nivell de desenvolupament, madur...

Role of phosphatase and tensin homolog deleted on chromosome ten in a rat model of carbon tetrachloride-induced liver fibrosis and the effect of qi-tonifying and blood-activating prescription

Directory of Open Access Journals (Sweden)

NIU Xuemin

2018-01-01

Full Text Available Objective To investigate the role of phosphatase and tensin homology deleted on chromosome ten (PTEN in a rat model of carbon tetrachloride (CCl4-induced liver fibrosis and the molecular mechanism of action of qi-tonifying and blood-activating prescription in regulating PTEN and inhibiting liver fibrosis. Methods A total of 27 male Wistar rats were randomly divided into three groups, with 9 rats in each group. The rats in liver fibrosis group were treated with CCl4 to establish a model of liver fibrosis, and those in qi-tonifying and blood-activating prescription group were also treated with CCl4 to establish a model and then given a self-made qi-tonifying and blood-activating prescription containing Astragalus membranaceus, Salvia miltiorrhiza, and poria. The rats in the control group were given intraperitoneally injected olive oil. HE staining, Masson staining, and immunohistochemical staining of collagen type I alpha 1 (Col1A1 and collagen type Ⅳ (Col4 were performed to observe the degree of liver fibrosis and collagen deposition; qRT-PCR, immunohistochemistry, and Western blot were used to measure the expression of transforming growth factor-β1 (TGF-β1, PTEN, and downstream genes AKT, mTOR, and p70S6K. A one-way analysis of variance was used for comparison of continuous data between multiple groups and the least significant difference t-test was used for further comparison between any two groups. Results In the liver fibrosis group, liver pathology showed perisinusoidal fibrosis and fibrous tissue proliferation, collagen deposition, and formation of fibrous septum in the portal area; compared with the control group, the liver fibrosis group had significant increases in the mRNA and protein expression of TGF-β1, a significant reduction in the expression of PTEN, and significant increases in the mRNA and phosphorylated protein expression of AKT, mTOR, and p70S6K (all P＜0.01. The qi-tonifying and blood-activating prescription group had a

[Design and establishment of modern literature database about acupuncture Deqi].

Science.gov (United States)

Guo, Zheng-rong; Qian, Gui-feng; Pan, Qiu-yin; Wang, Yang; Xin, Si-yuan; Li, Jing; Hao, Jie; Hu, Ni-juan; Zhu, Jiang; Ma, Liang-xiao

2015-02-01

A search on acupuncture Deqi was conducted using four Chinese-language biomedical databases (CNKI, Wan-Fang, VIP and CBM) and PubMed database and using keywords "Deqi" or "needle sensation" "needling feeling" "needle feel" "obtaining qi", etc. Then, a "Modern Literature Database for Acupuncture Deqi" was established by employing Microsoft SQL Server 2005 Express Edition, introducing the contents, data types, information structure and logic constraint of the system table fields. From this Database, detailed inquiries about general information of clinical trials, acupuncturists' experience, ancient medical works, comprehensive literature, etc. can be obtained. The present databank lays a foundation for subsequent evaluation of literature quality about Deqi and data mining of undetected Deqi knowledge.

Predicting new indications of compounds with a network pharmacology approach: Liuwei Dihuang Wan as a case study.

Science.gov (United States)

Wang, Yin-Ying; Bai, Hong; Zhang, Run-Zhi; Yan, Hong; Ning, Kang; Zhao, Xing-Ming

2017-11-07

With the ever increasing cost and time required for drug development, new strategies for drug development are highly demanded, whereas repurposing old drugs has attracted much attention in drug discovery. In this paper, we introduce a new network pharmacology approach, namely PINA, to predict potential novel indications of old drugs based on the molecular networks affected by drugs and associated with diseases. Benchmark results on FDA approved drugs have shown the superiority of PINA over traditional computational approaches in identifying new indications of old drugs. We further extend PINA to predict the novel indications of Traditional Chinese Medicines (TCMs) with Liuwei Dihuang Wan (LDW) as a case study. The predicted indications, including immune system disorders and tumor, are validated by expert knowledge and evidences from literature, demonstrating the effectiveness of our proposed computational approach.

Jiao Tai Wan Attenuates Hepatic Lipid Accumulation in Type 2 Diabetes Mellitus

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Zhaoyi Huang

2013-01-01

Full Text Available Jiao Tai Wan (JTW, a Chinese herbal formula containing Rhizoma Coptidis and Cortex Cinnamomi, has been used for diabetic treatment for many years. The aim of this study was to determine the main components in JTW and to investigate the effects of JTW on hepatic lipid accumulation in diabetic rats and humans. JTW extract was prepared and the main components were assayed by HPLC. An animal model of diabetes mellitus was established and JTW was administered intragastrically. In the clinical study, diabetic patients with poor glycemic control were treated with JTW. Blood glucose and lipid parameters, liver histology, hepatic triglyceride content and lipogenic gene expression were examined. Our data demonstrated that JTW significantly improved hyperglycemia, hyperlipidemia and hepatic lipid accumulation in diabetic rats. This was accompanied by the down-regulation of acetyl coenzyme A carboxylase (ACC and fatty acid synthase (FAS protein expressions, and the up-regulation of AMP-activated protein kinase (AMPK and phosphorylated-ACC (pACC protein expressions in the liver tissues. Diabetic patients also exhibited decreases in their hepatic triglyceride content. The results suggest that JTW attenuates hepatic lipid accumulation in diabetic rats and humans. These beneficial effects are possibly associated with the inhibition of lipogenic gene expression in the liver.

Qi-Dong-Huo-Xue-Yin Inhibits Inflammation in Acute Lung Injury in Mice via Toll-Like Receptor 4/Caveolin-1 Signaling

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Li-Ying Xu

2018-01-01

Full Text Available Acute lung injury (ALI is a critical illness with no current effective treatment. Caveolin-1 indirectly activates inflammation-associated signaling pathways by inhibiting endothelial nitric oxide synthase (eNOS. This induces an imbalance between pro- and anti-inflammatory cytokine levels, which are involved in the pathogenesis of ALI. The compound Chinese prescription Qi-Dong-Huo-Xue-Yin (QDHXY is efficacious for ALI treatment via an anti-inflammatory effect; however, the exact underlying mechanism is unknown. Therefore, we explored the protective effect of QDHXY against lipopolysaccharide- (LPS- induced ALI in mice. Histopathological changes in mouse lung tissues were studied. Furthermore, alterations in the serum levels of pro- and anti-inflammatory cytokines were investigated. The levels of tumor necrosis factor- (TNF-α, interleukin- (IL- 6, IL-1β, and interferon-γ-induced protein 10 in bronchoalveolar lavage fluid were measured. Additionally, the expression levels of myeloid differentiation factor 88 (MyD88, caveolin-1, and eNOS were assessed. QDHXY significantly reduced lung infiltration with inflammatory cells and the production of serum pro- and anti-inflammatory cytokines and inhibited the expression of TNF-α, IL-1β, caveolin-1, and MyD88 but not eNOS. These indicate that QDHXY significantly improved the balance between pro- and anti-inflammatory cytokine levels, possibly by inhibiting the caveolin-1 signaling pathway. Therefore, QDHXY may be a potential treatment for ALI.

The influence of intestine-based treatment using Xuan Bai Cheng Qi Tang on the concentration of trace elements in the main organs of COPD rats

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Jiamin Yang

2017-01-01

Conclusion: This study showed that “treating from the intestine” using Xuan Bai Cheng Qi Tang and its modified formulae can regulate the concentration of trace elements in the main organs of COPD rats. This may be one of the mechanisms for intestine-based treatment for COPD.

[Experimental study on the treatment of serious soft tissue injuries with strengthening the spleen and replenishing qi].

Science.gov (United States)

Chen, Xun-wen; Zhu, Yong-zhan; Chen, Zhi-wei; Wu, Zheng-jie; He, Li-lei

2008-09-01

To study the effects of Chinese drugs based on strengthening the spleen and replenishing qi treatment rule on neoformative capillaries and fibroblast during the soft tissue repair after serious trauma in rats, so as to explore the biological basis of the TCM theory "the spleen dominate extremities and muscles" applied to the treatment of soft tissue injuries. The model rats were established by bleeding from femoral artery and lancing method, and the rats were randomly divided into the control group, strengthening the spleen group and activating blood and resolving stasis group. The samples were got from the tissue of the wounded area at the 5th, 10th and 15th days after oral administration of the traditional Chinese medicine. After fixation and section, the tissues were stained by CD31 and PCNA staining. The amount of the capillaries and fibroblasts in the tissue of the wounded area were observed through multi-purpose microscope (ZEISS Axioskop2). Quantitative analysis was carried out on Image-ProPlus image analyzer. The amount of the capillaries and fibroblasts in the wounded tissue in the strengthening the spleen group were larger than that in the control group at the 5th, 10th and 15th day. And the proliferation speed of capillaries and fibroblasts was faster than those in the control group or the activating blood and resolving stasis group. The Chinese drugs according to strengthening the spleen and replenishing qi treatment rule were effective to promote growth of the granulation tissue and facilitate healing of the wounded area. And it has better effect than the treatment of promoting blood circulation and removing stasis.

On the qi deficiency in traditional Chinese medicine.

Science.gov (United States)

Chiang, Hui-Chu; Chang, Hen-Hong; Huang, Po-Yu; Hsu, Mutsu

2014-09-01

Qi deficiency (QD), one of the most common disorders in Traditional Chinese medicine (TCM), is relevant to many disorders in obstetrics and gynecology. This study aimed to identify the common processes and criteria for diagnosing QD among contemporary proficient TCM practitioners. Steps of decision tree analysis and modified Delphi method were merged together into four-round postal questionnaires to collect qualitative and quantitative data. Open-ended questions and content analysis were used to explore the proficient TCM practitioners' cognitive activities used for diagnosis. The statements obtained from the qualitative responses were used to develop the items for subsequent questionnaires. Based on the TCM practitioners' responses, the diagnostic processes and criteria for making diagnosis were generated. Twenty-eight out of the 30 participants completed all four questionnaires from June 2007 to January 2010. The 11 diagnostic procedures identified in the returned first round of questionnaires were used as the alternatives to select and rank for all the steps to diagnose QD. After three more rounds of postal surveys, an algorithm with a five-stage diagnostic process as well as sets of decision criteria were identified. Although the priorities of procedures and descriptions of reasoning were varied, the content revealed the major themes in the model. The criteria to differentiate signs and symptoms (S/S) included five principles for correlating S/S with QD, and 17 S/S should be differentiated carefully. The results demonstrate that the TCM practitioners precisely diagnosed QD using a number of specific procedures and criteria that could be used as a reference to understand women complaining of S/S that could be similar to QD. Copyright © 2014. Published by Elsevier B.V.

[Health assessment of Qi'ao Island mangrove wetland ecosystem in Pearl River Estuary].

Science.gov (United States)

Wang, Shu-Gong; Zheng, Yao-Hui; Peng, Yi-Sheng; Chen, Gui-Zhu

2010-02-01

Based on the theories of wetland ecosystem health and by using "Pressure-State-Response" model, a health assessment indicator system for Qi' ao Island mangrove wetland ecosystem in Pearl River Estuary was built, and the assessment indices, assessment criteria, indices weighted values, assessment grades, and assessment methods were established to assess the health state of this ecosystem. In 2008, the overall health index of this ecosystem was 0.6580, health level was of grade II (healthy), and the pressure, state, and response indices were 0.3469, 0.8718, and 0.7754, respectively, suggesting that this ecosystem was good in state and response, but still had definite pressure. As a provincial nature reserve, this ecosystem was to be further improved in its health level. However, the research on the health assessment of mangrove wetland ecosystem was still young. Further studies should be made on the selection of assessment indices, long-term oriented monitoring of these indices, and quantification of the relations between ecosystem health level and ecosystem services.

Assessment of Electromagnetic Interference with Active Cardiovascular Implantable Electronic Devices (CIEDs) Caused by the Qi A13 Design Wireless Charging Board.

Science.gov (United States)

Seckler, Tobias; Jagielski, Kai; Stunder, Dominik

2015-05-27

Electromagnetic interference is a concern for people wearing cardiovascular implantable electronic devices (CIEDs). The aim of this study was to assess the electromagnetic compatibility between CIEDs and the magnetic field of a common wireless charging technology. To do so the voltage induced in CIEDs by Qi A13 design magnetic fields were measured and compared with the performance limits set by ISO 14117. In order to carry this out a measuring circuit was developed which can be connected with unipolar or bipolar pacemaker leads. The measuring system was positioned at the four most common implantation sites in a torso phantom filled with physiological saline solution. The phantom was exposed by using Helmholtz coils from 5 µT to 27 µT with 111 kHz sine‑bursts or by using a Qi A13 design wireless charging board (Qi‑A13‑Board) in two operating modes "power transfer" and "pinging". With the Helmholtz coils the lowest magnetic flux density at which the performance limit was exceeded is 11 µT. With the Qi‑A13‑Board in power transfer mode 10.8% and in pinging mode 45.7% (2.2% at 10 cm distance) of the performance limit were reached at maximum. In neither of the scrutinized cases, did the voltage induced by the Qi‑A13‑Board exceed the performance limits.

Incidencia de Mindfulness y Qi Gong sobre el Estado de Salud, Bienestar Psicológico, Satisfacción Vital y Estrés Laboral

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Luis Armando Oblitas Guadalupe

2017-02-01

Full Text Available El presente estudio se realizó a través de un abordaje metodológico pre-experimental con medidas de tipo pre-test y post-test. Participaron 52 trabajadores de la Universidad de la Costa (Barranquilla, Colombia, quienes asistieron por invitación al taller de ocho horas de mindfulness y qi gong para el mejoramiento de la salud, bienestar psicológico, satisfacción vital y reducción del estrés. Los instrumentos utilizados fueron el Cuestionario de Salud sf-11, Escala de Bienestar Psicológico (Ryff & Keyes, 1995, Escala de Satisfacción Vital (Cortés, 2013 y Escala Numérica de Estrés Laboral. La combinación de mindfulness y qi gong produjo una mejoría en el estado de salud de los trabajadores —salud general, energía, eficiencia, actividades domésticas y disminución del dolor—, cambios importantes en el bienestar psicológico —adaptación, confianza, claridad, apertura y autoestima—, y mejoramiento de la satisfacción vital —salud y productividad—. No se encontraron diferencias significativas en los niveles de estrés laboral.

[Retrospective analysis of risk factors in 900 patients with ischemic cerebral stroke of wind-phlegm collateral obstruction syndrome and qi deficiency blood stasis syndrome in Wuhan District].

Science.gov (United States)

Qiu, Xin; Wang, Kai-xin; Chen, Guo-hua

2011-11-01

To analyze the correlation between risk factors and ischemic cerebral stroke of wind-phlegm collateral obstruction syndrome and qi deficiency blood stasis syndrome. Totally 900 patients of the two syndrome types were recruited. Risk factors correlated to ischemic cerebral stroke such as gender, age, time of onset, site of infarction, tongue proper, tongue fur, pulse picture, hypertension, diabetes, past stroke history, hyperlipidemia, hematocrit, smoking, drinking, genetic factor, blood type, complications were analyzed using Chi-square test and non-conditional Logistic regression analysis. Statistical significance existed between the two syndrome types in age (X2 = 8.2392, P = 0.0413), hyperlipidemia (X2 = 4.8386, P = 0.0278), tongue proper (X2 = 7.9470, P = 0.0048), and tongue fur (X2 = 4.3298, P = 0.0375). Statistical significance existed between the two syndrome types in hyperlipidemia, tongue proper, and tongue fur, and their OR value was 0.699 (P = 0.0282), 0.332 (P =0.0071), and 0.667 (P = 0.0382) respectively. The OR value of the past stroke history was 3.226 (P = 0.0314), that of complications 0.203 (P = 0.0705), and that of anterior circulation infarction 0.214 (P = 0.0098). Among different ages groups, the constituent ratio of qi deficiency blood stasis syndrome was obviously higher than that of wind-phlegm collateral obstruction syndrome. Besides, patients of qi deficiency blood stasis syndrome were liable to suffer from hyperlipidemia, anterior circulation infarction, and complications. The age, blood lipid levels, site of infarction, complications are closely correlated with Chinese syndrome types of ischemic cerebral stroke, which can provide objective indices for typing ischemic cerebral stroke.

Lipidomics study of plasma phospholipid metabolism in early type 2 diabetes rats with ancient prescription Huang-Qi-San intervention by UPLC/Q-TOF-MS and correlation coefficient.

Science.gov (United States)

Wu, Xia; Zhu, Jian-Cheng; Zhang, Yu; Li, Wei-Min; Rong, Xiang-Lu; Feng, Yi-Fan

2016-08-25

Potential impact of lipid research has been increasingly realized both in disease treatment and prevention. An effective metabolomics approach based on ultra-performance liquid chromatography/quadrupole-time-of-flight mass spectrometry (UPLC/Q-TOF-MS) along with multivariate statistic analysis has been applied for investigating the dynamic change of plasma phospholipids compositions in early type 2 diabetic rats after the treatment of an ancient prescription of Chinese Medicine Huang-Qi-San. The exported UPLC/Q-TOF-MS data of plasma samples were subjected to SIMCA-P and processed by bioMark, mixOmics, Rcomdr packages with R software. A clear score plots of plasma sample groups, including normal control group (NC), model group (MC), positive medicine control group (Flu) and Huang-Qi-San group (HQS), were achieved by principal-components analysis (PCA), partial least-squares discriminant analysis (PLS-DA) and orthogonal partial least-squares discriminant analysis (OPLS-DA). Biomarkers were screened out using student T test, principal component regression (PCR), partial least-squares regression (PLS) and important variable method (variable influence on projection, VIP). Structures of metabolites were identified and metabolic pathways were deduced by correlation coefficient. The relationship between compounds was explained by the correlation coefficient diagram, and the metabolic differences between similar compounds were illustrated. Based on KEGG database, the biological significances of identified biomarkers were described. The correlation coefficient was firstly applied to identify the structure and deduce the metabolic pathways of phospholipids metabolites, and the study provided a new methodological cue for further understanding the molecular mechanisms of metabolites in the process of regulating Huang-Qi-San for treating early type 2 diabetes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Treatment of Motor Neuron Disease with Qi-invigorating Herbs—— A Report of 31 Cases

Institute of Scientific and Technical Information of China (English)

覃小兰; 杨志敏; 何德平; 刘旭生; 陈红霞; 黄燕; 张文青

2002-01-01

@@ The motor neuron disease (MND) refers to a group of progressive diseases with unknown reasons, which attacks the cells of the anterior horn of the spinal cord, the motor nuclei of the brain stem cranial nerves and the pyramidal cells of the cerebral motor cortex. It is characterized in clinic by atrophy of the muscles, myasthenia and even death due to paralysis of the respiratory muscle. Currently, there is still no any effective cure for this illness. 50-70% of the victims will die in 3 to 5 years, and the survival time for those with brain stem injuries is no more than two years.1 Since 1996, the authors have treated 31 cases of motor neuron disease with large dosage of qi-invigorating drugs in accordance with Prof. Liu Mocai's experience, and obtained certain therapeutic effects. A report follows.

Investigating And Evaluating Of Network Failures And Performance Over Distributed WAN In Application Protocol Layer

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Enoch Okoh Kofi

2015-08-01

Full Text Available The Experiment was done to find out network failures and application performance relationship over distributed Wide Area Net WAN. In order to access related application over the cloud there must be an internet connectivity which will help the respective workstations to access the remote server for applications being deployed over the network. Bandwidth improvement helps in reducing utilization over the network and it also helps in improving Application Efficiency of these Applications in terms of Response Time. Routers were configured under Enhance Interior Gateway Routing Protocol EIGRP to reduce utilization and to ensure load sharing over the network. Three scenarios were modeled and their performance efficiency was evaluated. A modeled computer Network with and without a fail Router under different scenarios and such Network was simulated with emphasis on the Application Performance. The Experiment was done for fifty workstations under three scenarios and these three scenarios were accessed and evaluated on experimental basis using Riverbed modeler to show the Effect of Application Network performance. The performance results show that increasing the bandwidth reduces utilization and also with the failure of one communication bandwidth users can still access Network Application with a minimal cost.

The MWA archive infrastructure: archiving terabytes of data over dedicated WAN connections

Science.gov (United States)

Wicenec, Andreas; Pallot, Dave; Checcucci, Alessio; Kitaeff, Slava; Vinsen, Kevin; Wu, Chen

2012-09-01

The Murchison Wide Field Array (MWA) is being upgraded from 32 tiles to 128 tiles of 16 dual-polarization dipole antennas. In the course of this project the software and the data infrastructure are also undergoing a major overhaul in order to cope with a more continuous and remote operational model; and the substantial increase in data rate (400 MB/s from the correlator plus 160 MB/s from the real time imaging pipeline). During the course of 2012/13 the data collected by the MWA will be transported via a dedicated 40 Gbit WAN network link between the Murchison Radio Observatory (MRO) and Perth (700 km). However, this network will not be available for some time; and until then, the data will be transported using disk arrays instead. Once in Perth, the data will be ingested into a tape library. The archiving process itself consists of various steps executed either at the MRO site or in Perth, and makes use of a modied version of the archiving system from the Atacama Large Millimeter Array (ALMA). This includes the extraction of meta-data from the original raw data and the ingestion and generation of the appropriate data links for the MWA archive. The MWA correlator generates a collection of small les all belonging to the same observation. In order to optimise the network transfer and the storage of those les they are transparently packed into larger containers at the MRO site and subsequently handled as one big le. This paper describes the setup of the MWA archiving infrastructure.

To compare the efficacy of two kinds of Zhizhu pills in the treatment of functional dyspepsia of spleen-deficiency and qi-stagnation syndrome:a randomized group sequential comparative trial

Science.gov (United States)

2011-01-01

Background In Traditional Chinese Medicine (TCM) theory, functional dyspepsia (FD) can be divided into different syndromes according to different clinical symptoms and signs, and the most common one is spleen-deficiency and qi-stagnation syndrome that can be treated by Chinese traditional patent medicine ---- two kinds of Zhizhu pills, between which the primary difference in ingredients is that one contains immature orange fruit of Citrus aurantium L.(IFCA) and the other contains that of Citrus sinensis Osbeck (IFCS). The trial's objective was to compare the efficacy of two kinds of Zhizhu pills on symptom changes in patients with FD of spleen-deficiency and qi-stagnation syndrome. Methods A randomized, group sequential, double-blinded, multicenter trial was conducted in patients with FD of spleen-deficiency and qi-stagnation syndrome at 3 hospitals in Beijing between June 2003 and May 2005. Participants were randomly allocated into two groups (IFCA group and IFCS group) in a 1:1 ratio, and respectively took one of the two kinds of Zhizhu pills orally, 6 g each time, 3 times a day, for 4 weeks. Statistical analysis was performed with use of a group sequential method, the triangular test (TT). Results A total of 163 patients were randomized, and 3 patients were excluded from analysis because of early dropouts, leaving 160 patients (IFCA group: n = 82; IFCS group: n = 78) for statistical analysis. Three interim analyses were done after 62, 116, and 160 patients had completed their 4-week treatment, respectively. At the third interim analysis, the sample path crossed the upper boundary and the trial was stopped, the cure-markedly effective rates were 45% for IFCS group and 67% for IFCA group, respectively, the one-sided p-value was 0.0036, the median unbiased estimate of the odds ratio (OR) for the benefit of IFCA relative to IFCS was 2.91 with 95%CI: 1.40 to 6.06. No adverse events were observed in the two groups. Conclusions Zhizhu pills containing IFCA was superior

THE ERUPTION OF THE CANDIDATE YOUNG STAR ASASSN-15QI

Energy Technology Data Exchange (ETDEWEB)

Herczeg, Gregory J.; Dong, Subo; Chen, Ping; Jose, Jessy; Gully-Santiago, Michael [Kavli Institute for Astronomy and Astrophysics, Peking University, Yi He Yuan Lu 5, Haidian Qu, 100871 Beijing (China); Shappee, Benjamin J. [Carnegie Observatories, 813 Santa Barbara Street, Pasadena, CA 91101 (United States); Hillenbrand, Lynne A. [Caltech, MC 105-24, 1200 E. California Boulevard, Pasadena, CA 91125 (United States); Kochanek, Christopher S.; Stanek, K. Z.; Holoien, Thomas W.-S. [Department of Astronomy, The Ohio State University, 140 West 18th Avenue, Columbus, OH 43210 (United States); Prieto, Jose L. [Núcleo de Astronomía de la Facultad de Ingeniería, Universidad Diego Portales, Av. Ejército 441, Santiago (Chile); Kaplan, Kyle [Department of Astronomy, The University of Texas at Austin, Austin, TX 78712 (United States); Mairs, Steve; Johnstone, Doug [Department of Physics and Astronomy, University of Victoria, Victoria, BC, V8P 1A1 (Canada); Zhu, Zhaohuan [Department of Astrophysical Sciences, 4 Ivy Lane, Peyton Hall, Princeton University, Princeton, NJ 08544 (United States); Smith, Martin C. [Key Laboratory for Research in Galaxies and Cosmology, Shanghai Astronomical Observatory, Chinese Academy of Sciences, 80 Nandan Road, Shanghai 200030 (China); Bersier, David [Astrophysics Research Institute, Liverpool Science Park, 146 Brownlow Hill, Liverpool L3 5RF (United Kingdom); Mulders, Gijs D. [Lunar and Planetary Laboratory, The University of Arizona, Tucson, AZ 85721 (United States); Filippenko, Alexei V. [Department of Astronomy, University of California, Berkeley, CA 94720-3411 (United States); Ayani, Kazuya, E-mail: gherczeg1@gmail.com [Bisei Astronomical Observatory, 1723-70 Okura, Bisei, Ibara, Okayama 714-1411 (Japan); and others

2016-11-10

Outbursts on young stars are usually interpreted as accretion bursts caused by instabilities in the disk or the star–disk connection. However, some protostellar outbursts may not fit into this framework. In this paper, we analyze optical and near-infrared spectra and photometry to characterize the 2015 outburst of the probable young star ASASSN-15qi. The ∼3.5 mag brightening in the V band was sudden, with an unresolved rise time of less than one day. The outburst decayed exponentially by 1 mag for 6 days and then gradually back to the pre-outburst level after 200 days. The outburst is dominated by emission from ∼10,000 K gas. An explosive release of energy accelerated matter from the star in all directions, seen in a spectacular cool, spherical wind with a maximum velocity of 1000 km s{sup −1}. The wind and hot gas both disappeared as the outburst faded and the source returned to its quiescent F-star spectrum. Nebulosity near the star brightened with a delay of 10–20 days. Fluorescent excitation of H{sub 2} is detected in emission from vibrational levels as high as v = 11, also with a possible time delay in flux increase. The mid-infrared spectral energy distribution does not indicate the presence of warm dust emission, though the optical photospheric absorption and CO overtone emission could be related to a gaseous disk. Archival photometry reveals a prior outburst in 1976. Although we speculate about possible causes for this outburst, none of the explanations are compelling.

Diseño de la infraestructura física y lógica para una red de área local y extensa (LAN y WAN) de una PYME

OpenAIRE

Durán Nieto, Raúl

2015-01-01

En la actualidad, las comunicaciones entre los distintos lugares (WAN) y los localizados en un mismo punto (LAN) permiten el crecimiento y aumento de productividad en las empresas. Las infraestructuras deben adaptarse para la llegada de las nuevas tecnologías y por ello la elección idónea de una infraestructura, tanto física como lógica, evitaría la aparición de problemas y costes a la empresa. Para garantizar la información y comunicación las instalaciones deben responder a un...

Global Application of TaiWan Ionospheric Model to Single-Frequency GPS Positioning

Science.gov (United States)

Macalalad, E.; Tsai, L. C.; Wu, J.

2012-04-01

Ionospheric delay is one the major sources of error in GPS positioning and navigation. This error in both pseudorange and phase ranges vary depending on the location of observation, local time, season, solar cycle and geomagnetic activity. For single-frequency receivers, this delay is usually removed using ionospheric models. Two of them are the Klobuchar, or broadcast, model and the global ionosphere map (GIM) provided by the International GNSS Service (IGS). In this paper, a three dimensional ionospheric electron (ne) density model derived from FormoSat3/COSMIC GPS Radio Occultation measurements, called the TaiWan Ionosphere Model, is used. It was used to calculate the slant total electron content (STEC) between receiver and GPS satellites to correct the pseudorange single-frequency observations. The corrected pseudorange for every epoch was used to determine a more accurate position of the receiver. Observations were made in July 2, 2011(Kp index = 0-2) in five randomly selected sites across the globe, four of which are IGS stations (station ID: cnmr, coso, irkj and morp) while the other is a low-cost single-frequency receiver located in Chungli City, Taiwan (ID: isls). It was illustrated that TEC maps generated using TWIM exhibited a detailed structure of the ionosphere, whereas Klobuchar and GIM only provided the basic diurnal and geographic features of the ionosphere. Also, it was shown that for single-frequency static point positioning TWIM provides more accurate and more precise positioning than the Klobuchar and GIM models for all stations. The average %error of the corrections made by Klobuchar, GIM and TWIM in DRMS are 3.88%, 0.78% and 17.45%, respectively. While the average %error in VRMS for Klobuchar, GIM and TWIM are 53.55%, 62.09%, 66.02%, respectively. This shows the capability of TWIM to provide a good global 3-dimensional ionospheric model.

[metabonomics research on coronary heart disease patients of phlegm turbidity syndrome and qi deficiency syndrome].

Science.gov (United States)

Cheng, Peng; Chen, Ze-qi; Wang, Dong-sheng

2015-02-01

To study the correlation between Chinese medical types of coronary heart disease (CHD) [i.e., phlegm turbidity syndrome (PTS) and qi deficiency syndrome (QDS)] and their metabolites. Recruited were 65 CHD patients including 37 cases of PTS and 28 cases of QDS. Serum endogenous metabolites in the two syndrome types were determined by gas chromatograph-mass spectrometer-computer (GC/MS), and their differences between their metabolic profiles analyzed. More than 100 chromatographic peaks were totally scanned. Chromatograms obtained was matched with mass spectrum bank, and finally we got the category contribution value of 46 kinds of substances. Results of MCTree analysis showed patients of PTS and patients of QDS could be effectively distinguished. Compounds contributing to identify the two syndromes were sequenced as serine, valine, 2 hydroxy propionic acid. Comparison of metabolites showed contents of serine and 2 hydroxy propionic acid were higher in patients of PTS than in patients of QDS (Pmetabonomics of CHD TCM syndrome types could provide material bases for TCM syndrome differentiation of CHD, indicating that metabonomics technologies might become a new research method for TCM syndrome typing.

[Effects of Chinese herbal medicines for regulating liver qi on expression of 5-hydroxytryptamine 3B receptor in hypothalamic tissues of rats with anger emotion].

Science.gov (United States)

Ge, Qing-fang; Zhang, Hui-yun

2011-08-01

To explore the central mechanisms of anger emotion and the effects of Chinese herbal medicines for regulating liver qi on the anger emotion and the expression level of 5-hydroxytryptamine 3B receptor (5-HT3BR) in rat hypothalamus. Rat models of anger-in or anger-out emotions were prepared by the methods of resident intruder paradigm. There were five groups in this study: control, anger-in model, Jingqianshu Granule-treated anger-in, anger-out model and Jingqianping Granule-treated anger-out groups. The treatment groups were orally given Jingqianshu granules and Jingqianping granules respectively, and the model groups and the normal control group were given sterile water. Open-field test and sucrose preference test were used to evaluate behavioristics of the rats. Semi-quantitative reverse transcription-polymerase chain reaction and Western blot methods were used to detect the expression levels of 5-HT3BR mRNA and protein in the rat hypothalamus. The expression of 5-HT3BR in hypothalamus of anger-in model rats increased obviously (Pexpressions of 5-HT3BR in the treatment groups were significantly improved (Pexpression and the anger-out emotion can obviously reduce its expression. Chinese herbal medicines for regulating liver qi may treat anger emotion in rats by improving the hypothalamic 5-HT3BR protein and gene expression levels.

A prototype Infrastructure for Cloud-based distributed services in High Availability over WAN

International Nuclear Information System (INIS)

Bulfon, C.; De Salvo, A.; Graziosi, C.; Carlino, G.; Doria, A; Pardi, S; Sanchez, A.; Carboni, M; Bolletta, P; Puccio, L.; Capone, V; Merola, L

2015-01-01

In this work we present the architectural and performance studies concerning a prototype of a distributed Tier2 infrastructure for HEP, instantiated between the two Italian sites of INFN-Romal and INFN-Napoli. The network infrastructure is based on a Layer-2 geographical link, provided by the Italian NREN (GARR), directly connecting the two remote LANs of the named sites. By exploiting the possibilities offered by the new distributed file systems, a shared storage area with synchronous copy has been set up. The computing infrastructure, based on an OpenStack facility, is using a set of distributed Hypervisors installed in both sites. The main parameter to be taken into account when managing two remote sites with a single framework is the effect of the latency, due to the distance and the end-to-end service overhead. In order to understand the capabilities and limits of our setup, the impact of latency has been investigated by means of a set of stress tests, including data I/O throughput, metadata access performance evaluation and network occupancy, during the life cycle of a Virtual Machine. A set of resilience tests has also been performed, in order to verify the stability of the system on the event of hardware or software faults.The results of this work show that the reliability and robustness of the chosen architecture are effective enough to build a production system and to provide common services. This prototype can also be extended to multiple sites with small changes of the network topology, thus creating a National Network of Cloud-based distributed services, in HA over WAN. (paper)

A prototype Infrastructure for Cloud-based distributed services in High Availability over WAN

Science.gov (United States)

Bulfon, C.; Carlino, G.; De Salvo, A.; Doria, A.; Graziosi, C.; Pardi, S.; Sanchez, A.; Carboni, M.; Bolletta, P.; Puccio, L.; Capone, V.; Merola, L.

2015-12-01

In this work we present the architectural and performance studies concerning a prototype of a distributed Tier2 infrastructure for HEP, instantiated between the two Italian sites of INFN-Romal and INFN-Napoli. The network infrastructure is based on a Layer-2 geographical link, provided by the Italian NREN (GARR), directly connecting the two remote LANs of the named sites. By exploiting the possibilities offered by the new distributed file systems, a shared storage area with synchronous copy has been set up. The computing infrastructure, based on an OpenStack facility, is using a set of distributed Hypervisors installed in both sites. The main parameter to be taken into account when managing two remote sites with a single framework is the effect of the latency, due to the distance and the end-to-end service overhead. In order to understand the capabilities and limits of our setup, the impact of latency has been investigated by means of a set of stress tests, including data I/O throughput, metadata access performance evaluation and network occupancy, during the life cycle of a Virtual Machine. A set of resilience tests has also been performed, in order to verify the stability of the system on the event of hardware or software faults. The results of this work show that the reliability and robustness of the chosen architecture are effective enough to build a production system and to provide common services. This prototype can also be extended to multiple sites with small changes of the network topology, thus creating a National Network of Cloud-based distributed services, in HA over WAN.

A network pharmacology approach to investigate the pharmacological effects of Guizhi Fuling Wan on uterine fibroids.

Science.gov (United States)

Zeng, Liuting; Yang, Kailin; Liu, Huiping; Zhang, Guomin

2017-11-01

To investigate the pharmacological mechanism of Guizhi Fuling Wan (GFW) in the treatment of uterine fibroids, a network pharmacology approach was used. Information on GFW compounds was collected from traditional Chinese medicine (TCM) databases, and input into PharmMapper to identify the compound targets. Genes associated with uterine fibroids genes were then obtained from the GeneCards and Online Mendelian Inheritance in Man databases. The interaction data of the targets and other human proteins was also collected from the STRING and IntAct databases. The target data were input into the Database for Annotation, Visualization and Integrated Discovery for gene ontology (GO) and pathway enrichment analyses. Networks of the above information were constructed and analyzed using Cytoscape. The following networks were compiled: A compound-compound target network of GFW; a herb-compound target-uterine fibroids target network of GWF; and a compound target-uterine fibroids target-other human proteins protein-protein interaction network, which were subjected to GO and pathway enrichment analyses. According to this approach, a number of novel signaling pathways and biological processes underlying the effects of GFW on uterine fibroids were identified, including the negative regulation of smooth muscle cell proliferation, apoptosis, and the Ras, wingless-type, epidermal growth factor and insulin-like growth factor-1 signaling pathways. This network pharmacology approach may aid the systematical study of herbal formulae and make TCM drug discovery more predictable.

The Core Pattern Analysis on Chinese Herbal Medicine for Sjögren's syndrome: A Nationwide Population-Based Study

Science.gov (United States)

Chang, Ching-Mao; Chu, Hsueh-Ting; Wei, Yau-Huei; Chen, Fang-Pey; Wang, Shengwen; Wu, Po-Chang; Yen, Hung-Rong; Chen, Tzeng-Ji; Chang, Hen-Hong

2015-01-01

This large-scale survey aimed to evaluate frequencies and patterns of Chinese herbal medicine (CHM) used for Sjögren's syndrome (SS) in Taiwan by analyzing the National Health Insurance Research Database (NHIRD) for cases in which CHM was used as an alternative therapy to Western medicine for improving patients' discomforts. We analyzed cases of SS principal diagnosis (ICD-9:710.2) with a catastrophic illness certificate (CIC) in traditional Chinese medicine (TCM) outpatient clinics from three cohorts of the Longitudinal Health Insurance Database (LHID) in the NHIRD between 2002 and 2011. CHM prescription patterns for SS were evaluated from claimed visitation files and corresponding prescription files. There were 15,914 SS patients with CIC (SS/CIC), and we found only 130 SS/CIC cases visiting TCM clinics in LHID2000, 133 in LHID2005, and 126 in LHID2010. After removing duplicate data, 366 SS/CIC and 4,867 visits were analyzed. The 50–59 year age group showed the highest ratio (29.51%) in both women and men. “Qi-Ju-Di-Huang-Wan” and “Xuan-Shen” (Scrophularia ningpoensis Hemsl.) was the most commonly used formula and single herb, respectively. “Qi-Ju-Di-Huang-Wan, Gan-Lu-Yin, Xuan-Shen, Mai-Men-Dong (Ophiopogon japonicus (L. f.) Ker-Gawl.), and Sheng-Di-Huang (raw Rehmannia glutinosa Libosch)” were the core pattern prescriptions in treating SS/CIC. PMID:25923413

Altered regional homogeneity of spontaneous brain activity in idiopathic trigeminal neuralgia

OpenAIRE

Wang, Yanping; Zhang, Xiaoling; Guan, Qiaobing; Wan, Lihong; Yi, Yahui; Liu, Chun-Feng

2015-01-01

Yanping Wang,1,2 Xiaoling Zhang,2 Qiaobing Guan,2 Lihong Wan,2 Yahui Yi,2 Chun-Feng Liu1 1Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, 2Department of Neurology, The Second Hospital of Jiaxing City, Jiaxing, Zhejiang Province, People’s Republic of China Abstract: The pathophysiology of idiopathic trigeminal neuralgia (ITN) has conventionally been thought to be induced by neurovascular compression theory. Recent structural ...

6 June 2012 - Chinese Nanjing University President J.Chen in the ATLAS visitor centre with Member of the ATLAS Collaboration I. Wingerter and International Relations Office Adviser E. Tsesmelis. M. Qi, Nanjing University and ATLAS Collaboration, accompanies the delegation.

CERN Multimedia

Maximilien Brice

2012-01-01

6 June 2012 - Chinese Nanjing University President J.Chen in the ATLAS visitor centre with Member of the ATLAS Collaboration I. Wingerter and International Relations Office Adviser E. Tsesmelis. M. Qi, Nanjing University and ATLAS Collaboration, accompanies the delegation.

Implementación del nuevo modelo de infraestructura de telecomunicaciones para despliegue de servicios tecnológicos desde el data center virtual a todas las localidades del Ministerio de Educación, WAN Educativa

OpenAIRE

Ortiz Garcés, Ivan Patricio

2015-01-01

El presente artículo aborda el proyecto tecnológico enmarcado en el Nuevo Modelo de Gestión del Sistema Educativo del país, que consiste en implementar el Nuevo Modelo de Infraestructura de Telecomunicaciones para despliegue de servicios tecnológicos desde el Data Center Virtual a todas las localidades del Ministerio de Educación, - WAN EDUCATIVA-. El proyecto define el modelo de conectividad adecuado para integrar a todos los usuarios de las localidades a nivel nacional a l...

Courtship and mating of Scorpiops luridus Zhu Lourenço & Qi, 2005 (Scorpiones: Euscorpiidae from Xizang province, China

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GB Jiao

2010-01-01

Full Text Available In the current work, the courtship and mating of Scorpiops luridus Zhu Lourenço & Qi, 2005 (Euscorpiidae from Xizang province (Tibet, China, were studied for the first time in the laboratory. Most of the mating behaviors in Scorpiops luridus are not remarkably different from those exhibited by other scorpions. However, for the first time a male pulling a female with its chelicerae to rapidly accomplish the sperm uptake was observed. Additionally, the sexual stinging behavior displayed by the male occurred in the initial stage, not during the promenade stage as previously described in several scorpion species. Through observation and analysis, we speculate that venom injection during sexual stinging is selective, possibly relying on the status shown by the stung scorpion (passive or aggressive. In order to clearly describe the process of courtship and mating, both sequences are represented in a flow chart, while the main behavior components of these processes were identified, analyzed and discussed.

Quality Control of the Traditional Patent Medicine Yimu Wan Based on SMRT Sequencing and DNA Barcoding

Science.gov (United States)

Jia, Jing; Xu, Zhichao; Xin, Tianyi; Shi, Linchun; Song, Jingyuan

2017-01-01

Substandard traditional patent medicines may lead to global safety-related issues. Protecting consumers from the health risks associated with the integrity and authenticity of herbal preparations is of great concern. Of particular concern is quality control for traditional patent medicines. Here, we establish an effective approach for verifying the biological composition of traditional patent medicines based on single-molecule real-time (SMRT) sequencing and DNA barcoding. Yimu Wan (YMW), a classical herbal prescription recorded in the Chinese Pharmacopoeia, was chosen to test the method. Two reference YMW samples were used to establish a standard method for analysis, which was then applied to three different batches of commercial YMW samples. A total of 3703 and 4810 circular-consensus sequencing (CCS) reads from two reference and three commercial YMW samples were mapped to the ITS2 and psbA-trnH regions, respectively. Moreover, comparison of intraspecific genetic distances based on SMRT sequencing data with reference data from Sanger sequencing revealed an ITS2 and psbA-trnH intergenic spacer that exhibited high intraspecific divergence, with the sites of variation showing significant differences within species. Using the CCS strategy for SMRT sequencing analysis was adequate to guarantee the accuracy of identification. This study demonstrates the application of SMRT sequencing to detect the biological ingredients of herbal preparations. SMRT sequencing provides an affordable way to monitor the legality and safety of traditional patent medicines. PMID:28620408

Da-Bu-Yin-Wan and Qian-Zheng-San to Neuroprotect the Mouse Model of Parkinson’s Disease

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Xiao-Gang Gong

2014-01-01

Full Text Available Da-Bu-Yin-Wan (DBYW and Qian-Zheng-San (QZS, two classic traditional Chinese medicinal formulas, were clinically employed to treat Parkinson’s disease (PD. Our previous studies demonstrated neuroprotective effects of them on mitochondrial function in PD mice induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP. The purpose of this research was to investigate their possible mechanisms in the light of mitochondrial ATP-sensitive potassium (mitoKATP channels. The neuroprotective effect of DBYW and QZS on dopamine (DA neurons in substantia nigra (SN in the MPTP-induced PD mice was investigated by behavioral test (pole test and immunohistochemistry. Adenosine triphosphate (ATP level in the midbrain tissue was detected by firefly luciferase method. MitoKATP channel subunits SUR1 and Kir6.2 mRNA and protein expressions were tested by real-time PCR (RT-PCR and Western blot. It was observed that DBYW and/or QZS served to ameliorate MPTP-induced behavioral impairment and prevent the loss of substantia nigra dopamine neurons, as well as increase ATP level in the midbrain tissue and downregulate SUR1 expression at mRNA and protein levels with no marked influence on Kir6.2. We concluded that DBYW and QZS exhibit neuroprotective effects probably through the regulation of ATP level and mitoKATP channel subunit expressions.

Marine environmental impact assessment of abalone, Haliotis discus hannai, cage farm in Wan-do, Republic of Korea

Science.gov (United States)

Oh, Hyun-Taik; Jung, Rae-Hong; Cho, Yoon-Sik; Hwang, Dong-Woon; Yi, Yong-Min

2015-12-01

To assess the marine environmental impacts of abalone, Haliotis discus hannai, cage farms in Wan-do, we monitored the benthic environment on top of the sediment underneath cage farm stations and reference stations. We applied two methods for this assessment. One was the A- and B-investigation of the MOM system (Modeling-On fish farm-Monitoring) developed in Norway. The other was a general environmental monitoring method which is widely used. In this study, we found benthic animals in all samples that belonged to condition 1 which were based on group 1(presence of macrofauna) of the B-investigation method. The values of redox potential (group 2-pH, redox potential) in all samples were above +65 mV belonging to condition 1. Based on sensory results (group 3-gas, color, odor, thickness of deposits), five out of seven experiment samples showed condition 1 while stations 2 and 7 showed condition 2, which have been cultured for 10 years in semi-closed waters. As group 2 takes precedence over group 3, the level of the conditions for B-investigation results consequently showed condition 1 in all stations. We found that pollutants and trace metals in the sediment underneath cage farms were lower than the pollution standard. This led us to conclude that the environmental impacts of the cage farms in this study were not significant.

Petrography, geochemistry and geochronology of the host porphyries and associated alteration at the Tuwu Cu deposit, NW China: a case for increased depositional efficiency by reaction with mafic hostrock?

Science.gov (United States)

Shen, Ping; Pan, Hongdi; Zhou, Taofa; Wang, Jingbin

2014-08-01

Tuwu is the largest porphyry copper deposit discovered in the Eastern Tianshan Mountains, Xinjiang, China. A newly recognized volcanic complex in the Early Carboniferous Qi'eshan Group at Tuwu consists of basalt, andesite, and diorite porphyry. The plagiogranite porphyry was emplaced into this complex at 332.8±2.5 Ma (U-Pb zircon SIMS determination). Whole-rock element geochemistry shows that the volcanic complex and plagiogranite porphyry formed in the same island arc, although the complex was derived by partial melting of the mantle wedge and the plagiogranite porphyry by partial melting of a subducting slab. The diorite and the plagiogranite porphyries have both been subjected to intense hydrothermal alteration and associated mineralization, but the productive porphyry is the plagiogranite porphyry. Three alteration and mineralization stages, including pre-, syn- and post-ore stages, have been recognized. The pre-ore stage formed a barren propylitic alteration which is widespread in the volcanic complex. The syn-ore stage is divided into three sub-stages: Stage 1 is characterized by potassic alteration with chalcopyrite + bornite + chalcocite; Stage 2 is marked by chlorite-sericite-albite alteration with chalcopyrite ± pyrite ± bornite; Stage 3 is represented by phyllic alteration with chalcopyrite + pyrite ± molybdenite. The post-ore stage produced a barren argillic alteration limited to the diorite porphyry. A specific feature of the Tuwu deposit is that the productive porphyry was emplaced into a very mafic package, and reaction of the resulting fluids with the ferrous iron-rich hostrocks was a likely reason that Tuwu is the largest porphyry in the district.

Effect of Rat Medicated Serum Containing You Gui Wan on Mouse Oocyte In Vitro Maturation and Subsequent Fertilization Competence

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Xiao-Hui Jiang

2014-01-01

Full Text Available You Gui Wan (YGW is a classic herbal formula in traditional Chinese medicine (TCM used for the clinical treatment of infertility. This study was to explore whether YGW has an impact on mouse oocyte maturation in vitro and subsequent fertilization competence. Rat medicated serum containing YGW was prepared by orally administrating YGW. Mouse immature oocytes were cultured with YGW medicated serum and compared to those cultured with or without normal rat serum or follicle-stimulating hormone (FSH. YGW medicated serum significantly increased the percentages of matured oocytes when compared to the groups with or without normal rat serum (P < 0.01. Furthermore, YGW medicated serum increased the rate of in vitro fertilization (IVF when compared to the groups treated with FSH and with or without normal rat serum (P < 0.001. YGW medicated serum also had significant effects on the mRNA expressions of PKA, CREB, MAPK, PKC, PKG, and MPF and the concentrations of cAMP, cGMP, and NO in matured oocytes. These results indicate that YGW can promote mouse oocyte maturation and IVF in vitro. Signaling pathways, such as the cAMP/PKA/MAPK, the PKC-MAPK, and the NO-cGMP-PKG pathway, which are similar to those induced by FSH, may be responsible for this action.

Patterns of Chinese medicine use in prescriptions for treating Alzheimer's disease in Taiwan.

Science.gov (United States)

Lin, Shun-Ku; Yan, Sui-Hing; Lai, Jung-Nien; Tsai, Tung-Hu

2016-01-01

Certain Chinese medicine (CM) herbs and acupuncture may protect against Alzheimer's disease (AD). However, there is a lack of research regarding the use of CM in patients with AD. The aim of this study was to investigate CM usage patterns in patients with AD, and identify the Chinese herbal formulae most commonly used for AD. This retrospective, nationwide, population-based cohort study was conducted using a randomly sampled cohort of one million patients, selected from the National Health Insurance Research Database between 1997 and 2008 in Taiwan. CM use and the top ten most frequently prescribed formulae for treating AD were assessed, including average formulae dose and frequency of prescriptions. Demographic characteristics, including sex, age and insurance level were examined, together with geographic location. Existing medical conditions with the behavioral and psychological symptoms of dementia, and medications associated with CM were also examined. Factors associated with CM use were analyzed by multiple logistic regressions. The cohort included 1137 newly diagnosed AD patients, who were given conventional treatment for AD between 1997 and 2008. Among them, 78.2 % also used CM treatments, including Chinese herbal remedies, acupuncture and massage manipulation. Female patients (aOR 1.57 with 95 % CI 1.16-2.13) and those living in urban areas (aOR 3.00 with 95 % CI 1.83-4.90 in the middle of Taiwan) were more likely to use CM. After adjusting for demographic factors, AD patients suffering from the behavioral and psychological symptoms of dementia were more likely to seek CM treatment than those with no symptoms (aOR 2.26 with 95 % CI 1.48-3.43 in patients suffering more than three symptoms). Bu-Zhong-Yi-Qi-Tang and Ji-Sheng-Shen-Qi-Wan were the two formulae most frequently prescribed by CM practitioners for treating AD. Most people with AD who consumed herbal products used supplement qi, nourish the blood, and quiet the heart spirit therapy as

辛弃疾的“事功派”思想及在稼轩词中的体现%Xin Qi-ji’s Utilitarianism Ethics Thought And influence on Jiaxuan Ci-poems

Institute of Scientific and Technical Information of China (English)

宋学达

2013-01-01

事功派哲学家陈亮与辛弃疾私交甚厚，其哲学思想必然会对辛弃疾产生影响，而历来对辛弃疾的研究中，似乎很少关注其思想哲学的相关问题。本文旨在论证辛弃疾的哲学思想乃是以陈亮为代表的事功派哲学一脉，并探讨事功派哲学对稼轩词艺术特质及词史地位所产生的深刻影响。%Chen Liang, the philosopher of Utilitarianism Ethics Thought, has a good relationship with Xin Qi-ji. So his philosophical thoughts certainly would have an influence on Xin Qiji. But in the past, on the study of Xin Qi-ji, we can seldom found researches concerning his thought of philosophy. This dissertation is aimed to argue that Xin's philosophical thoughts is a brunch of Chen’s Utilitarianism Ethics Thought and the latter had great influence on Jiaxuan Ci-Poems, including its artistic particularities and the status in Ci-poetry history.

Evaluation of the feasibility of security technologies in teleradiology as biometric fingerprint scanners for data exchange over a satellite WAN

Science.gov (United States)

Soegner, Peter I.; Helweg, Gernot; Holzer, Heimo; zur Nedden, Dieter

2000-05-01

We evaluated the feasibility of fingerprint-scanners in combination with smart cards for personal identification and transmission of encrypted TCP/IP-data-packages via satellite between the university-hospital of Innsbruck and the rural hospital of Reutte. The aim of our study was the proof of the userfriendliness of the SkymedTM technology for security purpose in teleradiology. We examined the time of the personal identification process, the time for the necessary training and the personal satisfaction. The images were sent from the local PACS in Reutte via a Data-Encryption-and-Transmission- Box via satellite from Reutte to Innsbruck. We used an asymmetric bandwidth of 512 kbit/s from Reutte to Innsbruck and 128 kbit/s in the opposite direction. Window NT 4.0- operating PCs were used for the electronical patient record, the medical inquiry of the referring physician and the final report of the radiologist. The images were reported on an UNIX-PACS viewing station. After identification through fingerprint-scanners in combination with the smart card the radiologist was able to open the electronic patient record (EPR) from Reutte and sign with his digital signature his confirmed final report before it was send back to Reutte. The used security technology enables encrypted communication over a WAN, which fulfill data-protection.

Identification of the Chemical Constituents in Simiao Wan and Rat Plasma after Oral Administration by GC-MS and LC-MS

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Yunshuang Fan

2017-01-01

Full Text Available Simiao Wan (SMW, an important multiherbal formula used in traditional Chinese medicine, is extensively used to treat rheumatoid arthritis. However, the knowledge of the bioactive components of SMW remains unclear. Thus, gas chromatography–mass spectrometry (GC-MS and liquid chromatography–mass spectrometry (LC-MS were used to analyze the chemical constituents of volatile and nonvolatile extracts of SMW, as well as its absorbed components in rat plasma after oral SMW administration. Identification of several compounds was enabled by comparison of retention times, MS spectra, and MS/MS spectral data with the standard substance and reference materials reported in the literature. In the volatile extracts, GC-MS identified 26 compounds in vitro, three of which observed in blood by GC-MS. In the nonvolatile extracts, LC-MS identified 49 compounds in SMW; 18 compounds containing 7 prototype compounds, 5 metabolites, and 6 unknown compounds were absorbed by blood. The proposed GC-MS and LC-MS method was appropriate not only for the rapid screening and identification of multiple components of an SMW extract but also for screening its bioactive constituents in vivo. The proposed method could be a promising tool for the quality control of other Chinese herbal medicines.

Hu-Lu-Ba-Wan Attenuates Diabetic Nephropathy in Type 2 Diabetic Rats through PKC-α/NADPH Oxidase Signaling Pathway

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Lishan Zhou

2013-01-01

Full Text Available Hu-Lu-Ba-Wan (HLBW is a Chinese herbal prescription used to treat kidney deficiency. The aim of this study was to explore the effect and mechanism of HLBW on diabetic nephropathy (DN in type 2 diabetic rats. The rat model of DN was established by being fed a high-fat diet and intravenous injection of streptozotocin. Then, HLBW decoction was administered for 16 weeks. Blood glucose level, lipid profile, renal function, 24-hour total urinary protein, and albumin content were examined. Renal morphology and superoxide anion levels were evaluated. The activity of nicotinamide-adenine dinucleotide phosphate (NADPH and protein kinase C-alpha (PKC-α related genes expression in renal tissue were also determined. Our data demonstrated that HLBW significantly improved hyperglycemia, hyperlipidemia, and proteinuria in diabetic rats compared with those of control group. HLBW also alleviated glomerular expansion and fibrosis, extracellular matrix accumulation and effacement of the foot processes. Additionally, HLBW reduced superoxide anion level, NADPH oxidase activity, the protein and mRNA expressions of p47phox, and the protein expression of phosphorylated PKC-α in renal tissue. These results suggest that HLBW is effective in the treatment of DN in rats. The underlying mechanism may be related to the attenuation of renal oxidative stress via PKC-α/NADPH oxidase signaling pathway.

The absence of fan activism in the queer fandom of Ho Denise Wan See (HOCC in Hong Kong

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Cheuk Yin Li

2012-06-01

Full Text Available The queer fandom of female Hong Kong pop singer Ho Denise Wan See (HOCC from 2009 to mid-2011 is dealt with through the qualitative methodology of in-depth interviews and media ethnography. HOCC, an idiosyncratic cultural producer who dabbles in the politics of ambiguity, creates texts that invite queer interpretations from fans and from queer activists in Hong Kong. Via analyses informed by both queer studies and audience studies, the various creative practices of fans in reshaping their sexual identities via popular culture are explored. These practices are highly political and empowering to a queer audience. However, the intensive rewriting of meanings as queer symbolic creativity and tactics in cultural politics fail to transform into formal institutional politics and more confrontational queer activism. This is so for several reasons. Internally, the hierarchical structure of fan organization, fan proximity to the culture industry, and the top-down encouragement of social charity as the only channel of activism have all reduced the possibility of transforming fans' queer sensibilities into institutional queer politics. Furthermore, Hong Kong, under the influence of three major discourses that seek to discipline and regulate sexualities—traditional Chinese ethics, the British colonial legacy, and the postcolonial revival of rightist Christianity—has a long social history of heterosexist discrimination and a preference for normalizing when striving for queer citizenship. This empirical study examines relations between cultural specificity and fan agency in a non-Western context.

Impact of a national QI programme on reducing electronic health record notifications to clinicians.

Science.gov (United States)

Shah, Tina; Patel-Teague, Shilpa; Kroupa, Laura; Meyer, Ashley N D; Singh, Hardeep

2018-03-05

Emerging evidence suggests electronic health record (EHR)-related information overload is a risk to patient safety. In the US Department of Veterans Affairs (VA), EHR-based 'inbox' notifications originally intended for communicating important clinical information are now cited by 70% of primary care practitioners (PCPs) to be of unmanageable volume. We evaluated the impact of a national, multicomponent, quality improvement (QI) programme to reduce low-value EHR notifications. The programme involved three steps: (1) accessing daily PCP notification load data at all 148 facilities operated nationally by the VA; (2) standardising and restricting mandatory notification types at all facilities to a recommended list; and (3) hands-on training for all PCPs on customising and processing notifications more effectively. Designated leaders at each of VA's 18 regional networks led programme implementation using a nationally developed toolkit. Each network supervised technical requirements and data collection, ensuring consistency. Coaching calls and emails allowed the national team to address implementation challenges and monitor effects. We analysed notification load and mandatory notifications preintervention (March 2017) and immediately postintervention (June-July 2017) to assess programme impact. Median number of mandatory notification types at each facility decreased significantly from 15 (IQR: 13-19) to 10 (IQR: 10-11) preintervention to postintervention, respectively (Pmanage them. Nevertheless, our project suggests feasibility of using large-scale 'de-implementation' interventions to reduce unintended safety or efficiency consequences of well-intended electronic communication systems. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The cost-effectiveness analysis of JinQi Jiangtang tablets for the treatment on prediabetes: a randomized, double-blind, placebo-controlled, multicenter design.

Science.gov (United States)

Sun, Xiao; Guo, Liping; Shang, Hongcai; Ren, Ming; Wang, Yue; Huo, Da; Lei, Xiang; Wang, Hui; Zhai, Jingbo

2015-11-03

reduced the incidence of diabetes mellitus and enhanced reversion rate. compared with the control group (p 0.05); finally the compliance of participants between the two groups had no significant difference. The cost-effectiveness analysis outcomes:in the intervention period of 12 months,on the aspect of reversion rate, the treatment group had better economic advantage by using cost-effectiveness ratio and the incremental cost-effectiveness ratio;on the aspect of the incidence of diabetes, the control group had better economic advantage by using cost-effectiveness ratio and the incremental cost-effectiveness ratio; in the follow-up period of 24 months, on the aspect of reversion rate, the treatment group had better economic advantage by using cost-effectiveness ratio and the incremental cost-effectiveness ratio, on the aspect of the incidence of diabetes, the control group had better economic advantage by using cost-effectivenes ratio and the incremental cost-effectiveness ratio.At the same time, these outcomes remained the same by sensitivity analysis. Assuming that prices and resident incomes rose 5%, the sensitiveness analysis shows that the two group affected by the paremeters changed little. The importance and effectiveness of lifestyle education and JinQi Jiangtang tablets was proven. In both the intervention period and follow-up, JinQi Jiangtang tablets combined with lifestyle education had a greater cost advantage effect than the lifestyle education alone on the reversion rate; the lifestyle education had a greater cost advantage effect than the JinQi Jiangtang tablets combined with lifestyle education on the incidence of diabetes. Chinese Clinical Trials ChiCTR-TRC-09000401 ) , registered on 25 May 2009.

A ginástica terapêutica e preventiva chinesa Lian Gong/Qi Gong como um dos instrumentos na prevenção e reabilitação da LER/DORT

OpenAIRE

Livramento,Gutembergue; Franco,Tânia; Livramento,Alaíde

2010-01-01

Este ensaio traz elementos da medicina ocidental, da medicina tradicional chinesa e da sociologia do trabalho para reflexão sobre o Qi Gong - exercícios terapêuticos, um dos pilares da Medicina Tradicional Chinesa (MTC) - como importante meio de prevenção da LER/DORT e recuperação da saúde. Considerando a natureza interdisciplinar e diversos níveis de prevenção, aborda aspectos sociológicos sobre as condições de trabalho frequentemente relacionadas com este tipo de adoecimento e categorias de...

Effect of Da-Cheng-Qi Decoction on Pancreatitis-Associated Intestinal Dysmotility in Patients and in Rat Models

Directory of Open Access Journals (Sweden)

Jianlei Zhao

2015-01-01

Full Text Available The impairment of intestinal motility and related infectious complications are the predominant clinical phenomenon in patients with severe acute pancreatitis (SAP. We aimed to investigate the effects of Da-Cheng-Qi decoction (DCQD on the gastrointestinal injury in SAP patients and the potential mechanism involved in rats. DCQD was enema administered to 70 patients for 7 days in West China Hospital. Mortality and organ failure during admission were observed and blood samples for laboratory analysis were collected. We also experimentally examined plasma inflammatory cytokines in rat serum and carried the morphometric studies of the gut. Intestinal propulsion index and serum and tissue vasoactive intestinal peptide (VIP were also detected. Though DCQD did not affect the overall incidence of organ failure, it shortened the average time of paralytic intestinal obstruction and decreased the morbidity of infectious complications in patients with SAP. Compared with untreated rats, the DCQD lowered the levels of proinflammatory cytokine and decreased the mean pathological intestinal lesion scores. The VIP level in intestinal tissue or serum in DCQD group was obviously lowered and intestinal propulsion index was significantly improved. In conclusion, DCQD has good effect on pancreatitis-associated intestinal dysmotility in patients and in rat models.

Treatment of Goiter with Traditional Chinese Medicine Regimen Xing Qi Hua Ying Tang: A Clinical Study on 72 Patients with Multinodular and Diffuse Goiter.

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Yang, Ming-Li; Lu, Bo

2018-04-01

The present work aimed to further explore the therapeutic potential of Xing Qi Hua Ying Tang (XQHYT) by conducting a systemic clinical study in patients with goiter. Seventy-two patients with either multinodular or diffuse goiter were enrolled and randomly assigned into treatment group receiving XQHYT (n = 36) and control group receiving Hai Zao Yu Hu Tang (n = 36). Traditional Chinese Medicine Hospital of Shanxi. Patients were diagnosed multinodular goiter or diffuse goiter resulting from Qi stagnation. All patients took the extract twice a day (100 mL each time) for two courses of treatment, of which a single course lasted for 3 months. Before the treatment was commenced and after the completion of the treatment, general body checks, thyroid function test, and goiter size examination were performed. Scoring of the clinical symptoms using Chinese medicine symptomatology was also done. The symptom score of the treatment group was significantly lower than that of the control group (treatment group, 8.26 ± 2.62; control group, 10.02 ± 2.62; p < 0.05). Substantial reduction in goiter size was seen in 82.3% of XQHYT-treated patients, whereas in the control group only 67.7% of patients exhibited constricted goiter. When assessed by both the Chinese medicine criteria and goiter size, the overall effective rate of the treatment group was 91.2%, whereas that of the control group was only 67.7%. The difference was statistically significant (p < 0.05). XQHYT did not affect the normal functions of liver, kidney, and heart. For both groups of patients, their levels of thyroid-stimulating hormone, free T4 and free T3 were normal before the treatment, and were not affected by the treatment. XQHYT was shown to be a promising therapeutic regimen for the treatment of goiter. The herbal regimen ameliorated clinical symptoms of patients that were accompanied with reduction in the size of goiter.

Si Shen Wan Regulates Phospholipase Cγ-1 and PI3K/Akt Signal in Colonic Mucosa from Rats with Colitis

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Duan-yong Liu

2015-01-01

Full Text Available The present study explored the feasible pathway of Si Shen Wan (SSW in inhibiting apoptosis of intestinal epithelial cells (IECs by observing activation of phospholipase Cγ-1 (PLC-γ1 and PI3K/Akt signal in colonic mucosa from rats with colitis. Experimental colitis was induced by 2,4,6-trinitrobenzene sulfonic acid (TNBS in the Sprague-Dawley rats. After SSW was administrated for 7 days after TNBS infusion, western blot showed an increment in levels of PI3K, p-Akt, and IL-23 and a decrement in levels of PLC-γ1 and HSP70 in colonic mucosal injury induced by TNBS. Meanwhile, assessments by ELISA revealed an increment in concentrations of IL-2, IL-6, and IL-17 and a reduction in level of TGF-β after TNBS challenge. Impressively, treatment with SSW for 7 days significantly attenuated the expressions of PI3K and p-Akt and the secretion of IL-2, IL-6, IL-17, and IL-23 and promoted the activation of PLC-γ1, HSP70, and TGF-β. Our previous studies had demonstrated that SSW restored colonic mucosal ulcers by inhibiting apoptosis of IECs. The present study demonstrated that the effect of SSW on inhibiting apoptosis of IECs was realized probably by activation of PLC-γ1 and suppression of PI3K/Akt signal pathway.

Searching for Synergistic Bronchodilators and Novel Therapeutic Regimens for Chronic Lung Diseases from a Traditional Chinese Medicine, Qingfei Xiaoyan Wan

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Hou, Yuanyuan; Cheng, Binfeng; Zhou, Mengge; Fang, Runping; Jiang, Min; Hou, Wenbin; Bai, Gang

2014-01-01

Classical Chinese pharmacopeias describe numerous excellent herbal formulations, and each prescription is an outstanding pool of effective compounds for drug discovery. Clarifying the bioactivity of the combined mechanisms of the ingredients in complex traditional Chinese medicine formulas is challenging. A classical formula known as Qingfei Xiaoyan Wan, used clinically as a treatment for prevalent chronic lung disease, was investigated in this work. A mutually enhanced bioactivity-guided ultra-performance liquid chromatography/quadrupole time-of-flight mass spectrometry (UPLC/Q-TOF-MS) characterization system was proposed, coupled with a dual-luciferase reporter assay for β2AR-agonist cofactor screening. Arctiin, arctigenin, descurainoside and descurainolide B, four lignin compounds that showed synergistic bronchodilation effects with ephedrine, were revealed. The synergistic mechanism of arctigenin with the β2ARagonist involved with the reduction of free Ca2+ was clarified by a dual-luciferase reporter assay for intracellular calcium and the Ca2+ indicator fluo-4/AM to monitor changes in the fluorescence. The relaxant and contractile responses of airway smooth muscle are regulated by crosstalk between the intracellular cAMP and calcium signaling pathways. Our data indicated the non-selective βAR agonist ephedrine as the principal bronchodilator of the formula, whereas the lignin ingredients served as adjuvant ingredients. A greater understanding of the mechanisms governing the control of these pathways, based on conventional wisdom, could lead to the identification of novel therapeutic targets or new agents for the treatment of asthma and COPD. PMID:25397687

Searching for synergistic bronchodilators and novel therapeutic regimens for chronic lung diseases from a traditional Chinese medicine, Qingfei Xiaoyan Wan.

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Yuanyuan Hou

Full Text Available Classical Chinese pharmacopeias describe numerous excellent herbal formulations, and each prescription is an outstanding pool of effective compounds for drug discovery. Clarifying the bioactivity of the combined mechanisms of the ingredients in complex traditional Chinese medicine formulas is challenging. A classical formula known as Qingfei Xiaoyan Wan, used clinically as a treatment for prevalent chronic lung disease, was investigated in this work. A mutually enhanced bioactivity-guided ultra-performance liquid chromatography/quadrupole time-of-flight mass spectrometry (UPLC/Q-TOF-MS characterization system was proposed, coupled with a dual-luciferase reporter assay for β2AR-agonist cofactor screening. Arctiin, arctigenin, descurainoside and descurainolide B, four lignin compounds that showed synergistic bronchodilation effects with ephedrine, were revealed. The synergistic mechanism of arctigenin with the β2ARagonist involved with the reduction of free Ca2+ was clarified by a dual-luciferase reporter assay for intracellular calcium and the Ca2+ indicator fluo-4/AM to monitor changes in the fluorescence. The relaxant and contractile responses of airway smooth muscle are regulated by crosstalk between the intracellular cAMP and calcium signaling pathways. Our data indicated the non-selective βAR agonist ephedrine as the principal bronchodilator of the formula, whereas the lignin ingredients served as adjuvant ingredients. A greater understanding of the mechanisms governing the control of these pathways, based on conventional wisdom, could lead to the identification of novel therapeutic targets or new agents for the treatment of asthma and COPD.

Woman Survival in Chinese Feudal Patrilineal Society: An Analysis of Song Lian's Destiny in Qi Qie Chenqun By Su Tong

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Xuc Lin

2009-05-01

Full Text Available Article depicted woman’s difficulties in maintaining her life as well as her aggressiveness in the patrilineal society in Chinese feudal time. Article analyzed Song Lian’s bad fate. She was the main character of qi qie chenqun novel, written by Su Tong. Article analysis consisted of three parts. The first part described Song Lian’s background of life and her becoming a mistress. The second part indicated Song Lian’s attacking behavior to other woman because of defending her life. His third part analyzed some causes that made Song Lian did not survive in life. It can be concluded that the fact, Song Lian is able to be survive but she decides to be a mistress caused by both personal and o social reasons. Song Lian’s attacking other woman is caused by her anger representing her unsuccessful life. Principally, Song Lian’s failure in the feudal life is caused by her unsuccessful in becoming a respected woman. If she had been a respected woman, she would have also competed with other women in achieving a better life.      

STIR Proposal For Research Area 2.1.2 Surface Energy Balance: Transient Soil Density Impacts Land Surface Characteristics and Characterization

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2015-12-22

al., 2008; Logsdon, 2012; Liu et al., 2014). Freeze-thaw processes alter surface density and arrangement seasonally (Staricka and Benoit , 1995... Ma , L., L.R. Ahuja, B.T. Nolan, R.W. Malone, T.J. Trout, and Z. Qi. 2012. Root zone water quality model (RZWQM2): model use, calibration, and

HPLC法测定清肺消炎丸中三种抗炎成分含量%Determination of content of three anti-inflammatory ingredients in Qingfei Xiaoyan Wan by using HPLC method

Institute of Scientific and Technical Information of China (English)

崔庆新; 廖承美; 陈志凯; 马芳; 陶瑾

2016-01-01

采用高效液相色谱法(HPLC)对清肺消炎丸中牛蒡子苷、牛蒡子苷元和绿原酸进行定量测定.色谱柱：Symmetry ® C18柱.流动相：牛蒡子苷、牛蒡子苷元采用甲醇-水(体积比为50∶50),检测波长280 nm；绿原酸采用乙腈-0．4％的磷酸(体积比为13∶87),检测波长327 nm.结果表明,清肺消炎丸中含牛蒡子苷407 mg/g,牛蒡子苷元0．19 mg/g,绿原酸0．076 mg/g.牛蒡子苷、牛蒡子苷元和绿原酸进样量分别在1．94～9．70μg、0．20～1．00μg、0．05～0．25μg 范围内与峰面积的线性关系良好.牛蒡子苷、牛蒡子苷元和绿原酸的回收率分别为102．59％(RSD＝1．69％,n＝5),98．17％(RSD＝1．52％,n＝5)和9833％(RSD＝1．46％,n＝5).该方法简单、精确、灵敏、专属性强、重复性好,可定量测定清肺消炎丸中抗炎物质含量.%By using the method of high performance liquid chromatography (HPLC)to quantitatively determine the content of arctii,arctigenin and chlorogenic acid in Qingfei Xiaoyan Wan.The chromatographic column is Symmetry ® C18 color table.The mobile phase for arctii and arctigenin is methanol-water (50:50 ),the detection wavelength is 280 nm;for the chlorogenic acid was acetonitrile-0.4% phosphoric acid (13:87),the detection wavelength is 327 nm.The contents of arctii,arctigenin and chlorogenic acid were 4.07 mg/g(n=3), 0.1 9 mg/g (n=3)and 0.076 mg/g(n=3)respectively in Qingfei Xiaoyan Wan.It shows that there is a good linear relationship between the peak area and sample size of arctii,arctigenin and chlorogenic in the range of 194-9.70 μg,0.20 - 1.00 μg and 0.05 -0.25 μg,respectively.The recovery rates were arctii 102.59%(RSD=1.69%,n = 5 ),arctigenin 98.1 7 %(RSD= 1.52%,n = 5 )and chlorogenic acid 98.33% (RSD= 1. 46%,n=5).The method used in this study is simple,accurate,sensitive,and has strong specificity and good repeatability.And it can be used to quantitatively determine the content of the material in

Reliability and validity of a 20-s alternative to the wingate anaerobic test in team sport male athletes.

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Ahmed Attia

Full Text Available The intent of this study was to evaluate relative and absolute reliability of the 20-s anaerobic test (WAnT20 versus the WAnT30 and to verify how far the various indices of the 30-s Wingate anaerobic test (WAnT30 could be predicted from the WAnT20 data in male athletes. The participants were Exercise Science majors (age: 21.5±1.6 yrs, stature: 0.183±0.08 m, body mass: 81.2±10.9 kg who participated regularly in team sports. In Phase I, 41 participants performed duplicate WAnT20 and WAnT30 tests to assess reliability. In Phase II, 31 participants performed one trial each of the WAnT20 and WAnT30 to determine the ability of the WAnT20 to predict components of the WAnT30. In Phase III, 31 participants were used to cross-validate the prediction equations developed in Phase II. Respective intra-class correlation coefficients (ICC for peak power output (PPO (ICC = 0.98 and 0.95 and mean power output (MPO (ICC 0.98 and 0.90 did not differ significantly between WAnT20 and WAnT30. ICCs for minimal power output (POmin and fatigue index (FI were poor for both tests (range 0.53 to 0.76. Standard errors of the means (SEM for PPO and MPO were less than their smallest worthwhile changes (SWC in both tests; however, POmin and FI values were "marginal," with SEM values greater than their respective SWCs for both tests values. Stepwise regression analysis showed that MPO had the highest coefficient of predictability (R = 0.97, with POmin and FI considerable lower (R = 0.71 and 0.41 respectively. Cross-validation showed insignificant bias with limits of agreement of 0.99±1.04, 6.5±92.7 W, and 1.6±9.8% between measured and predicted MPO, POmin, and FI, respectively. WAnT20 offers a reliable and valid test of leg anaerobic power in male athletes and could replace the classic WAnT30.

À la recherche d’innovations dans l’enseignement du FLE destinées aux étudiants sinophones en mobilité interuniversitaire : le cas de Taïwan

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LEE Hsin-I

2016-11-01

Full Text Available Un nombre croissant d’étudiants sinophones vient en France pour poursuivre ses études. Afin de préciser les problèmes rencontrés, nous avons effectué des enquêtes auprès d’un échantillon de 90 étudiants taïwanais de diverses disciplines, durant les années universitaires 2013 et 2014, avant le départ et pendant le séjour en France. La question linguistique est souvent un problème majeur, mais elle n’est pas la seule. Les étudiants vont également faire l’expérience des différences culturelles. De plus, l’adaptation à la méthodologie universitaire soulève des difficultés. Notre conclusion consiste à proposer dans l’enseignement du FLE à Taïwan des innovations pédagogiques destinées à mieux préparer en amont les étudiants et ainsi leur permettre de mieux s’adapter au système éducatif français.

Application of TaiWan Ionosphere Model to Single-Frequency Ionospheric Delay Correction for GPS Static Position Positioning

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Macalalad, E. P.; Tsai, L.; Wu, J.

2011-12-01

Ionospheric delay is one of the major sources of error in GPS positioning and navigation. This error in both pseudorange and phase ranges can vary depending on the location of observation, local time, season, solar cycle and geomagnetic activity. This effect can be practically removed using dual-frequency receivers. However, these types of receivers are very expensive and thus, impractical for most users. Therefore, for single-frequency receivers, ionosphere is usually modeled to attempt to remove this effect analytically. Numerous ionosphere models have been introduced in the past. Some of which are the Klobuchar (or broadcast) model and the global ionosphere map (GIM) provided by the International GNSS Service (IGS). In this paper, another model, called the TaiWan Ionosphere Model (TWIM) was used to correct this effect. TWIM is a three dimensional ionospheric electron (ne) density model derived from FormoSat3/COSMIC GPS Radio Occultation measurements, was used to calculate ionospheric delay for GPS single-frequency positioning. The ne profiles were used to calculate the slant TEC (STEC) between a receiver and each GPS satellite and correct the pseudorange single-frequency observations. The corrected pseudorange for every epoch was used to calculate the position of the receiver. Observations were made in a low-latitude location near one of the peaks of the equatorial anomaly. It was shown that TEC maps generated using TWIM exhibited detailed structure of the ionosphere, whereas Klobuchar and GIM only provided the basic diurnal and geographic features of the ionosphere. Also, it was shown that for static point positioning TWIM provides more accurate and more precise positioning than the Klobuchar and GIM models. That is, on the average, the horizontal accuracy, represented by the circular error probable (CEP), distance RMS (DRMS) and twice the DRMS (2DRMS), were better by 15-18% as compared with the CEP, DRMS and 2DRMS of uncorrected, Klobuchar and GIM. Moreover

Measurements of VOC fluxes by Eddy-covariance with a PTR-Qi-TOF-MS over a mature wheat crop near Paris: Evaluation of data quality and uncertainties.

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Buysse, Pauline; Loubet, Benjamin; Ciuraru, Raluca; Lafouge, Florence; Zurfluh, Olivier; Gonzaga-Gomez, Lais; Fanucci, Olivier; Gueudet, Jean-Christophe; Decuq, Céline; Gros, Valérie; Sarda, Roland; Zannoni, Nora

2017-04-01

The quantification of volatile organic compounds (VOC) fluxes exchanged by terrestrial ecosystems is of large interest because of their influence on the chemistry and composition of the atmosphere including aerosols and oxidants. Latest developments in the techniques for detecting, identifying and measuring VOC fluxes have considerably improved the abilities to get reliable estimates. Among these, the eddy-covariance (EC) methodology constitutes the most direct approach, and relies on both well-established principles (Aubinet et al. 2000) and a sound continuously worldwide improving experience. The combination of the EC methodology with the latest proton-transfer-reaction mass spectrometer (PTR-MS) device, the PTR-Qi-TOF-MS, which allows the identification and quantification of more than 500 VOC at high frequency, now provides a very powerful and precise tool for an accurate quantification of VOC fluxes on various types of terrestrial ecosystems. The complexity of the whole methodology however demands that several data quality requirements are fulfilled. VOC fluxes were measured by EC with a PTR-Qi-TOF-MS (national instrument within the ANAEE-France framework) for one month and a half over a mature wheat crop near Paris (FR-GRI ICOS site). Most important emissions (by descending order) were observed from detected compounds with mass-over-charge (m/z) ratios of 33.033 (methanol), 45.033 (acetaldehyde), 93.033 (not identified yet), 59.049 (acetone), and 63.026 (dimethyl sulfide or DMS). Emissions from higher-mass compounds, which might be due to pesticide applications at the beginning of our observation period, were also detected. Some compounds were also seen to deposit (e.g. m/z 47.013, 71.085, 75.044, 83.05) while others exhibited bidirectional fluxes (e.g. m/z 57.07, 69.07). Before analyzing VOC flux responses to meteorological and crop development drivers, a data quality check was performed which included (i) uncertainty analysis of mass and concentration

Pharmacist leadership in ICU quality improvement: coordinating spontaneous awakening and breathing trials.

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Stollings, Joanna L; Foss, Julie J; Ely, E Wesley; Ambrose, Anna M; Rice, Todd W; Girard, Timothy D; Wheeler, Arthur P

2015-08-01

Coordinating efforts across disciplines in the intensive care unit is a key component of quality improvement (QI) efforts. Spontaneous awakening trials (SATs) and spontaneous breathing trials (SBTs) are considered key components of guidelines, yet unfortunately are often not done or coordinated properly. To determine if a pharmacist-driven awakening and breathing coordination (ABC) QI program would improve compliance (ie, process measures) as compared with the previous protocol, which did not involve pharmacists. The QI program included pharmacist-led education, daily discussion on rounds, and weekly performance reports to staff. Using a pre-QI versus during-QI versus post-QI intervention design, we compared data from 500 control ventilator-days (pre-QI period) versus 580 prospective ventilator-days (during-QI period). We then evaluated the sustainability of the QI program in 216 ventilator-days in the post-QI period. SAT safety screens were performed on only 20% pre-QI patient-days versus 97% of during-QI patient-days (P improved process measures compliance, comparing the pre-QI versus during-QI rates of screening, performing, and coordinating SAT and SBTs, and these results were sustained in the 8-month follow-up period post-QI program. © The Author(s) 2015.

Association of adult weight gain and nonalcoholic fatty liver in a cross-sectional study in Wan Song Community, China

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W.-J. Zhang

2014-02-01

Full Text Available Our objective was to examine associations of adult weight gain and nonalcoholic fatty liver disease (NAFLD. Cross-sectional interview data from 844 residents in Wan Song Community from October 2009 to April 2010 were analyzed in multivariate logistic regression models to examine odds ratios (OR and 95% confidence intervals (CI between NAFLD and weight change from age 20. Questionnaires, physical examinations, laboratory examinations, and ultrasonographic examination of the liver were carried out. Maximum rate of weight gain, body mass index, waist circumference, waist-to-hip ratio, systolic blood pressure, diastolic blood pressure, fasting blood glucose, cholesterol, triglycerides, uric acid, and alanine transaminase were higher in the NAFLD group than in the control group. HDL-C in the NAFLD group was lower than in the control group. As weight gain increased (measured as the difference between current weight and weight at age 20 years, the OR of NAFLD increased in multivariate models. NAFLD OR rose with increasing weight gain as follows: OR (95%CI for NAFLD associated with weight gain of 20+ kg compared to stable weight (change <5 kg was 4.23 (2.49-7.09. Significantly increased NAFLD OR were observed even for weight gains of 5-9.9 kg. For the “age 20 to highest lifetime weight” metric, the OR of NAFLD also increased as weight gain increased. For the “age 20 to highest lifetime weight” metric and the “age 20 to current weight” metric, insulin resistance index (HOMA-IR increased as weight gain increased (P<0.001. In a stepwise multivariate regression analysis, significant association was observed between adult weight gain and NAFLD (OR=1.027, 95%CI=1.002-1.055, P=0.025. We conclude that adult weight gain is strongly associated with NAFLD.

SuHeXiang Wan essential oil alleviates amyloid beta induced memory impairment through inhibition of tau protein phosphorylation in mice.

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Jeon, Songhee; Hur, Jinyoung; Jeong, Ha Jin; Koo, Byung-Soo; Pak, Sok Cheon

2011-01-01

SuHeXiang Wan (SHXW), a traditional Chinese medicine, has been used orally for the treatment of seizures, infantile convulsions and stroke. Previously, we reported the effects of a modified SHXW essential oil in terms of sedative effect, anticonvulsant activity and antioxidative activity. The purpose of this study was to evaluate the potential beneficial effects of SHXW essential oil in neurodegenerative diseases such as Alzheimer's disease (AD). SHXW essential oil was extracted from nine herbs. The mouse AD model was induced by a single injection of amyloid β protein (Aβ(1-42)) into the hippocampus. The animals were divided into four groups, the negative control group injected with Aβ(42-1), the Aβ group injected with Aβ(1-42), the SHXW group inhaled SHXW essential oil and received Aβ(1-42) injection, and the positive control group administered with docosahexaenoic acid (DHA, 10 mg/kg) and with subsequent Aβ(1-42) injection. Mice were analyzed by behavioral tests and immunological examination in the hippocampus. An additional in vitro investigation was performed to examine whether SHXW essential oil inhibits Aβ(1-42) induced neurotoxicity in a human neuroblastoma cell line, SH-SY5Y cells. Pre-inhalation of SHXW essential oil improved the Aβ(1-42) induced memory impairment and suppressed Aβ(1-42) induced JNK, p38 and Tau phosphorylation in the hippocampus. SHXW essential oil suppressed Aβ-induced apoptosis and ROS production via an up-regulation of HO-1 and Nrf2 expression in SH-SY5Y cells. The present study suggests that SHXW essential oil may have potential as a therapeutic inhalation drug for the prevention and treatment of AD.

Pediatrics Residents' Confidence and Performance Following a Longitudinal Quality Improvement Curriculum.

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Courtlandt, Cheryl; Noonan, Laura; Koricke, Maureen Walsh; Zeskind, Philip Sanford; Mabus, Sarah; Feld, Leonard

2016-02-01

Quality improvement (QI) training is an integral part of residents' education. Understanding the educational value of a QI curriculum facilitates understanding of its impact. The purpose of this study was to evaluate the effects of a longitudinal QI curriculum on pediatrics residents' confidence and competence in the acquisition and application of QI knowledge and skills. Three successive cohorts of pediatrics residents (N = 36) participated in a longitudinal curriculum designed to increase resident confidence in QI knowledge and skills. Key components were a succession of progressive experiential projects, QI coaching, and resident team membership culminating in leadership of the project. Residents completed precurricular and postcurricular surveys and demonstrated QI competence by performance on the pediatric QI assessment scenario. Residents participating in the Center for Advancing Pediatric Excellence QI curriculum showed significant increases in pre-post measures of confidence in QI knowledge and skills. Coaching and team leadership were ranked by resident participants as having the most educational value among curriculum components. A pediatric QI assessment scenario, which correlated with resident-perceived confidence in acquisition of QI skills but not QI knowledge, is a tool available to test pediatrics residents' QI knowledge. A 3-year longitudinal, multimodal, experiential QI curriculum increased pediatrics residents' confidence in QI knowledge and skills, was feasible with faculty support, and was well-accepted by residents.

Evaluation of Women with Myofascial Abdominal Syndrome Based on Traditional Chinese Medicine

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Andréia Mitidieri

2015-12-01

Full Text Available Objectives: This study used semiology based on traditional Chinese medicine (TCM to investigate vital energy (Qi behavior in women with abdominal myofascial pain syndrome (AMPS. Methods: Fifty women diagnosed with chronic pelvic pain (CPP secondary to AMPS were evaluated by using a questionnaire based on the theories of “yin-yang,” “zang-fu”, and “five elements”. We assessed the following aspects of the illness: symptomatology; specific location of myofascial trigger points (MTrPs; onset, cause, duration and frequency of symptoms; and patient and family history. The patients tongues, lips, skin colors, and tones of speech were examined. Patients were questioned on various aspects related to breathing, sweating, sleep quality, emotions, and preferences related to color, food, flavors, and weather or seasons. Thirst, gastrointestinal dysfunction, excreta (feces and urine, menstrual cycle, the five senses, and characteristic pain symptoms related to headache, musculoskeletal pain, abdomen, and chest were also investigated. Results: Patients were between 22 and 56 years old, and most were married (78%, possessed a elementary school (66%, and had one or two children (76%. The mean body mass index and body fat were 26.86 kg/ cm2 (range: 17.7 — 39.0 and 32.4% (range: 10.7 — 45.7, respectively. A large majority of women (96% exhibited alterations in the kidney meridian, and 98% had an altered gallbladder meridian. We observed major changes in the kidney and the gallbladder Qi meridians in 76% and 62% of patients, respectively. Five of the twelve meridians analyzed exhibited Qi patterns similar to pelvic innervation Qi and meridians, indicating that the paths of some of these meridians were directly related to innervation of the pelvic floor and abdominal region. Conclusion: The women in this study showed changes in the behavior of the energy meridians, and the paths of some of the meridians were directly related to innervation of the

Comparison of practice based research network based quality improvement technical assistance and evaluation to other ongoing quality improvement efforts for changes in agency culture.

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Livingood, William C; Peden, Angela H; Shah, Gulzar H; Marshall, Nandi A; Gonzalez, Ketty M; Toal, Russell B; Alexander, Dayna S; Wright, Alesha R; Woodhouse, Lynn D

2015-07-31

Public health agencies in the USA are increasingly challenged to adopt Quality Improvement (QI) strategies to enhance performance. Many of the functional and structural barriers to effective use of QI can be found in the organizational culture of public health agencies. The purpose of this study was to assess the impact of public health practice based research network (PBRN) evaluation and technical assistance for QI interventions on the organizational culture of public health agencies in Georgia, USA. An online survey of key informants in Georgia's districts and county health departments was used to compare perceptions of characteristics of organizational QI culture between PBRN supported QI districts and non-PBRN supported districts before and after the QI interventions. The primary outcomes of concern were number and percentage of reported increases in characteristics of QI culture as measured by key informant responses to items assessing organizational QI practices from a validated instrument on QI Collaboratives. Survey results were analyzed using Multi-level Mixed Effects Logistic Model, which accounts for clustering/nesting. Increases in QI organizational culture were consistent for all 10- items on a QI organizational culture survey related to: leadership support, use of data, on-going QI, and team collaboration. Statistically significant odds ratios were calculated for differences in increased QI organizational culture between PBRN-QI supported districts compared to Non-PBRN supported districts for 5 of the 10 items, after adjusting for District clustering of county health departments. Agency culture, considered by many QI experts as the main goal of QI, is different than use of specific QI methods, such as Plan-Do-Study-Act (PDSA) cycles or root-cause analyses. The specific use of a QI method does not necessarily reflect culture change. Attempts to measure QI culture are newly emerging. This study documented significant improvements in characteristics of

Educational system factors that engage resident physicians in an integrated quality improvement curriculum at a VA hospital: a realist evaluation.

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Ogrinc, Greg; Ercolano, Ellyn; Cohen, Emily S; Harwood, Beth; Baum, Karyn; van Aalst, Robertus; Jones, Anne C; Davies, Louise

2014-10-01

Learning about quality improvement (QI) in resident physician training is often relegated to elective or noncore clinical activities. The authors integrated teaching, learning, and doing QI into the routine clinical work of inpatient internal medicine teams at a Veterans Affairs (VA) hospital. This study describes the design factors that facilitated and inhibited the integration of a QI curriculum-including real QI work-into the routine work of inpatient internal medicine teams. A realist evaluation framework used three data sources: field notes from QI faculty; semistructured interviews with resident physicians; and a group interview with QI faculty and staff. From April 2011 to July 2012, resident physician teams at the White River Junction VA Medical Center used the Model for Improvement for their QI work and analyzed data using statistical process control charts. Three domains affected the delivery of the QI curriculum and engagement of residents in QI work: setting, learner, and teacher. The constant presence of the QI material on a public space in the team workroom was a facilitating mechanism in the setting. Explicit sign-out of QI work to the next resident team formalized the handoff in the learner domain. QI teachers who were respected clinical leaders with QI expertise provided role modeling and local system knowledge. Integrating QI teaching into the routine clinical and educational systems of an inpatient service is challenging. Identifiable, concrete strategies in the setting, learner, and teacher domains helped integrate QI into the clinical and educational systems.

Management and Long-Term Outcome of Acute Coronary Syndrome Patients Presenting with Heart Failure in a Contemporary New Zealand Cohort (ANZACS-QI 4).

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Kueh, Shaw Hua Anthony; Devlin, Gerry; Lee, Mildred; Doughty, Rob N; Kerr, Andrew J

2016-08-01

Acute heart failure (HF) associated with an acute coronary syndrome (ACS) predicts adverse outcome. There have been important recent improvements in ACS management. Our aim was to describe the management and outcomes in those with and without HF in a contemporary ACS cohort. Consecutive patients presenting with ACS between 2007 and 2011 were enrolled in the All New Zealand Acute Coronary Syndrome Quality Improvement (ANZACS-QI) registry. Outcomes and medication dispensing were obtained using anonymised linkage to national data sets. A summary pharmacotherapy measure of "quadruple therapy" was defined as dispensing of at least one agent from each of the four evidence-based classes - anti-platelet, statin, angiotensin converting enzyme inhibitor/angiotensin receptor blocker and beta blocker. Of 3743 ACS patients 14% had acute HF. Acute heart failure patients were older (69.2±12.6 vs 62.3±12.8 years, pcoronary angiography (66% vs 86%, pAcute heart failure complicating ACS is associated with heightened risk of short-term and long-term mortality. One in three ACS patients with HF did not have coronary angiography and less than half received quadruple therapy a year after presentation. Copyright © 2016. Published by Elsevier B.V.

Quality Improvement in Athletic Health Care.

Science.gov (United States)

Lopes Sauers, Andrea D; Sauers, Eric L; Valier, Alison R Snyder

2017-11-01

  Quality improvement (QI) is a health care concept that ensures patients receive high-quality (safe, timely, effective, efficient, equitable, patient-centered) and affordable care. Despite its importance, the application of QI in athletic health care has been limited.   To describe the need for and define QI in health care, to describe how to measure quality in health care, and to present a QI case in athletic training.   As the athletic training profession continues to grow, a widespread engagement in QI efforts is necessary to establish the value of athletic training services for the patients that we serve. A review of the importance of QI in health care, historical perspectives of QI, tools to drive QI efforts, and examples of common QI initiatives is presented to assist clinicians in better understanding the value of QI for advancing athletic health care and the profession. Clinical and Research Advantages:  By engaging clinicians in strategies to measure outcomes and improve their patient care services, QI practice can help athletic trainers provide high-quality and affordable care to patients.

Strategies for addressing barriers to publishing pediatric quality improvement research.

Science.gov (United States)

Van Cleave, Jeanne; Dougherty, Denise; Perrin, James M

2011-09-01

Advancing the science of quality improvement (QI) requires dissemination of the results of QI. However, the results of few QI interventions reach publication. To identify barriers to publishing results of pediatric QI research and provide practical strategies that QI researchers can use to enhance publishability of their work. We reviewed and summarized a workshop conducted at the Pediatric Academic Societies 2007 meeting in Toronto, Ontario, Canada, on conducting and publishing QI research. We also interviewed 7 experts (QI researchers, administrators, journal editors, and health services researchers who have reviewed QI manuscripts) about common reasons that QI research fails to reach publication. We also reviewed recently published pediatric QI articles to find specific examples of tactics to enhance publishability, as identified in interviews and the workshop. We found barriers at all stages of the QI process, from identifying an appropriate quality issue to address to drafting the manuscript. Strategies for overcoming these barriers included collaborating with research methodologists, creating incentives to publish, choosing a study design to include a control group, increasing sample size through research networks, and choosing appropriate process and clinical quality measures. Several well-conducted, successfully published QI studies in pediatrics offer guidance to other researchers in implementing these strategies in their own work. Specific, feasible approaches can be used to improve opportunities for publication in pediatric, QI, and general medical journals.

Sustaining a quality improvement culture in local health departments applying for accreditation.

Science.gov (United States)

Verma, Pooja; Moran, John W

2014-01-01

This article focuses on local health departments (LHDs) that are advanced in accreditation and quality improvement (QI) efforts and the barriers and facilitators associated with sustaining improvements and building an organizational culture of QI. To understand the barriers and facilitators associated with building and sustaining progress toward a QI culture in LHDs. Quantitative data from a self-reporting survey and qualitative data from telephone interviews. Twenty-two LHDs across the United States responded to the survey. Ten of the 22 LHD respondents participated in telephone interviews. QI lead staff at LHDs that are advanced in accreditation preparation and QI. Self-reported LHD survey ratings against indicators for a QI culture, and the identified barriers and facilitators around sustaining QI initiatives. Of the 6 domains of a QI culture measured in the survey, the percentages of respondents that scored themselves highly to at least 1 indicator in each domain are as follows: leadership commitment (100%); employee empowerment (100%); teamwork and collaboration (100%); continuous process improvement (86%); customer focus (72%); and QI infrastructure (64%). Qualitative data from 10 telephone interviews revealed that key barriers to sustaining progress around QI included staff turnover, budget cuts, and major crises or events that arise as priority. Key facilitators included leadership commitment, accreditation, and dedication of resources and staff time to QI. When engaging in QI, LHDs should consider investing efforts in gaining leadership support and dedicating staff time early in the QI journey to ensure that QI efforts and initiatives are sustained. Local health departments interested in developing a QI culture should also consider pursuing accreditation, as it provides a structured framework for continuous improvement. They should also actively develop QI knowledge and skills among all staff members to minimize the negative impact of staff turnover.

Effects of Qi-Fang-Xi-Bi-Granules on Cartilage Morphology and C/ebpα Promoter Methylation in Rats with Knee Osteoarthritis

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Xinxin Wang

2018-01-01

Full Text Available Objective. To investigate the effects of Qi-Fang-Xi-Bi-Granules (QFXBGs on cartilage morphology and methylation of C/ebpα (CCAAT/enhancer binding proteinα at the promoter region. Methods. Knee osteoarthritis (KOA modeling was performed in rats in accordance with Hulth’s method, and control group received sham operation. Eight weeks after KOA modeling, the rats in the KOA modeling group were further divided into 6 groups. Each group was given the appropriate drug. After 8 weeks, half of the rats were used for Micro-CT scan, HE staining, ABH/OG staining, immunohistochemistry, and TUNNEL staining of the knee joint tissue, and the other half were used to examine C/ebpα promoter methylation. Results. The three dose groups of QFXBGs all showed lower degrees of surface fissures and flaking, thicker cartilage layer, and restored chondrocyte and subchondral bone morphology, compared with the KOA model group. C/ebpα-22 promoter methylation levels in the high- and low-dose groups were significantly higher than that in the KOA modeling group (p<0.05, while C/ebpα-2 promoter methylation level in the medium-dose group was significantly higher than that in the KOA modeling group (p<0.05. Conclusions. QFXBGs may alleviate articular cartilage degeneration through promoting C/ebpα-2 or C/ebpα-22 methylation at specific promoter sites.

MO-E-12A-01: Quantitative Imaging: Techniques, Applications, and Challenges

International Nuclear Information System (INIS)

Jackson, E; Jeraj, R; McNitt-Gray, M; Cao, Y

2014-01-01

The first symposium in the Quantitative Imaging Track focused on the introduction of quantitative imaging (QI) by illustrating the potential of QI in diagnostic and therapeutic applications in research and patient care, highlighting key challenges in implementation of such QI applications, and reviewing QI efforts of selected national and international agencies and organizations, including the FDA, NCI, NIST, and RSNA. This second QI symposium will focus more specifically on the techniques, applications, and challenges of QI. The first talk of the session will focus on modalityagnostic challenges of QI, beginning with challenges of the development and implementation of QI applications in single-center, single-vendor settings and progressing to the challenges encountered in the most general setting of multi-center, multi-vendor settings. The subsequent three talks will focus on specific QI challenges and opportunities in the modalityspecific settings of CT, PET/CT, and MR. Each talk will provide information on modality-specific QI techniques, applications, and challenges, including current efforts focused on solutions to such challenges. Learning Objectives: Understand key general challenges of QI application development and implementation, regardless of modality. Understand selected QI techniques and applications in CT, PET/CT, and MR. Understand challenges, and potential solutions for such challenges, for the applications presented for each modality

Yi Qi Qing Re Gao-containing serum inhibits lipopolysaccharide-induced rat mesangial cell proliferation by suppressing the Wnt pathway and TGF-β1 expression.

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Yang, Liping; Sun, Xueyan; Zhan, Yongli; Liu, Huijie; Wen, Yumin; Mao, Huimin; Dong, X I; Li, Ping

2016-04-01

The aim of the present study was to investigate the effect of Yi Qi Qing Re Gao-containing serum (YQ-S) on rat mesangial cell (MC) proliferation and to investigate the underlying mechanism. MCs were divided into the control, lipopolysaccharide (LPS)-stimulated, YQ-S and fosinopril-containing serum (For-S) groups, and cultured for 48 h. An MTT assay was used to evaluate the proliferation of MCs. In addition, reverse transcription-quantitative polymerase chain reaction and western blot analysis were conducted to detect the expression levels of Wnt4, β-catenin and transforming growth factor (TGF)-β1 in MCs. The results indicated that YQ-S inhibited LPS-induced MC proliferation. The Wnt4 and TGF-β1 mRNA expression levels were reduced in the YQ-S group (P<0.01 or P<0.05). Furthermore, the Wnt4, β-catenin and TGF-β1 protein expression levels were suppressed in the YQ-S group (P<0.01 or P<0.05). Therefore, YQ-S appears to inhibit MC proliferation, and its mechanism may involve the inhibition of the Wnt signaling pathway and downregulation of TGF-β1 expression.

Documentation of quality improvement exposure by internal medicine residency applicants.

Science.gov (United States)

Kolade, Victor O; Sethi, Anuradha

2016-01-01

Quality improvement (QI) has become an essential component of medical care in the United States. In residency programs, QI is a focus area of the Clinical Learning Environment Review visits conducted by the Accreditation Council for Graduate Medical Education. The readiness of applicants to internal medicine residency to engage in QI on day one is unknown. To document the reporting of QI training or experience in residency applications. Electronic Residency Application Service applications to a single internal medicine program were reviewed individually looking for reported QI involvement or actual projects in the curriculum vitae (CVs), personal statements (PSs), and letters of recommendation (LORs). CVs were also reviewed for evidence of education in QI such as completion of Institute for Healthcare Improvement (IHI) modules. Of 204 candidates shortlisted for interview, seven had QI items on their CVs, including one basic IHI certificate. Three discussed their QI work in their PSs, and four had recommendation letters describing their involvement in QI. One applicant had both CV and LOR evidence, so that 13 (6%) documented QI engagement. Practice of or instruction in QI is rarely mentioned in application documents of prospective internal medicine interns.

Team dynamics within quality improvement teams: a scoping review.

Science.gov (United States)

Rowland, Paula; Lising, Dean; Sinclair, Lynne; Baker, G Ross

2018-03-31

This scoping review examines what is known about the processes of quality improvement (QI) teams, particularly related to how teams impact outcomes. The aim is to provide research-informed guidance for QI leaders and to inform future research questions. Databases searched included: MedLINE, EMBASE, CINAHL, Web of Science and SCOPUS. Eligible publications were written in English, published between 1999 and 2016. Articles were included in the review if they examined processes of the QI team, were related to healthcare QI and were primary research studies. Studies were excluded if they had insufficient detail regarding QI team processes. Descriptive detail extracted included: authors, geographical region and health sector. The Integrated (Health Care) Team Effectiveness Model was used to synthesize findings of studies along domains of team effectiveness: task design, team process, psychosocial traits and organizational context. Over two stages of searching, 4813 citations were reviewed. Of those, 48 full-text articles are included in the synthesis. This review demonstrates that QI teams are not immune from dysfunction. Further, a dysfunctional QI team is not likely to influence practice. However, a functional QI team alone is unlikely to create change. A positive QI team dynamic may be a necessary but insufficient condition for implementing QI strategies. Areas for further research include: interactions between QI teams and clinical microsystems, understanding the role of interprofessional representation on QI teams and exploring interactions between QI team task, composition and process.

Guizhi Fuling Wan, a Traditional Chinese Herbal Formula, Sensitizes Cisplatin-Resistant Human Ovarian Cancer Cells through Inactivation of the PI3K/AKT/mTOR Pathway

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Li Han

2016-01-01

Full Text Available The aim of the study was to explore the possible mechanisms that Guizhi Fuling Wan (GFW enhances the sensitivity of the SKOV3/DDP ovarian cancer cells and the resistant xenograft tumours to cisplatin. Rat medicated sera containing GFW were prepared by administering GFW to rats, and the primary bioactive constituents of the sera were gallic acid, paeonol, and paeoniflorin analysed by HPLC/QqQ MS. Cell counting kit-8 analysis was shown that coincubation of the sera with cisplatin/paclitaxel enhanced significantly the cytotoxic effect of cisplatin or paclitaxel in SKOV3/DDP cells. The presence of the rat medicated sera containing GFW resulted in an increase in rhodamine 123 accumulation by flow cytometric assays and a decrease in the protein levels of P-gp, phosphorylation of AKT at Ser473, and mTOR in a dose-dependent manner in SKOV3/DDP cells by western blot analysis, but the sera had no effect on the protein levels of PI3K p110α and total AKT. The low dose of GFW enhanced the anticancer efficacy of cisplatin and paclitaxel treatment in resistant SKOV3/DDP xenograft tumours. GFW could sensitize cisplatin-resistant SKOV3/DDP cells by inhibiting the protein level and function of P-gp, which may be medicated through inactivation of the PI3K/AKT/mTOR pathway.

Qingfei Xiaoyan Wan, a traditional Chinese medicine formula, ameliorates Pseudomonas aeruginosa–induced acute lung inflammation by regulation of PI3K/AKT and Ras/MAPK pathways

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Yuanyuan Hou

2016-05-01

Full Text Available Gram-negative pathogen–induced nosocomial infections and resistance are a most serious menace to global public health. Qingfei Xiaoyan Wan (QF, a traditional Chinese medicine (TCM formula, has been used clinically in China for the treatment of upper respiratory tract infections, acute or chronic bronchitis and pulmonary infection. In this study, the effects of QF on Pseudomonas aeruginosa–induced acute pneumonia in mice were evaluated. The mechanisms by which four typical anti-inflammatory ingredients from QF, arctigenin (ATG, cholic acid (CLA, chlorogenic acid (CGA and sinapic acid (SPA, regulate anti-inflammatory signaling pathways and related targets were investigated using molecular biology and molecular docking techniques. The results showed that pretreatment with QF significantly inhibits the release of cytokines (TNF-α and IL-6 and chemokines (IL-8 and RANTES, reduces leukocytes recruitment into inflamed tissues and ameliorates pulmonary edema and necrosis. In addition, ATG was identified as the primary anti-inflammatory agent with action on the PI3K/AKT and Ras/MAPK pathways. CLA and CGA enhanced the actions of ATG and exhibited synergistic NF-κB inactivation effects possibly via the Ras/MAPK signaling pathway. Moreover, CLA is speculated to target FGFR and MEK firstly. Overall, QF regulated the PI3K/AKT and Ras/MAPK pathways to inhibit pathogenic bacterial infections effectively.

Quality Improvement Cycles that Reduced Waiting Times at ...

African Journals Online (AJOL)

It was decided to undertake quality improvement (QI) cycles to analyse and improve the situation, using waiting time as a measure of improvement. Methods: A QI team was chosen to conduct two QI cycles. The allocated time for QI cycle 1 was from May to August 2006 and for QI cycle 2 from September to December 2006.

Quality Improvement and Performance Management Benefits of Public Health Accreditation: National Evaluation Findings.

Science.gov (United States)

Siegfried, Alexa; Heffernan, Megan; Kennedy, Mallory; Meit, Michael

To identify the quality improvement (QI) and performance management benefits reported by public health departments as a result of participating in the national, voluntary program for public health accreditation implemented by the Public Health Accreditation Board (PHAB). We gathered quantitative data via Web-based surveys of all applicant and accredited public health departments when they completed 3 different milestones in the PHAB accreditation process. Leadership from 324 unique state, local, and tribal public health departments in the United States. Public health departments that have achieved PHAB accreditation reported the following QI and performance management benefits: improved awareness and focus on QI efforts; increased QI training among staff; perceived increases in QI knowledge among staff; implemented new QI strategies; implemented strategies to evaluate effectiveness and quality; used information from QI processes to inform decision making; and perceived achievement of a QI culture. The reported implementation of QI strategies and use of information from QI processes to inform decision making was greater among recently accredited health departments than among health departments that had registered their intent to apply but not yet undergone the PHAB accreditation process. Respondents from health departments that had been accredited for 1 year reported higher levels of staff QI training and perceived increases in QI knowledge than those that were recently accredited. PHAB accreditation has stimulated QI and performance management activities within public health departments. Health departments that pursue PHAB accreditation are likely to report immediate increases in QI and performance management activities as a result of undergoing the PHAB accreditation process, and these benefits are likely to be reported at a higher level, even 1 year after the accreditation decision.

Impact of a competency based curriculum on quality improvement among internal medicine residents.

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Fok, Mark C; Wong, Roger Y

2014-11-28

Teaching quality improvement (QI) principles during residency is an important component of promoting patient safety and improving quality of care. The literature on QI curricula for internal medicine residents is limited. We sought to evaluate the impact of a competency based curriculum on QI among internal medicine residents. This was a prospective, cohort study over four years (2007-2011) using pre-post curriculum comparison design in an internal medicine residency program in Canada. Overall 175 post-graduate year one internal medicine residents participated. A two-phase, competency based curriculum on QI was developed with didactic workshops and longitudinal, team-based QI projects. The main outcome measures included self-assessment, objective assessment using the Quality Improvement Knowledge Assessment Tool (QIKAT) scores to assess QI knowledge, and performance-based assessment via presentation of longitudinal QI projects. Overall 175 residents participated, with a response rate of 160/175 (91%) post-curriculum and 114/175 (65%) after conducting their longitudinal QI project. Residents' self-reported confidence in making changes to improve health increased and was sustained at twelve months post-curriculum. Self-assessment scores of QI skills improved significantly from pre-curriculum (53.4 to 69.2 percent post-curriculum [p-value 0.002]) and scores were sustained at twelve months after conducting their longitudinal QI projects (53.4 to 72.2 percent [p-value 0.005]). Objective scores using the QIKAT increased post-curriculum from 8.3 to 10.1 out of 15 (p-value for difference value for difference from pre-curriculum based assessment occurred via presentation of all projects at the annual QI Project Podium Presentation Day. The competency based curriculum on QI improved residents' QI knowledge and skills during residency training. Importantly, residents perceived that their QI knowledge improved after the curriculum and this also correlated to improved QIKAT

What infusion flow should be used for mid-dilution hemodiafiltration?

Science.gov (United States)

Maduell, Francisco; Arias, Marta; Fontseré, Néstor; Vera, Manel; Masso, Elisabeth; Garro, Julia; Barros, Xoana; Martina, Maria N; Elena, Montserrat; Bergadá, Eduardo; Cases, Aleix; Bedini, Jose Luis; Campistol, Josep M

2010-01-01

There is still no consensus on the optimal infusion flow (Qi) in mid-dilution hemodiafiltration. The aim of this study was to compare mid-dilution with varying Qi. Prospective study in 25 patients who underwent seven hemodialysis sessions with a Qi of 0, 50, 100, 150, 200, 250 and 300 ml/min. All sessions were well tolerated except Qi 300 ml/min. No significant differences in urea, creatinine, alpha(1)-microglobulin or alpha(1)-acid glycoprotein reduction ratios were observed. beta(2)-Microglobulin, myoglobin and prolactin reduction ratios were higher with Qi 150, 200, 250 and 300 ml/min in comparison with Qi of 0, 50 and 100 ml/min. There were no differences in the removal of small or larger molecules when Qi was 150 ml/min or higher. Optimal Qi in mid-dilution appears to be in the range of 150-250 ml/min since good clinical outcomes, similar efficiency and no technical complications up to a Qi of 250 ml/min were observed.

Validity and Reliability of the 30-s Continuous Jump for Anaerobic Power and Capacity Assessment in Combat Sport

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Drazen Čular

2018-05-01

Full Text Available Cycling test such Wingate anaerobic test (WAnT is used to measure anaerobic power (AP, but not anaerobic capacity (AC, i.e., the metabolic energy demand. However, in sports that do not involve cycling movements (Karate, the continuous jump for 30 s (vertical jumps for 30 s has been extensively used to measure anaerobic performance in all young athletes. Limited information’s are available concerning its validity and reliability especially in children. As such, the current study aimed to test validity and reliability of a continuous jumps test (the CJ30s, using WAnT as a reference. Thirteen female Karate kids (age: 11.07 ± 1.32 years; mass: 41.76 ± 15.32 kg; height: 152 ± 11.52 cm; training experience: 4.38 ± 2.14 years were tested on three separate sessions. The first and second sessions were used to assess the reliability using Intra-class correlation coefficient (ICC of CJ30s, whereas on the third session WAnT was administered. Following CJ30s and WAnT, we assessed AP (1/CJ30s, as jump height [JH], fatigue index [FI], and blood lactate [BL]; 2/WAnT, as mechanical power [P], FI, and BL and AC as the excess post-exercise oxygen consumption (EPOC. Large/highly significant correlations were found between CJ30s and WAnT EPOCs (r = 0.730, P = 0.003, and BLs (r = 0.713, P = 0.009. Moderate/significant correlations were found between CJ30s and WAnT FIs (r = 0.640, P = 0.014, CJ30s first four jumps mean JH and WAnT peak P (r = 0.572, P = 0.032, and CJ30s mean JH and WAnT mean P (r = 0.589, P = 0.021. CJ30s showed excellent and moderate reliability (ICC for AP (maximal JH 0.884, mean JH 0.742, FI 0.657, BL 0.653 and AC (EPOC 0.788, respectively. Correlations observed especially in terms of AC between CJ30s and WAnT provide evidence that former may adequately assess anaerobic performance for the young combat athlete. CJ30 is a reliable test and allow an easy assessment of AP and AC in karate children.

Key Characteristics of Rehabilitation Quality Improvement Publications: Scoping Review From 2010 to 2016.

Science.gov (United States)

Jesus, Tiago S; Papadimitriou, Christina; Pinho, Cátia S; Hoenig, Helen

2017-09-28

To characterize the peer-reviewed quality improvement (QI) literature in rehabilitation. Five electronic databases were searched for English-language articles from 2010 to 2016. Keywords for QI and safety management were searched for in combination with keywords for rehabilitation content and journals. Secondary searches (eg, references-list scanning) were also performed. Two reviewers independently selected articles using working definitions of rehabilitation and QI study types; of 1016 references, 112 full texts were assessed for eligibility. Reported study characteristics including study focus, study setting, use of inferential statistics, stated limitations, and use of improvement cycles and theoretical models were extracted by 1 reviewer, with a second reviewer consulted whenever inferences or interpretation were involved. Fifty-nine empirical rehabilitation QI studies were found: 43 reporting on local QI activities, 7 reporting on QI effectiveness research, 8 reporting on QI facilitators or barriers, and 1 systematic review of a specific topic. The number of publications had significant yearly growth between 2010 and 2016 (P=.03). Among the 43 reports on local QI activities, 23.3% did not explicitly report any study limitations; 39.5% did not used inferential statistics to measure the QI impact; 95.3% did not cite/mention the appropriate reporting guidelines; only 18.6% reported multiple QI cycles; just over 50% reported using a model to guide the QI activity; and only 7% reported the use of a particular theoretical model. Study sites and focuses were diverse; however, nearly a third (30.2%) examined early mobilization in intensive care units. The number of empirical, peer-reviewed rehabilitation QI publications is growing but remains a tiny fraction of rehabilitation research publications. Rehabilitation QI studies could be strengthened by greater use of extant models and theory to guide the QI work, consistent reporting of study limitations, and use of

Embedding organisational quality improvement through middle manager ownership.

Science.gov (United States)

Balding, Cathy

2005-01-01

To strengthen the middle manager role in a hospital quality improvement (QI) program, with a view to increasing and sustaining organisational QI implementation. Case study based action research project, combining pre- and post-action quantitative and qualitative data collection, relating to a QI program intervention in an Australian metropolitan specialist teaching hospital. A model for enhancing the middle manager role in QI was developed and then implemented as the action over a 12-month period. Middle manager understanding and ownership of the QI program and organisational QI implementation significantly increased, although their perceived enjoyment of being involved in QI decreased. This case-study based action research project was limited to one organisation of a specific type - a large specialist metropolitan teaching hospital. The composition of the middle manager group, therefore, is necessarily limited to particular specialties. It is acknowledged that findings from case study and action research methodologies are limited in their generalisability, but assist in the development of knowledge and principles that can be adapted to different settings. This QI implementation model can increase levels of organisational QI implementation by effecting a positive change in middle manager attitude to and involvement in QI. There are many theories regarding the importance of the middle manager role in QI, but little empirical research into exactly what this role may be and how it may be strengthened. This research adds to the knowledge base, and provides clear steps for achieving increased staff involvement and QI implementation.

Integrating Quality Improvement and Continuing Professional Development at an Academic Medical Center: A Partnership Between Practice Plan, Hospital, and Medical School.

Science.gov (United States)

Gold, Barbara; England, Dawn; Riley, William; Jacobs-Halsey, Ginny; Webb, Corinne; Daniels, Bobbi

2016-01-01

While quality improvement (QI) initiatives can be a highly effective means for improving health care delivery in academic medical centers (AMCs), many health care professionals are not formally trained in basic QI methodology, engaging clinicians in QI activities can be challenging, and there is often a lack of integration and coordination among QI functions (eg, Departments of Quality and Safety, Continuing Professional Development). In our AMC, we undertook a collaborative approach to achieve better vertical and horizontal integration of our QI education efforts. This article provides a case example describing our organizational context, what was done, and with what effect and makes our example and lessons learned available to others. We developed a new educational QI program that was jointly planned and implemented by a group comprising major QI stakeholders. This project was intended to create horizontal organizational linkages between continuing professional development, clinicians, the hospital, and QI department and produce QI activities that aligned with the strategic objectives of senior management. The group developed and implemented a curriculum based on Lean methodology and concepts from the Institute for Health Care Improvement Model for Improvement. Two cohorts (27 teams) completed the training and planned and implemented QI projects. All projects were aligned with organizational quality, safety, and patient experience goals. The majority of projects met their aim statements. This case description provides an example of successful horizontal integration of an AMCs' QI functions to disseminate knowledge and implement meaningful QI aligned with strategic objectives (vertical integration).

Community Sourced Knowledge: Solving the Maintenance Problem

Science.gov (United States)

2012-05-01

The end-user doesn’t need further assistance. KPI – Key Performance Indicator KPI -1 = Relayed solution to the end-user. KPI -2 = Trouble ticket is...created for the end-user and escalated for further review. KPI -3 = Trouble ticket is created for the end-user. KPI -4 = End of Call. Start of Process...14i KPI -1 KPI -2 KPI -3 KPI -4 QI-2QI-3 QI-4 QI-5 QI-6 Does the analyst understand the end- user’s rqst. Yes No 7 QI-1 Inform KMT. Legend KMT

A national study of nurse leadership and supports for quality improvement in rural hospitals.

Science.gov (United States)

Paez, Kathryn; Schur, Claudia; Zhao, Lan; Lucado, Jennifer

2013-01-01

This study assessed the perceptions and actions of rural hospital nurse executives with regard to patient safety and quality improvement (QI). A national sample of rural hospital nurse executives (n = 300) completed a survey measuring 4 domains related to patient safety and QI: (a) patient "Safety Culture," (b) adequacy of QI "Resources," (c) "Barriers" related to QI, and (d) "Nurse Leader Engagement" in activities supporting QI. Perceptions of Safety Culture were strong but 47% of the Resources needed to carry out QI were inadequate, 29% of Barriers were moderate to major, and 25% of Nurse Leader Engagement activities were performed infrequently. Nurse Leader Engagement in quality-related activities was less frequent among nurses in isolated and small rural town hospitals compared with large rural city hospitals. To further QI, rural nurse executives may need to use their communications and actions to raise the visibility of QI.

Sleep Deprivation Alters Choice Strategy Without Altering Uncertainty or Loss Aversion Preferences

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O'Dhaniel A Mullette-Gillman

2015-10-01

Full Text Available Sleep deprivation alters decision making; however, it is unclear what specific cognitive processes are modified to drive altered choices. In this manuscript, we examined how one night of total sleep deprivation (TSD alters economic decision making. We specifically examined changes in uncertainty preferences dissociably from changes in the strategy with which participants engage with presented choice information. With high test-retest reliability, we show that TSD does not alter uncertainty preferences or loss aversion. Rather, TSD alters the information the participants rely upon to make their choices. Utilizing a choice strategy metric which contrasts the influence of maximizing and satisficing information on choice behavior, we find that TSD alters the relative reliance on maximizing information and satisficing information, in the gains domain. This alteration is the result of participants both decreasing their reliance on cognitively-complex maximizing information and a concomitant increase in the use of readily-available satisficing information. TSD did not result in a decrease in overall information use in either domain. These results show that sleep deprivation alters decision making by altering the informational strategies that participants employ, without altering their preferences.

Sleep deprivation alters choice strategy without altering uncertainty or loss aversion preferences.

Science.gov (United States)

Mullette-Gillman, O'Dhaniel A; Kurnianingsih, Yoanna A; Liu, Jean C J

2015-01-01

Sleep deprivation alters decision making; however, it is unclear what specific cognitive processes are modified to drive altered choices. In this manuscript, we examined how one night of total sleep deprivation (TSD) alters economic decision making. We specifically examined changes in uncertainty preferences dissociably from changes in the strategy with which participants engage with presented choice information. With high test-retest reliability, we show that TSD does not alter uncertainty preferences or loss aversion. Rather, TSD alters the information the participants rely upon to make their choices. Utilizing a choice strategy metric which contrasts the influence of maximizing and satisficing information on choice behavior, we find that TSD alters the relative reliance on maximizing information and satisficing information, in the gains domain. This alteration is the result of participants both decreasing their reliance on cognitively-complex maximizing information and a concomitant increase in the use of readily-available satisficing information. TSD did not result in a decrease in overall information use in either domain. These results show that sleep deprivation alters decision making by altering the informational strategies that participants employ, without altering their preferences.

Practical Implications for an Effective Radiology Residency Quality Improvement Program for Milestone Assessment.

Science.gov (United States)

Leddy, Rebecca; Lewis, Madelene; Ackerman, Susan; Hill, Jeanne; Thacker, Paul; Matheus, Maria; Tipnis, Sameer; Gordon, Leonie

2017-01-01

Utilization of a radiology resident-specific quality improvement (QI) program and curriculum based on the Accreditation Council for Graduate Medical Education (ACGME) milestones can enable a program's assessment of the systems-based practice component and prepare residents for QI implementation post graduation. This article outlines the development process, curriculum, QI committee formation, and resident QI project requirements of one institution's designated radiology resident QI program. A method of mapping the curriculum to the ACGME milestones and assessment of resident competence by postgraduate year level is provided. Sample projects, challenges to success, and lessons learned are also described. Survey data of current trainees and alumni about the program reveal that the majority of residents and alumni responders valued the QI curriculum and felt comfortable with principles and understanding of QI. The most highly valued aspect of the program was the utilization of a resident education committee. The majority of alumni responders felt the residency quality curriculum improved understanding of QI, assisted with preparation for the American Board of Radiology examination, and prepared them for QI in their careers. In addition to the survey results, outcomes of resident project completion and resident scholarly activity in QI are evidence of the success of this program. It is hoped that this description of our experiences with a radiology resident QI program, in accordance with the ACGME milestones, may facilitate the development of successful QI programs in other diagnostic radiology residencies. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Healthcare quality improvement work: a professional employee perspective.

Science.gov (United States)

Gadolin, Christian; Andersson, Thomas

2017-06-12

Purpose The purpose of this paper is to describe and analyze conditions that influence how employees engage in healthcare quality improvement (QI) work. Design/methodology/approach Qualitative case study based on interviews ( n=27) and observations ( n=10). Findings The main conditions that influence how employees engage in healthcare QI work are professions, work structures and working relationships. These conditions can both prevent and facilitate healthcare QI. Professions and work structures may cement existing institutional logics and thus prevent employees from engaging in healthcare QI work. However, attempts to align QI with professional logics, together with work structures that empower employees, can make these conditions increase employee engagement, which can be accomplished through positive working relationships that foster institutional work, which bridge different competing institutional logics, making it possible to overcome barriers that professions and work structures may constitute. Practical implications Understanding the conditions that influence how employees engage in healthcare QI work will make initiatives more likely to succeed. Originality/value Healthcare QI has mainly been studied from an implementer perspective, and employees have either been neglected or seen as passive resisters. Weak employee perspectives make healthcare QI research incomplete. In our research, healthcare QI work is studied closely at the actor level to understand healthcare QI from an employee perspective.

An analysis of the suitability of public spaces to physical activity practice in Rio de Janeiro, Brazil.

Science.gov (United States)

Vieira, Marcelo Carvalho; Sperandei, Sandro; Reis, Arianne; da Silva, Cláudia Gonçalves Thaumaturgo

2013-09-01

To assess the physical characteristics of public spaces designed for sport/physical activity/leisure in Rio de Janeiro, Brazil, and their relationship to the socioeconomic indicators. Public spaces (n = 38) spread across the city were evaluated between December 2011 and January 2012 using the Physical Activity Resource Assessment (PARA) instrument. Based on PARA results, a Quality Indicator (QI) was prepared and the sample was grouped into "High QI" and "Low QI" using a k-means clustering algorithm. The association between QI and the local Social Development Index (SDI) was tested using a Chi-square test. The average QI was 13.6 ± 4.91 and the median was equal to 13 points. The High QI group, composed of sites with a QI above median, reached 17.9 ± 2.35 points, while the Low QI group reached 9.3 ± 2.16 points. Pearson's Chi-square tests identified a significant association between QI and SDI when the value of SDI 0.7 was used as a criterion for separation (χ(2) = 17.84, p public spaces usually had a lower QI. Policies to encourage physical activity need to focus attention on the built environment also, particularly in socially vulnerable areas. Copyright © 2013 Elsevier Inc. All rights reserved.

A scoping review of online repositories of quality improvement projects, interventions and initiatives in healthcare.

Science.gov (United States)

Bytautas, Jessica P; Gheihman, Galina; Dobrow, Mark J

2017-04-01

Quality improvement (QI) is becoming an important focal point for health systems. There is increasing interest among health system stakeholders to learn from and share experiences on the use of QI methods and approaches in their work. Yet there are few easily accessible, online repositories dedicated to documenting QI activity. We conducted a scoping review of publicly available, web-based QI repositories to (i) identify current approaches to sharing information on QI practices; (ii) categorise these approaches based on hosting, scope and size, content acquisition and eligibility, content format and search, and evaluation and engagement characteristics; and (iii) review evaluations of the design, usefulness and impact of their online QI practice repositories. The search strategy consisted of traditional database and grey literature searches, as well as expert consultation, with the ultimate aim of identifying and describing QI repositories of practices undertaken in a healthcare context. We identified 13 QI repositories and found substantial variation across the five categories. The QI repositories used different terminology (eg, practices vs case studies) and approaches to content acquisition, and varied in terms of primary areas of focus. All provided some means for organising content according to categories or themes and most provided at least rudimentary keyword search functionality. Notably, none of the QI repositories included evaluations of their impact. With growing interest in sharing and spreading best practices and increasing reliance on QI as a key contributor to health system performance, the role of QI repositories is likely to expand. Designing future QI repositories based on knowledge of the range and type of features available is an important starting point for improving their usefulness and impact. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

A multi-state assessment of employer-sponsored quality improvement education for early-career registered nurses.

Science.gov (United States)

Djukic, Maja; Kovner, Christine T; Brewer, Carol S; Fatehi, Farida K; Seltzer, Joanna R

2013-01-01

Increasing participation of registered nurses (RNs) in quality improvement (QI) is a promising strategy to close the health care quality chasm. For RNs to participate effectively in hospital QI, they must have adequate QI knowledge and skills. This descriptive study assessed employer-sponsored QI education and RNs' preparedness across a wide range of QI steps and processes. RNs from 15 U.S. states who were employed in hospitals and were initially licensed to practice in 2007 to 2008 were surveyed. Fewer than one third of respondents reported being very prepared across all measured QI topics. More than half reported receiving zero hours of training in these same topics in the last year. Lack of educational offerings on the topic was the top reason respondents gave for not obtaining QI training. The QI education offered by employers to RNs could be substantially improved. Nurse educators play a critical role in making these improvements. Copyright 2013, SLACK Incorporated.

Aqueous alteration of Japanese simulated waste glass P0798: Effects of alteration-phase formation on alteration rate and cesium retention

International Nuclear Information System (INIS)

Inagaki, Y.; Shinkai, A.; Idemistu, K.; Arima, T.; Yoshikawa, H.; Yui, M.

2006-01-01

Aqueous alteration tests were performed with a Japanese simulated waste glass P0798 in alkaline solutions as a function of pH or species/concentration of alkaline metals in the solution in order to evaluate the alteration conditions determining whether smectite (2:1 clay mineral) or analcime (zeolite) forms as the major alteration-phase. XRD analysis of the alteration-phases showed that smectite forms at any pH between 9.5 and 12, and analcime forms at pH above 11, though the formation also depends on species and concentrations of alkaline metals in the solution. These results cannot agree with the thermodynamically predicted phase stability, e.g., smectite is more stable than the thermodynamic prediction shows. On the basis of the results of alteration conditions, the alteration tests were performed under smectite forming conditions, where only smectite forms or no crystalline phases form, in order to evaluate the alteration rate and the mechanism of cesium release/retention. The results showed that the glass alteration proceeds slowly in proportion to square root of time under smectite forming conditions, which indicates that the alteration rate can be controlled by a diffusion process. It was suggested that the alteration rate under smectite forming conditions is independent of the pH, alkaline metal species/concentration in the solution and whether smectite actually forms or not. The results also indicated that most of cesium dissolved from the glass can be retained in the alteration-phases by reversible sorption onto smectite or irreversible incorporation into analcime, pollucite or solid solutions of them

Security Analysis of a Software Defined Wide Area Network Solution

OpenAIRE

Rajendran, Ashok

2016-01-01

Enterprise wide area network (WAN) is a private network that connects the computers and other devices across an organisation's branch locations and the data centers. It forms the backbone of enterprise communication. Currently, multiprotocol label switching (MPLS) is commonly used to provide this service. As a recent alternative to MPLS, software-dened wide area networking (SD-WAN) solutions are being introduced as an IP based cloud-networking service for enterprises. SD-WAN virtualizes the n...

The Educational Toolbox: Kick Start Your Educational Program in Quality Improvement.

Science.gov (United States)

Hoffman, Rebecca L; Medbery, Rachel L; Vandermeer, Thomas J; Morris, Jon B; Kelz, Rachel R

2015-01-01

To disseminate materials and learning from the proceedings of the Association of Program Directors 2014 Annual Meeting workshop on the integration of quality improvement (QI) education into the existing educational infrastructure. Modern surgical practice demands an understanding of QI methodology. Yet, today׳s surgeons are not formally educated in QI methodology. Therefore, it is hard to follow the historical mantra of "see one, do one, teach one" in the quality realm. Participants were given a brief introduction to QI approaches. A number of concrete examples of how to incorporate QI education into training programs were presented, followed by a small group session focused on the identification of barriers to incorporation. Participants were provided with a worksheet to help navigate the initial incorporation of QI education in 3 steps. Participants were representative of all types of training programs, with differing levels of existing QI integration. Barriers to QI education included lack of resident interest/buy-in, concerns over the availability of educational resources (i.e., limited time to devote to QI), and a limited QI knowledge among surgical educators. The 3 steps to kick starting the educational process included (1) choosing a specific method of QI education, (2) incorporation via barrier, infrastructure, and stakeholder identification, and (3) implementation and ongoing assessment. Recent changes in the delivery of surgical care along with the new accreditation system have necessitated the development of QI education programs for use in surgical education. To continue to make surgery safer and ensure optimal patient outcomes, surgical educators must teach each resident to adopt quality science methodology in a meaningful way. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Developing a taxonomy for the science of improvement in public health.

Science.gov (United States)

Riley, William; Lownik, Beth; Halverson, Paul; Parrotta, Carmen; Godsall, Jonathan R; Gyllstrom, Elizabeth; Gearin, Kimberly J; Mays, Glen

2012-11-01

Quality improvement (QI) methods have been used for almost a decade in public health departments to increase effectiveness and efficiency. Although results are rapidly accumulating, the evidence for the science of improvement is shallow and limited. To advance the use and effectiveness of QI in public health, it is important to develop a science of improvement using practice-based research to build an evidence base for QI projects. This purpose of this study is to advance the science of improvement in public health departments with 3 objectives: (1) establish a taxonomy of QI projects in public health, (2) categorize QI projects undertaken in health departments using the taxonomy, and (3) create an opportunity modes and effects analysis. This study is a qualitative analysis of archival data from 2 separate large databases consisting of 51 QI projects undertaken in public health departments over the last 5 years. The study involves 2 separate QI collaboratives. One includes Minnesota health departments; the other is a national collaborative. We propose a standardized case definition, common metrics, and a taxonomy of QI projects to begin building the evidence base for QI in public health and to advance the science of continuous quality improvement. All projects created an aim statement and used metrics while 53% used a specific QI model with an average of 3.25 QI techniques per project. Approximately 40% of the projects incorporated a process control methodology, and 60% of the projects identified the process from beginning to end, while 11 of 12 PHAB (Public Health Accreditation Board) domains were included. The findings provide a baseline for QI taxonomy to operationalize a science of improvement for public health departments.

Quality Improvement in Otolaryngology Residency: Survey of Program Directors.

Science.gov (United States)

Bowe, Sarah N

2016-02-01

The Clinical Learning Environment Review focuses on the responsibility of the sponsoring institution for quality and patient safety. Very little information is known regarding the status of quality improvement (QI) education during otolaryngology training. The purpose of this survey is to evaluate the extent of resident and faculty participation in QI and identify opportunities for both resident curriculum and faculty development. Cross-sectional survey A 15-item survey was distributed to all 106 otolaryngology program directors. The survey was developed after an informal review of the literature regarding education in QI and patient safety. Questions were directed at the format and content of the QI curriculum, as well as barriers to implementation. There was a 39% response rate. Ninety percent of responding program directors considered education in QI important or very important to a resident's future success. Only 23% of responding programs contained an educational curriculum in QI, and only 33% monitored residents' individual outcome measures. Barriers to implementation of a QI program included inadequate number of faculty with expertise in QI (75%) and competing resident educational demands (90%). Every program director considered morbidity and mortality conferences as an integral component in QI education. Program directors recognize the importance of QI in otolaryngology practice. Unfortunately, this survey identifies a distinct lack of resources in support of these educational goals. The results highlight the need to generate a comprehensive and stepwise approach to QI for faculty development and resident instruction. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

Importance of Performance Measurement and MCH Epidemiology Leadership to Quality Improvement Initiatives at the National, State and Local Levels.

Science.gov (United States)

Rankin, Kristin M; Gavin, Loretta; Moran, John W; Kroelinger, Charlan D; Vladutiu, Catherine J; Goodman, David A; Sappenfield, William M

2016-11-01

Purpose In recognition of the importance of performance measurement and MCH epidemiology leadership to quality improvement (QI) efforts, a plenary session dedicated to this topic was presented at the 2014 CityMatCH Leadership and MCH Epidemiology Conference. This paper summarizes the session and provides two applications of performance measurement to QI in MCH. Description Performance measures addressing processes of care are ubiquitous in the current health system landscape and the MCH community is increasingly applying QI processes, such as Plan-Do-Study-Act (PDSA) cycles, to improve the effectiveness and efficiency of systems impacting MCH populations. QI is maximally effective when well-defined performance measures are used to monitor change. Assessment MCH epidemiologists provide leadership to QI initiatives by identifying population-based outcomes that would benefit from QI, defining and implementing performance measures, assessing and improving data quality and timeliness, reporting variability in measures throughout PDSA cycles, evaluating QI initiative impact, and translating findings to stakeholders. MCH epidemiologists can also ensure that QI initiatives are aligned with MCH priorities at the local, state and federal levels. Two examples of this work, one highlighting use of a contraceptive service performance measure and another describing QI for peripartum hemorrhage prevention, demonstrate MCH epidemiologists' contributions throughout. Challenges remain in applying QI to complex community and systems-level interventions, including those aimed at improving access to quality care. Conclusion MCH epidemiologists provide leadership to QI initiatives by ensuring they are data-informed and supportive of a common MCH agenda, thereby optimizing the potential to improve MCH outcomes.

The effects of Jiao-Tai-Wan on sleep, inflammation and insulin resistance in obesity-resistant rats with chronic partial sleep deprivation.

Science.gov (United States)

Zou, Xin; Huang, Wenya; Lu, Fuer; Fang, Ke; Wang, Dingkun; Zhao, Shuyong; Jia, Jiming; Xu, Lijun; Wang, Kaifu; Wang, Nan; Dong, Hui

2017-03-23

Jiao-Tai-Wan (JTW), composed of Rhizome Coptidis and Cortex Cinnamomi, is a classical traditional Chinese prescription for treating insomnia. Several in vivo studies have concluded that JTW could exert its therapeutical effect in insomnia rats. However, the specific mechanism is still unclear. The present study aimed to explore the effect of JTW on sleep in obesity-resistant (OR) rats with chronic partial sleep deprivation (PSD) and to clarify its possible mechanism. JTW was prepared and the main components contained in the granules were identified by 3D-High Performance Liquid Chromatography (3D-HPLC) assay. The Male Sprague-Dawley (SD) rats underwent 4 h PSD by environmental noise and the treatment with low and high doses of JTW orally for 4 weeks, respectively. Then sleep structure was analyzed by electroencephalographic (EEG). Inflammation markers including high-sensitivity C reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels were examined in the rat plasma. Meanwhile, metabolic parameters as body weight increase rate, fasting plasma glucose (FPG), fasting insulin (FINS) levels and insulin resistance index (HOMA-IR) were measured. The expressions of clock gene cryptochromes (Cry1 and Cry2) and inflammation gene nuclear factor-κB (NF-κB) in peripheral blood monocyte cells (PBMC) were also determined. The result showed that the administration of JTW significantly increased total sleep time and total slow wave sleep (SWS) time in OR rats with PSD. Furthermore, the treatment with JTW reversed the increase in the markers of systemic inflammation and insulin resistance caused by sleep loss. These changes were also associated with the up-regulation of Cry1 mRNA and Cry 2 mRNA and the down-regulation of NF-κB mRNA expression in PBMC. This study suggests that JTW has the beneficial effects of improving sleep, inflammation and insulin sensitivity. The mechanism appears to be related to the modulation of circadian clock and

Can first-year medical students acquire quality improvement knowledge prior to substantial clinical exposure? A mixed-methods evaluation of a pre-clerkship curriculum that uses education as the context for learning.

Science.gov (United States)

Brown, Allison; Nidumolu, Aditya; Stanhope, Alexandra; Koh, Justin; Greenway, Matthew; Grierson, Lawrence

2018-03-19

Quality Improvement (QI) training for health professionals is essential to strengthen health systems. However, QI training during medical school is constrained by students' lack of contextual understanding of the health system and an already saturated medical curriculum. The Program for Improvement in Medical Education (PRIME), an extracurricular offered at the Michael G. DeGroote School of Medicineat McMaster University (Hamilton, Canada), addresses these obstacles by having first-year medical students engage in QI by identifying opportunities for improvement within their own education. A sequential explanatory mixed-methods approach, which combines insights derived from quantitative instruments and qualitative interview methods, was used to examine the impact of PRIME on first-year medical students and the use of QI in the context of education. The study reveals that participation in PRIME increases both knowledge of, and comfort with, fundamental QI concepts, even when applied to clinical scenarios. Participants felt that education provided a meaningful context to learn QI at this stage of their training, and were motivated to participate in future QI projects to drive real-world improvements in the health system. Early exposure to QI principles that uses medical education as the context may be an effective intervention to foster QI competencies at an early stage and ultimately promote engagement in clinical QI. Moreover, PRIME also provides a mechanism to drive improvements in medical education. Future research is warranted to better understand the impact of education as a context for later engagement in clinical QI applications as well as the potential for QI methods to be translated directly into education. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Accumulation of Arsenic Speciation and In Vivo Toxicity Following Oral Administration of a Chinese Patent Medicine Xiao-Er-Zhi-Bao-Wan in Rats

Directory of Open Access Journals (Sweden)

Jiaoyang Luo

2017-07-01

Full Text Available Realgar-containing traditional Chinese medicines such as Xiao-Er-Zhi-Bao-Wan (XEZBW, have been widely used for thousands of years. However, events associated with arsenic-induced ailments have increasingly become a public concern. To address the toxicity of XEZBW, we studied the histopathology and blood biochemistry of rats exposed to XEZBW using technology like high-performance liquid chromatography-inductively coupled mass spectrometry to determine arsenic speciation. Our results demonstrated that dimethylarsinic acid (DMA increased from 18.57 ± 7.45 to 22.74 ± 7.45 ng/g in rat kidney after oral administration for 7 and 14 days, which was 10-fold higher than the levels observed in controls. Trivalent arsenite As(III showed a large increase on day 7 (26.99 ± 1.98 ng/g, followed by a slight decrease on day 14 (13.67 ± 6.48 ng/g. Total arsenic levels on day 7 (185.52 ± 24.56 ng/g and day 14 (198.57 ± 26.26 ng/g were nearly twofold higher than that in the control group (92.77 ± 14.98 ng/g. Histopathological analysis showed mild injury in the liver and kidney of rats subjected to oral administration of realgar for 14 days. As in the XEZBW groups, a mild injury in these organs was observed after administration for 14 days. This study inferred that the toxicity of arsenic was concentration- and time-dependent. The accumulation of DMA, a byproduct of choline metabolism, was responsible for inducing higher toxicity. Therefore, we concluded that measuring the levels of DMA, instead of total arsenic, might be more suitable for evaluating the toxicity of realgar-containing traditional Chinese medicines.

Quality Improvement Practices in Academic Emergency Medicine: Perspectives from the Chairs

Directory of Open Access Journals (Sweden)

DelliFraine, Jami L

2010-12-01

Full Text Available Objective: To assess academic emergency medicine (EM chairs’ perceptions of quality improvement (QI training programs.Methods: A voluntary anonymous 20 item survey was distributed to a sample of academic chairs of EM through the Association of Academic Chairs of Emergency Medicine. Data was collected to assess the percentage of academic emergency physicians who had received QI training, the type of training they received, their perception of the impact of this training on behavior, practice and outcomes, and any perceived barriers to implementing QI programs in the emergency department.Results: The response rate to the survey was 69% (N = 59. 59.3% of respondents report that their hospital has a formal QI program for physicians. Chairs received training in a variety of QI programs. The type of QI program used by respondents was perceived as having no impact on goals achieved by QI (χ2 = 12.382; p = 0.260, but there was a statistically significant (χ2 = 14.383; p = 0.006 relationship between whether or not goals were achieved and academic EM chairs’ perceptions about return on investment for QI training. Only 22% of chairs responded that they have already made changes as a result of the QI training. 78.8% of EM chairs responded that quality programs could have a significant positive impact on their practice and the healthcare industry. Chairs perceived that QI programs had the most potential value in the areas of understanding and reducing medical errors and improving patient flow and throughput. Other areas of potential value of QI include improving specific clinical indicators and standardizing physician care.Conclusion: Academic EM chairs perceived that QI programs were an effective way to drive needed improvements. The results suggest that there is a high level of interest in QI but a low level of adoption of training and implementation.[West J Emerg Med. 2010; 11(5:479-485.

The Model for Understanding Success in Quality (MUSIQ): building a theory of context in healthcare quality improvement.

Science.gov (United States)

Kaplan, Heather C; Provost, Lloyd P; Froehle, Craig M; Margolis, Peter A

2012-01-01

BACKGROUND Quality improvement (QI) efforts have become widespread in healthcare, however there is significant variability in their success. Differences in context are thought to be responsible for some of the variability seen. To develop a conceptual model that can be used by organisations and QI researchers to understand and optimise contextual factors affecting the success of a QI project. 10 QI experts were provided with the results of a systematic literature review and then participated in two rounds of opinion gathering to identify and define important contextual factors. The experts subsequently met in person to identify relationships among factors and to begin to build the model. The Model for Understanding Success in Quality (MUSIQ) is organised based on the level of the healthcare system and identifies 25 contextual factors likely to influence QI success. Contextual factors within microsystems and those related to the QI team are hypothesised to directly shape QI success, whereas factors within the organisation and external environment are believed to influence success indirectly. The MUSIQ framework has the potential to guide the application of QI methods in healthcare and focus research. The specificity of MUSIQ and the explicit delineation of relationships among factors allows a deeper understanding of the mechanism of action by which context influences QI success. MUSIQ also provides a foundation to support further studies to test and refine the theory and advance the field of QI science.

FLIP: Federation support for Long range low power Internet of things Protocols

OpenAIRE

Delbruel, Stéphane; Small, Nicolas; Hughes, Danny

2017-01-01

There is growing interest in the Internet of Things (IoT) and especially Low-Power Wide Area Networks (LPWAN), which are rapidly being rolled-out globally. Within the LPWAN market, LoRaWAN is considered a leading solution which has achieved significant success. Despite the rapid uptake of LoRaWAN, scalability concerns arising from interference and contention are also growing. While the current LoRaWAN protocol includes basic techniques to deal with these problems, recent research has shown th...

The development and work procedures to super speed network for the growing demands for the network

International Nuclear Information System (INIS)

Nosaki, Nobuhisa; Aoki, Kazuhisa

2001-01-01

Following the recently growing demands for the network, the modification of Local Area Network (LAN) and Wide Area Network (WAN) to super speed network have been reviewed in the Japan Nuclear Cycle Development Institute (JNC). Though the modification of the LAN to super speed network is being developed this year in Heisei 13 fiscal year, it of the WAN was developed in Heisei 12 fiscal year. In spite of various issues, technical reviews and etc., there are a lot of benefits and merit for the super speed network of the WAN and though the modification of it and reduction of the running cost are contradictory to each other, both of those have been achieved in the JNC. This paper introduces the development and work procedures for the WAN. (author)

Convergence

DEFF Research Database (Denmark)

Madsen, Ole Brun; Nielsen, Jens Frederik Dalsgaard; Schiøler, Henrik

2002-01-01

Convergence trends between the WAN Internet area, characterized by best effort service provision, and the real time LAN domain, with requirements for guaranteed services, are identified and discussed. A bilateral evolution is identified, where typical bulk service applications from WAN, such as m......Convergence trends between the WAN Internet area, characterized by best effort service provision, and the real time LAN domain, with requirements for guaranteed services, are identified and discussed. A bilateral evolution is identified, where typical bulk service applications from WAN...... with the emergence of remote service provision, such as supervision and control of decentralized heating facilities and wind based electrical power production. The reliability issue is addressed from a structural viewpoint, where the concept of Structural QoS (SQoS) is defined to support reliability modelling...

RN-to-BSN Students' Quality Improvement Knowledge, Skills, Confidence, and Systems Thinking.

Science.gov (United States)

Trent, Peggy; Dolansky, Mary A; DeBrew, Jacqueline Kayler; Petty, Gayle M

2017-12-01

Little evidence demonstrates that RN-to-baccalaureate nursing (BSN) graduates have met The Essentials of Baccalaureate Education for Professional Nursing Practice-specifically, evidence of the graduates' organizational and systems leadership related to quality care and patient safety. This BSN Essentials reflects the QSEN quality improvement (QI) competency. The purpose of this pilot study was to develop and test an assessment strategy to measure RN-to BSN students' QI competence and their perception of QI knowledge and skills. Students (N = 59) from six RN-to-BSN programs participated in a Qualtrics survey e-mailed during the last semester of their program. The majority of students (60%) reported that they did not experience QI content in their program. Scores on QI knowledge, skills, and systems thinking were low, yet the students self-reported that they were confident in their ability to perform QI. This pilot study provides an assessment strategy to measure students' competence related to QI. Nursing education has an opportunity to integrate and measure QI competence to ensure that nurses have the knowledge and skills to continually improve patient care. [J Nurs Educ. 2017;56(12):737-740.]. Copyright 2017, SLACK Incorporated.

Quality improvement primer part 1: Preparing for a quality improvement project in the emergency department.

Science.gov (United States)

Chartier, Lucas B; Cheng, Amy H Y; Stang, Antonia S; Vaillancourt, Samuel

2018-01-01

Emergency medicine (EM) providers work in a fast-paced and often hectic environment that has a high risk for patient safety incidents and gaps in the quality of care. These challenges have resulted in opportunities for frontline EM providers to play a role in quality improvement (QI) projects. QI has developed into a mature field with methodologies that can dramatically improve the odds of having a successful project with a sustainable impact. However, this expertise is not yet commonly taught during professional training. In this first of three articles meant as a QI primer for EM clinicians, we will introduce QI methodology and strategic planning using a fictional case study as an example. We will review how to identify a QI problem, define components of an effective problem statement, and identify stakeholders and core change team members. We will also describe three techniques used to perform root cause analyses-Ishikawa diagrams, Pareto charts and process mapping-and how they relate to preparing for a QI project. The next two papers in this series will focus on the execution of the QI project itself using rapid-cycle testing and on the evaluation and sustainability of QI projects.

Validation of a method for assessing resident physicians' quality improvement proposals.

Science.gov (United States)

Leenstra, James L; Beckman, Thomas J; Reed, Darcy A; Mundell, William C; Thomas, Kris G; Krajicek, Bryan J; Cha, Stephen S; Kolars, Joseph C; McDonald, Furman S

2007-09-01

Residency programs involve trainees in quality improvement (QI) projects to evaluate competency in systems-based practice and practice-based learning and improvement. Valid approaches to assess QI proposals are lacking. We developed an instrument for assessing resident QI proposals--the Quality Improvement Proposal Assessment Tool (QIPAT-7)-and determined its validity and reliability. QIPAT-7 content was initially obtained from a national panel of QI experts. Through an iterative process, the instrument was refined, pilot-tested, and revised. Seven raters used the instrument to assess 45 resident QI proposals. Principal factor analysis was used to explore the dimensionality of instrument scores. Cronbach's alpha and intraclass correlations were calculated to determine internal consistency and interrater reliability, respectively. QIPAT-7 items comprised a single factor (eigenvalue = 3.4) suggesting a single assessment dimension. Interrater reliability for each item (range 0.79 to 0.93) and internal consistency reliability among the items (Cronbach's alpha = 0.87) were high. This method for assessing resident physician QI proposals is supported by content and internal structure validity evidence. QIPAT-7 is a useful tool for assessing resident QI proposals. Future research should determine the reliability of QIPAT-7 scores in other residency and fellowship training programs. Correlations should also be made between assessment scores and criteria for QI proposal success such as implementation of QI proposals, resident scholarly productivity, and improved patient outcomes.

Project JOINTS: what factors affect bundle adoption in a voluntary quality improvement campaign?

Science.gov (United States)

Khodyakov, Dmitry; Ridgely, M Susan; Huang, Christina; DeBartolo, Katherine O; Sorbero, Melony E; Schneider, Eric C

2015-01-01

Diffusion and adoption of effective evidence-based clinical practices can be slow, especially if complex changes are required to implement new practices. To examine how hospital adherence to quality improvement (QI) methods and hospital engagement with a large-scale QI campaign could facilitate the adoption of an enhanced prevention bundle designed to reduce surgical site infection (SSI) rates after orthopaedic surgery (hip and knee arthroplasty). We conducted telephone interviews with hospital QI leaders from 73 of the 109 hospitals (67% response rate) in five states that participated in Project JOINTS (Joining Organizations IN Tackling SSIs), a QI campaign run by Institute for Healthcare Improvement (IHI). Using QI methods grounded in the IHI Model for Improvement, this campaign encouraged hospitals to implement an enhanced SSI prevention bundle. Hospital QI leaders reported on their hospital's adherence to the Project JOINTS QI methods; their level of engagement with Project JOINTS activities; and adoption of the SSI prevention bundle components. Interview data were analysed quantitatively and qualitatively. Both adherence to the QI methods and hospital engagement were positively associated with complete bundle adoption. Hospital engagement, especially the use of project materials and tools, was also positively associated with the initiation of and improved adherence to individual bundle components. Our findings suggest that greater adherence to the QI methods and active hospital engagement in a QI campaign facilitate adoption of evidence-based patient safety bundles in orthopaedic practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Mixed-Methods Assessment of Trauma and Acute Care Surgical Quality Improvement Programs in Peru.

Science.gov (United States)

LaGrone, Lacey N; Fuhs, Amy K; Egoavil, Eduardo Huaman; Rodriguez Castro, Manuel J A; Valderrama, Roberto; Isquith-Dicker, Leah N; Herrera-Matta, Jaime; Mock, Charles N

2017-04-01

Evidence for the positive impact of quality improvement (QI) programs on morbidity, mortality, patient satisfaction, and cost is strong. Data regarding the status of QI programs in low- and middle-income countries, as well as in-depth examination of barriers and facilitators to their implementation, are limited. This cross-sectional, descriptive study employed a mixed-methods design, including distribution of an anonymous quantitative survey and individual interviews with healthcare providers who participate in the care of the injured at ten large hospitals in Lima, Peru. Key areas identified for improvement in morbidity and mortality (M&M) conferences were the standardization of case selection, incorporation of evidence from the medical literature into case presentation and discussion, case documentation, and the development of a clear plan for case follow-up. The key barriers to QI program implementation were a lack of prioritization of QI, lack of sufficient human and administrative resources, lack of political support, and lack of education on QI practices. A national program that makes QI a required part of all health providers' professional training and responsibilities would effectively address a majority of identified barriers to QI programs in Peru. Specifically, the presence of basic QI elements, such as M&M conferences, should be required at hospitals that train pre-graduate physicians. Alternatively, short of this national-level organization, efforts that capitalize on local examples through apprenticeships between institutions or integration of QI into continuing medical education would be expected to build on the facilitators for QI programs that exist in Peru.

Do relationships exist between the scope and intensity of quality improvement activities and hospital operation performance? A 10-year observation in Taiwan.

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Chung, Kuo-Piao; Yu, Tsung-Hsien

2015-08-14

The relationship between the scope and intensity of quality improvement (QI) activities and hospital performance remains unclear. This study investigated the relationship between performance, external environment, and the scope and intensity of QI activities in hospitals. The study used a longitudinal observation. Data regarding the scope and intensity of QI activities were collected using a questionnaire survey among the administrative deputy superintendents / directors of quality management center in 139 hospitals. Hospital performance indicators were abstracted from the 2000-2009 national hospitals profiles. We adopted year 2000 as the baseline, and divided the study period into three 3-year periods. The Generalized Estimating Equations (GEE) model was used for the statistical analysis. Seventy-two hospitals responded to the survey, giving a response rate of 52%. The results showed a significant increase in the scope and intensity of QI activities between 2000 and 2009. The results also showed that the scope and intensity of a hospital's QI activities were associated with the scope and intensity of its competitors' QI activities in the previous period and its own prior performance. The scope of QI activities in the previous period was not significantly related to the selected hospital performance measures. However, the intensity of QI activities in the previous period showed a significant and positive relationship with the number of inpatients and the turnover of beds. The study demonstrates that the intensity of QI activities is associated with the external environment and the hospital's own performance in the previous period. Furthermore, some performance measures are associated with the intensity of the QI activities in the previous period.

MO-C-12A-01: Quantitative Imaging Initiatives: Why, Who, What, and How?

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Sullivan, D [Duke University, Durham, NC (United States); Jackson, E; Clarke, L; Petrick, N; Russek, S [University of Wisconsin, Madison, WI (United States)

2014-06-15

Over the past decade, there has been an increasing focus on quantitative imaging (QI), which, according to one definition, is “the extraction of quantifiable features from medical images for the assessment of normal or the severity, degree of change, or status of a disease, injury, or chronic condition relative to normal” ( www.rsna.org/QIBA ). To achieve the goals of QI requires the development and standardization of data acquisition, data analysis, and data display techniques, as well as appropriate reporting structures. As such, successful implementation of QI relies heavily on expertise from the fields of medical physics, radiology, statistics, and informatics as well as collaboration from vendors of imaging acquisition, analysis, and reporting systems. When successfully implemented, QI techniques will provide image-derived metrics with known bias and variance that can be validated with anatomically and physiologically relevant measures, including treatment response, and the heterogeneity of that response, and outcome. Such non-invasive measures can then be used effectively in clinical and translational research as well as patient care. In addition to modality-specific QI efforts implemented by individual scientific organizations, national and international organizations, including the NCI, RSNA, FDA, and NIST, appreciating the tremendous potential of QI but also understanding the associated challenges, have become increasingly involved. This symposium session will focus on 1) introducing QI and illustrating why it is important, even though challenging, in both research and clinical applications, and 2) providing overviews of QI efforts from national and international organizations, including the RSNA, NCI, FDA, and NIST. Learning Objectives: Understand the importance and potential of QI in research and clinical applications. Understand key challenges of QI and current barriers to implementation. Understand the current QI efforts of several national and

MO-C-12A-01: Quantitative Imaging Initiatives: Why, Who, What, and How?

International Nuclear Information System (INIS)

Sullivan, D; Jackson, E; Clarke, L; Petrick, N; Russek, S

2014-01-01

Over the past decade, there has been an increasing focus on quantitative imaging (QI), which, according to one definition, is “the extraction of quantifiable features from medical images for the assessment of normal or the severity, degree of change, or status of a disease, injury, or chronic condition relative to normal” ( www.rsna.org/QIBA ). To achieve the goals of QI requires the development and standardization of data acquisition, data analysis, and data display techniques, as well as appropriate reporting structures. As such, successful implementation of QI relies heavily on expertise from the fields of medical physics, radiology, statistics, and informatics as well as collaboration from vendors of imaging acquisition, analysis, and reporting systems. When successfully implemented, QI techniques will provide image-derived metrics with known bias and variance that can be validated with anatomically and physiologically relevant measures, including treatment response, and the heterogeneity of that response, and outcome. Such non-invasive measures can then be used effectively in clinical and translational research as well as patient care. In addition to modality-specific QI efforts implemented by individual scientific organizations, national and international organizations, including the NCI, RSNA, FDA, and NIST, appreciating the tremendous potential of QI but also understanding the associated challenges, have become increasingly involved. This symposium session will focus on 1) introducing QI and illustrating why it is important, even though challenging, in both research and clinical applications, and 2) providing overviews of QI efforts from national and international organizations, including the RSNA, NCI, FDA, and NIST. Learning Objectives: Understand the importance and potential of QI in research and clinical applications. Understand key challenges of QI and current barriers to implementation. Understand the current QI efforts of several national and

Identifying quality improvement intervention publications - A comparison of electronic search strategies

Directory of Open Access Journals (Sweden)

Rubenstein Lisa V

2011-08-01

Full Text Available Abstract Background The evidence base for quality improvement (QI interventions is expanding rapidly. The diversity of the initiatives and the inconsistency in labeling these as QI interventions makes it challenging for researchers, policymakers, and QI practitioners to access the literature systematically and to identify relevant publications. Methods We evaluated search strategies developed for MEDLINE (Ovid and PubMed based on free text words, Medical subject headings (MeSH, QI intervention components, continuous quality improvement (CQI methods, and combinations of the strategies. Three sets of pertinent QI intervention publications were used for validation. Two independent expert reviewers screened publications for relevance. We compared the yield, recall rate, and precision of the search strategies for the identification of QI publications and for a subset of empirical studies on effects of QI interventions. Results The search yields ranged from 2,221 to 216,167 publications. Mean recall rates for reference publications ranged from 5% to 53% for strategies with yields of 50,000 publications or fewer. The 'best case' strategy, a simple text word search with high face validity ('quality' AND 'improv*' AND 'intervention*' identified 44%, 24%, and 62% of influential intervention articles selected by Agency for Healthcare Research and Quality (AHRQ experts, a set of exemplar articles provided by members of the Standards for Quality Improvement Reporting Excellence (SQUIRE group, and a sample from the Cochrane Effective Practice and Organization of Care Group (EPOC register of studies, respectively. We applied the search strategy to a PubMed search for articles published in 10 pertinent journals in a three-year period which retrieved 183 publications. Among these, 67% were deemed relevant to QI by at least one of two independent raters. Forty percent were classified as empirical studies reporting on a QI intervention. Conclusions The presented

Increased Adoption of Quality Improvement Interventions to Implement Evidence-Based Practices for Pressure Ulcer Prevention in U.S. Academic Medical Centers.

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Padula, William V; Mishra, Manish K; Makic, Mary Beth F; Wald, Heidi L; Campbell, Jonathan D; Nair, Kavita V; Valuck, Robert J

2015-12-01

In 2008, the U.S. Centers for Medicare and Medicaid Services enacted a nonpayment policy for stage III and IV hospital-acquired pressure ulcers (HAPUs), which incentivized hospitals to improve prevention efforts. In response, hospitals looked for ways to support implementation of evidence-based practices for HAPU prevention, such as adoption of quality improvement (QI) interventions. The objective of this study was to quantify adoption patterns of QI interventions for supporting evidence-based practices for HAPU prevention. This study surveyed wound care specialists working at hospitals within the University HealthSystem Consortium. A questionnaire was used to retrospectively describe QI adoption patterns according to 25 HAPU-specific QI interventions into four domains: leadership, staff, information technology (IT), and performance and improvement. Respondents indicated QI interventions implemented between 2007 and 2012 to the nearest quarter and year. Descriptive statistics defined patterns of QI adoption. A t-test and statistical process control chart established statistically significant increase in adoption following nonpayment policy enactment in October 2008. Increase are described in terms of scope (number of QI domains employed) and scale (number of QI interventions within domains). Fifty-three of the 55 hospitals surveyed reported implementing QI interventions for HAPU prevention. Leadership interventions were most frequent, increasing in scope from 40% to 63% between 2008 and 2012; "annual programs to promote pressure ulcer prevention" showed the greatest increase in scale. Staff interventions increased in scope from 32% to 53%; "frequent consult driven huddles" showed the greatest increase in scale. IT interventions increased in scope from 31% to 55%. Performance and improvement interventions increased in scope from 18% to 40%, with "new skin care products . . ." increasing the most. Academic medical centers increased adoption of QI interventions

Vertical Jumping Tests versus Wingate Anaerobic Test in Female Volleyball Players: The Role of Age

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Pantelis Theodoros Nikolaidis

2016-02-01

Full Text Available Single and continuous vertical jumping tests, as well as the Wingate anaerobic test (WAnT, are commonly used to assess the short-term muscle power of female volleyball players; however, the relationship among these tests has not been studied adequately. Thus, the aim of the present study was to examine the relationship of single and continuous vertical jumps with the WAnT in female volleyball players. Seventy adolescent (age 16.0 ± 1.0 years, body mass 62.5 ± 7.1 kg, height 170.4 ± 6.1 cm, body fat 24.2% ± 4.3% and 108 adult female volleyball players (age 24.8 ± 5.2 years, body mass 66.5 ± 8.7 kg, height 173.2 ± 7.4 cm, body fat 22.0% ± 5.1% performed the squat jump (SJ, countermovement jump (CMJ, Abalakov jump (AJ, 30 s Bosco test and WAnT (peak power, Ppeak; mean power, Pmean. Mean power in the Bosco test was correlated (low to large magnitude with Pmean of the WAnT (r = 0.27, p = 0.030 in adolescents versus r = 0.56, p < 0.001 in adults. SJ, CMJ and AJ also correlated with Ppeak (0.28 ≤ r ≤ 0.46 in adolescents versus 0.58 ≤ r ≤ 0.61 in adults and with Pmean (0.43 ≤ r ≤ 0.51 versus 0.67 ≤ r ≤ 0.71, respectively of the WAnT (p < 0.05. In summary, the impact of the Bosco test and WAnT on muscle power varied, especially in the younger age group. Single jumping tests had larger correlations with WAnT in adults than in adolescent volleyball players. These findings should be taken into account by volleyball coaches and fitness trainers during the assessment of short-term muscle power of their athletes.

The first ever Cochrane event in Russia and Russian speaking countries - Cochrane Russia Launch - Evidence-based medicine: Achievements and barriers (QiQUM 2015) International Conference, Kazan, December 7-8, 2015.

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Ziganshina, Liliya Eugenevna; Jørgensen, Karsten Juhl

2016-01-01

Kazan hosted Russia's second International Conference QiQUM 2015 on Cochrane evidence for health policy, which was entirely independent of the pharmaceutical or other health industry, bringing together 259 participants from 11 countries and 13 regions of the Russian Federation. The Conference was greeted and endorsed by world leaders in Evidence-based medicine, health and pharmaceutical information, policy and regulation, and the World Health Organization. Participants discussed the professional and social problems arising from biased health information, unethical pharmaceutical promotion, misleading reporting of clinical trials with consequent flaws in health care delivery and the role of Cochrane evidence for informed decisions and better health. The first in history Cochrane workshop, facilitated jointly by experts from Cochrane and the WHO, with 40 participants from Kazakhstan, Kyrgyzstan, Tajikistan and Russia introduced the concept of Cochrane systematic review and the Use of Cochrane evidence in WHO policy setting. Websites document conference materials and provide interface for future collaboration: http://kpfu.ru/biology-medicine/struktura-instituta/kafedry/kfikf/konferenciya/mezhdunarodnaya-konferenciya-39dokazatelnaya.html and http://russia.cochrane.org/news/international-conference.

A pilot study for the integration of cytometry reports in digital cytology telemedicine applications.

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Giansanti, Daniele; Cerroni, Fabio; Amodeo, Rachele; Filoni, Marco; Giovagnoli, Maria Rosaria

2010-01-01

Up to date, tele-pathology in the three different forms of application, "dynamic", "static" and "virtual microscopy" has been mainly based on tele-hystology remote consulting. Today the diffusion of specialized WAN connections is guiding the research of new applications of tele-pathology. A specific analysis has been conducted, focused on digital cytology, in the biomedical laboratory of Sant'Andrea Hospital to investigate the technologies potentially useful to integrate in the LAN/WAN for telemedicine applications. Among the possible tools useful to be integrated in the LAN/WAN for telemedicine applications, the cytometry equipment available in the technical unity of cytometry has been considered important. The study finally provides a proposal for a tele-consulting architecture for the integration of cytometry reports both in the hospital LAN and the WAN for possible cooperative diagnosis and second opinion support.

A pilot study for the integration of cytometry reports in digital cytology telemedicine applications

Directory of Open Access Journals (Sweden)

Daniele Giansanti

2010-06-01

Full Text Available Up to date, tele-pathology in the three different forms of application, "dynamic", "static" and "virtual microscopy" has been mainly based on tele-hystology remote consulting. Today the diffusion of specialized WAN connections is guiding the research of new applications of tele-pathology. A specific analysis has been conducted, focused on digital cytology, in the biomedical laboratory of Sant'Andrea Hospital to investigate the technologies potentially useful to integrate in the LAN/WAN for telemedicine applications. Among the possible tools useful to be integrated in the LAN/WAN for telemedicine applications, the cytometry equipment available in the technical unity of cytometry has been considered important. The study finally provides a proposal for a tele-consulting architecture for the integration of cytometry reports both in the hospital LAN and the WAN for possible cooperative diagnosis and second opinion support.

Modelling glass alteration in an altered argillaceous environment

International Nuclear Information System (INIS)

Bildstein, O.; Trotignon, L.; Pozo, C.; Jullien, M.

2007-01-01

The long term behaviour of materials such as glass, steel and clay has been investigated in the context of deep geological disposal of radioactive wastes. The interactions between vitrified wastes, canister corrosion products (CPs) and clay are studied using a modified version of the reaction-transport code Crunch, especially looking at pH changes and possible cementation at the interface with the clayey materials. These perturbations may indeed affect the lifetime of glass matrix in deep repositories, e.g., high pH enhances the rate of glass alteration. This work focuses on the argillite of Bure. The calculations were performed at 323 K with a glass alteration rate switching from a high initial rate to a residual rate according to the sorption capacity of CPs. The time at which this sorption capacity is saturated is crucial to the system in terms of wastes package lifetime. The results show that the glass alteration imposes a high pH value at the interface with CPs and clay: up to a value of 9.2, compared to 7.3 which is the initial pH value in the argillite. Experimental data show that the rate of glass alteration is much higher in such pH conditions. For a R7T7-type glass, the rate is about five times higher at pH 9 than at pH 7. This pH perturbation migrates through the clayey domain as a result of the migration of mobile elements such as boron and sodium, and despite the existence of strong pH buffers in the argillite. The cementation of porosity at the interface between glass and clay is predicted by the model due to the massive precipitation of iron corrosion products and glass alteration products. At this point of the evolution of the system, the pH starts to decrease and the alteration rate of the glass could be significantly reduced. This porosity clogging effect is difficult to confirm by experiments especially since existing data on short term experiments tend to show a pervasive precipitation of silica in the domain instead of a localized precipitation

Effectiveness of a quality improvement curriculum for medical students

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Kimberly M. Tartaglia

2015-05-01

Full Text Available Introduction: As health systems find ways to improve quality of care, medical training programs are finding opportunities to prepare learners on principles of quality improvement (QI. The impact of QI curricula for medical students as measured by student learning is not well delineated. The aim of this study is to evaluate the effectiveness of a QI curriculum for senior medical students as measured by student knowledge and skills. Methods: This study was an observational study that involved a self-assessment and post-test Quality Improvement Knowledge Application Tool (QIKAT for intervention and control students. A QI curriculum consisting of online modules, live discussions, independent readings and reflective writing, and participation in a mentored QI project was offered to fourth-year medical students completing an honor's elective (intervention group. Senior medical students who received the standard QI curriculum only were recruited as controls. Results: A total of 22 intervention students and 12 control students completed the self-assessment and QIKAT. At baseline, there was no difference between groups in self-reported prior exposure to QI principles. Students in the intervention group reported more comfort with their skills in QI overall and in 9 of the 12 domains (p<0.05. Additionally, intervention students performed better in each of the three case scenarios (p<0.01. Discussion: A brief QI curriculum for senior medical students results in improved comfort and knowledge with QI principles. The strengths of our curriculum include effective use of classroom time and faculty mentorship with reliance on pre-existing online modules and written resources. Additionally, the curriculum is easily expandable to larger groups of students and transferable to other institutions.

Integrating Quality Improvement and Continuing Professional Development: A Model From the Mental Health Care System.

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Sockalingam, Sanjeev; Tehrani, Hedieh; Lin, Elizabeth; Lieff, Susan; Harris, Ilene; Soklaridis, Sophie

2016-04-01

To explore the perspectives of leaders in psychiatry and continuing professional development (CPD) regarding the relationship, opportunities, and challenges in integrating quality improvement (QI) and CPD. In 2013-2014, the authors interviewed 18 participants in Canada: 10 psychiatrists-in-chief, 6 CPD leaders in psychiatry, and 2 individuals with experience integrating these domains in psychiatry who were identified through snowball sampling. Questions were designed to identify participants' perspectives about the definition, relationship, and integration of QI and CPD in psychiatry. Interviews were recorded and transcribed. An iterative, inductive method was used to thematically analyze the transcripts. To ensure the rigor of the analysis, the authors performed member checking and sampling until theoretical saturation was achieved. Participants defined QI as a concept measured at the individual, hospital, and health care system levels and CPD as a concept measured predominantly at the individual and hospital levels. Four themes related to the relationship between QI and CPD were identified: challenges with QI training, adoption of QI into the mental health care system, implementation of QI in CPD, and practice improvement outcomes. Despite participants describing QI and CPD as mutually beneficial, they expressed uncertainty about the appropriateness of aligning these domains within a mental health care context because of the identified challenges. This study identified challenges with aligning QI and CPD in psychiatry and yielded a framework to inform future integration efforts. Further research is needed to determine the generalizability of this framework to other specialties and health care professions.

Effect of material strength on the relationship between the principal Hugoniot and quasi-isentrope of beryllium and 6061-T6 aluminum below 35 GPa

International Nuclear Information System (INIS)

Moss, W.C.

1985-01-01

Quasi-isentropic (QI) compression can be achieved by loading a specimen with a low strain rate, long rise time uniaxial strain wave. Recent experimental data show that the quasi-isentrope of 6061-T6 aluminum lies a few percent above the principal Hugoniot, that is, at a given specific volume, the QI stress exceeds the principal Hugoniot stress. It has been suggested that this effect is due to material strength. Using Hugoniot data, shock-reshock, and shock-unload data for beryllium and 6061-T6 aluminum, we have constructed the quasi-isentropes as functions of specific volume. Our results show that the QI stress exceeds the principal Hugoniot stress above a Hugoniot stress of 8.4 GPa in beryllium, and between Hugoniot stresses of 3.8 and 21.4 GPa in aluminum. The effect is due to strength and implies that the QI yield strength can be large. Our calculations show that the QI yield strength is 0.9 GPa in aluminum at a QI stress of 9 GPa, and 5.2 GPa in beryllium at a QI stress of 35 GPa

Epidemiological Distribution and Subtype Analysis of Premenstrual Dysphoric Disorder Syndromes and Symptoms Based on TCM Theories

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Mingqi Qiao

2017-01-01

Full Text Available We performed an epidemiological investigation of subjects with premenstrual dysphoric disorder (PMDD to identify the clinical distribution of the major syndromes and symptoms. The pathogenesis of PMDD mainly involves the dysfunction of liver conveyance and dispersion. Excessive liver conveyance and dispersion are associated with liver-qi invasion syndrome, while insufficient liver conveyance and dispersion are expressed as liver-qi depression syndrome. Additionally, a nonconditional logistic regression was performed to analyze the symptomatic features of liver-qi invasion and liver-qi depression. As a result of this analysis, two subtypes of PMDD are proposed, namely, excessive liver conveyance and dispersion (liver-qi invasion syndrome and insufficient liver conveyance and dispersion (liver-qi depression syndrome. Our findings provide an epidemiological foundation for the clinical diagnosis and treatment of PMDD based on the identification of different types.

Glyphosate-based herbicides toxicity on life history parameters of zoophytophagous Podisus nigrispinus (Heteroptera: Pentatomidae).

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C Zanuncio, José; C Lacerda, Mabio; Alcántara-de la Cruz, Ricardo; P Brügger, Bruno; Pereira, Alexandre I A; F Wilcken, Carlos; E Serrão, José; S Sediyama, Carlos

2018-01-01

The increase of agricultural areas with glyphosate-resistant (GR) crops, and use of this herbicide in Brazil, makes necessary to assess its impacts on non-target organisms. The objective was to evaluate the development, reproduction and life table parameters of Podisus nigrispinus (Heteroptera: Pentatomidae) reared on GR-soybean plants treated with glyphosate formulations (Zapp-Qi, Roundup-Transorb-R and Roundup-Original) at the recommended field dose (720g acid equivalent ha -1 ). Glyphosate formulations had no affect on nymph and adult weight of this predator. Fourth instar stage was shortest with Zapp Qi. Egg-adult period was similar between treatments (26 days) with a survival over 90%. Zapp-Qi and Roundup-Transorb-R (potassium-salt: K-salt) reduced the egg, posture and nymph number per female, and the longevity and oviposition periods of this predator. Podisus nigrispinus net reproductive rate was highest in GR-soybean plants treated with Roundup-Original (isopropylamine-salt: IPA-salt). However, the duration of one generation, intrinsic and finite increase rates, and time to duplicate the population, were similar between treatments. Glyphosate toxicity on P. nigrispinus depends of the glyphosate salt type. IPA-salt was least harmless to this predator. Formulations based on K-salt altered its reproductive parameters, however, the development and population dynamic were not affect. Therefore, these glyphosate formulations are compatible with the predator P. nigrispinus with GR-soybean crop. Copyright © 2017 Elsevier Inc. All rights reserved.

[Effects of Chinese herbal compound for supplementing qi and activating blood circulation on actin, Cx43 expressions and gap junctional intercellular communication functions of myocardial cells in patients with Coxsackie virus B 3 viral myocarditis].

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Zhang, Ming-xue; He, Wei; Gu, Ping

2010-08-01

To observe the effect of Chinese herbal compound for supplementing qi and activating blood circulation (CHC) on the gap junctional intercellular communication (GJIC) function of myocardial cells in patients with Coxsackie virus B 3 (CVB3) viral myocarditis. Expressions of actin and connexin43 (Cx43) in myocardial cells of patients arranged in three groups (the normal control group, the viral infected group and the CHC treated group) were detected by immunohistochemical method; the fluorescence photobleaching recovery rate of cells was detected by laser scanning confocal microscope. As compared with the viral infected group, the expressions of actin and Cx43 were increased and the GJIC function was improved in the CHC treated group. CHC could antagonize viral injury on skeleton protein, and repair the structure of gap junction channel to improve the GJIC function of myocardial cells after being attacked by CVB3.

Assessing the Organizational Characteristics Influencing Quality Improvement Implementation in Saudi Hospitals.

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Shamsuddin Alaraki, Mohammad

The health care system in Saudi Arabia has serious problems with quality and safety that can be reduced through systematic quality improvement (QI) activities. Despite the use of different QI models to improve health care in Saudi hospitals during the last 2 decades, consistent improvements have not yet been achieved and the results are still far below expectations. This may reflect a problem in introducing and implementing the QI models in the local contexts. The objective of this study is to assess the extent of QI implementation in Saudi hospitals and to identify the organizational characteristics that make Saudi hospitals particularly challenging for QI. Understanding these characteristics can inform efforts to improve them and may lead to more successful implementation. A mixed-methods approach was conducted using 2 data collection tools: questionnaires and interviews. The quantitative phase (questionnaires) aimed to uncover the current level of QI implementation in Saudi hospital as measured by 7 critical dimensions adapted from the literature. The qualitative phase (interviews) aimed to understand the organizational characteristics that impede or underpin QI in Saudi hospitals. The QI implementation was found to be significantly poor across the 7 dimensions with average score ranging between 22.80 ± 0.57 and 2.11 ± 0.69 on a 5-point Likert scale and with P value of less than .05. We also found that the current level of QI implementation helped Saudi hospitals neither to improve "customer satisfaction" nor to achieve measurable improvements in "quality results" scoring significantly low at 2.11 ± 0.69 with P value of .000 and 2.47 ± 0.57 with P value of .000, respectively. Our study confirms the presence of a multitude of organizational barriers that impede QI in Saudi hospitals. These are related to organizational culture, human resources management, processes and systems, and structure. These 4 were found to have the strongest impact on QI in Saudi

Educational gaps and solutions for early-career nurse managers' education and participation in quality improvement.

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Djukic, Maja; Kovner, Christine T; Brewer, Carol S; Fatehi, Farida; Jun, Jin

2015-04-01

The objective of this study was to examine early-career frontline nurse managers' (FLNMs') reported educational preparedness and participation in quality improvement (QI). Frontline nurse managers are vitally important for leading QI. However, it is not well known if they have adequate knowledge and skills to lead this important function. We examined cross-sectional survey data from 42 FLNMs using descriptive statistics. About 30% of FLNMs reported being very prepared across 12 measured QI skills by schools or employers and 35% reported participating in a specific clinical effort to improve patient care on their unit more than once a month. More than 50% reported having good organizational support for QI, but only about 30% reported being rewarded for their contributions to QI. Our study highlights opportunities for development in QI for FLNMs and offers some solutions for nurse executives that can bridge the educational gaps.

Vitrification and Devitrification of Rigid Amorphous Fraction of PET during Quasi-isothermal Cooling and Heating

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Cebe, Peggy; Chen, Huipeng

2009-03-01

Poly(ethylene terephthalate), PET, was studied by quasi-isothermal (QI) Temperature Modulated Differential Scanning Calorimetry (TMDSC). For the first time, both the temperature dependent crystalline fraction and rigid amorphous fraction (RAF) were quantitatively analyzed during QI cooling and reheating. Specific reversing heat capacity measurements show that most RAF vitrifies step by step during QI cooling after completion of crystallization. Upon subsequent QI reheating, the RAF devitrifies also step by step and only a small RAF of 0.04 remains at 470K, while melting starts above 473K. To obtain the exact temperature of the start of melting, heat capacity measurements were made using subsequent standard DSC heating, after QI cooling. By combining this method with the QI results, the temperature dependent phase fractions were obtained during standard DSC heating. We conclude that RAF completely devitrifies before the temperature reaches the crystal melting endotherm under the conditions used in this work.

Effectiveness of strengthened stimulation during acupuncture for the treatment of Bell palsy: a randomized controlled trial.

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Xu, Sha-bei; Huang, Bo; Zhang, Chen-yan; Du, Peng; Yuan, Qi; Bi, Gui-juan; Zhang, Gui-bin; Xie, Min-jie; Luo, Xiang; Huang, Guang-ying; Wang, Wei

2013-04-02

The traditional Chinese theory of acupuncture emphasizes that the intensity of acupuncture must reach a threshold to generate de qi, which is necessary to achieve the best therapeutic effect. De qi is an internal compound sensation of soreness, tingling, fullness, aching, cool, warmth and heaviness, and a radiating sensation at and around the acupoints. However, the notion that de qi must be achieved for maximum benefit has not been confirmed by modern scientific evidence. We performed a prospective multicentre randomized controlled trial involving patients with Bell palsy. Patients were randomly assigned to the de qi (n = 167) or control (n = 171) group. Both groups received acupuncture: in the de qi group, the needles were manipulated manually until de qi was reached, whereas in the control group, the needles were inserted without any manipulation. All patients received prednisone as a basic treatment. The primary outcome was facial nerve function at month 6. We also assessed disability and quality of life 6 months after randomization. After 6 months, patients in the de qi group had better facial function (adjusted odds ratio [OR] 4.16, 95% confidence interval [CI] 2.23-7.78), better disability assessment (differences of least squares means 9.80, 95% CI 6.29-13.30) and better quality of life (differences of least squares means 29.86, 95% CI 22.33-37.38). Logistic regression analysis showed a positive effect of the de qi score on facial-nerve function (adjusted OR 1.07, 95% CI 1.04-1.09). Among patients with Bell palsy, acupuncture with strong stimulation that elicited de qi had a greater therapeutic effect, and stronger intensity of de qi was associated with the better therapeutic effects. Clinicaltrials.gov no. NCT00685789.

Sadhana | Indian Academy of Sciences

Indian Academy of Sciences (India)

Home; Journals; Sadhana. WAN HASLINA HASSAN. Articles written in Sadhana. Volume 41 Issue 7 July 2016 pp 727-753. Comparison between hybridized algorithm of GA–SA and ABC, GA, DE and PSO for vertical-handover in heterogeneous wireless networks · SHIDROKH GOUDARZI WAN HASLINA HASSAN ...

Evaluating the state of quality-improvement science through evidence synthesis: insights from the closing the quality gap series.

Science.gov (United States)

McDonald, Kathryn M; Schultz, Ellen M; Chang, Christine

2013-01-01

The Closing the Quality Gap series from the Agency for Healthcare Research and Quality summarizes evidence for eight high-priority health care topics: outcomes used in disability research, bundled payment programs, public reporting initiatives, health care disparities, palliative care, the patient-centered medical home, prevention of health care-associated infections, and medication adherence. To distill evidence from this series and provide insight into the "state of the science" of quality improvement (QI). We provided common guidance for topic development and qualitatively synthesized evidence from the series topic reports to identify cross-topic themes, challenges, and evidence gaps as related to QI practice and science. Among topics that examined effectiveness of QI interventions, we found improvement in some outcomes but not others. Implementation context and potential harms from QI activities were not widely evaluated or reported, although market factors appeared important for incentive-based QI strategies. Patient-focused and systems-focused strategies were generally more effective than clinician-focused strategies, although the latter approach improved clinician adherence to infection prevention strategies. Audit and feedback appeared better for targeting professionals and organizations, but not patients. Topic reviewers observed heterogeneity in outcomes used for QI evaluations, weaknesses in study design, and incomplete reporting. Synthesizing evidence across topics provided insight into the state of the QI field for practitioners and researchers. To facilitate future evidence synthesis, consensus is needed around a smaller set of outcomes for use in QI evaluations and a framework and lexicon to describe QI interventions more broadly, in alignment with needs of decision makers responsible for improving quality.

Is the implementation of quality improvement methods in hospitals subject to the neighbourhood effect?

Science.gov (United States)

Yu, Tsung-Hsien; Chung, Kuo-Piao

2014-06-01

Quality improvement (QI) methods have been fashionable in hospitals for decades. Previous studies have discussed the relationships between the implementation of QI methods and various external and internal factors, but there has been no examination to date of whether the neighbourhood effect influences such implementation. The aim of this study was to use a multilevel model to investigate whether and how the neighbourhood effect influences the implementation of QI methods in the hospital setting in Taiwan. This is a retrospective questionnaire-based survey. All medical centres, regional hospitals and district teaching hospitals in Taiwan. Directors or persons in charge of implementing QI methods in hospitals. None. The breadth and depth of QI method implementation. Seventy-two of the 139 hospitals contacted returned the questionnaire, yielding a 52% response rate. The breadth and depth of QI method implementation increased over the 10-year study period, particularly between 2004 and 2006. The breadth and depth of the QI methods implemented in the participating hospitals were significantly associated with the average breadth and depth of those implemented by their competitors in the same medical area during the previous period. In addition, time was positively associated with the breadth and depth of QI method implementation. In summary, the findings of this study show that hospitals' QI implementation status is influenced by that of their neighbours. Hence, the neighbourhood effect is an important factor in understanding hospital behaviour. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Intermittent Theta Burst Over M1 May Increase Peak Power of a Wingate Anaerobic Test and Prevent the Reduction of Voluntary Activation Measured with Transcranial Magnetic Stimulation.

Science.gov (United States)

Giboin, Louis-Solal; Thumm, Patrick; Bertschinger, Raphael; Gruber, Markus

2016-01-01

Despite the potential of repetitive transcranial magnetic stimulation (rTMS) to improve performances in patients suffering from motor neuronal afflictions, its effect on motor performance enhancement in healthy subjects during a specific sport task is still unknown. We hypothesized that after an intermittent theta burst (iTBS) treatment, performance during the Wingate Anaerobic Test (WAnT) will increase and supraspinal fatigue following the exercise will be lower in comparison to a control treatment. Ten subjects participated in two randomized experiments consisting of a WAnT 5 min after either an iTBS or a control treatment. We determined voluntary activation (VA) of the right knee extensors with TMS (VATMS) and with peripheral nerve stimulation (VAPNS) of the femoral nerve, before and after the WAnT. T-tests were applied to the WAnT results and a two way within subject ANOVA was applied to VA results. The iTBS treatment increased the peak power and the maximum pedalling cadence and suppressed the reduction of VATMS following the WAnT compared to the control treatment. No behavioral changes related to fatigue (mean power and fatigue index) were observed. These results indicate for the first time that iTBS could be used as a potential intervention to improve anaerobic performance in a sport specific task.

Ethernet over SDH (EoS): Summary

Indian Academy of Sciences (India)

Cost effective way to support data customers. Use of integrated Ethernet eliminates the need for costly WAN interfaces (E1/E3/STM-1) on routers connecting to SDH/SONET; WAN bandwidth can be provided directly from customers' Ethernet switches, potentially eliminating routers at customer sites ...

78 FR 75345 - Ocean Transportation Intermediary License Applicants

Science.gov (United States)

2013-12-11

.... Romero, President (QI). Application Type: New NVO & OFF License. F.H.L. Logistics, Inc. (NVO & OFF), 1354.... Officers: Arif H. Butt, General Manager (QI), Unni Krishnan Nair, President. Application Type: New NVO...: Stephen F. Crooks, Vice President (QI), Scott Kelly, President. Application Type: Adding NVO Service...

Event Based Simulator for Parallel Computing over the Wide Area Network for Real Time Visualization

Science.gov (United States)

Sundararajan, Elankovan; Harwood, Aaron; Kotagiri, Ramamohanarao; Satria Prabuwono, Anton

As the computational requirement of applications in computational science continues to grow tremendously, the use of computational resources distributed across the Wide Area Network (WAN) becomes advantageous. However, not all applications can be executed over the WAN due to communication overhead that can drastically slowdown the computation. In this paper, we introduce an event based simulator to investigate the performance of parallel algorithms executed over the WAN. The event based simulator known as SIMPAR (SIMulator for PARallel computation), simulates the actual computations and communications involved in parallel computation over the WAN using time stamps. Visualization of real time applications require steady stream of processed data flow for visualization purposes. Hence, SIMPAR may prove to be a valuable tool to investigate types of applications and computing resource requirements to provide uninterrupted flow of processed data for real time visualization purposes. The results obtained from the simulation show concurrence with the expected performance using the L-BSP model.

Enhancement on Wingate Anaerobic Test Performance With Hyperventilation.

Science.gov (United States)

Leithäuser, Renate M; Böning, Dieter; Hütler, Matthias; Beneke, Ralph

2016-07-01

Relatively long-lasting metabolic alkalizing procedures such as bicarbonate ingestion have potential for improving performance in long-sprint to middle-distance events. Within a few minutes, hyperventilation can induce respiratory alkalosis. However, corresponding performance effects are missing or equivocal at best. To test a potential performance-enhancing effect of respiratory alkalosis in a 30-s Wingate Anaerobic Test (WAnT). 10 men (mean ± SD age 26.6 ± 4.9 y, height 184.4 ± 6.1 cm, body-mass test 1 80.7 ± 7.7 kg, body-mass test 2 80.4 ± 7.2 kg, peak oxygen uptake 3.95 ± 0.43 L/min) performed 2 WAnTs, 1 with and 1 without a standardized 15-min hyperventilation program pre-WAnT in randomized order separated by 1 wk. Compared with the control condition, hyperventilation reduced (all P respiratory alkalosis can enhance WAnT cycling sprint performance well in the magnitude of what is seen after successful bicarbonate ingestion.

Just-in-Time Training: A Novel Approach to Quality Improvement Education.

Science.gov (United States)

Knutson, Allison; Park, Nesha D; Smith, Denise; Tracy, Kelly; Reed, Danielle J W; Olsen, Steven L

2015-01-01

Just-in-time training (JITT) is accepted in medical education as a training method for newer concepts or seldom-performed procedures. Providing JITT to a large nursing staff may be an effective method to teach quality improvement (QI) initiatives. We sought to determine if JITT could increase knowledge of a specific nutrition QI initiative. Members of the nutrition QI team interviewed staff using the Frontline Contextual Inquiry to assess knowledge regarding the specific QI project. The inquiry was completed pre- and post-JITT. A JITT educational cart was created, which allowed trainers to bring the educational information to the bedside for a short, small group educational session. The results demonstrated a marked improvement in the knowledge of the frontline staff regarding our Vermont Oxford Network involvement and the specifics of the nutrition QI project. Just-in-time training can be a valuable and effective method to disseminate QI principles to a large audience of staff members.

Alteration of consciousness in focal epilepsy: the global workspace alteration theory.

Science.gov (United States)

Bartolomei, Fabrice; McGonigal, Aileen; Naccache, Lionel

2014-01-01

Alteration of consciousness (AOC) is an important clinical manifestation of partial seizures that greatly impacts the quality of life of patients with epilepsy. Several theories have been proposed in the last fifty years. An emerging concept in neurology is the global workspace (GW) theory that postulates that access to consciousness (from several sensorial modalities) requires transient coordinated activity from associative cortices, in particular the prefrontal cortex and the posterior parietal associative cortex. Several lines of evidence support the view that partial seizures alter consciousness through disturbance of the GW. In particular, a nonlinear relation has been shown between excess of synchronization in the GW regions and the degree of AOC. Changes in thalamocortical synchrony occurring during the spreading of the ictal activity seem particularly involved in the mechanism of altered consciousness. This link between abnormal synchrony and AOC offers new perspectives in the treatment of the AOC since means of decreasing consciousness alteration in seizures could improve patients' quality of life. © 2013.

Predictors of high-intensity running capacity in collegiate women during a soccer game.

Science.gov (United States)

McCormack, William P; Stout, Jeffrey R; Wells, Adam J; Gonzalez, Adam M; Mangine, Gerald T; Fragala, Maren S; Hoffman, Jay R

2014-04-01

The purpose of this investigation was to determine which physiological assessments best predicted high-intensity running (HIR) performance during a women's collegiate soccer game. A secondary purpose was to examine the relationships among physiological performance measures including muscle architecture on soccer performance (distance covered, HIR, and sprints during the game) during a competitive collegiate women's soccer game. Ten National Collegiate Athletic Association (NCAA) Division I women soccer players performed physiological assessments within a 2-week period before a competitive regulation soccer game performed during the spring season. Testing consisted of height, body mass, ultrasound measurement of dominant (DOMleg), and nondominant leg (NDOMleg) vastus lateralis for muscle thickness (MT) and pennation angle (PA), VO2max, running economy, and Wingate anaerobic test (WAnT) for peak power (PP), mean power (MP), and fatigue rate (FR). During the game, distance run, HIR, and sprints were measured using a 10-Hz global positioning system. Stepwise regression revealed that VO2max, dominant leg thickness, and dominant leg PA were the strongest predictors of HIR distance during the game (R = 0.989, SEE = 115.5 m, p = 0.001). V[Combining Dot Above]O2max was significantly correlated with total distance run (r = 0.831; p = 0.003), HIR (r = 0.755; p = 0.012), WAnTPP (r = -0.737; p = 0.015), WAnTPP·kg (r = -0.706; p = 0.022), and WAnTFR (r = -0.713; p = 0.021). DOMlegMT was significantly correlated with WAnTFR (r = 0.893; p = 0.001). DOMlegPA was significantly correlated with WAnTFR (r = 0.740; p = 0.023). The NDOMlegPA was significantly correlated to peak running velocity (r = 0.781; p = 0.013) and WAnT MP·kg (r = 0.801; p = 0.01). Results of this study indicate that V[Combining Dot Above]O2max and muscle architecture are important characteristics of NCAA Division I women soccer players and may predict HIR distance during a competitive contest.

Network analysis of genomic alteration profiles reveals co-altered functional modules and driver genes for glioblastoma.

Science.gov (United States)

Gu, Yunyan; Wang, Hongwei; Qin, Yao; Zhang, Yujing; Zhao, Wenyuan; Qi, Lishuang; Zhang, Yuannv; Wang, Chenguang; Guo, Zheng

2013-03-01

The heterogeneity of genetic alterations in human cancer genomes presents a major challenge to advancing our understanding of cancer mechanisms and identifying cancer driver genes. To tackle this heterogeneity problem, many approaches have been proposed to investigate genetic alterations and predict driver genes at the individual pathway level. However, most of these approaches ignore the correlation of alteration events between pathways and miss many genes with rare alterations collectively contributing to carcinogenesis. Here, we devise a network-based approach to capture the cooperative functional modules hidden in genome-wide somatic mutation and copy number alteration profiles of glioblastoma (GBM) from The Cancer Genome Atlas (TCGA), where a module is a set of altered genes with dense interactions in the protein interaction network. We identify 7 pairs of significantly co-altered modules that involve the main pathways known to be altered in GBM (TP53, RB and RTK signaling pathways) and highlight the striking co-occurring alterations among these GBM pathways. By taking into account the non-random correlation of gene alterations, the property of co-alteration could distinguish oncogenic modules that contain driver genes involved in the progression of GBM. The collaboration among cancer pathways suggests that the redundant models and aggravating models could shed new light on the potential mechanisms during carcinogenesis and provide new indications for the design of cancer therapeutic strategies.

On the pathologically altered pulmonary pattern

International Nuclear Information System (INIS)

Ginzburg, M.A.; Kinoshenko, Yu.T.

1982-01-01

The notions ''normal'' and ''pathologically altered pulmonary pattern'' are specified. A grouping of lung pattern alterations based on morphopathogenetic features is provided: blood and lymphatic vascular alterations, changes in the bronchi, lung stroma, and combined alterations. Radiologic appearance of the altered pulmonary pattern is classified in keeping with the basic principles of an X-ray shade examination. The terms, such as ''enriching'', ''strengthening'', ''deformation'', etc., used for describing the pathologically altered pulmonary pattern are defined

A CoAP-Based Network Access Authentication Service for Low-Power Wide Area Networks: LO-CoAP-EAP

Directory of Open Access Journals (Sweden)

Dan Garcia-Carrillo

2017-11-01

Full Text Available The Internet-of-Things (IoT landscape is expanding with new radio technologies. In addition to the Low-Rate Wireless Personal Area Network (LR-WPAN, the recent set of technologies conforming the so-called Low-Power Wide Area Networks (LP-WAN offers long-range communications, allowing one to send small pieces of information at a reduced energy cost, which promotes the creation of new IoT applications and services. However, LP-WAN technologies pose new challenges since they have strong limitations in the available bandwidth. In general, a first step prior to a smart object being able to gain access to the network is the process of network access authentication. It involves authentication, authorization and key management operations. This process is of vital importance for operators to control network resources. However, proposals for managing network access authentication in LP-WAN are tailored to the specifics of each technology, which could introduce interoperability problems in the future. In this sense, little effort has been put so far into providing a wireless-independent solution for network access authentication in the area of LP-WAN. To fill this gap, we propose a service named Low-Overhead CoAP-EAP (LO-CoAP-EAP, which is based on previous work designed for LR-WPAN. LO-CoAP-EAP integrates the use of Authentication, Authorization and Accounting (AAA infrastructures and the Extensible Authentication Protocol (EAP protocol. For this integration, we use the Constrained Application Protocol (CoAP to design a network authentication service independent of the type of LP-WAN technology. LO-CoAP-EAP represents a trade-off between flexibility, wireless technology independence, scalability and performance in LP-WAN.

A CoAP-Based Network Access Authentication Service for Low-Power Wide Area Networks: LO-CoAP-EAP.

Science.gov (United States)

Garcia-Carrillo, Dan; Marin-Lopez, Rafael; Kandasamy, Arunprabhu; Pelov, Alexander

2017-11-17

The Internet-of-Things (IoT) landscape is expanding with new radio technologies. In addition to the Low-Rate Wireless Personal Area Network (LR-WPAN), the recent set of technologies conforming the so-called Low-Power Wide Area Networks (LP-WAN) offers long-range communications, allowing one to send small pieces of information at a reduced energy cost, which promotes the creation of new IoT applications and services. However, LP-WAN technologies pose new challenges since they have strong limitations in the available bandwidth. In general, a first step prior to a smart object being able to gain access to the network is the process of network access authentication. It involves authentication, authorization and key management operations. This process is of vital importance for operators to control network resources. However, proposals for managing network access authentication in LP-WAN are tailored to the specifics of each technology, which could introduce interoperability problems in the future. In this sense, little effort has been put so far into providing a wireless-independent solution for network access authentication in the area of LP-WAN. To fill this gap, we propose a service named Low-Overhead CoAP-EAP (LO-CoAP-EAP), which is based on previous work designed for LR-WPAN. LO-CoAP-EAP integrates the use of Authentication, Authorization and Accounting (AAA) infrastructures and the Extensible Authentication Protocol (EAP) protocol. For this integration, we use the Constrained Application Protocol (CoAP) to design a network authentication service independent of the type of LP-WAN technology. LO-CoAP-EAP represents a trade-off between flexibility, wireless technology independence, scalability and performance in LP-WAN.

Parameters of anaerobic physiological profile of elite athletes

Directory of Open Access Journals (Sweden)

Karaba-Jakovljević Dea

2015-01-01

Full Text Available Introduction. Anaerobic capacity is much less evaluated in literature compared to aerobic component. Anaerobic performance of athletes can be measured using different motoric tests, lasting 20 to 30 seconds, one of them being the Wingate anaerobic test (WAnT. Objective. The aim of this study was to determine the work performed and power generated by athletes and non-athletes during a 30-second high intensity exercise, as well as to compare explosive characteristics of subjects using a new parameter of WAnT, named explosive power, or slope of power. Methods. All parameters of anaerobic power were investigated in 152 subjects classed into different groups depending on their physical fitness and sport specialties as follows: non-athletes (n=31, rowers (n=26, volleyball players (n=37, handball players (n=34 and judo players (n=24. The WAnT, as well as basic anthropometric measurements, was administrated to all participants. Results. Values of anaerobic parameters were higher in the group of athletes compared to physically inactive subjects. The highest values of the WAnT parameters were registered in the group of volleyball players (AP=1006 W; relative AP=11.4 W/ kg, AC=19.8 kJ, compared to athletes of other sport disciplines (volleyball, rowing and judo. The new parameter of the WAnT, explosive power, also showed highest values in volleyball players (EP=154 W/s; relative EP=1.74 W/s/kg. These differences were statistically significant (p<0.05. Conclusion. The results of laboratory tests can provide useful information on improvements in training processes. The new parameter of the WAnT could be implemented in further analyses of explosive characteristics of muscle contraction.

Relationship Between Blood Flow and Performance Recovery: A Randomized, Placebo-Controlled Study.

Science.gov (United States)

Borne, Rachel; Hausswirth, Christophe; Bieuzen, François

2017-02-01

To investigate the effect of different limb blood-flow levels on cycling-performance recovery, blood lactate concentration, and heart rate. Thirty-three high-intensity intermittent-trained athletes completed two 30-s Wingate anaerobic test sessions, 3 × 30-s (WAnT 1-3) and 1 × 30-s (WAnT 4), on a cycling ergometer. WAnT 1-3 and WAnT 4 were separated by a randomly assigned 24-min recovery intervention selected from among blood-flow restriction, passive rest, placebo stimulation, or neuromuscular electrical-stimulation-induced blood flow. Calf arterial inflow was measured by venous occlusion plethysmography at regular intervals throughout the recovery period. Performance was measured in terms of peak and mean power output during WAnT 1 and WAnT 4. After the recovery interventions, a large (r = .68 [90% CL .42; .83]) and very large (r = .72 (90% CL .49; .86]) positive correlation were observed between the change in calf arterial inflow and the change in mean and peak power output, respectively. Calf arterial inflow was significantly higher during the neuromuscular-electrical-stimulation recovery intervention than with the blood-flow-restriction, passive-rest, and placebo-stimulation interventions (P .05). No recovery effect was linked to heart rate or blood lactate concentration levels. For the first time, these data support the existence of a positive correlation between an increase in blood flow and performance recovery between bouts of high-intensity exercise. As a practical consideration, this effect can be obtained by using neuromuscular electrical stimulation-induced blood flow since this passive, simple strategy could be easily applied during short-term recovery.

Quality improvement education incorporated as an integral part of critical care fellows training at the Mayo Clinic.

Science.gov (United States)

Kashani, Kianoush B; Ramar, Kannan; Farmer, J Christopher; Lim, Kaiser G; Moreno-Franco, Pablo; Morgenthaler, Timothy I; Dankbar, Gene C; Hale, Curt W

2014-10-01

The Accreditation Council for Graduate Medical Education emphasizes quality improvement (QI) education in residency/fellowship training programs. The Mayo Clinic Combined Critical Care Fellowship (CCF) program conducted a pilot QI education program to incorporate QI training as a required curriculum for the 2010-2011 academic year. CCF collaborated with the Mayo Quality Academy to customize and teach the existing Mayo Quality Fellows curriculum to the CCF fellows with the help of two quality coaches over five months starting July 2010. All fellows were to achieve Bronze and Silver certification prior to graduation. Silver required passing four written exams and submitting a health care QI project. Five projects were selected on the basis of the Impact-Effort Prioritization matrix, and DMAIC (Define, Measure, Analyze, Improve, and Control) methodology was used to complete the projects. The primary outcome was to assess learners' satisfaction, knowledge, and skill transfer. All 20 fellows were Bronze certified, and 14 (70%) were Silver certified by the time of graduation. All five QI projects were completed and showed positive impacts on patient safety and care. Surveys showed improved learner satisfaction. Graduates felt the QI training improved their QI skills and employment and career advancement. The QI curriculum had appropriate content and teaching pace and did not significantly displace other important clinical core curriculum topics. The pilot was successfully implemented in the CCF program and now is in the fourth academic year as an established and integral part of the fellowship core curriculum.

76 FR 63184 - Addition of Certain Persons on the Entity List; Implementation of Entity List Annual Review...

Science.gov (United States)

2011-10-12

... Road, Tsuen Wan, Hong Kong; and 2. Hang Tat Electronics Enterprises Co., Room 2608, Technology Plaza, 29-35 Sha Tsui Road, Tsuen Wan, Hong Kong. Removals From the Entity List This rule removes four... to part 732 of the EAR, ``BIS's `Know Your Customer' Guidance and Red Flags,'' when persons are...

Smart Grid Educational Series | Energy Systems Integration Facility | NREL

Science.gov (United States)

, 2016. Download Presentation PDF Role of Software Defined Networking and WAN Virtualization in Securing (ISO), hosted a webinar on April 27, 2016, on the role of software defined networking and WAN presentation PDF IoT/PowerMatcher Transactive Energy for Smart Cities William J. Miller, President of MaCT USA

The Relation between Structure and Quantum Interference in Single Molecule Junctions

DEFF Research Database (Denmark)

Markussen, Troels; Stadler, Robert; Thygesen, Kristian Sommer

2010-01-01

Quantum interference (QI) of electron pathways has recently attracted increased interest as an enabling tool for single-molecule electronic devices. Although various molecular systems have been shown to exhibit QI effects and a number of methods have been proposed for its analysis, simple...... guidelines linking the molecular structure to QI effects in the phase-coherent transport regime have until now been lacking. In the present work we demonstrate that QI in aromatic molecules is intimately related to the topology of the molecule’s π system and establish a simple graphical scheme to predict...

Addressing Opioid-Associated Constipation Using Quality Oncology Practice Initiative Scores and Plan-Do-Study-Act Cycles.

Science.gov (United States)

Kaur, Varinder; Haider, Sajjad; Sasapu, Appalanaidu; Mehta, Paulette; Arnaoutakis, Konstantinos; Makhoul, Issam

2017-01-01

Using the Quality Oncology Practice Initiative, an affiliate program of ASCO, we outlined opioid-associated constipation (OAC) as a subject in need of quality improvement (QI) in our fellowship program at the University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System. We initiated a fellow-led QI project to advance the quality of patient care and provide a valuable avenue for QI training of young physicians. Fellows organized meetings with all stakeholders, addressed the scope of the problem, and devised strategies for OAC management. Monthly meetings were organized using Plan-Do-Study-Act principles. Mandatory check boxes were inserted into our electronic medical record templates to remind all physicians to identify patients on opioid medications and assess and address OAC. Final chart audit and patient satisfaction surveys were performed 6 months after project initiation. Assessment of OAC improved from 52% at baseline to 92% ( P < .003). This improvement corresponded with high patient satisfaction scores, with 90% of surveyed patients reporting adequate management of their constipation. In this QI initiative, we showed that participation in ASCO's Quality Oncology Practice Initiative helps identify areas in need of QI, and such fellow-led QI projects can serve as models for QI training of young physicians.

78 FR 78956 - Ocean Transportation Intermediary License Applicants

Science.gov (United States)

2013-12-27

... & OFF), 1515 Kona Drive, Compton, CA 90220, Officers: Won Rok (aka Steve) Choi, CFO (QI), Myeong H. Kim..., El Monte, CA 91731, Officers: Lynn H. Tran, Secretary (QI), Zheng Feng, CFO, Application Type: New.... 25th Street, Suite 107D, Miami, FL 33182, Officers: Sergio I. Lotero, President (QI), Stephen A. Blass...

Intermittent theta burst over M1 may increase peak power of a Wingate anaerobic test and prevent the reduction of voluntary activation measured with transcranial magnetic stimulation

Directory of Open Access Journals (Sweden)

Louis-Solal Giboin

2016-07-01

Full Text Available Despite the potential of repetitive transcranial magnetic stimulation (rTMS to improve performances in patients suffering from motor neuronal afflictions, its effect on motor performance enhancement in healthy subjects during a specific sport task is still unknown. We hypothesised that after an intermittent theta burst (iTBS treatment, performance during the Wingate Anaerobic Test (WAnT, will increase and supraspinal fatigue following the exercise will be lower in comparison to a control treatment.Ten subjects participated in two randomised experiments consisting of a WAnT 5 minutes after either an iTBS or a control treatment. We determined voluntary activation (VA of the right knee extensors with TMS (VATMS and with peripheral nerve stimulation (VAPNS of the femoral nerve, before and after the WAnT. T-tests were applied to the WAnT results and a 2 way within subject ANOVA was applied to VA results. The iTBS treatment increased the peak power and the maximum pedalling cadence and suppressed the reduction of VATMS following the WAnT compared to the control treatment. No behavioural changes related to fatigue (mean power and fatigue index were observed.These results indicate for the first time that iTBS could be used as a potential intervention to improve anaerobic performance in a sport specific task.

Promoting mobility and reducing length of stay in hospitalized general medicine patients: A quality-improvement project.

Science.gov (United States)

Hoyer, Erik H; Friedman, Michael; Lavezza, Annette; Wagner-Kosmakos, Kathleen; Lewis-Cherry, Robin; Skolnik, Judy L; Byers, Sherrie P; Atanelov, Levan; Colantuoni, Elizabeth; Brotman, Daniel J; Needham, Dale M

2016-05-01

To determine whether a multidisciplinary mobility promotion quality-improvement (QI) project would increase patient mobility and reduce hospital length of stay (LOS). Implemented using a structured QI model, the project took place between March 1, 2013 and March 1, 2014 on 2 general medicine units in a large academic medical center. There were 3352 patients admitted during the QI project period. The Johns Hopkins Highest Level of Mobility (JH-HLM) scale, an 8-point ordinal scale ranging from bed rest (score = 1) to ambulating ≥250 feet (score = 8), was used to quantify mobility. Changes in JH-HLM scores were compared for the first 4 months of the project (ramp-up phase) versus 4 months after project completion (post-QI phase) using generalized estimating equations. We compared the relative change in median LOS for the project months versus 12 months prior among the QI units, using multivariable linear regression analysis adjusting for 7 demographic and clinically relevant variables. Comparing the ramp-up versus post-QI phases, patients reaching JH-HLM's ambulation status increased from 43% to 70% (P mobility scores between admission and discharge increased from 32% to 45% (P 7 days), were associated with a significantly greater adjusted median reduction in LOS of 1.11 (95% CI: -1.53 to -0.65, P mobility was not associated with an increase in injurious falls compared to 12 months prior on the QI units (P = 0.73). Active prevention of a decline in physical function that commonly occurs during hospitalization may be achieved with a structured QI approach. In an adult medicine population, our QI project was associated with improved mobility, and this may have contributed to a reduction in LOS, particularly for more complex patients with longer expected hospital stay. Journal of Hospital Medicine 2016. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

What is needed to implement a web-based audit and feedback intervention with outreach visits to improve care quality: A concept mapping study among cardiac rehabilitation teams.

Science.gov (United States)

van Engen-Verheul, Mariëtte M; Peek, Niels; Haafkens, Joke A; Joukes, Erik; Vromen, Tom; Jaspers, Monique W M; de Keizer, Nicolette F

2017-01-01

Evidence on successful quality improvement (QI) in health care requires quantitative information from randomized clinical trials (RCTs) on the effectiveness of QI interventions, but also qualitative information from professionals to understand factors influencing QI implementation. Using a structured qualitative approach, concept mapping, this study determines factors identified by cardiac rehabilitation (CR) teams on what is needed to successfully implement a web-based audit and feedback (A&F) intervention with outreach visits to improve the quality of CR care. Participants included 49 CR professionals from 18 Dutch CR centres who had worked with the A&F system during a RCT. In three focus group sessions participants formulated statements on factors needed to implement QI successfully. Subsequently, participants rated all statements for importance and feasibility and grouped them thematically. Multi dimensional scaling was used to produce a final concept map. Forty-two unique statements were formulated and grouped into five thematic clusters in the concept map. The cluster with the highest importance was QI team commitment, followed by organisational readiness, presence of an adequate A&F system, access to an external quality assessor, and future use and functionalities of the A&F system. Concept mapping appeared efficient and useful to understand contextual factors influencing QI implementation as perceived by healthcare teams. While presence of a web-based A&F system and external quality assessor were seen as instrumental for gaining insight into performance and formulating QI actions, QI team commitment and organisational readiness were perceived as essential to actually implement and carry out these actions. These two sociotechnical factors should be taken into account when implementing and evaluating the success of QI implementations in future research. Copyright © 2016. Published by Elsevier Ireland Ltd.

Quality improvement cycles that reduced waiting times at Tshwane ...

African Journals Online (AJOL)

improvement. QI in medical practices is a method for continuously finding better ways to provide better care and service.11 The QI cycle is a recognised tool for analysing and improving the efficiency and quality of healthcare services.12 QI is a team effort, requiring knowledge, skills, experience and perspective of each team ...

Chemistry, mineralogy and alteration intensity of hydrothermal altered Mt Unzen conduit rocks (Shimabara/Japan)

Science.gov (United States)

Hess, Kai-Uwe; Yilmaz, Tim; Gilg, H. Albert; Janots, Emilie; Mayer, Klaus; Nakada, Setsuya; Dingwell, Donald

2017-04-01

Investigations were carried out on hydrothermally altered coherent dacitic dykes samples from (USDP-4) drill core at Mt Unzen stratovolcano (Shimabara/Japan). XRF, XRD, EMPA, C-O-isotope, hot-cathode CL and SEM analysis led to insights concerning chemistry, mineralogy, and intensity and type of alteration as well as the origin of carbonate-precipitating fluids. Additionally a textural characterization of the occurring replacement features in the volcanic conduit rocks was performed. The occurrence of the main secondary phases such as chlorite, pyrite, carbonates, and R1 (Reichweite parameter) illite-smectite and kaolinite group minerals indicate a weak to moderate propylitic to phyllic hydrothermal alteration. The dacitic samples of the dykes show different hydrothermal alteration features: (i) carbonate and chlorite pseudomorphs after hornblende as well as core and zonal textures due to replacement of plagioclase by R1 illite-smectite as well as kaolinite group minerals, (ii) colloform banded fracture fillings and fillings in dissolution vugs, and (iii) chlorite, R1 illite-smectite as well as kaolinite group minerals in the groundmass. Late chlorite veins crosscut precipitates of R1 illite-smectite as well as kaolinite group minerals. Carbonates in fractures and in pseudomorphs after hornblende comprise iron-rich dolomite solid solutions ("ankerite") and calcite. Isotopic values indicate a hydrothermal-magmatic origin for the carbonate formation. The chlorite-carbonate-pyrite index (CCPI) and the Ishikawa alteration index (AI), applied to the investigated samples show significant differences (CCPI=52.7-57.8; AI=36.1-40.6) indicating their different degree of alteration. According to Nakada et al., 2005, the C13 to C16 dykes represent the feeder dyke from the latest eruption (1991-1995) whereas C8 represents an earlier dyke feeder dyke from an older eruption. Weakest alteration, which was obtained in samples C16-1-5 and C13-2-5, correlates with the alteration

Improved ultra-performance liquid chromatography with electrospray ionization quadrupole-time-of-flight high-definition mass spectrometry method for the rapid analysis of the chemical constituents of a typical medical formula: Liuwei Dihuang Wan.

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Wang, Ping; Lv, Hai tao; Zhang, Ai hua; Sun, Hui; Yan, Guang li; Han, Ying; Wu, Xiu hong; Wang, Xi jun

2013-11-01

Liuwei Dihuang Wan (LDW), a classic Chinese medicinal formula, has been used to improve or restore declined functions related to aging and geriatric diseases, such as impaired mobility, vision, hearing, cognition, and memory. It has attracted increasing attention as one of the most popular and valuable herbal medicines. However, the systematic analysis of the chemical constituents of LDW is difficult and thus has not been well established. In this paper, a rapid, sensitive, and reliable ultra-performance LC with ESI quadrupole TOF high-definition MS method with automated MetaboLynx analysis in positive and negative ion mode was established to characterize the chemical constituents of LDW. The analysis was performed on a Waters UPLC™ HSS T3 using a gradient elution system. MS/MS fragmentation behavior was proposed for aiding the structural identification of the components. Under the optimized conditions, a total of 50 peaks were tentatively characterized by comparing the retention time and MS data. It is concluded that a rapid and robust platform based on ultra-performance LC with ESI quadrupole TOF high-definition MS has been successfully developed for globally identifying multiple constituents of traditional Chinese medicine prescriptions. This is the first report on the systematic analysis of the chemical constituents of LDW. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Partnering health disparities research with quality improvement science in pediatrics.

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Lion, K Casey; Raphael, Jean L

2015-02-01

Disparities in pediatric health care quality are well described in the literature, yet practical approaches to decreasing them remain elusive. Quality improvement (QI) approaches are appealing for addressing disparities because they offer a set of strategies by which to target modifiable aspects of care delivery and a method for tailoring or changing an intervention over time based on data monitoring. However, few examples in the literature exist of QI interventions successfully decreasing disparities, particularly in pediatrics, due to well-described challenges in developing, implementing, and studying QI with vulnerable populations or in underresourced settings. In addition, QI interventions aimed at improving quality overall may not improve disparities, and in some cases, may worsen them if there is greater uptake or effectiveness of the intervention among the population with better outcomes at baseline. In this article, the authors review some of the challenges faced by researchers and frontline clinicians seeking to use QI to address health disparities and propose an agenda for moving the field forward. Specifically, they propose that those designing and implementing disparities-focused QI interventions reconsider comparator groups, use more rigorous evaluation methods, carefully consider the evidence for particular interventions and the context in which they were developed, directly engage the social determinants of health, and leverage community resources to build collaborative networks and engage community members. Ultimately, new partnerships between communities, providers serving vulnerable populations, and QI researchers will be required for QI interventions to achieve their potential related to health care disparity reduction. Copyright © 2015 by the American Academy of Pediatrics.

Exploration of contextual factors in a successful quality improvement collaborative in English ambulance services: cross‐sectional survey

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Phung, Viet‐Hai; Essam, Nadya; Asghar, Zahid; Spaight, Anne

2015-01-01

Abstract Rationale, aims and objectives Clinical leadership and organizational culture are important contextual factors for quality improvement (QI) but the relationship between these and with organizational change is complex and poorly understood. We aimed to explore the relationship between clinical leadership, culture of innovation and clinical engagement in QI within a national ambulance QI Collaborative (QIC). Methods We used a self‐administered online questionnaire survey sent to front‐line clinicians in all 12 English ambulance services. We conducted a cross‐sectional analysis of quantitative data and qualitative analysis of free‐text responses. Results There were 2743 (12% of 22 117) responses from 11 of the 12 participating ambulance services. In the 3% of responders that were directly involved with the QIC, leadership behaviour was significantly higher than for those not directly involved. QIC involvement made no significant difference to responders' perceptions of the culture of innovation in their organization, which was generally considered poor. Although uptake of QI methods was low overall, QIC members were significantly more likely to use QI methods, which were also significantly associated with leadership behaviour. Conclusions Despite a limited organizational culture of innovation, clinical leadership and use of QI methods in ambulance services generally, the QIC achieved its aims to significantly improve pre‐hospital care for acute myocardial infarction and stroke. We postulate that this was mediated through an improvement subculture, linked to the QIC, which facilitated large‐scale improvement by stimulating leadership and QI methods. Further research is needed to understand success factors for QI in complex health care environments. PMID:26303398

The missing link between submarine volcano and promising geothermal potential in Jinshan, Northern Taiwan

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Wang, S. C.; Hutchings, L.; Chang, C. C.; Lee, C. S.

2017-12-01

The Tatun volcanic group (TVG) and the Keelung submarine volcano (KSV) are active volcanoes and surrounding three nuclear plant sites in north Taiwan. The famous Jinshan-Wanli hot springs locates between TVG and KSV, moreover, the geochemical anomalies of acidic boiling springs on the seacoast infer that the origin is from magmatic fluids, sea water and meteoric water mixture, strongly implying that mantle fluids ascends into the shallow crust. The evidence for a magma chamber, submarine volcano, and boiling springs have a close spatial relationship. Based on UNECE specifications to Geothermal Energy Resources (2016), the Jinshan-Wanli geothermal area could be classified as Known Geothermal Energy Source for geothermal direct use and Potential Geothermal Energy Source for conventional geothermal system. High resolution reservoir exploration and modeling in Jinshan-Wanli geothermal area is developing for drilling risk mitigation. The geothermal team of National Taiwan Ocean University and local experts are cooperating for further exploration drilling and geothermal source evaluation. Keywords: geothermal resource evaluation, Jinshan-Wanli geothermal area, submarine volcano

The science of quality improvement implementation: developing capacity to make a difference.

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Alexander, Jeffrey A; Hearld, Larry R

2011-12-01

Quality improvement (QI) holds promise to improve quality of care; however, organizations often struggle with its implementation. It has been recommended that practitioners, managers, and researchers attempt to increase systematic understanding of the structure, practices, and context of organizations that facilitate or impede the implementation of QI innovations. To critically review the empirical research on QI implementation in health care organizations. A literature review of 107 studies that examined the implementation of QI innovations in health care organizations. Studies were classified into 4 groups based on the types of predictors that were assumed to affect implementation (content of QI innovation, organizational processes, internal context, and external context). Internal context and organizational processes were the most frequently studied categories. External context and organizational process categories exhibited the highest rate of positive effects on QI implementation. The review revealed several important gaps in the QI implementation literature. Studies often lacked clear conceptual frameworks to guide the research, which may hinder efforts to compare relationships across studies. Studies also tended to adopt designs that were narrowly focused on independent effects of predictors and did not include holistic frameworks to capture interactions among the many factors involved in implementation. Other design limitations included the use of cross-sectional designs, single-source data collection, and potential selection bias among study participants.

The effect of the SQUIRE (Standards of QUality Improvement Reporting Excellence) guidelines on reporting standards in the quality improvement literature: a before-and-after study.

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Howell, Victoria; Schwartz, Amanda Eva; O'Leary, James Daniel; Mc Donnell, Conor

2015-06-01

The SQUIRE (Standards of QUality Improvement Reporting Excellence) guidelines were developed to improve the reporting of quality improvement (QI) projects. The effect of the guidelines on the completeness of reporting in the QI literature is unknown. Our primary objective was to determine if the completeness of reporting in the QI literature has been improved[OUP_CE13] since the introduction of the SQUIRE guidelines. We performed a before-and-after evaluation of QI articles selected from four prominent journals of healthcare quality. Twenty-five articles published in each of two time periods (2006-2008 and 2010-2011) were confirmed to be QI projects using a standardised definition and were independently evaluated by two investigators as an interim evaluation of a planned larger sample. Articles were assessed using 50 statements of the SQUIRE guidelines, and the overall change in the completeness of reporting between the two groups was determined. The value of pimprovement observed in the completeness of reporting of QI projects after the publication of the SQUIRE guidelines, and the study was stopped early. There is potential for improvement in reporting standards, particularly for those guideline items or statements specific to QI projects. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Efficacy of MaZiRenWan, a Chinese Herbal Medicine, in Patients With Functional Constipation in a Randomized Controlled Trial.

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Zhong, Linda Ld; Cheng, Chung-Wah; Kun, Wai; Dai, Liang; Hu, Dong-Dong; Ning, Zi-Wan; Xiao, Hai-Tao; Lin, Cheng-Yuan; Zhao, Ling; Huang, Tao; Tian, Ke; Chan, King-Hong; Lam, Ting-Wa; Chen, Xiao-Rui; Wong, Chi-Tak; Li, Min; Lu, Ai-Ping; Wu, Justin Cy; Bian, Zhao-Xiang

2018-04-11

The Chinese herbal medicine, MaZiRenWan (MZRW), has been used for more than 2000 years to treat constipation, but it has not been tested in a randomized controlled trial. We performed a trial to evaluate the efficacy and safety of MZRW, compared with the stimulant laxative senna or placebo, for patients with functional constipation (FC). We performed a double-blind, double-dummy, trial of 291 patients with FC based on Rome III criteria, seen at 8 clinics in Hong Kong from June 2013 through August 2015. Patients were observed for 2 weeks and then assigned randomly (1:1:1) to groups given MZRW (7.5 g, twice daily), senna (15 mg daily), or placebo for 8 weeks. Patients were then followed for 8 weeks and evaluated at baseline and weeks 4, 8 (end of treatment), and 16 (end of follow up). Participants recorded information on stool form and frequency, feeling of complete evacuation, and research medication taken. Data on individual bowel symptoms, global symptom improvement, and adverse events were collected. A complete response was defined as an increase ≥1 complete spontaneous bowel movement (CSBM)/week from baseline (the primary outcome). Secondary outcomes included response during the follow-up period, colonic transit, individual and global symptom assessments, quality of life measured with 36-item short form Chinese version, and adverse events. Although there was no statistically significant difference in proportions of patients with a complete response to MZRW (68%) vs. senna (57.7%) (P=.14) at week 8, there was a statistically significant difference vs. placebo (33.0%) (P<.005). At the 16-week timepoint (after the 8-week follow-up period), 47.4% of patients had a complete response to MZRW, 20.6% had a complete response to senna, and 17.5% had a complete response to placebo (P<.005 for MZRW vs. placebo). The group that received MZRW group also had significant increases in colonic transit and reduced severity of constipation, straining, incomplete evacuation, and

One size does not fit all: a qualitative content analysis of the importance of existing quality improvement capacity in the implementation of Releasing Time to Care: the Productive Ward™ in Saskatchewan, Canada.

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Hamilton, Jessica; Verrall, Tanya; Maben, Jill; Griffiths, Peter; Avis, Kyla; Baker, G Ross; Teare, Gary

2014-12-19

Releasing Time to Care: The Productive Ward™ (RTC) is a method for conducting continuous quality improvement (QI). The Saskatchewan Ministry of Health mandated its implementation in Saskatchewan, Canada between 2008 and 2012. Subsequently, a research team was developed to evaluate its impact on the nursing unit environment. We sought to explore the influence of the unit's existing QI capacity on their ability to engage with RTC as a program for continuous QI. We conducted interviews with staff from 8 nursing units and asked them to speak about their experience doing RTC. Using qualitative content analysis, and guided by the Organizing for Quality framework, we describe the existing QI capacity and impact of RTC on the unit environment. The results focus on 2 units chosen to highlight extreme variation in existing QI capacity. Unit B was characterized by a strong existing environment. RTC was implemented in an environment with a motivated manager and collaborative culture. Aided by the structural support provided by the organization, the QI capacity on this unit was strengthened through RTC. Staff recognized the potential of using the RTC processes to support QI work. Staff on unit E did not have the same experience with RTC. Like unit B, they had similar structural supports provided by their organization but they did not have the same existing cultural or political environment to facilitate the implementation of RTC. They did not have internal motivation and felt they were only doing RTC because they had to. Though they had some success with RTC activities, the staff did not have the same understanding of the methods that RTC could provide for continuous QI work. RTC has the potential to be a strong tool for engaging units to do QI. This occurs best when RTC is implemented in a supporting environment. One size does not fit all and administrative bodies must consider the unique context of each environment prior to implementing large-scale QI projects. Use of an

Patterns of Energy Imbalance of the Meridians in Patients with Temporomandibular Dysfunction

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Vera L. Rasera Zotelli

2018-02-01

Full Text Available Temporomandibular dysfunction (TMD is a set of changes that affects the muscles of mastication, temporomandibular joint, teeth, and associated periodontal and orofacial structures. According to Traditional Chinese Medicine, the imbalance of energy (Qi circulating in the acupuncture meridians is always the primary etiologic cause of any physical manifestation. The aim of this study was to describe the patterns of Qi imbalance in patients with TMD by means of an objective measurement. The clinical study was conducted at the Piracicaba Dental School (FOP/Unicamp, in Piracicaba-SP, Brazil. We evaluated 40 adult volunteers with TMD. The Qi measurement was carried out by the researcher using the Ryodoraku method using 24 points representing the 12 acupuncture meridians: LU9 (Taiyuan, PC7 (Daling, HT7 (Shemen, SI5 (Yanggu, TE4 (Yangchi, LI5 (Yangxi, SP3 (Taibai, LR3 (Taichong, KI3 (Taixi, BL64 (Jinggu, GB40 (Qiuxu, and ST42 (Chongyang. The average total Qi of 40 volunteers (21.7 μA ± 1.5, was below the normal range (40–60 μA and was classified as deficiency of Qi (empty. The coupled meridians that showed the highest Qi imbalance were the kidney (29.4 μA ± 2.8 and bladder (13.8 μA ± 1. The Qi planes with greatest imbalance were the Shao Yang and Shao Yin. In conclusion, volunteers with TMD presented a pattern of Qi deficiency, and the most prevalent imbalance patterns identified were in the kidney and bladder coupled meridians and in the energetic planes Shao Yin (heart/kidney and Shao Yang (triple energizer/gall bladder.

Developing an Interdisciplinary, Team-Based Quality Improvement Leadership Training Program for Clinicians: The Partners Clinical Process Improvement Leadership Program.

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Rao, Sandhya K; Carballo, Victoria; Cummings, Brian M; Millham, Frederick; Jacobson, Joseph O

Although there has been tremendous progress in quality improvement (QI) education for students and trainees in recent years, much less has been published regarding the training of active clinicians in QI. The Partners Clinical Process Improvement Leadership Program (CPIP) is a 6-day experiential program. Interdisciplinary teams complete a QI project framed by didactic sessions, interactive exercises, case-based problem sessions, and a final presentation. A total of 239 teams composed of 516 individuals have graduated CPIP. On completion, participant satisfaction scores average 4.52 (scale 1-5) and self-reported understanding of QI concepts improved. At 6 months after graduation, 66% of survey respondents reported sustained QI activity. Three opportunities to improve the program have been identified: (1) increasing faculty participation through online and tiered course offerings, (2) integrating the faculty-focused program with the trainee curriculum, and (3) developing a postgraduate curriculum to address the challenges of sustained improvement.

Call to action: Better care, better health, and greater value in college health.

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Ciotoli, Carlo; Smith, Allison J; Keeling, Richard P

2018-03-05

It is time for action by leaders across higher education to strengthen quality improvement (QI) in college health, in pursuit of better care, better health, and increased value - goals closely linked to students' learning and success. The size and importance of the college student population; the connections between wellbeing, and therefore QI, and student success; the need for improved standards and greater accountability; and the positive contributions of QI to employee satisfaction and professionalism all warrant a widespread commitment to building greater capacity and capability for QI in college health. This report aims to inspire, motivate, and challenge college health professionals and their colleagues, campus leaders, and national entities to take both immediate and sustainable steps to bring QI to the forefront of college health practice - and, by doing so, to elevate care, health, and value of college health as a key pathway to advancing student success.

A retrospective evaluation of the Perfecting Patient Care University training program for health care organizations.

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Morganti, Kristy Gonzalez; Lovejoy, Susan; Beckjord, Ellen Burke; Haviland, Amelia M; Haas, Ann C; Farley, Donna O

2014-01-01

This study evaluated how the Perfecting Patient Care (PPC) University, a quality improvement (QI) training program for health care leaders and clinicians, affected the ability of organizations to improve the health care they provide. This training program teaches improvement methods based on Lean concepts and principles of the Toyota Production System and is offered in several formats. A retrospective evaluation was performed that gathered data on training, other process factors, and outcomes after staff completed the PPC training. A majority of respondents reported gaining QI competencies and cultural achievements from the training. Organizations had high average scores for the success measures of "outcomes improved" and "sustainable monitoring" but lower scores for diffusion of QI efforts. Total training dosage was significantly associated with the measures of QI success. This evaluation provides evidence that organizations gained the PPC competencies and cultural achievements and that training dosage is a driver of QI success.

Capacity and readiness for quality improvement among home and community-based service providers.

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Abrahamson, Kathleen; Myers, Jaclyn; Arling, Greg; Davila, Heather; Mueller, Christine; Abery, Brian; Cai, Yun

2016-01-01

The objective of this study was to explore home and community-based service (HCBS) providers' perspectives of organizational readiness for quality improvement (QI). Data were obtained from a survey of participants (N = 56) in a state-sponsored HCBS QI initiative. Quality improvement challenges included lack of time and resources, staff apprehension or resistance, resistance from consumers and families, and project sustainability. Support from leadership was viewed as an important factor in participating organizations' decision to engage in QI. Internal resources available to support QI varied widely between participating organizations, with differences observed between smaller and larger agencies, as well as between provider types and populations served.

Chlorite alteration in aqueous solutions and uranium removal by altered chlorite

Energy Technology Data Exchange (ETDEWEB)

Kim, Eungyeong; Ahn, Hyangsig [Department of Earth and Environmental Sciences, Korea University, Anam-dong, Seongbuk-gu, Seoul 02841 (Korea, Republic of); Jo, Ho Young, E-mail: hyjo@korea.ac.kr [Department of Earth and Environmental Sciences, Korea University, Anam-dong, Seongbuk-gu, Seoul 02841 (Korea, Republic of); Ryu, Ji-Hun; Koh, Yong-Kwon [Korea Atomic Energy Research Institute, 1045 Daedeokdaero, Yuseong-gu, Daejeon 34057 (Korea, Republic of)

2017-04-05

Highlights: • Chlorite alteration and the U removal capacity of altered chlorite were investigated. • Initial pH affected more chlorite dissolution than ionic strength. • Chlorite dissolution at pH{sub o} = 3–8 was inversely proportional to the U removal capacity. • Chlorite dissolution at pH{sub o} = 10 was proportional to the U removal capacity. • The formation of Fe-containing secondary minerals affected the U removal capacity. - Abstract: Chlorite alteration and the U removal capacity of altered chlorite were investigated. Batch kinetic dissolution tests using clinochlore CCa-2 were conducted for 60 days in aqueous solutions of various pHs and ionic strengths. Batch sorption tests using these altered chlorite samples were conducted for 48 h with natural groundwater containing 3.06 × 10{sup −6} M U. Chlorite dissolution was influenced more by pH{sub o} than by the ionic strength of the solution. TEM analysis revealed Fe(oxy)hydroxide aggregates in the solid residue from the batch dissolution test with 0.1 M NaClO{sub 4} solution at pH{sub o} = 10. The U removal capacity of the reacted chlorite samples at pH{sub o} = 6–10 was higher than that of the reacted chlorite samples at pH{sub o} = 3. The degree of dissolution of chlorite samples reacted at pH{sub o} = 3–8 was inversely proportional to the U removal capacity, but that of chlorite samples reacted at pH{sub o} = 10 was proportional to the U removal capacity. The positive correlation between the U removal capacity and degree of chlorite dissolution at pH{sub o} = 10 might be due to the formation of Fe-containing secondary minerals and changes in the reactive sites.

Enhancing system-wide implementation of opioid prescribing guidelines in primary care: protocol for a stepped-wedge quality improvement project.

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Zgierska, Aleksandra E; Vidaver, Regina M; Smith, Paul; Ales, Mary W; Nisbet, Kate; Boss, Deanne; Tuan, Wen-Jan; Hahn, David L

2018-06-05

Systematic implementation of guidelines for opioid therapy management in chronic non-cancer pain can reduce opioid-related harms. However, implementation of guideline-recommended practices in routine care is subpar. The goal of this quality improvement (QI) project is to assess whether a clinic-tailored QI intervention improves the implementation of a health system-wide, guideline-driven policy on opioid prescribing in primary care. This manuscript describes the protocol for this QI project. A health system with 28 primary care clinics caring for approximately 294,000 primary care patients developed and implemented a guideline-driven policy on long-term opioid therapy in adults with opioid-treated chronic non-cancer pain (estimated N = 3980). The policy provided multiple recommendations, including the universal use of treatment agreements, urine drug testing, depression and opioid misuse risk screening, and standardized documentation of the chronic pain diagnosis and treatment plan. The project team drew upon existing guidelines, feedback from end-users, experts and health system leadership to develop a robust QI intervention, targeting clinic-level implementation of policy-directed practices. The resulting multi-pronged QI intervention included clinic-wide and individual clinician-level educational interventions. The QI intervention will augment the health system's "routine rollout" method, consisting of a single educational presentation to clinicians in group settings and a separate presentation for staff. A stepped-wedge design will enable 9 primary care clinics to receive the intervention and assessment of within-clinic and between-clinic changes in adherence to the policy items measured by clinic-level electronic health record-based measures and process measures of the experience with the intervention. Developing methods for a health system-tailored QI intervention required a multi-step process to incorporate end-user feedback and account for the needs of

Quality of care achievements of the Prostate Cancer Outcomes Registry-Victoria.

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Sampurno, Fanny; Earnest, Arul; Kumari, Patabendi B; Millar, Jeremy L; Davis, Ian D; Murphy, Declan G; Frydenberg, Mark; Kearns, Paul A; Evans, Sue M

2016-05-02

To analyse the performance of the quality of prostate cancer (CaP) care over a 5-year period with reference to three quality indicators (QIs) reported by the Prostate Cancer Outcomes Registry-Victoria (PCOR-Vic):QI-1: Alignment with the modified Prostate Cancer Research International Active Surveillance (PRIAS) protocol guideline;QI-2: Timeliness of CaP care for men with high risk and locally advanced disease;QI-3: Positive surgical margins (PSMs) for organ-confined pathological T2 disease. Between 1 January 2009 and 31 December 2013, 4708 men diagnosed with CaP who met the QI-1, QI-2 or QI-3 inclusion criteria were recruited from Victorian hospitals.Outcome measures and statistical analysis: Trend analysis was conducted to monitor performance according to QI-1, QI-2 and QI-3. We used the autoregressive integrated moving average (ARIMA) model to account for any inherent autocorrelation in the data when analysing the monthly incidence of each indicator. Differences in the annual figures for the indicators across years were also analysed by aggregating data by year and applying the ARIMA model. There was a downward trend over the 5 years in the percentage of men with low risk disease who underwent active treatment (45% to 34%; P = 0.024), an upward trend in the percentage of those with high risk and locally advanced disease who received active treatment within 12 months of diagnosis (88% to 93%; P = 0.181), and a decline in PSM rate in men with pathological T2 disease after radical prostatectomy (21% to 12%; P = 0.036). Limitations of the study include the fact that the improvement in the QIs was detected using PCOR-Vic as a single population, but there may be institutional variations in quality improvement. Over 2009-2013, the performance of the Victorian health system improved according to the three processes of care indicators reported by the PCOR-Vic.

Altered Sensory Feedbacks in Pianist's Dystonia: the altered auditory feedback paradigm and the glove effect

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Felicia Pei-Hsin Cheng

2013-12-01

Full Text Available Background: This study investigates the effect of altered auditory feedback (AAF in musician's dystonia (MD and discusses whether altered auditory feedback can be considered as a sensory trick in MD. Furthermore, the effect of AAF is compared with altered tactile feedback, which can serve as a sensory trick in several other forms of focal dystonia. Methods: The method is based on scale analysis (Jabusch et al. 2004. Experiment 1 employs synchronization paradigm: 12 MD patients and 25 healthy pianists had to repeatedly play C-major scales in synchrony with a metronome on a MIDI-piano with 3 auditory feedback conditions: 1. normal feedback; 2. no feedback; 3. constant delayed feedback. Experiment 2 employs synchronization-continuation paradigm: 12 MD patients and 12 healthy pianists had to repeatedly play C-major scales in two phases: first in synchrony with a metronome, secondly continue the established tempo without the metronome. There are 4 experimental conditions, among them 3 are the same altered auditory feedback as in Experiment 1 and 1 is related to altered tactile sensory input. The coefficient of variation of inter-onset intervals of the key depressions was calculated to evaluate fine motor control. Results: In both experiments, the healthy controls and the patients behaved very similarly. There is no difference in the regularity of playing between the two groups under any condition, and neither did AAF nor did altered tactile feedback have a beneficial effect on patients’ fine motor control. Conclusions: The results of the two experiments suggest that in the context of our experimental designs, AAF and altered tactile feedback play a minor role in motor coordination in patients with musicians' dystonia. We propose that altered auditory and tactile feedback do not serve as effective sensory tricks and may not temporarily reduce the symptoms of patients suffering from MD in this experimental context.

Introduction of a super speed network in JNC

International Nuclear Information System (INIS)

Nosaki, Nobuhisa; Aoki, Kazuhisa; Narita, Nobuiku

2002-01-01

The construction of a super speed and broadband network with high cost performance is now possible through the resent remarkable development of information-communication technologies. Under such circumstances, the modification of LAN and WAN to the super speed network was required in accordance with the recent network demand in JNC. The trend of the information-communication technologies and the needs of information-communication infrastructure were reviewed as the first step. A modification of WAN to the super speed network with high cost performance was established in fiscal year 2000. This paper introduces the work procedures and the modification of the WAN in order to acquire a reduction in the running cost and the super speed network in the fiscal year. (author)

Does lean muddy the quality improvement waters? A qualitative study of how a hospital management team understands lean in the context of quality improvement.

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Savage, Carl; Parke, Louise; von Knorring, Mia; Mazzocato, Pamela

2016-10-19

Health care has experimented with many different quality improvement (QI) approaches with greater variation in name than content. This has been dubbed pseudoinnovation. However, it could also be that the subtleties and differences are not clearly understood. To explore this further, the purpose of this study was to explore how hospital managers perceive lean in the context of QI. We used a qualitative study design with semi-structured interviews to explore twelve top managers' perceptions of the relationship between lean and quality improvement (QI) at a university-affiliated hospital. Managers described that QI and lean shared the same overall purpose: focus on patient needs and improve efficiency and effectiveness. Employee involvement was emphasized in both strategies, as well as the support offered by managers of staff initiatives. QI was perceived as a strategy that could support structural changes at the organizational level whereas lean was seen as applicable at the operational level. Moreover, lean carried a negative connotation, lacked the credibility of QI, and was perceived as a management fad. Aspects of QI and lean were misunderstood. In a context where lean remains an abstract term, and staff associate lean with automotive applications and cost reduction, it may be fruitful for managers to invest time and resources to develop a strategy for continual improvement and utilize vocabulary that resonates with health care staff. This could reduce the risk that improvement efforts are rejected out of hand.

Simultaneous Qualitative and Quantitative Analysis of Multiple Chemical Constituents in YiQiFuMai Injection by Ultra-Fast Liquid Chromatography Coupled with Ion Trap Time-of-Flight Mass Spectrometry

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Chunhua Liu

2016-05-01

Full Text Available YiQiFuMai injection (YQFM is a modern lyophilized powder preparation derived from the traditional Chinese medicine Sheng-mai san (SMS used for treating cardiovascular diseases, such as chronic heart failure. However, its chemical composition has not been fully elucidated, particularly for the preparation derived from Ophiopogon japonicus. This study aimed to establish a systematic and reliable method to quickly and simultaneously analyze the chemical constituents in YQFM by ultra-fast liquid chromatography coupled with ion trap time-of-flight mass spectrometry (UFLC-IT-TOF/MS. Sixty-five compounds in YQFM were tentatively identified by comparison with reference substances or literature data. Furthermore, twenty-one compounds, including three ophiopogonins, fifteen ginsenosides and three lignans were quantified by UFLC-IT-TOF/MS. Notably, this is the first determination of steroidal saponins from O. japonicus in YQFM. The relative standard deviations (RSDs of intra- and inter-day precision, reproducibility and stability were <4.9% and all analytes showed good linearity (R2 ≥ 0.9952 and acceptable recovery of 91.8%–104.2% (RSD ≤ 5.4%, indicating that the methods were reliable. These methods were successfully applied to quantitative analysis of ten batches of YQFM. The developed approach can provide useful and comprehensive information for quality control, further mechanistic studies in vivo and clinical application of YQFM.

Syringomyelia presenting with unilateral optic neuropathy: a case report

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Ngoo QZ

2017-03-01

Full Text Available Qi Zhe Ngoo, Evelyn Li Min Tai, Wan Hazabbah Wan Hitam Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia Purpose: In this case report, we present two cases of syringomyelia with optic neuropathy.Findings: In Case 1, a 36-year-old Malay lady presented to our clinic with acute onset of blurring of vision in her left eye that she experienced since past 1 month. She was diagnosed with syringomyelia 12 years ago and was on conservative management. Her visual acuity was 6/6 in the right eye and counting fingers at 1 m in the left. There was a positive relative afferent pupillary defect in her left eye. Optic nerve functions of her left eye were reduced. Visual field showed a left inferior field defect. Her extraocular muscle movements were full. Magnetic resonance imaging of the brain and spine showed syringomyelia at the level of C2–C6 and T2–T9. Both of her optic nerves were normal. Her condition improved with intravenous and oral corticosteroids. In Case 2, a 44-year-old Malay lady presented to our clinic with a progressive central scotoma in her right eye that she experienced since past 1 month. She had previous history of recurrent episodes of weakness in both of her lower limbs from past 8 months. Visual acuity in her right and left eye was 6/9 and 6/6, respectively. The relative afferent pupillary defect in her right eye was positive. Optic nerve functions of her right eye were affected. Visual field showed a central scotoma in her right eye. Her extraocular muscle movements were full. Fundoscopy of her right eye showed a pale optic disc. Her left eye fundus was normal. Magnetic resonance imaging of the brain and spine showed syringomyelia at T3–T6. Both of her optic nerves were normal. A diagnosis of syringomyelia with right optic atrophy was performed. Her condition improved with intravenous and oral corticosteroids.Conclusion: Optic neuropathy is a rare neuro

[Profound meaning of acupuncture taboos in Internal Classic based on the fault of reinforcing and reducing technique by mind conduction of acupuncture therapy].

Science.gov (United States)

Qin, Yuge; Wang, Feng; Qin, Yuheng; Li, Li; Li, Mei

2016-05-01

By analyzing the acupuncture taboos in Neijing (Internal Classic) on clinical application of mind conduction of acupuncture therapy in going against the actual situation, astronomy and others, it is found that the relevant acupuncture taboo implies many subtle mysteries of human body, qi, mind and astronomy, which have not been discovered yet in modern science and are very significant in qi protection. In Neijing, the acupuncture physicians have been highly required in the mind treatment, in which, accurately regulating qi circulation is the target in the treatment. The mind conduction is used for qi circulation to accomplish accurately the reinforcing or reducing in the deficiency or excess condition. All of the taboos are provided to normalize the accuracy of reinforcing and reducing technique of acupuncture therapy and avoid the damage of qi in human body. Hence, those taboos must be obeyed so as to prevent from serious consequence and ensure the safety of this acupuncture therapy.

The Association of Organizational Culture and Quality Improvement Implementation With Neonatal Outcomes in the NICU.

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Mahl, Sukhy; Lee, Shoo K; Baker, G Ross; Cronin, Catherine M G; Stevens, Bonnie; Ye, Xiang Y

2015-01-01

Studies of adult patient populations suggest that organizational culture is associated with quality improvement (QI) implementation, as well as patient outcomes. However, very little research on organizational culture has been performed in neonatal patient populations. This combined cross-sectional survey and retrospective cohort study assessed employee perceptions of organizational culture and QI implementation within 18 Canadian neonatal intensive care units. The associations between these data and neonatal outcomes in extremely preterm infants (born at culture and QI implementation varied according to occupation and age. Higher hierarchical culture was associated with increased survival without major morbidities (odds ratio, 1.04; 95% confidence interval, 1.01-1.06), as were higher QI implementation scores (odds ratio range, 1.20-1.36 by culture type). Our data suggest that organizational culture, particularly hierarchical culture, and level of QI implementation may play a role in neonatal outcomes. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Engaging Australian physicians in evidence-based medicine: a representative national survey.

Science.gov (United States)

Toulkidis, V; Donnelly, N J; Ward, J E

2005-01-01

To assess Australian adult physicians' views about evidence-based medicine (EBM) and quality improvement (QI). Cross-sectional postal survey of two hundred and forty-four randomly selected Australian physicians (78.5% response rate). Physicians' views about the promotion of EBM and QI and their impact on patient care, strategies to support better clinical practice and self-reported understanding of EBM terms. Sixty-eight per cent (95% confidence interval (CI): 62-74%) of physicians had a positive view of the current promotion of EBM in Australia. Significantly fewer (45%; 95% CI: 38-51%) were so positive about QI (P evidence, significantly fewer (21%; 95% CI: 17-27%) agreed they had sufficient time to do so (P Australian physicians have positive views of EBM, QI appears less well regarded. Initiatives to improve quality and safety that incorporate principles and language of EBM will likely be received better by physicians than isolated QI. Further enhancement of EBM requires concomitant attention to physician training, workplace infrastructure and supportive professional development.

Organization Complexity and Primary Care Providers' Perceptions of Quality Improvement Culture Within the Veterans Health Administration.

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

2016-01-01

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

Patterns of Energy Imbalance of the Meridians in Patients with Temporomandibular Dysfunction.

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Rasera Zotelli, Vera L; Grillo, Cássia M; Bressiani Gil, Maria L; Wada, Ronaldo S; Sato, Jorge E; de Sousa, Maria da Luz R

2018-02-01

Temporomandibular dysfunction (TMD) is a set of changes that affects the muscles of mastication, temporomandibular joint, teeth, and associated periodontal and orofacial structures. According to Traditional Chinese Medicine, the imbalance of energy (Qi) circulating in the acupuncture meridians is always the primary etiologic cause of any physical manifestation. The aim of this study was to describe the patterns of Qi imbalance in patients with TMD by means of an objective measurement. The clinical study was conducted at the Piracicaba Dental School (FOP/Unicamp), in Piracicaba-SP, Brazil. We evaluated 40 adult volunteers with TMD. The Qi measurement was carried out by the researcher using the Ryodoraku method using 24 points representing the 12 acupuncture meridians: LU9 (Taiyuan), PC7 (Daling), HT7 (Shemen), SI5 (Yanggu), TE4 (Yangchi), LI5 (Yangxi), SP3 (Taibai), LR3 (Taichong), KI3 (Taixi), BL64 (Jinggu), GB40 (Qiuxu), and ST42 (Chongyang). The average total Qi of 40 volunteers (21.7 μA ± 1.5), was below the normal range (40-60 μA) and was classified as deficiency of Qi (empty). The coupled meridians that showed the highest Qi imbalance were the kidney (29.4 μA ± 2.8) and bladder (13.8 μA ± 1). The Qi planes with greatest imbalance were the Shao Yang and Shao Yin. In conclusion, volunteers with TMD presented a pattern of Qi deficiency, and the most prevalent imbalance patterns identified were in the kidney and bladder coupled meridians and in the energetic planes Shao Yin (heart/kidney) and Shao Yang (triple energizer/gall bladder). Copyright © 2017. Published by Elsevier B.V.

Process Evaluation of a Quality Improvement Project to Decrease Hospital Readmissions From Skilled Nursing Facilities.

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Meehan, Thomas P; Qazi, Daniel J; Van Hoof, Thomas J; Ho, Shih-Yieh; Eckenrode, Sheila; Spenard, Ann; Pandolfi, Michelle; Johnson, Florence; Quetti, Deborah

2015-08-01

To describe and evaluate the impact of quality improvement (QI) support provided to skilled nursing facilities (SNFs) by a Quality Improvement Organization (QIO). Retrospective, mixed-method, process evaluation of a QI project intended to decrease preventable hospital readmissions from SNFs. Five SNFs in Connecticut. SNF Administrators, Directors of Nursing, Assistant Directors of Nursing, Admissions Coordinators, Registered Nurses, Certified Nursing Assistants, Receptionists, QIO Quality Improvement Consultant. QIO staff provided training and technical assistance to SNF administrative and clinical staff to establish or enhance QI infrastructure and implement an established set of QI tools [Interventions to Reduce Acute Care Transfers (INTERACT) tools]. Baseline SNF demographic, staffing, and hospital readmission data; baseline and follow-up SNF QI structure (QI Committee), processes (general and use of INTERACT tools), and outcome (30-day all-cause hospital readmission rates); details of QIO-provided training and technical assistance; QIO-perceived barriers to quality improvement; SNF leadership-perceived barriers, accomplishments, and suggestions for improvement of QIO support. Success occurred in establishing QI Committees and targeting preventable hospital readmissions, as well as implementing INTERACT tools in all SNFs; however, hospital readmission rates decreased in only 2 facilities. QIO staff and SNF leaders noted the ongoing challenge of engaging already busy SNF staff and leadership in QI activities. SNF leaders reported that they appreciated the training and technical assistance that their institutions received, although most noted that additional support was needed to bring about improvement in readmission rates. This process evaluation documented mixed clinical results but successfully identified opportunities to improve recruitment of and provision of technical support to participating SNFs. Recommendations are offered for others who wish to conduct

[Epigenetic alterations in acute lymphoblastic leukemia].

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Navarrete-Meneses, María Del Pilar; Pérez-Vera, Patricia

Acute lymphoblastic leukemia (ALL) is the most common childhood cancer. It is well-known that genetic alterations constitute the basis for the etiology of ALL. However, genetic abnormalities are not enough for the complete development of the disease, and additional alterations such as epigenetic modifications are required. Such alterations, like DNA methylation, histone modifications, and noncoding RNA regulation have been identified in ALL. DNA hypermethylation in promoter regions is one of the most frequent epigenetic modifications observed in ALL. This modification frequently leads to gene silencing in tumor suppressor genes, and in consequence, contributes to leukemogenesis. Alterations in histone remodeling proteins have also been detected in ALL, such as the overexpression of histone deacetylases enzymes, and alteration of acetyltransferases and methyltransferases. ALL also shows alteration in the expression of miRNAs, and in consequence, the modification in the expression of their target genes. All of these epigenetic modifications are key events in the malignant transformation since they lead to the deregulation of oncogenes as BLK, WNT5B and WISP1, and tumor suppressors such as FHIT, CDKN2A, CDKN2B, and TP53, which alter fundamental cellular processes and potentially lead to the development of ALL. Both genetic and epigenetic alterations contribute to the development and evolution of ALL. Copyright © 2017 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

78 FR 13342 - Ocean Transportation Intermediary License Applicants

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2013-02-27

.... Officers: Keith Phillips, Vice President (QI), Glenn Henderson, President. Application Type: New NVO & OFF.... Officers: Paul Pellitieri, President (QI), Virginia Pellitieri, Vice President. Application Type: New NVO...

Performance Evaluation of LoRa Considering Scenario Conditions.

Science.gov (United States)

Sanchez-Iborra, Ramon; Sanchez-Gomez, Jesus; Ballesta-Viñas, Juan; Cano, Maria-Dolores; Skarmeta, Antonio F

2018-03-03

New verticals within the Internet of Things (IoT) paradigm such as smart cities, smart farming, or goods monitoring, among many others, are demanding strong requirements to the Radio Access Network (RAN) in terms of coverage, end-node's power consumption, and scalability. The technologies employed so far to provide IoT scenarios with connectivity, e.g., wireless sensor network and cellular technologies, are not able to simultaneously cope with these three requirements. Thus, a novel solution known as Low Power - Wide Area Network (LP-WAN) has emerged as a promising alternative to provide with low-cost and low-power-consumption connectivity to end-nodes spread in a wide area. Concretely, the Long-Range Wide Area Network (LoRaWAN) technology is one of the LP-WAN platforms that is receiving greater attention from both the industry and the academia. For that reason, in this work, a comprehensive performance evaluation of LoRaWAN under different environmental conditions is presented. The results are obtained from three real scenarios, namely, urban, suburban, and rural, considering both dynamic and static conditions, hence a discussion about the most proper LoRaWAN physical-layer configuration for each scenario is provided. Besides, a theoretical coverage study is also conducted by the use of a radio planning tool considering topographic maps and a precise propagation model. From the attained results, it can be concluded that it is necessary to evaluate the propagation conditions of the deployment scenario prior to the system implantation in order to reach a compromise between the robustness of the network and the transmission data-rate.

Development of a Multi-Domain Assessment Tool for Quality Improvement Projects.

Science.gov (United States)

Rosenbluth, Glenn; Burman, Natalie J; Ranji, Sumant R; Boscardin, Christy K

2017-08-01

Improving the quality of health care and education has become a mandate at all levels within the medical profession. While several published quality improvement (QI) assessment tools exist, all have limitations in addressing the range of QI projects undertaken by learners in undergraduate medical education, graduate medical education, and continuing medical education. We developed and validated a tool to assess QI projects with learner engagement across the educational continuum. After reviewing existing tools, we interviewed local faculty who taught QI to understand how learners were engaged and what these faculty wanted in an ideal assessment tool. We then developed a list of competencies associated with QI, established items linked to these competencies, revised the items using an iterative process, and collected validity evidence for the tool. The resulting Multi-Domain Assessment of Quality Improvement Projects (MAQIP) rating tool contains 9 items, with criteria that may be completely fulfilled, partially fulfilled, or not fulfilled. Interrater reliability was 0.77. Untrained local faculty were able to use the tool with minimal guidance. The MAQIP is a 9-item, user-friendly tool that can be used to assess QI projects at various stages and to provide formative and summative feedback to learners at all levels.

Progress of Shenqi Fuzheng Injection as Adjuvant Therapy for Malignant Tumors

Directory of Open Access Journals (Sweden)

Jing WANG

2017-09-01

Full Text Available Tumor is a kind of common and frequently-occurring disease that severely impaires human lives and health. As is proposed in Required Readings for Medical Professions, “Accumulation of virus causes insuffcient healthy qi, and then results in invasion of evil qi into the body”. Tumor is caused by interaction of exogenous evil qi and pathogenic products in the body such as phlegm and blood stasis on the basis of healthy qi defciency and disharmony of viscera. Therefore, the condition of healthy qi is not only the key of the occurrence of tumor, but a decisive factor of the development and prognosis of the disease. At present, the main therapeutic approaches for malignant tumors are radiotherapy and chemotherapy. However, during the disease process, the healthy qi gradually decreases due to the consumption of malignant tumors and the injury caused by radiotherapy and chemotherapy. In recent years, taking advantages of traditional Chinese drugs such as Shenqi Fuzheng Injection in combination with radiotherapy or chemotherapy is an important approach for many clinical physicians to improve therapeutic effects and alleviate toxic and side effects induced by radiotherapy and chemotherapy. This study mainly reviewed the progress of mechanisms and application of Shenqi Fuzhen Injection in malignant tumors in recent years.

Evaluation of an on-line methodology for measuring volatile organic compounds (VOC) fluxes by eddy-covariance with a PTR-TOF-Qi-MS

Science.gov (United States)

Loubet, Benjamin; Buysse, Pauline; Lafouge, Florence; Ciuraru, Raluca; Decuq, Céline; Zurfluh, Olivier

2017-04-01

Field scale flux measurements of volatile organic compounds (VOC) are essential for improving our knowledge of VOC emissions from ecosystems. Many VOCs are emitted from and deposited to ecosystems. Especially less known, are crops which represent more than 50% of French terrestrial surfaces. In this study, we evaluate a new on-line methodology for measuring VOC fluxes by Eddy Covariance with a PTR-Qi-TOF-MS. Measurements were performed at the ICOS FR-GRI site over a crop using a 30 m long high flow rate sampling line and an ultrasonic anemometer. A Labview program was specially designed for acquisition and on-line covariance calculation: Whole mass spectra ( 240000 channels) were acquired on-line at 10 Hz and stored in a temporary memory. Every 5 minutes, the spectra were mass-calibrated and normalized by the primary ion peak integral at 10 Hz. The mass spectra peaks were then retrieved from the 5-min averaged spectra by withdrawing the baseline, determining the resolution and using a multiple-peak detection algorithm. In order to optimize the peak detection algorithm for the covariance, we determined the covariances as the integrals of the peaks of the vertical-air-velocity-fluctuation weighed-averaged-spectra. In other terms, we calculate , were w is the vertical component of the air velocity, Sp is the spectra, t is time, lag is the decorrelation lag time and denotes an average. The lag time was determined as the decorrelation time between w and the primary ion (at mass 21.022) which integrates the contribution of all reactions of VOC and water with the primary ion. Our algorithm was evaluated by comparing the exchange velocity of water vapor measured by an open path absorption spectroscopy instrument and the water cluster measured with the PTRQi-TOF-MS. The influence of the algorithm parameters and lag determination is discussed. This study was supported by the ADEME-CORTEA COV3ER project (http://www6.inra.fr/cov3er).

Logic Learning in Hopfield Networks

OpenAIRE

Sathasivam, Saratha; Abdullah, Wan Ahmad Tajuddin Wan

2008-01-01

Synaptic weights for neurons in logic programming can be calculated either by using Hebbian learning or by Wan Abdullah's method. In other words, Hebbian learning for governing events corresponding to some respective program clauses is equivalent with learning using Wan Abdullah's method for the same respective program clauses. In this paper we will evaluate experimentally the equivalence between these two types of learning through computer simulations.

High-Speed Optical Wide-Area Data-Communication Network

Science.gov (United States)

Monacos, Steve P.

1994-01-01

Proposed fiber-optic wide-area network (WAN) for digital communication balances input and output flows of data with its internal capacity by routing traffic via dynamically interconnected routing planes. Data transmitted optically through network by wavelength-division multiplexing in synchronous or asynchronous packets. WAN implemented with currently available technology. Network is multiple-ring cyclic shuffle exchange network ensuring traffic reaches its destination with minimum number of hops.

Methods for the guideline-based development of quality indicators--a systematic review

Science.gov (United States)

2012-01-01

Background Quality indicators (QIs) are used in many healthcare settings to measure, compare, and improve quality of care. For the efficient development of high-quality QIs, rigorous, approved, and evidence-based development methods are needed. Clinical practice guidelines are a suitable source to derive QIs from, but no gold standard for guideline-based QI development exists. This review aims to identify, describe, and compare methodological approaches to guideline-based QI development. Methods We systematically searched medical literature databases (Medline, EMBASE, and CINAHL) and grey literature. Two researchers selected publications reporting methodological approaches to guideline-based QI development. In order to describe and compare methodological approaches used in these publications, we extracted detailed information on common steps of guideline-based QI development (topic selection, guideline selection, extraction of recommendations, QI selection, practice test, and implementation) to predesigned extraction tables. Results From 8,697 hits in the database search and several grey literature documents, we selected 48 relevant references. The studies were of heterogeneous type and quality. We found no randomized controlled trial or other studies comparing the ability of different methodological approaches to guideline-based development to generate high-quality QIs. The relevant publications featured a wide variety of methodological approaches to guideline-based QI development, especially regarding guideline selection and extraction of recommendations. Only a few studies reported patient involvement. Conclusions Further research is needed to determine which elements of the methodological approaches identified, described, and compared in this review are best suited to constitute a gold standard for guideline-based QI development. For this research, we provide a comprehensive groundwork. PMID:22436067

Establishing a portfolio of quality-improvement projects in pediatric surgery through advanced improvement leadership systems.

Science.gov (United States)

Gerrein, Betsy T; Williams, Christina E; Von Allmen, Daniel

2013-01-01

Formal quality-improvement (QI) projects require that participants are educated in QI methods to provide them with the capability to carry out successful, meaningful work. However, orchestrating a portfolio of projects that addresses the strategic mission of the institution requires an extension of basic QI training to provide the division or business unit with the capacity to successfully develop and manage the portfolio. Advanced Improvement Leadership Systems is a program to help units create a meaningful portfolio. This program, used by the Division of Pediatric General and Thoracic Surgery at Cincinnati Children's Hospital Medical Center, helped establish a portfolio of targeted QI projects designed to achieve outstanding outcomes at competitive costs in multiple clinical areas aligned with the institution's strategic goals (improve disease-based outcomes, patient safety, flow, and patient and family experience). These objectives are addressed in an institutional strategic plan built around 5 core areas: Safety, Productivity, Care Coordination and Outcomes, Patient and Family Experience, and Value. By combining the portfolio of QI projects with improvements in the divisional infrastructure, effective improvement efforts were realized throughout the division. In the 9 months following the program, divisional capability resulted in a 16.5% increase (5.7% to 22.2%) of formally trained staff working on 10 QI teams. Concurrently, a leadership team, designed to coordinate projects, remove barriers, and provide technical support, provided the capacity to pursue this ongoing effort. The Advanced Improvement Leadership Systems program increased the Division's efficiency and effectiveness in pursing the QI mission that is integral at our hospital.

Establishing a Portfolio of Quality-Improvement Projects in Pediatric Surgery through Advanced Improvement Leadership Systems

Science.gov (United States)

Gerrein, Betsy T; Williams, Christina E; von Allmen, Daniel

2013-01-01

Formal quality-improvement (QI) projects require that participants are educated in QI methods to provide them with the capability to carry out successful, meaningful work. However, orchestrating a portfolio of projects that addresses the strategic mission of the institution requires an extension of basic QI training to provide the division or business unit with the capacity to successfully develop and manage the portfolio. Advanced Improvement Leadership Systems is a program to help units create a meaningful portfolio. This program, used by the Division of Pediatric General and Thoracic Surgery at Cincinnati Children’s Hospital Medical Center, helped establish a portfolio of targeted QI projects designed to achieve outstanding outcomes at competitive costs in multiple clinical areas aligned with the institution’s strategic goals (improve disease-based outcomes, patient safety, flow, and patient and family experience). These objectives are addressed in an institutional strategic plan built around 5 core areas: Safety, Productivity, Care Coordination and Outcomes, Patient and Family Experience, and Value. By combining the portfolio of QI projects with improvements in the divisional infrastructure, effective improvement efforts were realized throughout the division. In the 9 months following the program, divisional capability resulted in a 16.5% increase (5.7% to 22.2%) of formally trained staff working on 10 QI teams. Concurrently, a leadership team, designed to coordinate projects, remove barriers, and provide technical support, provided the capacity to pursue this ongoing effort. The Advanced Improvement Leadership Systems program increased the Division’s efficiency and effectiveness in pursing the QI mission that is integral at our hospital. PMID:24361020

Clinical and Educational Outcomes of an Integrated Inpatient Quality Improvement Curriculum for Internal Medicine Residents.

Science.gov (United States)

Ogrinc, Greg; Cohen, Emily S; van Aalst, Robertus; Harwood, Beth; Ercolano, Ellyn; Baum, Karyn D; Pattison, Adam J; Jones, Anne C; Davies, Louise; West, Al

2016-10-01

Integrating teaching and hands-on experience in quality improvement (QI) may increase the learning and the impact of resident QI work. We sought to determine the clinical and educational impact of an integrated QI curriculum. This clustered, randomized trial with early and late intervention groups used mixed methods evaluation. For almost 2 years, internal medicine residents from Dartmouth-Hitchcock Medical Center on the inpatient teams at the White River Junction VA participated in the QI curriculum. QI project effectiveness was assessed using statistical process control. Learning outcomes were assessed with the Quality Improvement Knowledge Application Tool-Revised (QIKAT-R) and through self-efficacy, interprofessional care attitudes, and satisfaction of learners. Free text responses by residents and a focus group of nurses who worked with the residents provided information about the acceptability of the intervention. The QI projects improved many clinical processes and outcomes, but not all led to improvements. Educational outcome response rates were 65% (68 of 105) at baseline, 50% (18 of 36) for the early intervention group at midpoint, 67% (24 of 36) for the control group at midpoint, and 53% (42 of 80) for the late intervention group. Composite QIKAT-R scores (range, 0-27) increased from 13.3 at baseline to 15.3 at end point ( P  < .01), as did the self-efficacy composite score ( P  < .05). Satisfaction with the curriculum was rated highly by all participants. Learning and participating in hands-on QI can be integrated into the usual inpatient work of resident physicians.

78 FR 10173 - Ocean Transportation Intermediary License Applicants

Science.gov (United States)

2013-02-13

... Road, Scituate, MA 02066, Officers: Stephen J. Zambo, Member (QI), Stephen A. Zambo, Member... 60007, Officers: Joshua H. Chau, President (QI), Bessie S. Chau, Secretary, Application Type: New NVO...

ESTUDIO DE ATAQUES DE ESCANEO DE PUERTOS BASADO EN CAPTURAS DE TRÁFICO DE ENLACES WAN (WIDE ÁREA NETWORK EN LA RED DE DATOS DE LA UNIVERSIDAD DE LOS ANDES, MÉRIDA, VENEZUELA

Directory of Open Access Journals (Sweden)

Leonardo Uzcategui

2015-07-01

Full Text Available Con el continuo crecimiento de Internet y todas sus aplicaciones, desde comercio electrónico, redes sociales, hasta el Internet de las cosas (IoT = Internet of Thinks, los ataques a las redes se han vuelto más comunes y sofisticados. Por tanto, se hace necesario nuevas medidas de protección, las cuales deben ser más elaboradas y perfeccionadas para que puedan garantizar que las redes de datos operen de manera segura y así poder brindar continuidad a todos los servicios prestados; estas medidas incluyen métodos de detección y repuesta en tiempo real a los intentos de intrusión. En este artículo, se propone un estudio de ataques de escaneo de puertos y/o DoS (Denial of Service encontrados en análisis realizados a los enlaces WAN (Wide Area Network que interconectan la Universidad de los Andes (ULA, Mérida, Venezuela, con Internet, a través de la Red de Datos de la ULA, RedULA. Asimismo, se hacen comparaciones con estadísticas internacionales, así como el análisis del origen de dichos ataques y su respectiva identificación. Los resultados muestran que si bien RedULA no es víctima de paquetes mal formados, si lo es de tráfico excesivo, lo cual se presume sea producto de un malware.

78 FR 30921 - Ocean Transportation Intermediary License Applicants

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2013-05-23

.... (NVO & OFF), 2500 Wilcrest Drive, Suite 300, Houston, TX 77042, Officers: Myrian T. Morales, Vice..., FL 33178, Officer: Jose R. Gantus, President (QI), Application Type: QI Change XL Worldwide Corp...

Inter-rater reliability of nursing home quality indicators in the U.S

Directory of Open Access Journals (Sweden)

Roy Jason

2003-11-01

Full Text Available Abstract Background In the US, Quality Indicators (QI's profiling and comparing the performance of hospitals, health plans, nursing homes and physicians are routinely published for consumer review. We report the results of the largest study of inter-rater reliability done on nursing home assessments which generate the data used to derive publicly reported nursing home quality indicators. Methods We sampled nursing homes in 6 states, selecting up to 30 residents per facility who were observed and assessed by research nurses on 100 clinical assessment elements contained in the Minimum Data Set (MDS and compared these with the most recent assessment in the record done by facility nurses. Kappa statistics were generated for all data items and derived for 22 QI's over the entire sample and for each facility. Finally, facilities with many QI's with poor Kappa levels were compared to those with many QI's with excellent Kappa levels on selected characteristics. Results A total of 462 facilities in 6 states were approached and 219 agreed to participate, yielding a response rate of 47.4%. A total of 5758 residents were included in the inter-rater reliability analyses, around 27.5 per facility. Patients resembled the traditional nursing home resident, only 43.9% were continent of urine and only 25.2% were rated as likely to be discharged within the next 30 days. Results of resident level comparative analyses reveal high inter-rater reliability levels (most items >.75. Using the research nurses as the "gold standard", we compared composite quality indicators based on their ratings with those based on facility nurses. All but two QI's have adequate Kappa levels and 4 QI's have average Kappa values in excess of .80. We found that 16% of participating facilities performed poorly (Kappa .75 on 12 or more QI's. No facility characteristics were related to reliability of the data on which Qis are based. Conclusion While a few QI's being used for public reporting

Quality and safety training in primary care: making an impact.

Science.gov (United States)

Byrne, John M; Hall, Susan; Baz, Sam; Kessler, Todd; Roman, Maher; Patuszynski, Mark; Thakkar, Kruti; Kashner, T Michael

2012-12-01

Preparing residents for future practice, knowledge, and skills in quality improvement and safety (QI/S) is a requisite element of graduate medical education. Despite many challenges, residency programs must consider new curricular innovations to meet the requirements. We report the effectiveness of a primary care QI/S curriculum and the role of the chief resident in quality and patient safety in facilitating it. Through the Veterans Administration Graduate Medical Education Enhancement Program, we added a position for a chief resident in quality and patient safety, and 4 full-time equivalent internal medicine residents, to develop the Primary Care Interprofessional Patient-Centered Quality Care Training Curriculum. The curriculum includes a first-or second-year, 1-month block rotation that serves as a foundational experience in QI/S and interprofessional care. The responsibilities of the chief resident in quality and patient safety included organizing and teaching the QI/S curriculum and mentoring resident projects. Evaluation included prerotation and postrotation surveys of self-assessed QI/S knowledge, abilities, skills, beliefs, and commitment (KASBC); an end-of-the-year KASBC; prerotation and postrotation knowledge test; and postrotation and faculty surveys. Comparisons of prerotation and postrotation KASBC indicated significant self-assessed improvements in 4 of 5 KASBC domains: knowledge (P < .001), ability (P < .001), skills (P < .001), and belief (P < .03), which were sustained on the end-of-the-year survey. The knowledge test demonstrated increased QI/S knowledge (P  =  .002). Results of the postrotation survey indicate strong satisfaction with the curriculum, with 76% (25 of 33) and 70% (23 of 33) of the residents rating the quality and safety curricula as always or usually educational. Most faculty members acknowledged that the chief resident in quality and patient safety enhanced both faculty and resident QI/S interest and

Development of a core set of quality indicators for paediatric primary care practices in Europe, COSI-PPC-EU.

Science.gov (United States)

Ewald, Dominik A; Huss, Gottfried; Auras, Silke; Caceres, Juan Ruiz-Canela; Hadjipanayis, Adamos; Geraedts, Max

2018-06-01

Paediatric ambulatory healthcare systems in Europe are, because of historical reasons, diverse and show strikingly different outcomes. All across Europe, the benchmarking of structures, processes and outcomes could reveal opportunities for improving Paediatric Primary Care (PPC). The aim of this study was to develop a set of Quality Indicators (QIs) to assess and monitor PPC in Europe. In a three-step process, we used the available external evidence and European expert consensus in a modified RAND/UCLA Appropriateness Method (RAM) to develop an indicator set. (1) A broad literature and online research of published QI and guidelines yielded an inventory of 1516 QI. (2) A collaborative panel of paediatric senior experts from the European Academy of Paediatrics (EAP) and the European Confederation of Primary Care Paediatricians (ECPCP) from 15 European countries participated in a first consensus process to reduce the initial indicator inventory by eliminating not PPC-focused indicators and duplicates. (3) In a second consensus process, the panel rated the QI regarding validity and feasibility. The final QI set "COSI-PPC-EU" consists of 42 indicators in five categories of PPC: (A) health promotion/prevention/screening (13 QI), (B) acute care (9 QI), (C) chronic care (8 QI), (D) practice management (3 QI) and (E) patient safety (9 QI). COSI-PPC-EU represents a consented set of a limited number of valid quality indicators for the application in paediatric primary care in different healthcare systems throughout Europe. What is Known: • Paediatric ambulatory healthcare systems in Europe are diverse and show strikingly different outcomes. • There are known gaps in quality performance measures of paediatric primary care in Europe. Pre-existing sets of quality indicators are predominantly limited to national populations, specific diseases and hospital care. What is New: • A set of 42 quality indicators for primary paediatric care in Europe was developed in a multi

The Mechanism Research of Qishen Yiqi Formula by Module-Network Analysis

OpenAIRE

Zheng, Shichao; Zhang, Yanling; Qiao, Yanjiang

2015-01-01

Qishen Yiqi formula (QSYQ) has the effect of tonifying Qi and promoting blood circulation, which is widely used to treat the cardiovascular diseases with Qi deficiency and blood stasis syndrome. However, the mechanism of QSYQ to tonify Qi and promote blood circulation is rarely reported at molecular or systems level. This study aimed to elucidate the mechanism of QSYQ based on the protein interaction network (PIN) analysis. The targets’ information of the active components was obtained from C...

78 FR 38336 - Ocean Transportation Intermediary License Applicants

Science.gov (United States)

2013-06-26

..., President (QI), Stephen B. Schwark, Treasurer, Application Type: License Transfer to EFL Container Lines...., Suite K, Mobile, AL 36609, Officers: Thomas (Mac) H. McPhillips IV, Assistant Vice President (QI), Oscar...

An alter-centric perspective on employee innovation: The importance of alters' creative self-efficacy and network structure.

Science.gov (United States)

Grosser, Travis J; Venkataramani, Vijaya; Labianca, Giuseppe Joe

2017-09-01

While most social network studies of employee innovation behavior examine the focal employees' ("egos'") network structure, we employ an alter-centric perspective to study the personal characteristics of employees' network contacts-their "alters"-to better understand employee innovation. Specifically, we examine how the creative self-efficacy (CSE) and innovation behavior of employees' social network contacts affects their ability to generate and implement novel ideas. Hypotheses were tested using a sample of 144 employees in a U.S.-based product development organization. We find that the average CSE of alters in an employee's problem solving network is positively related to that employee's innovation behavior, with this relationship being mediated by these alters' average innovation behavior. The relationship between the alters' average innovation behavior and the employee's own innovation behavior is strengthened when these alters have less dense social networks. Post hoc results suggest that having network contacts with high levels of CSE also leads to an increase in ego's personal CSE 1 year later in cases where the employee's initial level of CSE was relatively low. Implications for theory and practice are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

A story of success: continuous quality improvement in cystic fibrosis care in the USA.

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Quon, Bradley S; Goss, Christopher H

2011-12-01

Continuous quality improvement (CQI) in healthcare can be described as a reiterative approach to improving processes to reduce unexpected variation in health outcomes. CQI represents one model to achieve quality improvement (QI) and has long been recognized as a key to success in the manufacturing industry with companies like Toyota leading the way. Healthcare, and specifically pulmonary, critical care and sleep medicine represent ideal settings for the application of CQI. This opinion piece will describe QI and CQI initiatives in the US Cystic fibrosis (CF) population. QI in CF care in the United States has been ongoing since inception of the US CF Foundation (CFF) in 1955. This effort has included work to improve the quality of clinical care provided at CF centers and work to improve clinical outcomes in CF. More recently, QI methods have been applied to the conduct of clinical research. The CF community has become a leader in the area of QI and has pointed out the opportunities for others to follow in the area of lung diseases.

[Brief discussion on acupuncture technique "controlling Qihai to regulate blood pressure" proposed by academician SHI Xuemin].

Science.gov (United States)

Yu, Liang; Xu, Xifa; Liu, Jian; Fan, Xiaonong

2017-08-12

According to Qihai theory, academician SHI Xuemin established the acupuncture technique "controlling Qihai to regulate blood pressure" which focused on Renying (ST 9), and achieved favorable effects in clinical application. In this paper, based on the Qihai theory, from aspects of Yuan qi , Zong qi , Ying qi and Wei qi and relations among qi , blood and veins in TCM, and cardiac output, sympathetic nerve activity and blood vessels in modern medicine, the understanding on hypertension was explained. As a result, both TCM and modern medicine had consistency in the understanding of hypertension, reflecting the scientificity and practicability of this acupuncture technique. Besides, according to Qihai theory and "wind leading to vertigo" theory, academician SHI Xuemin brought forward the key pathogenesis of hypertension was "dysfunction of Qihai ", and the acupoint selected Renying (ST 9), Quchi (LI 11), Hegu (LI 4), Zusanli (ST 36) and Taichong (LR 3). At the same time, the operation specification of each acupoint was mainly discussed, and the references of acupoint selection was explained based on TCM theory and modern clinical research.

An Empirical Study of Critical Soft Factors for Quality Improvement in The Electrical and Electronics Firms in Malaysia

Directory of Open Access Journals (Sweden)

Muhammad Madi Abdullah

2009-03-01

Full Text Available Soft factors are important aspect that sustains the organizations in their efforts towards continuous quality improvement (QI and customer satisfaction. The conventional wisdom states that quality improvement in organizations increases profits and productivity. Therefore, the aim of the paper is to examine the influence of critical soft factors (CSF on quality improvement (QI. For that purpose, this study examine: (i the relationship between the CSF and QI and (ii to what extent the six CSF explain QI. The study used survey data from 255 electrical and electronics (E&E firms in Malaysia. The individual managers representing the each firm made the unit of analysis of the study. The finding reveals that QI was significantly influenced by the following soft factors: management commitment, customer focus, employee involvement, training & education, and reward & recognition. Supplier relationship was not a significant predictor of quality improvement. Finally, this study has empirically shown that quality improvement will increase when the organizations emphasize more on soft factors.Keywords: Critical soft factors, quality improvement, Electrical and Electronics firms

Hospital accreditation: staff experiences and perceptions.

Science.gov (United States)

Bogh, Søren Bie; Blom, Ane; Raben, Ditte Caroline; Braithwaite, Jeffrey; Thude, Bettina; Hollnagel, Erik; Plessen, Christian von

2018-06-11

Purpose The purpose of this paper is to understand how staff at various levels perceive and understand hospital accreditation generally and in relation to quality improvement (QI) specifically. Design/methodology/approach In a newly accredited Danish hospital, the authors conducted semi-structured interviews to capture broad ranging experiences. Medical doctors, nurses, a quality coordinator and a quality department employee participated. Interviews were audio recorded and subjected to framework analysis. Findings Staff reported that The Danish Healthcare Quality Programme affected management priorities: office time and working on documentation, which reduced time with patients and on improvement activities. Organisational structures were improved during preparation for accreditation. Staff perceived that the hospital was better prepared for new QI initiatives after accreditation; staff found disease specific requirements unnecessary. Other areas benefited from accreditation. Interviewees expected that organisational changes, owing to accreditation, would be sustained and that the QI focus would continue. Practical implications Accreditation is a critical and complete hospital review, including areas that often are neglected. Accreditation dominates hospital agendas during preparation and surveyor visits, potentially reducing patient care and other QI initiatives. Improvements are less likely to occur in areas that other QI initiatives addressed. Yet, accreditation creates organisational foundations for future QI initiatives. Originality/value The authors study contributes new insights into how hospital staff at different organisational levels perceive and understand accreditation.

Hierarchical and Complex System Entropy Clustering Analysis Based Validation for Traditional Chinese Medicine Syndrome Patterns of Chronic Atrophic Gastritis.

Science.gov (United States)

Zhang, Yin; Liu, Yue; Li, Yannan; Zhao, Xia; Zhuo, Lin; Zhou, Ajian; Zhang, Li; Su, Zeqi; Chen, Cen; Du, Shiyu; Liu, Daming; Ding, Xia

2018-03-22

Chronic atrophic gastritis (CAG) is the precancerous stage of gastric carcinoma. Traditional Chinese Medicine (TCM) has been widely used in treating CAG. This study aimed to reveal core pathogenesis of CAG by validating the TCM syndrome patterns and provide evidence for optimization of treatment strategies. This is a cross-sectional study conducted in 4 hospitals in China. Hierarchical clustering analysis (HCA) and complex system entropy clustering analysis (CSECA) were performed, respectively, to achieve syndrome pattern validation. Based on HCA, 15 common factors were assigned to 6 syndrome patterns: liver depression and spleen deficiency and blood stasis in the stomach collateral, internal harassment of phlegm-heat and blood stasis in the stomach collateral, phlegm-turbidity internal obstruction, spleen yang deficiency, internal harassment of phlegm-heat and spleen deficiency, and spleen qi deficiency. By CSECA, 22 common factors were assigned to 7 syndrome patterns: qi deficiency, qi stagnation, blood stasis, phlegm turbidity, heat, yang deficiency, and yin deficiency. Combination of qi deficiency, qi stagnation, blood stasis, phlegm turbidity, heat, yang deficiency, and yin deficiency may play a crucial role in CAG pathogenesis. In accord with this, treatment strategies by TCM herbal prescriptions should be targeted to regulating qi, activating blood, resolving turbidity, clearing heat, removing toxin, nourishing yin, and warming yang. Further explorations are needed to verify and expand the current conclusions.

Quantitative Reasoning in Environmental Science: Rasch Measurement to Support QR Assessment

Directory of Open Access Journals (Sweden)

Robert L. Mayes

2015-07-01

Full Text Available The ability of middle and high school students to reason quantitatively within the context of environmental science was investigated. A quantitative reasoning (QR learning progression, with associated QR assessments in the content areas of biodiversity, water, and carbon, was developed based on three QR progress variables: quantification act, quantitative interpretation, and quantitative modeling. Diagnostic instruments were developed specifically for the progress variable quantitative interpretation (QI, each consisting of 96 Likert-scale items. Each content version of the instrument focused on three scale levels (macro scale, micro scale, and landscape scale and four elements of QI identified in prior research (trend, translation, prediction, and revision. The QI assessments were completed by 362, 6th to 12th grade students in three U.S. states. Rasch (1960/1980 measurement was used to determine item and person measures for the QI instruments, both to examine validity and reliability characteristics of the instrument administration and inform the evolution of the learning progression. Rasch methods allowed identification of several QI instrument revisions, including modification of specific items, reducing number of items to avoid cognitive fatigue, reconsidering proposed item difficulty levels, and reducing Likert scale to 4 levels. Rasch diagnostics also indicated favorable levels of instrument reliability and appropriate targeting of item abilities to student abilities for the majority of participants. A revised QI instrument is available for STEM researchers and educators.

Performance Evaluation of LoRa Considering Scenario Conditions

Directory of Open Access Journals (Sweden)

Ramon Sanchez-Iborra

2018-03-01

Full Text Available New verticals within the Internet of Things (IoT paradigm such as smart cities, smart farming, or goods monitoring, among many others, are demanding strong requirements to the Radio Access Network (RAN in terms of coverage, end-node’s power consumption, and scalability. The technologies employed so far to provide IoT scenarios with connectivity, e.g., wireless sensor network and cellular technologies, are not able to simultaneously cope with these three requirements. Thus, a novel solution known as Low Power - Wide Area Network (LP-WAN has emerged as a promising alternative to provide with low-cost and low-power-consumption connectivity to end-nodes spread in a wide area. Concretely, the Long-Range Wide Area Network (LoRaWAN technology is one of the LP-WAN platforms that is receiving greater attention from both the industry and the academia. For that reason, in this work, a comprehensive performance evaluation of LoRaWAN under different environmental conditions is presented. The results are obtained from three real scenarios, namely, urban, suburban, and rural, considering both dynamic and static conditions, hence a discussion about the most proper LoRaWAN physical-layer configuration for each scenario is provided. Besides, a theoretical coverage study is also conducted by the use of a radio planning tool considering topographic maps and a precise propagation model. From the attained results, it can be concluded that it is necessary to evaluate the propagation conditions of the deployment scenario prior to the system implantation in order to reach a compromise between the robustness of the network and the transmission data-rate.

Developing a Benchmarking Process in Perfusion: A Report of the Perfusion Downunder Collaboration

Science.gov (United States)

Baker, Robert A.; Newland, Richard F.; Fenton, Carmel; McDonald, Michael; Willcox, Timothy W.; Merry, Alan F.

2012-01-01

Abstract: Improving and understanding clinical practice is an appropriate goal for the perfusion community. The Perfusion Downunder Collaboration has established a multi-center perfusion focused database aimed at achieving these goals through the development of quantitative quality indicators for clinical improvement through benchmarking. Data were collected using the Perfusion Downunder Collaboration database from procedures performed in eight Australian and New Zealand cardiac centers between March 2007 and February 2011. At the Perfusion Downunder Meeting in 2010, it was agreed by consensus, to report quality indicators (QI) for glucose level, arterial outlet temperature, and pCO2 management during cardiopulmonary bypass. The values chosen for each QI were: blood glucose ≥4 mmol/L and ≤10 mmol/L; arterial outlet temperature ≤37°C; and arterial blood gas pCO2 ≥ 35 and ≤45 mmHg. The QI data were used to derive benchmarks using the Achievable Benchmark of Care (ABC™) methodology to identify the incidence of QIs at the best performing centers. Five thousand four hundred and sixty-five procedures were evaluated to derive QI and benchmark data. The incidence of the blood glucose QI ranged from 37–96% of procedures, with a benchmark value of 90%. The arterial outlet temperature QI occurred in 16–98% of procedures with the benchmark of 94%; while the arterial pCO2 QI occurred in 21–91%, with the benchmark value of 80%. We have derived QIs and benchmark calculations for the management of several key aspects of cardiopulmonary bypass to provide a platform for improving the quality of perfusion practice. PMID:22730861

Quality improvement and accreditation readiness in state public health agencies.

Science.gov (United States)

Madamala, Kusuma; Sellers, Katie; Beitsch, Leslie M; Pearsol, Jim; Jarris, Paul

2012-01-01

There were 3 specific objectives of this study. The first objective was to examine the progress of state/territorial health assessment, health improvement planning, performance management, and quality improvement (QI) activities at state/territorial health agencies and compare findings to the 2007 findings when available. A second objective was to examine respondent interest and readiness for national voluntary accreditation. A final objective was to explore organizational factors (eg, leadership and capacity) that may influence QI or accreditation readiness. Cross-sectional study. State and Territorial Public Health Agencies. Survey respondents were organizational leaders at State and Territorial Public Health Agencies. Sixty-seven percent of respondents reported having a formal performance management process in place. Approximately 77% of respondents reported a QI process in place. Seventy-three percent of respondents agreed or strongly agreed that they would seek accreditation and 36% agreed or strongly agreed that they would seek accreditation in the first 2 years of the program. In terms of accreditation prerequisites, a strategic plan was most frequently developed, followed by a state/territorial health assessment and health improvement plan, respectively. Advancements in the practice and applied research of QI in state public health agencies are necessary steps for improving performance. In particular, strengthening the measurement of the QI construct is essential for meaningfully assessing current practice patterns and informing future programming and policy decisions. Continued QI training and technical assistance to agency staff and leadership is also critical. Accreditation may be the pivotal factor to strengthen both QI practice and research. Respondent interest in seeking accreditation may indicate the perceived value of accreditation to the agency.

Vertical Jumping Tests versus Wingate Anaerobic Test in Female Volleyball Players: The Role of Age

Science.gov (United States)

Nikolaidis, Pantelis Theodoros; Afonso, Jose; Clemente-Suarez, Vicente Javier; Alvarado, Jose Rafael Padilla; Driss, Tarak; Knechtle, Beat; Torres-Luque, Gema

2016-01-01

Single and continuous vertical jumping tests, as well as the Wingate anaerobic test (WAnT), are commonly used to assess the short-term muscle power of female volleyball players; however, the relationship among these tests has not been studied adequately. Thus, the aim of the present study was to examine the relationship of single and continuous vertical jumps with the WAnT in female volleyball players. Seventy adolescent (age 16.0 ± 1.0 years, body mass 62.5 ± 7.1 kg, height 170.4 ± 6.1 cm, body fat 24.2% ± 4.3%) and 108 adult female volleyball players (age 24.8 ± 5.2 years, body mass 66.5 ± 8.7 kg, height 173.2 ± 7.4 cm, body fat 22.0% ± 5.1%) performed the squat jump (SJ), countermovement jump (CMJ), Abalakov jump (AJ), 30 s Bosco test and WAnT (peak power, Ppeak; mean power, Pmean). Mean power in the Bosco test was correlated (low to large magnitude) with Pmean of the WAnT (r = 0.27, p = 0.030 in adolescents versus r = 0.56, p volleyball players. These findings should be taken into account by volleyball coaches and fitness trainers during the assessment of short-term muscle power of their athletes.

Applying ethnography to the study of context in healthcare quality and safety.

Science.gov (United States)

Leslie, Myles; Paradis, Elise; Gropper, Michael A; Reeves, Scott; Kitto, Simon

2014-02-01

Translating and scaling healthcare quality improvement (QI) and patient safety interventions remains a significant challenge. Context has been identified as a major factor in this. QI and patient safety research have begun to focus on context, with ethnography seen as a promising methodology for understanding the professional, organisational and cultural aspects of context. While ethnography is used to investigate the context of a variety of QI and safety interventions, the challenges inherent in effectively importing a qualitative methodology and its social science practitioners into this work have been largely unexamined. We explain ethnography as a research practice grounded in theory and dependent on observations gathered and interpreted in particular ways. We then review the approach of health services literature to evaluating this sort of qualitative research. Although the study of context is an interest shared by both social scientists and healthcare QI and safety researchers, we identify three key points at which those 'exporting' ethnography as a methodology and those 'importing' it to deal with QI and safety challenges may diverge. We describe perspectival divergences on the methodology's mission, form and scale. At the level of mission we demonstrate how ethnography has been adapted to a 'describe and feed back' role in the service of QI. At the level of form, we show how the long-term embedded observation at the heart of ethnography can be adapted only so far to accommodate QI interests if both data quality and ethical standards are to be upheld. Finally, at the level of scale, we demonstrate one ethnographic study design that balances breadth of exposure with depth of experience in its observations and so generates a particular type of scalable findings. The effective export of ethnography into QI and safety research requires discussion and negotiation between social scientific and health services research perspectives, as well as creative approaches

[Effect of medicines for activating blood and reinforcing Qi on angiogenesis in infarcted myocardium edge area of acute myocardial infarction model in rats].

Science.gov (United States)

Zang, Wen-Hua; Yin, Shen-Hua; Tang, De-Cai; Li, Bing-Bing

2014-03-01

To study the effect of medicines for activating blood and reinforcing Qi on the number of new micro-vessels and the protein expressions of VEGF and bFGF in the infarcted myocardium edge area of acute myocardial infarction (AMI) model in rats. The AMI model of rats was established. After the successful model establishment, rats were randomly divided into the sham-operated group, the model group, the Danshen-Huangqi (1 : 2) group, the Danshen-Huangqi (1 : 1) group, the Chuanxiong-Huangqi (1 : 2) group, the Danshen group, the Chuanxiong group, the Chishao group and the Shexiang Baoxin pill group, with five rats in each group. Rats in each medicated group were orally administered with drugs as per 13.5 g x kg(-1) x d(-1) once everyday for three weeks. The immunohistochemical SP method was adopted to detect the expression of vWF in myocardial tissues, and count the number of micro-vessels (MVC). The protein expression of VEGF and bFGF in myocardial tissues were determined by Western blot. The new micro-vessels stained by vWF factor could be found in the infarcted myocardium edge area of the sham-operated group, the model group and all of medicated groups. The sham-operated group show unobvious new micro-vessels in myocardial tissues. A small amount of new micro-vessels could be seen in the infarcted myocardium edge area of the model group. Whereas a larger number of micro-vessels could be seen in the infarcted myocardium edge area of all of medicated groups. The differences between the sham-operated group and the model group had statistical significance (P effect in promoting angiogenesis. Their mechanism for promoting angiogenesis may be related to the improvement of the protein expressions of VEGF and bFGF, so as to increase the contents of VEGF and bFGF and promote the angiogenesis of new vessels.

CADDIS Volume 2. Sources, Stressors and Responses: Flow Alteration

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Introduction to the flow alteration module, when to list flow alteration as a candidate cause, ways to measure flow alteration, simple and detailed conceptual model diagrams for flow alteration, flow alteration module references and literature reviews.

A kernel version of multivariate alteration detection

DEFF Research Database (Denmark)

Nielsen, Allan Aasbjerg; Vestergaard, Jacob Schack

2013-01-01

Based on the established methods kernel canonical correlation analysis and multivariate alteration detection we introduce a kernel version of multivariate alteration detection. A case study with SPOT HRV data shows that the kMAD variates focus on extreme change observations.......Based on the established methods kernel canonical correlation analysis and multivariate alteration detection we introduce a kernel version of multivariate alteration detection. A case study with SPOT HRV data shows that the kMAD variates focus on extreme change observations....

Investigation of alteration zones in Garandake and Kurokawa

Energy Technology Data Exchange (ETDEWEB)

Kinbara, K [Geological Survey of Japan, Kawasaki; Sudo, S

1977-01-01

The eastern part of the Garan area contains both the Myoban and Tsukahara hot springs. The springs are associated with the Sanin Formation, and an alteration zone is present which strikes easterly. Throughout the altered area, a clear zonation of the alteration is present. The zonation runs: silicified - alunitized - kaolin/argillized - montmorillonite/zeolite. In the Kurokawa area, a total of 0.96 km/sup 2/ of altered zones were observed near Suzumejigoku and throughout Yoshikawa and Tawara. The most heavily altered areas were at Kurokawa hot springs and Yoshikawa, where alunite and kaolinite are abundant. The time of alteration is believed to be prior to the deposition of the Hisazumi pumice. Around the Kurokawa hot springs, where the water temperature is 98/sup 0/C, the alteration extends as far as the pumice.

28 CFR 36.405 - Alterations: Historic preservation.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Alterations: Historic preservation. 36... Alterations: Historic preservation. (a) Alterations to buildings or facilities that are eligible for listing in the National Register of Historic Places under the National Historic Preservation Act (16 U.S.C...

Defining and Assessing Quality Improvement Outcomes: A Framework for Public Health

Science.gov (United States)

Nawaz, Saira; Thomas, Craig; Young, Andrea

2015-01-01

We describe an evidence-based framework to define and assess the impact of quality improvement (QI) in public health. Developed to address programmatic and research-identified needs for articulating the value of public health QI in aggregate, this framework proposes a standardized set of measures to monitor and improve the efficiency and effectiveness of public health programs and operations. We reviewed the scientific literature and analyzed QI initiatives implemented through the Centers for Disease Control and Prevention’s National Public Health Improvement Initiative to inform the selection of 5 efficiency and 8 effectiveness measures. This framework provides a model for identifying the types of improvement outcomes targeted by public health QI efforts and a means to understand QI’s impact on the practice of public health. PMID:25689185

Radiation protection philosophy alters

International Nuclear Information System (INIS)

Firmin, G.

1977-01-01

Two significant events that have taken place this year in the field of radiation protection are reported. New SI units have been proposed (and effectively adopted), and the ICRP has revised its recommendations. Changes of emphasis in the latest recommendations (ICRP Publication 26) imply an altered radiation protection philosophy, in particular the relation of dose limits to estimates of average risk, an altered view of the critical organ approach and a new attitude to genetic dose to the population. (author)

Optical packet networks - conclusions from the IST DAVID project

DEFF Research Database (Denmark)

Dittmann, Lars

2004-01-01

This work outlines the result from the European research project DAVID working with optical packet switch solutions for both WAN and MAN. The project started July 2000 and has been completed successfully by the end of 2003.......This work outlines the result from the European research project DAVID working with optical packet switch solutions for both WAN and MAN. The project started July 2000 and has been completed successfully by the end of 2003....

28 CFR 36.403 - Alterations: Path of travel.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Alterations: Path of travel. 36.403... Alterations: Path of travel. (a) General. An alteration that affects or could affect the usability of or... the maximum extent feasible, the path of travel to the altered area and the restrooms, telephones, and...

Music and Alterity Processes

Directory of Open Access Journals (Sweden)

Josep Martí

2014-10-01

Full Text Available The concept of alterity constitutes an important issue in anthropological research and, therefore, in the study of musical practices, as well. Without it, we could hardly understand other kinds of music situated in different spaces and time from the observer. In order to effectively approach these musical practices, we have to develop strategies to help us reduce as much as possible that which distorts the vision of the other. However, beyond the strictly epistemological and methodological issues, the study of music cannot ignore the ethical question related to the manner in which Western thought has understood and treated the other: through a hierarchical and stereotypical type of thinking based on the condition of otherness. Throughout the article, different alterity procedures are presented and discussed, such as synecdochization, exoticization, undervaluation, overvaluation, misunderstanding and exclusion. Taking these different alterity strategies into account may help us to better understand how the musical other is constructed, used and ultimately instrumentalized.

Pay-for-performance policy and data-driven decision making within nursing homes: a qualitative study.

Science.gov (United States)

Abrahamson, Kathleen; Miech, Edward; Davila, Heather Wood; Mueller, Christine; Cooke, Valerie; Arling, Greg

2015-05-01

Health systems globally and within the USA have introduced nursing home pay-for-performance (P4P) programmes in response to the need for improved nursing home quality. Central to the challenge of administering effective P4P is the availability of accurate, timely and clinically appropriate data for decision making. We aimed to explore ways in which data were collected, thought about and used as a result of participation in a P4P programme. Semistructured interviews were conducted with 232 nursing home employees from within 70 nursing homes that participated in P4P-sponsored quality improvement (QI) projects. Interview data were analysed to identify themes surrounding collecting, thinking about and using data for QI decision making. The term 'data' appeared 247 times in the interviews, and over 92% of these instances (228/247) were spontaneous references by nursing home staff. Overall, 34% of respondents (79/232) referred directly to 'data' in their interviews. Nursing home leadership more frequently discussed data use than direct care staff. Emergent themes included using data to identify a QI problem, gathering data in new ways at the local level, and measuring outcomes in response to P4P participation. Alterations in data use as a result of policy change were theoretically consistent with the revised version of the Promoting Action on Research Implementation in Health Services framework, which posits that successful implementation is a function of evidence, context and facilitation. Providing a reimbursement context that facilitates the collection and use of reliable local evidence may be an important consideration to others contemplating the adaptation of P4P policies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Comparison of time-resolved autofluorescence in the eye-ground of healthy subjects and patients suffering from age-related macular degeneration

Science.gov (United States)

Schweitzer, Dietrich; Schweitzer, Frank; Hammer, Martin; Schenke, Stefan; Richter, Sandra

2005-08-01

Age-related macular degeneration (AMD) is the most frequent cause for blindness for person older than 65 years in western countries. Besides the subjective pain, it is also an economic problem in the ageing population. As the pathomechanism is unknown, no curative treatment is possible. International research for discovering of early age-related alterations at the fundus is directed on in vivo measurements of autofluorescence. One way is the measurement of fluorescence spectra. Unfortunately, any selective excitation of fluorophores is excluded by the absorption edge of the ocular media at 400 nm. Furthermore, the shape of fluorescence spectra is influenced by the spectral absorption of layers in front of the emitting fluorophore. Weakly emitting fluorophores are covered by intensive emitting substances. The most serious limitation in fluorescence measurements of the living human fundus is the maximal permissible exposure. For that reason, fluorescence spectra of the fundus can not be detected with a high spatial resolution. The detection of dynamic fluorescence provides substance-specific lifetimes Ti, amplitudes Ai, and information about the relative contribution Qi of components in fluorescence images. As these parameters are calculated for each image point, diagrams of Ti vs. Tj, Ai vs. Aj, and Qi vs. Qj can be drawn, in which specific clusters appear for healthy subjects or AMD - patients. The projection of lifetime - clusters onto corresponding axis represents histogram of the considered lifetime. The slope in the correlation between Ai and Aj can also be used as a discriminating mark. Considering image lines as intersection through characteristic anatomical structures (optic disc, macula) profiles of Ti, Ai, or Qi show changes of these parameters (e.g. depigmentation) as function of location, which might be specific for AMD.

Regulation of pulpal blood flow

International Nuclear Information System (INIS)

Kim, S.

1985-01-01

The regulation of blood flow of the dental pulp was investigated in dogs and rats anesthetized with sodium pentobarbital. Pulpal blood flow was altered by variations of local and systemic hemodynamics. Macrocirculatory blood flow (ml/min/100 g) in the dental pulp was measured with both the 133 Xe washout and the 15-microns radioisotope-labeled microsphere injection methods on the canine teeth of dogs, to provide a comparison of the two methods in the same tooth. Microcirculatory studies were conducted in the rat incisor tooth with microscopic determination of the vascular pattern, RBC velocity, and intravascular volumetric flow distribution. Pulpal resistance vessels have alpha- and beta-adrenergic receptors. Activation of alpha-receptors by intra-arterial injection of norepinephrine (NE) caused both a reduction in macrocirculatory Qp in dogs and decreases in arteriolar and venular diameters and intravascular volumetric flow (Qi) in rats. These responses were blocked by the alpha-antagonist PBZ. Activation of beta-receptors by intra-arterial injection of isoproterenal (ISO) caused a paradoxical reduction of Qp in dogs. In rats, ISO caused a transient increase in arteriolar Qi followed by a flow reduction; arteriolar dilation was accompanied by venular constriction. These macrocirculatory and microcirculatory responses to ISO were blocked by the alpha-antagonist propranolol

A representative prescription for emotional disease, Ding-Zhi-Xiao-Wan restores 5-HT system deficit through interfering the synthesis and transshipment in chronic mild stress-induced depressive rats.

Science.gov (United States)

Dong, Xian-Zhe; Li, Zhao-Liang; Zheng, Xiao-Li; Mu, Li-Hua; Zhang, Gang-qiang; Liu, Ping

2013-12-12

Ding-Zhi-Xiao-Wan (DZ, also known as Kai-Xin-San) is a famous traditional Chinese medicine used for the treatment of emotional disease. Previously, we have found that in a variety of animal models of depression (such as tail suspension model, model of chronic fatigue and forced swimming model) DZ demonstrated significant antidepressant behavior and promoted the production of 5-hydroxytryptamine (5-HT). However, the mechanisms of 5-HT regulation are still unclear. Therefore, the current study is designed to further investigate the antidepressant effect of DZ by observing its influence on 5-HT synthesis, metabolism, transport and other key links, so as to clarify the molecular mechanism of its 5-HT regulation. Solitary rising combined with the chronic unpredictable mild stress (CMS) was used to establish the rat model of depression. The rats were given DZ for 3 weeks, the behavior change and the following items in hippocampus and prefrontal cortex were detected simultaneously: 5-HT, 5-hydroxyindoleacetic acid (5-HIAA), tryptophan hydroxylase (TPH), aromatic amino acid decarboxylase (AADC), monoamine oxidase (MAO) and 5-HT transporter (5-HTT) were observed. Our results showed that treatment with the DZ significantly improved the behavior and simultaneously increased the 5-HT level in the hippocampus, prefrontal cortex tissues and hippocampus extracellular of depressive rats. In future studies revealed that DZ could significantly increase the protein and mRNA expression of the key enzymes TPH during the 5-HT synthesis process in the hippocampus and prefrontal cortex of the depressed rats, and suppress the expression of 5-HTT protein and mRNA at the same time. But it had no effects on MAO-A and MAO-B activities. We believe that antidepressant effect of DZ is caused by the increase of 5-HT synthesis and reduction of 5-HT re-uptake, and eventually increase the content of 5-HT in the brain and the synaptic gaps. © 2013 Published by Elsevier Ireland Ltd.

Postgraduate Education in Quality Improvement Methods: Initial Results of the Fellows' Applied Quality Training (FAQT) Curriculum.

Science.gov (United States)

Winchester, David E; Burkart, Thomas A; Choi, Calvin Y; McKillop, Matthew S; Beyth, Rebecca J; Dahm, Phillipp

2016-06-01

Training in quality improvement (QI) is a pillar of the next accreditation system of the Accreditation Committee on Graduate Medical Education and a growing expectation of physicians for maintenance of certification. Despite this, many postgraduate medical trainees are not receiving training in QI methods. We created the Fellows Applied Quality Training (FAQT) curriculum for cardiology fellows using both didactic and applied components with the goal of increasing confidence to participate in future QI projects. Fellows completed didactic training from the Institute for Healthcare Improvement's Open School and then designed and completed a project to improve quality of care or patient safety. Self-assessments were completed by the fellows before, during, and after the first year of the curriculum. The primary outcome for our curriculum was the median score reported by the fellows regarding their self-confidence to complete QI activities. Self-assessments were completed by 23 fellows. The majority of fellows (15 of 23, 65.2%) reported no prior formal QI training. Median score on baseline self-assessment was 3.0 (range, 1.85-4), which was significantly increased to 3.27 (range, 2.23-4; P = 0.004) on the final assessment. The distribution of scores reported by the fellows indicates that 30% were slightly confident at conducting QI activities on their own, which was reduced to 5% after completing the FAQT curriculum. An interim assessment was conducted after the fellows completed didactic training only; median scores were not different from the baseline (mean, 3.0; P = 0.51). After completion of the FAQT, cardiology fellows reported higher self-confidence to complete QI activities. The increase in self-confidence seemed to be limited to the applied component of the curriculum, with no significant change after the didactic component.

Exploring the role of communications in quality improvement: A case study of the 1000 Lives Campaign in NHS Wales.

Science.gov (United States)

Cooper, Andrew; Gray, Jonathon; Willson, Alan; Lines, Chris; McCannon, Joe; McHardy, Karina

2015-03-01

Effective communication is critical to successful large-scale change. Yet, in our experience, communications strategies are not formally incorporated into quality improvement (QI) frameworks. The 1000 Lives Campaign ('Campaign') was a large-scale national QI collaborative that aimed to save an additional 1000 lives and prevent 50 000 episodes of harm in Welsh health care over a 2-year period. We use the Campaign as a case study to describe the development, application, and impact of a communications strategy embedded in a large-scale QI initiative. A comprehensive communications strategy guided communications work during the Campaign. The main aims of the communications strategy were to engage the hearts and minds of frontline National Health Service (NHS) staff in the Campaign and promote their awareness and understanding of specific QI interventions and the wider patient safety agenda. We used qualitative and quantitative measures to monitor communications outputs and assess how the communications strategy influenced awareness and knowledge of frontline NHS staff. The communications strategy facilitated clear and consistent framing of Campaign messages and allowed dissemination of information related to the range of QI interventions. It reaffirmed the aim and value of the Campaign to frontline staff, thereby promoting sustained engagement with Campaign activities. The communications strategy also built the profile of the Campaign both internally with NHS organizations across Wales and externally with the media, and played a pivotal role in improving awareness and understanding of the patient safety agenda. Ultimately, outcomes from the communications strategy could not be separated from overall Campaign outcomes. Systematic and structured communications can support and enhance QI initiatives. From our experience, we developed a 'communications bundle' consisting of six core components. We recommend that communications bundles be incorporated into existing QI

Integrated clinical and quality improvement coaching in Son La Province, Vietnam: a model of building public sector capacity for sustainable HIV care delivery.

Science.gov (United States)

Cosimi, Lisa A; Dam, Huong V; Nguyen, Thai Q; Ho, Huyen T; Do, Phuong T; Duc, Duat N; Nguyen, Huong T; Gardner, Bridget; Libman, Howard; Pollack, Todd; Hirschhorn, Lisa R

2015-07-17

The global scale-up of antiretroviral therapy included extensive training and onsite support to build the capacity of HIV health care workers. However, traditional efforts aimed at strengthening knowledge and skills often are not successful at improving gaps in the key health systems required for sustaining high quality care. We trained and mentored existing staff of the Son La provincial health department and provincial HIV clinic to work as a provincial coaching team (PCT) to provide integrated coaching in clinical HIV skills and quality improvement (QI) to the HIV clinics in the province. Nine core indicators were measured through chart extraction by clinic and provincial staff at baseline and at 6 month intervals thereafter. Coaching from the team to each of the clinics, in both QI and clinical skills, was guided by results of performance measurements, gap analyses, and resulting QI plans. After 18 months, the PCT had successfully spread QI activities, and was independently providing regular coaching to the provincial general hospital clinic and six of the eight district clinics in the province. The frequency and type of coaching was determined by performance measurement results. Clinics completed a mean of five QI projects. Quality of HIV care was improved throughout all clinics with significant increases in seven of the indicators. Overall both the PCT activities and clinic performance were sustained after integration of the model into the Vietnam National QI Program. We successfully built capacity of a team of public sector health care workers to provide integrated coaching in both clinical skills and QI across a province. The PCT is a feasible and effective model to spread and sustain quality activities and improve HIV care services in a decentralized rural setting.

Study on transferring improved green fluorescent protein gene into wheat via low energy Ar+ implantation

International Nuclear Information System (INIS)

Wu Lifang; Li Hong; Song Daojun

2000-01-01

An improved GFP gene (mGFP4) was introduced into mature embryo cells of wheat cultivars Wan 9210 and Wanmai 32 via low energy ion beam-mediated delivery technique. Resistant calli were selected on medium containing paromomycin (100-140 mg/L). Five green plants were regenerated from resistant calli of Wan 9210 derived from 387 implated mature embryos. 32 green plants were obtained from 776 irradiated mature embryos in Wanmai 32. No green plant was regenerated from calli of 200 non-transformed embryos. PCR assays of 37 green plants showed that they all obtained the expected size of amplified DNA fragment (600 bp). Southern blot of 4 well-developed green plants confirmed stable integration of GFP gene into wheat genome. The average transformation frequencies of Wan 9210 and Wanmai 32 were 1.3% and 4.1%, respectively, according to the results of PCR assays

Ins-Robust Primitive Words

OpenAIRE

Srivastava, Amit Kumar; Kapoor, Kalpesh

2017-01-01

Let Q be the set of primitive words over a finite alphabet with at least two symbols. We characterize a class of primitive words, Q_I, referred to as ins-robust primitive words, which remain primitive on insertion of any letter from the alphabet and present some properties that characterizes words in the set Q_I. It is shown that the language Q_I is dense. We prove that the language of primitive words that are not ins-robust is not context-free. We also present a linear time algorithm to reco...

Quality improvement tools and processes.

Science.gov (United States)

Lau, Catherine Y

2015-04-01

The Model for Improvement and the Plan-Do-Study-Act cycle is a popular quality improvement (QI) tool for health care providers to successfully lead QI projects and redesign care processes. This tool has several distinct components that must be addressed in sequence to organize and critically evaluate improvement activities. Unlike other health sciences clinical research, QI projects and research are based on dynamic hypotheses that develop into observable, serial tests of change with continuous collection and feedback of performance data to stakeholders. Copyright © 2015 Elsevier Inc. All rights reserved.

Chemical constituents of Cyperus rotundus L. and their inhibitory ...

African Journals Online (AJOL)

Background: Xiang Fu (Cyperus rotundus L) enters the liver, spleen and triple warmer meridians, and has qi stagnation-removing, qi circulation-promoting, menstruation-regulating and pain-relieving effects. Besides, it can improve ovarian function, and has hypolipidemic, hypoglycemic and neuroprotective actions.

Immunization alters body odor.

Science.gov (United States)

Kimball, Bruce A; Opiekun, Maryanne; Yamazaki, Kunio; Beauchamp, Gary K

2014-04-10

Infections have been shown to alter body odor. Because immune activation accompanies both infection and immunization, we tested the hypothesis that classical immunization might similarly result in the alteration of body odors detectable by trained biosensor mice. Using a Y-maze, we trained biosensor mice to distinguish between urine odors from rabies-vaccinated (RV) and unvaccinated control mice. RV-trained mice generalized this training to mice immunized with the equine West Nile virus (WNV) vaccine compared with urine of corresponding controls. These results suggest that there are similarities between body odors of mice immunized with these two vaccines. This conclusion was reinforced when mice could not be trained to directly discriminate between urine odors of RV- versus WNV-treated mice. Next, we trained biosensor mice to discriminate the urine odors of mice treated with lipopolysaccharide (LPS; a general elicitor of innate immunological responses) from the urine of control mice. These LPS-trained biosensors could distinguish between the odors of LPS-treated mouse urine and RV-treated mouse urine. Finally, biosensor mice trained to distinguish between the odors of RV-treated mouse urine and control mouse urine did not generalize this training to discriminate between the odors of LPS-treated mouse urine and control mouse urine. From these experiments, we conclude that: (1) immunization alters urine odor in similar ways for RV and WNV immunizations; and (2) immune activation with LPS also alters urine odor but in ways different from those of RV and WNV. Published by Elsevier Inc.

Evaluation of bentonite alteration due to interactions with iron. Sensitivity analyses to identify the important factors for the bentonite alteration

International Nuclear Information System (INIS)

Sasamoto, Hiroshi; Wilson, James; Sato, Tsutomu

2013-01-01

Performance assessment of geological disposal systems for high-level radioactive waste requires a consideration of long-term systems behaviour. It is possible that the alteration of swelling clay present in bentonite buffers might have an impact on buffer functions. In the present study, iron (as a candidate overpack material)-bentonite (I-B) interactions were evaluated as the main buffer alteration scenario. Existing knowledge on alteration of bentonite during I-B interactions was first reviewed, then the evaluation methodology was developed considering modeling techniques previously used overseas. A conceptual model for smectite alteration during I-B interactions was produced. The following reactions and processes were selected: 1) release of Fe 2+ due to overpack corrosion; 2) diffusion of Fe 2+ in compacted bentonite; 3) sorption of Fe 2+ on smectite edge and ion exchange in interlayers; 4) dissolution of primary phases and formation of alteration products. Sensitivity analyses were performed to identify the most important factors for the alteration of bentonite by I-B interactions. (author)

Effect of Lower and Upper Body High Intensity Training on Genes Associated with Cellular Stress Response.

Science.gov (United States)

Żychowska, Małgorzata; Kochanowicz, Andrzej; Kochanowicz, Kazimierz; Mieszkowski, Jan; Niespodziński, Bartłomiej; Sawczyn, Stanisław

2017-01-01

This study aimed to compare the effect of upper and lower body high intensity exercise (HIE) on select gene expression in athletes. Fourteen elite male artistic gymnasts (age 20.9 ± 2.6 years; weight 68.6 ± 7.2 kg; fat free mass 63.6 ± 6.7 kg; height 1.70 ± 0.04 m) performed lower and upper body 30 s Wingate Tests (WAnTs) before and after eight weeks of specific HIIT. Two milliliters of blood was collected before and after (5, 30 min, resp.) lower and upper body WAnTs, and select gene expression was determined by PCR. Eight weeks of HIIT caused a significant increase in maximal power (722 to 751 Wat), relative peak power in the lower body WAnTs (10.1 to 11 W/kg), mean power (444 to 464 W), and relative mean power (6.5 to 6.8 W/kg). No significant differences in lower versus upper body gene expression were detected after HIIT, and a significant decrease in the IL6/IL10 ratio was observed after lower (-2 ∧ 0.57 p = 0.0019) and upper (-2 ∧ 0.5 p = 0.03) WAnTs following eight weeks of HIIT. It is hypothesized that a similar adaptive response to exercise may be obtained by lower and upper body exercise.

Handoff Between a Wireless Local Area Network (WLAN and a Wide Area Network (UMTS

Directory of Open Access Journals (Sweden)

J. Sánchez–García

2009-04-01

Full Text Available With the appearance of wireless data networks with variable coverage, band width and handoff strategies, in addition to the growing need of mobile nodes to freely roam among these networks, the support of an interoperable handoff strategy for hybrid wireless data networks is a requirement that needs to be addressed. The current trend in wireless data networks is to offer multimedia access to mobile users by employing the wireless local area network (WLAN standard IEEE802.11 while the user is located indoors; on the other hand, 3rd generation wireless networks (WAN are being deployed to provide coverage while the user is located outdoors. As a result, the mobile node will require a handoff mechanism to allow the user to roam between WLAN and WAN environments; up to this date several strategies have been proposed (Sattari et al., 2004 and HyoJin, 2007 in the literature, however, none of these have been standardized to date. To support this interoperability, the mobile node must be equipped with configurable wireless inetrfaces to support the handoff between the WLAN and the WAN networks. In this work a new algorithm is proposed to allow a mobile node to roam between a wireless local area network (IEEE802.11 and a WAN base station (UMTS, while employing IP mobility support. The algorithm is implemented in simulation, using the Network Simulator 2.

Ca-Fe and Alkali-Halide Alteration of an Allende Type B CAI: Aqueous Alteration in Nebular or Asteroidal Settings

Science.gov (United States)

Ross, D. K.; Simon, J. I.; Simon, S. B.; Grossman, L.

2012-01-01

Ca-Fe and alkali-halide alteration of CAIs is often attributed to aqueous alteration by fluids circulating on asteroidal parent bodies after the various chondritic components have been assembled, although debate continues about the roles of asteroidal vs. nebular modification processes [1-7]. Here we report de-tailed observations of alteration products in a large Type B2 CAI, TS4 from Allende, one of the oxidized subgroup of CV3s, and propose a speculative model for aqueous alteration of CAIs in a nebular setting. Ca-Fe alteration in this CAI consists predominantly of end-member hedenbergite, end-member andradite, and compositionally variable, magnesian high-Ca pyroxene. These phases are strongly concentrated in an unusual "nodule" enclosed within the interior of the CAI (Fig. 1). The Ca, Fe-rich nodule superficially resembles a clast that pre-dated and was engulfed by the CAI, but closer inspection shows that relic spinel grains are enclosed in the nodule, and corroded CAI primary phases interfinger with the Fe-rich phases at the nodule s margins. This CAI also contains abundant sodalite and nepheline (alkali-halide) alteration that occurs around the rims of the CAI, but also penetrates more deeply into the CAI. The two types of alteration (Ca-Fe and alkali-halide) are adjacent, and very fine-grained Fe-rich phases are associated with sodalite-rich regions. Both types of alteration appear to be replacive; if that is true, it would require substantial introduction of Fe, and transport of elements (Ti, Al and Mg) out of the nodule, and introduction of Na and Cl into alkali-halide rich zones. Parts of the CAI have been extensively metasomatized.

Beyond coverage: improving the quality of antenatal care delivery through integrated mentorship and quality improvement at health centers in rural Rwanda.

Science.gov (United States)

Manzi, Anatole; Nyirazinyoye, Laetitia; Ntaganira, Joseph; Magge, Hema; Bigirimana, Evariste; Mukanzabikeshimana, Leoncie; Hirschhorn, Lisa R; Hedt-Gauthier, Bethany

2018-02-23

Inadequate antenatal care (ANC) can lead to missed diagnosis of danger signs or delayed referral to emergency obstetrical care, contributing to maternal mortality. In developing countries, ANC quality is often limited by skill and knowledge gaps of the health workforce. In 2011, the Mentorship, Enhanced Supervision for Healthcare and Quality Improvement (MESH-QI) program was implemented to strengthen providers' ANC performance at 21 rural health centers in Rwanda. We evaluated the effect of MESH-QI on the completeness of danger sign assessments. Completeness of danger sign assessments was measured by expert nurse mentors using standardized observation checklists. Checklists completed from October 2010 to May 2011 (n = 330) were used as baseline measurement and checklists completed between February and November 2012 (12-15 months after the start of MESH-QI implementation) were used for follow-up. We used a mixed-effects linear regression model to assess the effect of the MESH-QI intervention on the danger sign assessment score, controlling for potential confounders and the clustering of effect at the health center level. Complete assessment of all danger signs improved from 2.1% at baseline to 84.2% after MESH-QI (p ANC screening items. After controlling for potential confounders, the improvement in danger sign assessment score was significant. However, the effect of the MESH-QI was different by intervention district and type of observed ANC visit. In Southern Kayonza District, the increase in the danger sign assessment score was 6.28 (95% CI: 5.59, 6.98) for non-first ANC visits and 5.39 (95% CI: 4.62, 6.15) for first ANC visits. In Kirehe District, the increase in danger sign assessment score was 4.20 (95% CI: 3.59, 4.80) for non-first ANC visits and 3.30 (95% CI: 2.80, 3.81) for first ANC visits. Assessment of critical danger signs improved under MESH-QI, even when controlling for nurse-mentees' education level and previous training in focused ANC. MESH-QI

Factors influencing the long-term sustainment of quality improvements made in addiction treatment facilities: a qualitative study.

Science.gov (United States)

Stumbo, Scott P; Ford, James H; Green, Carla A

2017-11-01

A greater understanding of the factors that influence long-term sustainment of quality improvement (QI) initiatives is needed to promote organizational ability to sustain QI practices over time, help improve future interventions, and increase the value of QI investments. We approached 83 of 201 executive sponsors or change leaders at addiction treatment organizations that participated in the 2007-2009 NIATx200 QI intervention. We completed semi-structured interviews with 33 individuals between November 2015 and April 2016. NIATx200 goals were to decrease wait time, increase admissions and improve retention in treatment. Interviews sought to understand factors that either facilitated or impeded long-term sustainment of organizational QI practices made during the intervention. We used thematic analysis to organize the data and group patterns of responses. We assessed available quantitative outcome data and intervention engagement data to corroborate qualitative results. We used narrative analysis to group four important themes related to long-term sustainment of QI practices: (1) finding alignment between business- and client-centered practices; (2) staff engagement early in QI process added legitimacy which facilitated sustainment; (3) commitment to integrating data into monitoring practices and the identification of a data champion; and (4) adequate organizational human resources devoted to sustainment. We found four corollary factors among agencies which did not sustain practices: (1) lack of evidence of impact on business practices led to discontinuation; (2) disengaged staff and lack of organizational capacity during implementation period led to lack of sustainment; (3) no data integration into overall business practices and no identified data champion; and (4) high staff turnover. In addition, we found that many agencies' current use of NIATx methods and tools suggested a legacy effect that might improve quality elsewhere, even absent overall sustainment of

Evaluating the effectiveness of a tailored multifaceted performance feedback intervention to improve the quality of care: protocol for a cluster randomized trial in intensive care

Directory of Open Access Journals (Sweden)

Westert Gert P

2011-10-01

Full Text Available Abstract Background Feedback is potentially effective in improving the quality of care. However, merely sending reports is no guarantee that performance data are used as input for systematic quality improvement (QI. Therefore, we developed a multifaceted intervention tailored to prospectively analyzed barriers to using indicators: the Information Feedback on Quality Indicators (InFoQI program. This program aims to promote the use of performance indicator data as input for local systematic QI. We will conduct a study to assess the impact of the InFoQI program on patient outcome and organizational process measures of care, and to gain insight into barriers and success factors that affected the program's impact. The study will be executed in the context of intensive care. This paper presents the study's protocol. Methods/design We will conduct a cluster randomized controlled trial with intensive care units (ICUs in the Netherlands. We will include ICUs that submit indicator data to the Dutch National Intensive Care Evaluation (NICE quality registry and that agree to allocate at least one intensivist and one ICU nurse for implementation of the intervention. Eligible ICUs (clusters will be randomized to receive basic NICE registry feedback (control arm or to participate in the InFoQI program (intervention arm. The InFoQI program consists of comprehensive feedback, establishing a local, multidisciplinary QI team, and educational outreach visits. The primary outcome measures will be length of ICU stay and the proportion of shifts with a bed occupancy rate above 80%. We will also conduct a process evaluation involving ICUs in the intervention arm to investigate their actual exposure to and experiences with the InFoQI program. Discussion The results of this study will inform those involved in providing ICU care on the feasibility of a tailored multifaceted performance feedback intervention and its ability to accelerate systematic and local quality

Simultaneous estimation of QTL parameters for mapping multiple traits

Indian Academy of Sciences (India)

LIANG TONG

2018-03-13

XM ji ) denotes the conditional probability of the QTL genotype. X. ∗ ji (QiQi, Qiqi or ... random error of the ith trait value of the jth subject, with mean zero and ..... to adjust the conditional probabilities in table 1 when conducting ...

78 FR 50054 - Ocean Transportation Intermediary License Applicants

Science.gov (United States)

2013-08-16

...), Ross V. Stemmler, President, Application Type: QI Change. Dawson Logistics, Inc. (OFF), 2220 South... (QI), Chad Earwood, President, Application Type: Add NVO Service. Fesco Integrated Transport North...), Ugochukwu O. Ene, President, Application Type: New NVO & OFF License. Icon Logistics Services LLC (OFF...

Model for the growth of the world airline network

Science.gov (United States)

Verma, T.; Araújo, N. A. M.; Nagler, J.; Andrade, J. S.; Herrmann, H. J.

2016-06-01

We propose a probabilistic growth model for transport networks which employs a balance between popularity of nodes and the physical distance between nodes. By comparing the degree of each node in the model network and the World Airline Network (WAN), we observe that the difference between the two is minimized for α≈2. Interestingly, this is the value obtained for the node-node correlation function in the WAN. This suggests that our model explains quite well the growth of airline networks.

Accelerating Best Care in Pennsylvania: adapting a large academic system's quality improvement process to rural community hospitals.

Science.gov (United States)

Haydar, Ziad; Gunderson, Julie; Ballard, David J; Skoufalos, Alexis; Berman, Bettina; Nash, David B

2008-01-01

Industrial quality improvement (QI) methods such as continuous quality improvement (CQI) may help bridge the gap between evidence-based "best care" and the quality of care provided. In 2006, Baylor Health Care System collaborated with Jefferson Medical College of Thomas Jefferson University to conduct a QI demonstration project in select Pennsylvania hospitals using CQI techniques developed by Baylor. The training was provided over a 6-month period and focused on methods for rapid-cycle improvement; data system design; data management; tools to improve patient outcomes, processes of care, and cost-effectiveness; use of clinical guidelines and protocols; leadership skills; and customer service skills. Participants successfully implemented a variety of QI projects. QI education programs developed and pioneered within large health care systems can be adapted and applied successfully to other settings, providing needed tools to smaller rural and community hospitals that lack the necessary resources to establish such programs independently.

Competition in collaborative clothing: a qualitative case study of influences on collaborative quality improvement in the ICU.

Science.gov (United States)

Dainty, Katie N; Scales, Damon C; Sinuff, Tasnim; Zwarenstein, Merrick

2013-04-01

Multiorganisational quality improvement (QI) collaborative networks are promoted for improving quality within healthcare. Recently, several large-scale QI initiatives have been conducted in the intensive care unit (ICU) environment with successful quantitative results. However, the mechanisms through which such networks lead to QI success remain uncertain. We aim to understand ICU staff perspectives on collaborative QI based on involvement in a multiorganisational improvement network and hypothesise about theoretical constructs that might explain the effect of collaboration in such networks. Qualitative study using a modified grounded theory approach. Key informant interviews were conducted with staff from 12 community hospital ICUs that participated in a cluster randomized control trial (RCT) of a QI intervention using a collaborative approach between 2006 and 2008. Data analysis followed the standard procedure for grounded theory using constant comparative methodology. The collaborative network was perceived to promote increased intrateam cooperation over interorganisational cooperation, but friendly competition with other ICUs appeared to be a prominent driver of behaviour change. Bedsides, clinicians reported that belonging to a collaborative network provided recognition for the high-quality patient care that they already provided. However, the existing communication structure was perceived to be ineffective for staff engagement since it was based on a hierarchical approach to knowledge transfer and project awareness. QI collaborative networks may promote behaviour change by improving intrateam communication, fostering competition with other institutions, and increasing recognition for providing high-quality care. Other commonly held assumptions about their potential impact, for instance, increasing interorganisational legitimisation, communication and collaboration, may be less important.

Developing a caries risk registry to support caries risk assessment and management for children: A quality improvement initiative.

Science.gov (United States)

Ruff, Jesley C; Herndon, Jill Boylston; Horton, Roger A; Lynch, Julie; Mathwig, Dawn C; Leonard, Audra; Aravamudhan, Krishna

2017-10-27

Health registries are commonly used in medicine to support public health activities and are increasingly used in quality improvement (QI) initiatives. Illustrations of dental registries and their QI applications are lacking. Within dentistry, caries risk assessment implementation and documentation are vital to optimal patient care. The purpose of this article is to describe the processes used to develop a caries risk assessment registry as a QI initiative to support clinical caries risk assessment, caries prevention, and disease management for children. Developmental steps reflected Agency for Healthcare Research and Quality recommendations for planning QI registries and included engaging "champions," defining the project, identifying registry features, defining performance dashboard indicators, and pilot testing with participant feedback. We followed Standards for Quality Improvement Reporting Excellence guidelines. Registry eligibility is patients aged 0-17 years. QI tools include prompts to register eligible patients; decision support tools grounded in evidence-based guidelines; and performance dashboard reports delivered at the provider and aggregated levels at regular intervals. The registry was successfully piloted in two practices with documented caries risk assessment increasing from 57 percent to 92 percent and positive feedback regarding the potential to improve dental practice patient centeredness, patient engagement and education, and quality of care. The caries risk assessment registry demonstrates how dental registries may be used in QI efforts to promote joint patient and provider engagement, foster shared decision making, and systematically collect patient information to generate timely and actionable data to improve care quality and patient outcomes at the individual and population levels. © 2017 American Association of Public Health Dentistry.

Application of quality improvement analytic methodology in emergency medicine research: A comparative evaluation.

Science.gov (United States)

Harries, Bruce; Filiatrault, Lyne; Abu-Laban, Riyad B

2018-05-30

Quality improvement (QI) analytic methodology is rarely encountered in the emergency medicine literature. We sought to comparatively apply QI design and analysis techniques to an existing data set, and discuss these techniques as an alternative to standard research methodology for evaluating a change in a process of care. We used data from a previously published randomized controlled trial on triage-nurse initiated radiography using the Ottawa ankle rules (OAR). QI analytic tools were applied to the data set from this study and evaluated comparatively against the original standard research methodology. The original study concluded that triage nurse-initiated radiographs led to a statistically significant decrease in mean emergency department length of stay. Using QI analytic methodology, we applied control charts and interpreted the results using established methods that preserved the time sequence of the data. This analysis found a compelling signal of a positive treatment effect that would have been identified after the enrolment of 58% of the original study sample, and in the 6th month of this 11-month study. Our comparative analysis demonstrates some of the potential benefits of QI analytic methodology. We found that had this approach been used in the original study, insights regarding the benefits of nurse-initiated radiography using the OAR would have been achieved earlier, and thus potentially at a lower cost. In situations where the overarching aim is to accelerate implementation of practice improvement to benefit future patients, we believe that increased consideration should be given to the use of QI analytic methodology.

Improving Tanzanian childbirth service quality.

Science.gov (United States)

Jaribu, Jennie; Penfold, Suzanne; Green, Cathy; Manzi, Fatuma; Schellenberg, Joanna

2018-04-16

Purpose The purpose of this paper is to describe a quality improvement (QI) intervention in primary health facilities providing childbirth care in rural Southern Tanzania. Design/methodology/approach A QI collaborative model involving district managers and health facility staff was piloted for 6 months in 4 health facilities in Mtwara Rural district and implemented for 18 months in 23 primary health facilities in Ruangwa district. The model brings together healthcare providers from different health facilities in interactive workshops by: applying QI methods to generate and test change ideas in their own facilities; using local data to monitor improvement and decision making; and health facility supervision visits by project and district mentors. The topics for improving childbirth were deliveries and partographs. Findings Median monthly deliveries increased in 4 months from 38 (IQR 37-40) to 65 (IQR 53-71) in Mtwara Rural district, and in 17 months in Ruangwa district from 110 (IQR 103-125) to 161 (IQR 148-174). In Ruangwa health facilities, the women for whom partographs were used to monitor labour progress increased from 10 to 57 per cent in 17 months. Research limitations/implications The time for QI innovation, testing and implementation phases was limited, and the study only looked at trends. The outcomes were limited to process rather than health outcome measures. Originality/value Healthcare providers became confident in the QI method through engagement, generating and testing their own change ideas, and observing improvements. The findings suggest that implementing a QI initiative is feasible in rural, low-income settings.

How can we recognize continuous quality improvement?

Science.gov (United States)

Rubenstein, Lisa; Khodyakov, Dmitry; Hempel, Susanne; Danz, Margie; Salem-Schatz, Susanne; Foy, Robbie; O'Neill, Sean; Dalal, Siddhartha; Shekelle, Paul

2014-02-01

Continuous quality improvement (CQI) methods are foundational approaches to improving healthcare delivery. Publications using the term CQI, however, are methodologically heterogeneous, and labels other than CQI are used to signify relevant approaches. Standards for identifying the use of CQI based on its key methodological features could enable more effective learning across quality improvement (QI) efforts. The objective was to identify essential methodological features for recognizing CQI. Previous work with a 12-member international expert panel identified reliably abstracted CQI methodological features. We tested which features met rigorous a priori standards as essential features of CQI using a three-phase online modified-Delphi process. Primarily United States and Canada. 119 QI experts randomly assigned into four on-line panels. Participants rated CQI features and discussed their answers using online, anonymous and asynchronous discussion boards. We analyzed ratings quantitatively and discussion threads qualitatively. Main outcome measure(s) Panel consensus on definitional CQI features. /st> Seventy-nine (66%) panelists completed the process. Thirty-three completers self-identified as QI researchers, 18 as QI practitioners and 28 as both equally. The features 'systematic data guided activities,' 'designing with local conditions in mind' and 'iterative development and testing' met a priori standards as essential CQI features. Qualitative analyses showed cross-cutting themes focused on differences between QI and CQI. We found consensus among a broad group of CQI researchers and practitioners on three features as essential for identifying QI work more specifically as 'CQI.' All three features are needed as a minimum standard for recognizing CQI methods.

Smectite alteration

International Nuclear Information System (INIS)

Anderson, D.M.

1984-11-01

This report contains the proceedings of a second workshop in Washington DC December 8-9, 1983 on the alteration of smectites intended for use as buffer materials in the long-term containment of nuclear wastes. It includes extended summaries of all presentations and a transcript of the detailed scientific discussion. The discussions centered on three main questions: What is the prerequisite for and what is the precise mechanism by which smectite clays may be altered to illite. What are likly sources of potassium with respect to the KBS project. Is it likely that the conversion of smectite to illite will be of importance in the 10 5 to the 10 6 year time frame. The workshop was convened to review considerations and conclusions in connection to these questions and also to broaden the discussion to consider the use of smectite clays as buffer materials for similar applications in different geographical and geological settings. SKBF/KBS technical report 83-03 contains the proceedings from the first workshop on these matters that was held at the State University of New York, Buffalo May 26-27, 1982. (Author)

Summability of alterations of convergent series

Directory of Open Access Journals (Sweden)

T. A. Keagy

1981-01-01

Full Text Available The effect of splitting, rearrangement, and grouping series alterations on the summability of a convergent series by ℓ−ℓ and cs−cs matrix methods is studied. Conditions are determined that guarantee the existence of alterations that are transformed into divergent series and into series with preassigned sums.

Experiences in Traceroute and Bandwidth Change Analysis

Energy Technology Data Exchange (ETDEWEB)

Logg, C

2004-06-23

SLAC has been studying end-to-end WAN bandwidth availability and achievability for 2.5 years via IEPM-BW [1]. IEPM-BW performs network intensive tests every 90 minutes. Based on that experience we have also developed a light weight available bandwidth (ABwE [2]) measurement tool that can make a measurement within a second. We are now extending this to a WAN measurement and detection system (IEPM-LITE) aimed at more quickly detecting and troubleshooting network performance problems and also to be more friendly on lower performance paths. IEPM-LITE uses ping, forward traceroutes, and ABwE sensors to monitor, in close to real-time, Round Trip Times (RTT), changes in available bandwidth and routes to and from target hosts. This paper discusses the experiences, techniques and algorithms used to detect and report on significant traceroute and bandwidth changes. The ultimate aim is to develop a lightweight WAN network performance monitoring system that can detect, in near real time, significant changes and generate alerts.

ICSW2AN : An Inter-vehicle Communication System Using Mobile Access Point over Wireless Wide Area Networks

Science.gov (United States)

Byun, Tae-Young

This paper presents a prototype of inter-vehicle communication system using mobile access point that internetworks wired or wireless LAN and wireless WAN anywhere. Implemented mobile access point can be equipped with various wireless WAN interfaces such as WCDMA and HSDPA. Mobile access point in the IP mechanism has to process connection setup procedure to one wireless WAN. To show the applicability of the mobile access point to inter-vehicle communication, a simplified V2I2V-based car communication system called ICSW2AN is implemented to evaluate major performance metrics by road test. In addition, results of road test for traffic information service are investigated in view of RTT, latency and server processing time. The experimental result indicates that V2I2V-based car communication system sufficiently can provide time-tolerant traffic information to moving vehicles while more than two mobile devices in restricted spaces such as car, train and ship access wireless Internet simultaneously.

The effects of X window HEP graphics applications on ESnet

International Nuclear Information System (INIS)

Abar, F.A.; Lidinsky, W.P.

1994-01-01

Wide area networking is the next evolutionary step toward distributed computing. Many applications that were found useful in local area networks are beginning to show their presence in wide area networks (WANs). A question is: Given today's typical WAN infrastructure, what are the effects of the presence of distributed applications in the WANs and what can be done to facilitate full deployment of such services across wide area network? A simulation model for X window distributed graphical applications in high energy physics communities interacting across the DOE Energy Science wide area networks (ESnet) was created to examine X service resource requirements and ESnet resource limitations. Through simulation analysis the effects of the incremental introduction of X traffic to ESnet was determined as was the load level at which ESnet became unstable. Proposals for improving ESnet performance by upgrading to T3 links and also by introducing a service-based packet priority scheme at the network layer were also examined

Experiences in Traceroute and Bandwidth Change Analysis

International Nuclear Information System (INIS)

Logg, C

2004-01-01

SLAC has been studying end-to-end WAN bandwidth availability and achievability for 2.5 years via IEPM-BW [1]. IEPM-BW performs network intensive tests every 90 minutes. Based on that experience we have also developed a light weight available bandwidth (ABwE [2]) measurement tool that can make a measurement within a second. We are now extending this to a WAN measurement and detection system (IEPM-LITE) aimed at more quickly detecting and troubleshooting network performance problems and also to be more friendly on lower performance paths. IEPM-LITE uses ping, forward traceroutes, and ABwE sensors to monitor, in close to real-time, Round Trip Times (RTT), changes in available bandwidth and routes to and from target hosts. This paper discusses the experiences, techniques and algorithms used to detect and report on significant traceroute and bandwidth changes. The ultimate aim is to develop a lightweight WAN network performance monitoring system that can detect, in near real time, significant changes and generate alerts

Cloud-Centric and Logically Isolated Virtual Network Environment Based on Software-Defined Wide Area Network

Directory of Open Access Journals (Sweden)

Dongkyun Kim

2017-12-01

Full Text Available Recent development of distributed cloud environments requires advanced network infrastructure in order to facilitate network automation, virtualization, high performance data transfer, and secured access of end-to-end resources across regional boundaries. In order to meet these innovative cloud networking requirements, software-defined wide area network (SD-WAN is primarily demanded to converge distributed cloud resources (e.g., virtual machines (VMs in a programmable and intelligent manner over distant networks. Therefore, this paper proposes a logically isolated networking scheme designed to integrate distributed cloud resources to dynamic and on-demand virtual networking over SD-WAN. The performance evaluation and experimental results of the proposed scheme indicate that virtual network convergence time is minimized in two different network models such as: (1 an operating OpenFlow-oriented SD-WAN infrastructure (KREONET-S which is deployed on the advanced national research network in Korea, and (2 Mininet-based experimental and emulated networks.

Ethernet Networks for Real-Time Use in the ATLAS Experiment

CERN Document Server

Meirosu, C; Martin, B

2005-01-01

Ethernet became today's de-facto standard technology for local area networks. Defined by the IEEE 802.3 and 802.1 working groups, the Ethernet standards cover technologies deployed at the first two layers of the OSI protocol stack. The architecture of modern Ethernet networks is based on switches. The switches are devices usually built using a store-and-forward concept. At the highest level, they can be seen as a collection of queues and mathematically modelled by means of queuing theory. However, the traffic profiles on modern Ethernet networks are rather different from those assumed in classical queuing theory. The standard recommendations for evaluating the performance of network devices define the values that should be measured but do not specify a way of reconciling these values with the internal architecture of the switches. The introduction of the 10 Gigabit Ethernet standard provided a direct gateway from the LAN to the WAN by the means of the WAN PHY. Certain aspects related to the actual use of WAN ...

Strategic Combination of Isocratic and Gradient Elution for Simultaneous Separation of Polar Compounds in Traditional Chinese Medicines by HPLC

Directory of Open Access Journals (Sweden)

Mei-Tuo Zhang

2018-01-01

Full Text Available A simple high-performance liquid chromatography (HPLC method for the simultaneous separation of the highly polar and weakly polar components of traditional Chinese medicines was developed via a strategic combination of isocratic and gradient elution methods. Liu-Shen-Wan and Liu-Wei-Di-Huang-Wan were used as representative examples of traditional Chinese medicines. This is the first time that 6 components of varying degrees of polarity in Liu-Shen-Wan had been successfully resolved in a single chromatographic run using an ultraviolet-visible detector with a fixed wavelength of 296 nm. In contrast to conventional gradient separation methods, this novel method offered a viable route for separation of the highly and weakly polar fractions simultaneously, thus greatly reducing the time and cost of analysis. This method therefore provides a more efficient way to determine the polar components present in traditional Chinese medicines. It would find potential application in drug screening, drug authentication, and product quality control.

78 FR 68444 - Ocean Transportation Intermediary License Applicants

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2013-11-14

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Research and quality improvement experience and knowledge: a nursing survey.

Science.gov (United States)

Fox, Jolene; Bagley, Lisa; Day, Suzanne; Holleran, Renee; Handrahan, Diana

2011-07-01

To assess nursing staff's background and research and quality improvement (QI) experience. In this corporation, participation in research and QI is encouraged, but little is known about nurses' experiences. A web-based survey was distributed. Nursing staffs from an academic/teaching medical centre and other intra-corporation non-academic facilities were compared. Respondents included: 148 (52.9%) medical centre and 132 (47.1%) non-medical centre subjects. Medical centre respondents had a higher proportion previously engaged in research, currently engaged in research and previously engaged in QI. Productivity (grant, published and presented) was low for both groups but statistically lower for the non-medical centre group. Medical centre employees used research resources more often than the non-medical centre. Time was the most frequently mentioned barrier to participation in research and QI initiatives. A moderate proportion of respondents had research and QI experience, yet productivity and use of resources was low. Nurses at non-academically focused facilities were in most need of assistance. Familiarizing nurses with resources and providing protected time may increase productivity. Developing an infrastructure to support nursing research is a worthy goal. Information about interest and experience of nurses can aid management in determining how to focus financial resources. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

Organizational coherence in health care organizations: conceptual guidance to facilitate quality improvement and organizational change.

Science.gov (United States)

McAlearney, Ann Scheck; Terris, Darcey; Hardacre, Jeanne; Spurgeon, Peter; Brown, Claire; Baumgart, Andre; Nyström, Monica E

2014-01-01

We sought to improve our understanding of how health care quality improvement (QI) methods and innovations could be efficiently and effectively translated between settings to reduce persistent gaps in health care quality both within and across countries. We aimed to examine whether we could identify a core set of organizational cultural attributes, independent of context and setting, which might be associated with success in implementing and sustaining QI systems in health care organizations. We convened an international group of investigators to explore the issues of organizational culture and QI in different health care contexts and settings. This group met in person 3 times and held a series of conference calls to discuss emerging ideas over 2 years. Investigators also conducted pilot studies in their home countries to examine the applicability of our conceptual model. We suggest that organizational coherence may be a critical element of QI efforts in health care organizations and propose that there are 3 key components of organizational coherence: (1) people, (2) processes, and (3) perspectives. Our work suggests that the concept of organizational coherence embraces both culture and context and can thus help guide both researchers and practitioners in efforts to enhance health care QI efforts, regardless of organizational type, location, or context.

Patient-reported quality indicators for osteoarthritis: a patient and public generated self-report measure for primary care.

Science.gov (United States)

Blackburn, Steven; Higginbottom, Adele; Taylor, Robert; Bird, Jo; Østerås, Nina; Hagen, Kåre Birger; Edwards, John J; Jordan, Kelvin P; Jinks, Clare; Dziedzic, Krysia

2016-01-01

People with osteoarthritis desire high quality care, support and information. However, the quality of care for people with OA in general practice is not routinely collected. Quality Indicators can be used to benefit patients by measuring whether minimum standards of quality care are being met from a patient perspective. The aim of this study was to describe how a Research User Group (RUG) worked alongside researchers to co-produce a set of self-reported quality indicators for people with osteoarthritis when visiting their general practitioner or practice nurse (primary care). These were required in the MOSAICS study, which developed and evaluated a new model of supported self-management of OA to implement the NICE quality standards for OA. This article describes the public involvement in the MOSAICS study. This was 1) the co-development by RUG members and researchers of an Osteoarthritis Quality Indicators United Kingdom (OA QI (UK)) questionnaire for use in primary care, and 2) the comparison of the OA QI (UK) with a similar questionnaire developed in Norway. This study shows how important and effective a research user group can be in working with researchers in developing quality care indicators for osteoarthritis for use in a research study and, potentially, routine use in primary care. The questionnaire is intended to benefit patients by enabling the assessment of the quality of primary care for osteoarthritis from a patient's perspective. The OA QI (UK) has been used to examine differences in the quality of osteoarthritis care in four European countries. Background People with osteoarthritis (OA) desire high quality care, support and information about OA. However, the quality of care for people with OA in general practice is not routinely collected. Quality Indicators (QI) can be used to benefit patients by measuring whether minimum standards of quality care (e.g. NICE quality standards) are being met from a patient perspective. A Research User Group (RUG

77 FR 65887 - Ocean Transportation Intermediary License Applicants

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2012-10-31

..., Washington, DC 20573, by telephone at (202) 523-5843 or by email at [email protected] . ACM Logistics & Consulting... Type: New OFF License; Highland Project Logistics, Inc. (NVO & OFF), 35 Constitution Drive, Suite A.... Bonner, Special Manager (QI), Martine L. Plunkett, Manager, Application Type: Additional QI; Radiant...

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2013-03-07

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Investigation of the sequential validity of quality improvement team ...

African Journals Online (AJOL)

Background: Self-assessment is widely used in the health care improvement collaboratives quality improvement (QI) teams' to assess their own performance. There is mixed evidence on the validity of this approach. This study investigated sequential validity of self-assessments in a QI HIV collaborative in Tanzania.

Journal of Genetics | Indian Academy of Sciences

Indian Academy of Sciences (India)

Home; Journals; Journal of Genetics. SHUWU QI. Articles written in Journal of Genetics. Volume 96 Issue 4 September 2017 pp 695-700 RESEARCH NOTE. Clinical and genetic characterization of six cases with complete androgen insensitivity syndrome in China · JING HE SHUWU QI HUIJUN ZHANG JINGJING GUO ...

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2013-04-18

.... Logistics, Inc. dba BE Logistics dba Belogistics dba Core Logistics (NVO), 12911 Simms Avenue, Hawthorn, CA... (QI), Kevin L. Miller, Secretary, Application Type: QI Change Triple Eagle Logistics Inc. dba Triple Eagle Logistic Canada Inc. (NVO & OFF), 17890 Castleton Street, Suite 367, City of Industry, CA 91748...

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2010-10-27

... Logistics, Inc. (NVO), 17890 Castleton Street, Suite 398, City of Industry, CA 91748, Officers: Jennifer X... (Qualifying Individual), Application Type: QI Change. Concert Group Logistics, Inc. (NVO & OFF), 1430 Branding... Individual), Daniel Para, CEO, Application Type: QI Change. De Well Logistics LLC dba De Well Logistics, dba...

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2010-09-29

... Individual), Sharlene Chesnes, EVP/COB/EVP/Secretary, Application Type: QI Change IAL Container Line (USA..., Vice President (Qualifying Individual), Arjun Menon, Director, Application Type: QI Change LTA Import & Export, Inc. (NVO & OFF), 14331 SW 120th Street, 203, Miami, FL 33186, Officers: Eric E. Diaz, Director...

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2012-12-28

... Transport Co., PAC International Logistics Company, & Book Express Network. Stealth Logistics LLC (NVO & OFF.... Application Type: QI Change. Efrinsa Global Logistics Inc. (NVO & OFF), 8441 NW 68th Street, Miami, FL 33166... (QI), Sheila E. Lawrence, President. Application Type: New OFF License. MMC Logistics, LLC (OFF), 2853...

78 FR 28845 - Ocean Transportation Intermediary License Applicants

Science.gov (United States)

2013-05-16

..., President, Application Type: QI Change Contract Logistics, LLC (NVO), 4911 North Portland Avenue, Suite 200..., Application Type: Add Trade Name Smart Lines Worldwide Feiliks Global Logistics Corporation (NVO), 176-20 S..., Director, Application Type: QI Change Intermodal Tank Transport (USA), Inc. (NVO), 2537 S. Gessner, Suite...

Epigenetic alteration of sedimentary rocks at hydrogenic uranium deposit

International Nuclear Information System (INIS)

Ding Wanlie; Shen Kefeng

2001-01-01

The author introduces the concept, the recognition criteria, the genesis and classification of the epigenetic alteration of sedimentary rocks in brief, and expounds the mineral-geochemical indications and characteristics of oxidation and reduction alterations in different geochemical zones in detail, and proposes the two models of ore-controlling zonation of epigenetic alteration. The authors finally introduce research methods of epigenetic alteration

Development of gypsum alteration on marble and limestone

Science.gov (United States)

McGee, E.S.

1996-01-01

Blackened alteration crusts of gypsum plus particulates that form on sheltered areas on marble and limestone buildings pose a challenge for rehabilitation and cleaning. Fresh marble and limestone samples exposed at monitored exposure sites present conditions of simple geometry and well-documented exposures but have short exposure histories (one to five years). The gypsum alteration crusts that develop on these samples provide insight into the early stages and rate of alteration crust formation. Alteration crusts from buildings give a longer, but less well known exposure history and present much more complex surfaces for gypsum accumulation. Integrated observations and measurements of alteration crusts from exposure samples and from buildings identify four factors that are important in the formation and development of alteration crusts on marble and limestone: (1) pollution levels, (2) exposure to rain or washing, (3) geometry of exposure of the stone surface, and (4) permeability of the stone. The combination of these factors contributes to both the distribution and the physical characteristics of the gypsum crusts which may affect cleaning decisions.

Quality improvement "201": context-relevant quality improvement leadership training for the busy clinician-educator.

Science.gov (United States)

Stille, Christopher J; Savageau, Judith A; McBride, Jeanne; Alper, Eric J

2012-01-01

Development of quality improvement (QI) skills and leadership for busy clinician-educators in academic medical centers is increasingly necessary, although it is challenging given limited resources. In response, the authors developed the Quality Scholars program for primary care teaching faculty. They conducted a needs assessment, evaluated existing internal and national resources, and developed a 9-month, 20-session project-based curriculum that combines didactic and hands-on techniques with facilitated project discussion. They also conducted pre-post tests of knowledge and attitudes, and evaluations of each session, scholars' projects, and program sustainability and costs. In all, 10 scholars from all 3 generalist disciplines comprised the first class. A wide spectrum of previous experiences enhanced collaboration. QI knowledge increased slightly, and reported self-readiness to lead QI projects increased markedly. Protected time for project work and group discussion of QI topics was seen as essential. All 10 scholars completed projects and presented results. Institutional leadership agreed to sustain the program using institutional funds.

Quality Index Method (QIM) scheme developed for farmed Atlantic salmon ( Salmo salar )

DEFF Research Database (Denmark)

Sveinsdóttir, K.; Hyldig, Grethe; Martinsdóttir, E.

2003-01-01

The aim of the study was to develop 'Quality Index Method (QIM) scheme for raw, farmed Atlantic salmon (Salmo salar) and to evaluate the scheme. in a shelf life study. QIM is based on the evaluation of key parameters in the deterioration of seafood's. Demerit points are assigned to selected...... parameters according to their importance and a Quality Index (QI) is established by cumulating the resulting scores. The maximum storage time in ice was determined with Quantitative Descriptive Analysis (QDA) of the salmon after cooking and found to be 20-21 days. This was used as a reference to enable...... prediction of the remaining storage time of raw salmon in ice with QIM. The calculated QI evolved linearly with storage time in ice (QI=0.82x (days in ice)+0.18, R-2=0.97). Individual salmon varied in QI within each storage day. However, the multivariate analysis (PLS1) demonstrated that storage time could...

Physician Perceptions of Performance Feedback in a Quality Improvement Activity.

Science.gov (United States)

Eden, Aimee R; Hansen, Elizabeth; Hagen, Michael D; Peterson, Lars E

2017-10-01

Physician performance and peer comparison feedback can affect physician care quality and patient outcomes. This study aimed to understand family physician perspectives of the value of performance feedback in quality improvement (QI) activities. This study analyzed American Board of Family Medicine open-ended survey data collected between 2004 and 2014 from physicians who completed a QI module that provided pre- and post-QI project individual performance data and peer comparisons. Physicians made 3480 comments in response to a question about this performance feedback, which were generally positive in nature (86%). Main themes that emerged were importance of accurate feedback data, enhanced detail in the content of feedback, and ability to customize peer comparison groups to compare performance to peers with similar patient populations or practice characteristics. Meaningful and tailored performance feedback may be an important tool for physicians to improve their care quality and should be considered an integral part of QI project design.

The Role of Higher Education in National Quality Infrastructure Policy-Making

Directory of Open Access Journals (Sweden)

Jelena Ruso

2017-05-01

Full Text Available The aim of the paper is to raise awareness of the importance of the policy makers’ knowledge and expertise about quality infrastructure (QI for the successful policy-making. This article, which addresses the role of higher education in Serbian quality infrastructure policy-making, is an analysis of QI related contents of higher education institution curriculum. The target institutions are public faculties from whose official websites the data were collected. Depending on the keywords, the analysis was performed in order to classify the faculties into three categories. After reviewing the 307 subject titles and descriptions of undergraduate courses, the results show that the concepts of QI are widely recognized as an important and popular topic. The analysis of the QI adoption and diffusion indicates that although some of the faculties might be ‘leaders’ in a particular dimension, they still do not necessarily fall into the ‘leader’ category. JEL Classification:I21, I23, H54, L15

Tai Chi and Qi Gong

Science.gov (United States)

... of Grants and Contracts General Award Mechanisms Small Business Research Grant Program (SBIR) Funding for: Natural Product Research ... tai chi and qigong in older adults. Western Journal of Nursing Research. 2009;31(2):245–279. Saeed SA, Antonacci ...

Methods for Estimation of Radiation Risk in Epidemiological Studies Accounting for Classical and Berkson Errors in Doses

KAUST Repository

Kukush, Alexander

2011-01-16

With a binary response Y, the dose-response model under consideration is logistic in flavor with pr(Y=1 | D) = R (1+R)(-1), R = λ(0) + EAR D, where λ(0) is the baseline incidence rate and EAR is the excess absolute risk per gray. The calculated thyroid dose of a person i is expressed as Dimes=fiQi(mes)/Mi(mes). Here, Qi(mes) is the measured content of radioiodine in the thyroid gland of person i at time t(mes), Mi(mes) is the estimate of the thyroid mass, and f(i) is the normalizing multiplier. The Q(i) and M(i) are measured with multiplicative errors Vi(Q) and ViM, so that Qi(mes)=Qi(tr)Vi(Q) (this is classical measurement error model) and Mi(tr)=Mi(mes)Vi(M) (this is Berkson measurement error model). Here, Qi(tr) is the true content of radioactivity in the thyroid gland, and Mi(tr) is the true value of the thyroid mass. The error in f(i) is much smaller than the errors in ( Qi(mes), Mi(mes)) and ignored in the analysis. By means of Parametric Full Maximum Likelihood and Regression Calibration (under the assumption that the data set of true doses has lognormal distribution), Nonparametric Full Maximum Likelihood, Nonparametric Regression Calibration, and by properly tuned SIMEX method we study the influence of measurement errors in thyroid dose on the estimates of λ(0) and EAR. The simulation study is presented based on a real sample from the epidemiological studies. The doses were reconstructed in the framework of the Ukrainian-American project on the investigation of Post-Chernobyl thyroid cancers in Ukraine, and the underlying subpolulation was artificially enlarged in order to increase the statistical power. The true risk parameters were given by the values to earlier epidemiological studies, and then the binary response was simulated according to the dose-response model.

Construção e validação de um questionário para identificação da Síndrome de Ansiedade de Separação em cães domésticos Development and Validation of a questionnaire to identify Separation Anxiety Syndrome in domestic dogs

Directory of Open Access Journals (Sweden)

Guilherme Marques Soares

2009-06-01

Full Text Available Em cães, a Síndrome de Ansiedade de Separação em Animais (SASA pode ser definida como um conjunto de comportamentos indesejáveis exibidos por esses animais quando afastados da figura de apego. A partir da necessidade de um levantamento epidemiológico sobre esse problema, foi desenvolvido um questionário para identificação da SASA em cães (QI-SASA com base em dados da literatura e validado por meio de dois procedimentos. O primeiro foi a comparação entre pareceres de médicos veterinários brasileiros que atuam na área de etologia clínica a respeito de 40 QI-SASA respondidos por proprietários de cães. O segundo foi a comparação dos resultados da avaliação de 40 QI-SASA, a partir dos critérios estabelecidos neste trabalho, com o resultado de entrevistas para o diagnóstico da SASA. O QI-SASA mostrou-se completo, coerente e confiável com a finalidade de um levantamento epidemiológico do problema.The Separation Anxiety Syndrome in Animals (SASA and being more specific, in dogs, can be defined as a group of undesirable behaviors displayed by dogs when they are away from the attachment subject. The questionnaire was developed due to the need to identify this disorder and conduct an epidemiologic survey on SASA in dogs (QI-SASA. This instrument was developed based on reference data and was validated through two procedures. The first one was the comparison among evaluations of Brazilian ethologists on the appliance of 40 QI-SASA to dogs' owners. The second was the comparison between the previous evaluations, according to the criteria established in this research, with the results of the interviews to diagnose SASA. The QI-SASA seems to be a complete, safe and trustworthy tool to carry out epidemiologic surveys on SASA.

Effectiveness of teaching quality improvement to clinicians: a systematic review.

Science.gov (United States)

Boonyasai, Romsai T; Windish, Donna M; Chakraborti, Chayan; Feldman, Leonard S; Rubin, Haya R; Bass, Eric B

2007-09-05

Accreditation requirements mandate teaching quality improvement (QI) concepts to medical trainees, yet little is known about the effectiveness of teaching QI. To perform a systematic review of the effectiveness of published QI curricula for clinicians and to determine whether teaching methods influence the effectiveness of such curricula. The electronic literature databases of MEDLINE, EMBASE, CINAHL, and ERIC were searched for English-language articles published between January 1, 1980, and April 30, 2007. Experts in the field of QI were queried about relevant studies. Two independent reviewers selected studies for inclusion if the curriculum taught QI principles to clinicians and the evaluation used a comparative study design. Information about the features of each curriculum, its use of 9 principles of adult learning, and the type of educational and clinical outcomes were extracted. The relationship between the outcomes and the number of educational principles used was assessed. Of 39 studies that met eligibility criteria, 31 described team-based projects; 37 combined didactic instruction with experiential learning. The median number of adult learning principles used was 7 (range, 2-8). Evaluations included 22 controlled trials (8 randomized and 14 nonrandomized) and 17 pre/post or time series studies. Fourteen studies described educational outcomes (attitudes, knowledge, or skills or behaviors) and 28 studies described clinical process or patient outcomes. Nine of the 10 studies that evaluated knowledge reported only positive effects but only 2 of these described a validated assessment tool. The 6 assessments of attitudes found mixed results. Four of the 6 studies on skill or behavior outcomes reported only positive effects. Eight of the 28 studies of clinical outcomes reported only beneficial effects. Controlled studies were more likely than other studies to report mixed or null effects. Only 4 studies evaluated both educational and clinical outcomes

Methods for estimation of radiation risk in epidemiological studies accounting for classical and Berkson errors in doses.

Science.gov (United States)

Kukush, Alexander; Shklyar, Sergiy; Masiuk, Sergii; Likhtarov, Illya; Kovgan, Lina; Carroll, Raymond J; Bouville, Andre

2011-02-16

With a binary response Y, the dose-response model under consideration is logistic in flavor with pr(Y=1 | D) = R (1+R)(-1), R = λ(0) + EAR D, where λ(0) is the baseline incidence rate and EAR is the excess absolute risk per gray. The calculated thyroid dose of a person i is expressed as Dimes=fiQi(mes)/Mi(mes). Here, Qi(mes) is the measured content of radioiodine in the thyroid gland of person i at time t(mes), Mi(mes) is the estimate of the thyroid mass, and f(i) is the normalizing multiplier. The Q(i) and M(i) are measured with multiplicative errors Vi(Q) and ViM, so that Qi(mes)=Qi(tr)Vi(Q) (this is classical measurement error model) and Mi(tr)=Mi(mes)Vi(M) (this is Berkson measurement error model). Here, Qi(tr) is the true content of radioactivity in the thyroid gland, and Mi(tr) is the true value of the thyroid mass. The error in f(i) is much smaller than the errors in ( Qi(mes), Mi(mes)) and ignored in the analysis. By means of Parametric Full Maximum Likelihood and Regression Calibration (under the assumption that the data set of true doses has lognormal distribution), Nonparametric Full Maximum Likelihood, Nonparametric Regression Calibration, and by properly tuned SIMEX method we study the influence of measurement errors in thyroid dose on the estimates of λ(0) and EAR. The simulation study is presented based on a real sample from the epidemiological studies. The doses were reconstructed in the framework of the Ukrainian-American project on the investigation of Post-Chernobyl thyroid cancers in Ukraine, and the underlying subpolulation was artificially enlarged in order to increase the statistical power. The true risk parameters were given by the values to earlier epidemiological studies, and then the binary response was simulated according to the dose-response model.

Society and Ecosystem Carbon Budget through Life Cycle Assessment: Results from Asian Drylands

Science.gov (United States)

Chen, J.

2017-12-01

Land use, land cover changes, and ecosystem-specific management practices are recognized for their roles in mediating the climatic effects on ecosystem structure and function. A major challenge is that our understanding and forecasting of ecosystem functions, such as C fluxes, cannot rely solely on conventional biophysical regulations from the local ecosystem to the global scale. A second challenge lies in quantifying the magnitude of the C fluxes from managed ecosystems and landscapes over the lifetime of the C cycle, and to deduct the various energy inputs during management. Our specific challenge here is to quantify the landscape-scale C footprint of both managed agricultural-forest landscapes and people - the societal input and engagement in ecosystem studies. Using the East Asia Drylands (Chen et al., 2013) and an agricultural watershed in southwestern Michigan as a test bed, the mechanisms (carbon as an example) from both human activities and biophysical changes on ecosystem C dynamics at different temporal and spatial scales are proposed to be explored by modeling total net ecosystem C production (physical and social C fluxes), performing a spatially-explicit life cycle assessment (LCA) on the total C production. Remote sensing technology, available geospatial data, records of management practices, surveys of historical practices, a land surface model, and in situ measurements of C fluxes are all needed to achieve our objectives. Our case study calls for direct involvement of society as both the driver and beneficiary of ecosystem dynamics. Reference Chen, J., Wan, S., Henebry, G., Qi, J., Gutman, G., Sun, G., and Kappas, M. (Eds.) 2013. Dryland East Asia (DEA): Land Dynamics Amid Social And Climate Change. HEP and De Gruyter, 470 pp.

Cerebrospinal fluid space alterations in melancholic depression.

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Esther Via

Full Text Available Melancholic depression is a biologically homogeneous clinical entity in which structural brain alterations have been described. Interestingly, reports of structural alterations in melancholia include volume increases in Cerebro-Spinal Fluid (CSF spaces. However, there are no previous reports of CSF volume alterations using automated whole-brain voxel-wise approaches, as tissue classification algorithms have been traditionally regarded as less reliable for CSF segmentation. Here we aimed to assess CSF volumetric alterations in melancholic depression and their clinical correlates by means of a novel segmentation algorithm ('new segment', as implemented in the software Statistical Parametric Mapping-SPM8, incorporating specific features that may improve CSF segmentation. A three-dimensional Magnetic Resonance Image (MRI was obtained from seventy patients with melancholic depression and forty healthy control subjects. Although imaging data were pre-processed with the 'new segment' algorithm, in order to obtain a comparison with previous segmentation approaches, tissue segmentation was also performed with the 'unified segmentation' approach. Melancholic patients showed a CSF volume increase in the region of the left Sylvian fissure, and a CSF volume decrease in the subarachnoid spaces surrounding medial and lateral parietal cortices. Furthermore, CSF increases in the left Sylvian fissure were negatively correlated with the reduction percentage of depressive symptoms at discharge. None of these results were replicated with the 'unified segmentation' approach. By contrast, between-group differences in the left Sylvian fissure were replicated with a non-automated quantification of the CSF content of this region. Left Sylvian fissure alterations reported here are in agreement with previous findings from non-automated CSF assessments, and also with other reports of gray and white matter insular alterations in depressive samples using automated approaches

Successfully reducing newborn asphyxia in the labour unit in a large academic medical centre

DEFF Research Database (Denmark)

Hollesen, Rikke von Benzon; Johansen, Rie Laurine Rosenthal; Rørbye, Christina

2018-01-01

with a peer when using an oxytocin infusion and the use of a checklist before vacuum extractions. CONCLUSION: This QI project illustrates how aspects of patient safety, such as the prevention of asphyxia, can be improved using QI methods to more reliably implement best practice, even in high...

An Evaluation of the Technical Adequacy of a Revised Measure of Quality Indicators of Transition

Science.gov (United States)

Morningstar, Mary E.; Lee, Hyunjoo; Lattin, Dana L.; Murray, Angela K.

2016-01-01

This study confirmed the reliability and validity of the Quality Indicators of Exemplary Transition Programs Needs Assessment-2 (QI-2). Quality transition program indicators were identified through a systematic synthesis of transition research, policies, and program evaluation measures. To verify reliability and validity of the QI-2, we…

Effect of Lower and Upper Body High Intensity Training on Genes Associated with Cellular Stress Response

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Małgorzata Żychowska

2017-01-01

Full Text Available This study aimed to compare the effect of upper and lower body high intensity exercise (HIE on select gene expression in athletes. Fourteen elite male artistic gymnasts (age 20.9±2.6 years; weight 68.6±7.2 kg; fat free mass 63.6±6.7 kg; height 1.70±0.04 m performed lower and upper body 30 s Wingate Tests (WAnTs before and after eight weeks of specific HIIT. Two milliliters of blood was collected before and after (5, 30 min, resp. lower and upper body WAnTs, and select gene expression was determined by PCR. Eight weeks of HIIT caused a significant increase in maximal power (722 to 751 Wat, relative peak power in the lower body WAnTs (10.1 to 11 W/kg, mean power (444 to 464 W, and relative mean power (6.5 to 6.8 W/kg. No significant differences in lower versus upper body gene expression were detected after HIIT, and a significant decrease in the IL6/IL10 ratio was observed after lower (−2∧0.57 p=0.0019 and upper (−2∧0.5 p=0.03 WAnTs following eight weeks of HIIT. It is hypothesized that a similar adaptive response to exercise may be obtained by lower and upper body exercise.

LoRa Scalability: A Simulation Model Based on Interference Measurements.

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Haxhibeqiri, Jetmir; Van den Abeele, Floris; Moerman, Ingrid; Hoebeke, Jeroen

2017-05-23

LoRa is a long-range, low power, low bit rate and single-hop wireless communication technology. It is intended to be used in Internet of Things (IoT) applications involving battery-powered devices with low throughput requirements. A LoRaWAN network consists of multiple end nodes that communicate with one or more gateways. These gateways act like a transparent bridge towards a common network server. The amount of end devices and their throughput requirements will have an impact on the performance of the LoRaWAN network. This study investigates the scalability in terms of the number of end devices per gateway of single-gateway LoRaWAN deployments. First, we determine the intra-technology interference behavior with two physical end nodes, by checking the impact of an interfering node on a transmitting node. Measurements show that even under concurrent transmission, one of the packets can be received under certain conditions. Based on these measurements, we create a simulation model for assessing the scalability of a single gateway LoRaWAN network. We show that when the number of nodes increases up to 1000 per gateway, the losses will be up to 32%. In such a case, pure Aloha will have around 90% losses. However, when the duty cycle of the application layer becomes lower than the allowed radio duty cycle of 1%, losses will be even lower. We also show network scalability simulation results for some IoT use cases based on real data.

Epigenetic Alterations in Alzheimer's Disease

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Johannes eGräff

2015-12-01

Full Text Available Alzheimer’s disease (AD is the major cause of dementia in Western societies. It progresses asymptomatically during decades before being belatedly diagnosed when therapeutic strategies have become unviable. Although several genetic alterations have been associated with AD, the vast majority of AD cases do not show strong genetic underpinnings and are thus considered a consequence of non-genetic factors. Epigenetic mechanisms allow for the integration of long-lasting non-genetic inputs on specific genetic backgrounds, and recently, a growing number of epigenetic alterations in AD have been described. For instance, an accumulation of dysregulated epigenetic mechanisms in aging, the predominant risk factor of AD, might facilitate the onset of the disease. Likewise, mutations in several enzymes of the epigenetic machinery have been associated with neurodegenerative processes that are altered in AD such as impaired learning and memory formation. Genome-wide and locus-specific epigenetic alterations have also been reported, and several epigenetically dysregulated genes validated by independent groups. From these studies, a picture emerges of AD as being associated with DNA hypermethylation and histone deacetylation, suggesting a general repressed chromatin state and epigenetically reduced plasticity in AD. Here we review these recent findings and discuss several technical and methodological considerations that are imperative for their correct interpretation. We also pay particular focus on potential implementations and theoretical frameworks that we expect will help to better direct future studies aimed to unravel the epigenetic participation in AD.

Epigenetic Alterations in Alzheimer's Disease.

Science.gov (United States)

Sanchez-Mut, Jose V; Gräff, Johannes

2015-01-01

Alzheimer's disease (AD) is the major cause of dementia in Western societies. It progresses asymptomatically during decades before being belatedly diagnosed when therapeutic strategies have become unviable. Although several genetic alterations have been associated with AD, the vast majority of AD cases do not show strong genetic underpinnings and are thus considered a consequence of non-genetic factors. Epigenetic mechanisms allow for the integration of long-lasting non-genetic inputs on specific genetic backgrounds, and recently, a growing number of epigenetic alterations in AD have been described. For instance, an accumulation of dysregulated epigenetic mechanisms in aging, the predominant risk factor of AD, might facilitate the onset of the disease. Likewise, mutations in several enzymes of the epigenetic machinery have been associated with neurodegenerative processes that are altered in AD such as impaired learning and memory formation. Genome-wide and locus-specific epigenetic alterations have also been reported, and several epigenetically dysregulated genes validated by independent groups. From these studies, a picture emerges of AD as being associated with DNA hypermethylation and histone deacetylation, suggesting a general repressed chromatin state and epigenetically reduced plasticity in AD. Here we review these recent findings and discuss several technical and methodological considerations that are imperative for their correct interpretation. We also pay particular focus on potential implementations and theoretical frameworks that we expect will help to better direct future studies aimed to unravel the epigenetic participation in AD.

Using an online quiz-based reinforcement system to teach healthcare quality and patient safety and care transitions at the University of California.

Science.gov (United States)

Shaikh, Ulfat; Afsar-Manesh, Nasim; Amin, Alpesh N; Clay, Brian; Ranji, Sumant R

2017-10-01

Implementing quality improvement (QI) education during clinical training is challenging due to time constraints and inadequate faculty development in these areas. Quiz-based reinforcement systems show promise in fostering active engagement, collaboration, healthy competition and real-time formative feedback, although further research on their effectiveness is required. An online quiz-based reinforcement system to increase resident and faculty knowledge in QI, patient safety and care transitions. Experts in QI and educational assessment at the 5 University of California medical campuses developed a course comprised of 3 quizzes on Introduction to QI, Patient Safety and Care Transitions. Each quiz contained 20 questions and utilized an online educational quiz-based reinforcement system that leveraged spaced learning. Approximately 500 learners completed the course (completion rate 66-86%). Knowledge acquisition scores for all quizzes increased after completion: Introduction to QI (35-73%), Patient Safety (58-95%), and Care Transitions (66-90%). Learners reported that the quiz-based system was an effective teaching modality and preferred this type of education to classroom-based lectures. Suggestions for improvement included reducing frequency of presentation of questions and utilizing more questions that test learners on application of knowledge instead of knowledge acquisition. A multi-campus online quiz-based reinforcement system to train residents in QI, patient safety and care transitions was feasible, acceptable, and increased knowledge. The course may be best utilized to supplement classroom-based and experiential curricula, along with increased attention to optimizing frequency of presentation of questions and enhancing application skills. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Use of a structured template to facilitate practice-based learning and improvement projects.

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McClain, Elizabeth K; Babbott, Stewart F; Tsue, Terance T; Girod, Douglas A; Clements, Debora; Gilmer, Lisa; Persons, Diane; Unruh, Greg

2012-06-01

The Accreditation Council for Graduate Medical Education (ACGME) requires residency programs to meet and demonstrate outcomes across 6 competencies. Measuring residents' competency in practice-based learning and improvement (PBLI) is particularly challenging. We developed an educational tool to meet ACGME requirements for PBLI. The PBLI template helped programs document quality improvement (QI) projects and supported increased scholarly activity surrounding PBLI learning. We reviewed program requirements for 43 residency and fellowship programs and identified specific PBLI requirements for QI activities. We also examined ACGME Program Information Form responses on PBLI core competency questions surrounding QI projects for program sites visited in 2008-2009. Data were integrated by a multidisciplinary committee to develop a peer-protected PBLI template guiding programs through process, documentation, and evaluation of QI projects. All steps were reviewed and approved through our GME Committee structure. An electronic template, companion checklist, and evaluation form were developed using identified project characteristics to guide programs through the PBLI process and facilitate documentation and evaluation of the process. During a 24 month period, 27 programs have completed PBLI projects, and 15 have reviewed the template with their education committees, but have not initiated projects using the template. The development of the tool generated program leaders' support because the tool enhanced the ability to meet program-specific objectives. The peer-protected status of this document for confidentiality and from discovery has been beneficial for program usage. The document aggregates data on PBLI and QI initiatives, offers opportunities to increase scholarship in QI, and meets the ACGME goal of linking measures to outcomes important to meeting accreditation requirements at the program and institutional level.

Des Widerspenstigen Zähmung: Subjektives Alter(n, qualitativ erforscht

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Stefanie Graefe

2013-04-01

Full Text Available Der Beitrag präsentiert Forschungsergebnisse einer qualitativen Interviewstudie zur subjektiven Alter(nserfahrung von Menschen in der zweiten Lebenshälfte sowie aus dem Forschungsprozess resultierende Überlegungen zur Frage, wie sich die soziale Erfahrung Alter(n methodologisch konzeptualisieren und empirisch erforschen lässt. Die Auswertung erfolgte angelehnt an die Grounded-Theory- Methodologie. Ausgehend von der "relativen (subjektiven Alterslosigkeit" als fallübergreifender Schlüsselkategorie wird im Folgenden eine Typologie von (Alters- Selbstkonzepten vorgestellt: das "wandlungsfähige", das "kontinuierliche" und das "verunsicherte" (Alters- Selbst. Skizziert wird eine methodologische Konzeption von Alter(n als eine zugleich prinzipiell unscharfe und erheblich normierte soziale Kategorie. Die Ergebnisse der Studie deuten darauf hin, dass – insbesondere vor dem Hintergrund der in jüngerer Zeit erfolgten sozialpolitischen Aufwertung der Lebensphase Alter – spezifische Sozialmilieus besonders prädestiniert scheinen, normative Anforderungen einer aktiven, produktiven und selbstverantwortlichen Gestaltung der Lebensphase Alter in ihr Selbstkonzept zu integrieren. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1302114

Vocabulário e memória de trabalho predizem desempenho em leitura de crianças

OpenAIRE

Piccolo, Luciane da Rosa; Salles, Jerusa Fumagalli

2013-01-01

Resumo: Este trabalho investiga a relação entre leitura (palavras e texto), memória de trabalho, quociente de inteligência (QI) e vocabulário em crianças (2ª-5ª séries) de escolas públicas. Analisou-se também qual dessas habilidades melhor contribui para explicar o desempenho em leitura. Realizaram-se análises com e sem crianças com QI abaixo da média. Primeiro, avaliaram-se 57 crianças (9-11 anos) em QI, vocabulário, leitura de palavras isoladas, compreensão de leitura textual e quatro taref...

Factors influencing the long-term sustainment of quality improvements made in addiction treatment facilities: a qualitative study

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Scott P. Stumbo

2017-11-01

Full Text Available Abstract Background A greater understanding of the factors that influence long-term sustainment of quality improvement (QI initiatives is needed to promote organizational ability to sustain QI practices over time, help improve future interventions, and increase the value of QI investments. Methods We approached 83 of 201 executive sponsors or change leaders at addiction treatment organizations that participated in the 2007–2009 NIATx200 QI intervention. We completed semi-structured interviews with 33 individuals between November 2015 and April 2016. NIATx200 goals were to decrease wait time, increase admissions and improve retention in treatment. Interviews sought to understand factors that either facilitated or impeded long-term sustainment of organizational QI practices made during the intervention. We used thematic analysis to organize the data and group patterns of responses. We assessed available quantitative outcome data and intervention engagement data to corroborate qualitative results. Results We used narrative analysis to group four important themes related to long-term sustainment of QI practices: (1 finding alignment between business- and client-centered practices; (2 staff engagement early in QI process added legitimacy which facilitated sustainment; (3 commitment to integrating data into monitoring practices and the identification of a data champion; and (4 adequate organizational human resources devoted to sustainment. We found four corollary factors among agencies which did not sustain practices: (1 lack of evidence of impact on business practices led to discontinuation; (2 disengaged staff and lack of organizational capacity during implementation period led to lack of sustainment; (3 no data integration into overall business practices and no identified data champion; and (4 high staff turnover. In addition, we found that many agencies’ current use of NIATx methods and tools suggested a legacy effect that might improve

In-situ IR monitoring of the formation of Zr-fumarate MOF

CSIR Research Space (South Africa)

Ren, Jianwei

2017-05-01

Full Text Available monitoring of the formation of Zr-fumarate MOF Authors: Jianwei Ren, Nicholas M. Musyoka, Henrietta W. Langmi, Brian C. North, Mkhulu Mathe, Wan Pang, Mingjie Wang, Joseph Walker PII: S0169-4332(17)30296-9 DOI: http://dx.doi.org/doi:10.1016/j.apsusc.2017....01.271 Reference: APSUSC 35066 To appear in: APSUSC Received date: 21-9-2016 Revised date: 20-1-2017 Accepted date: 25-1-2017 Please cite this article as: Jianwei Ren, Nicholas M.Musyoka, Henrietta W.Langmi, Brian C.North, Mkhulu Mathe, Wan Pang, Mingjie Wang...

Hydrothermal alteration at Roosevelt Hot Springs KGRA: DDH 1976-1

Energy Technology Data Exchange (ETDEWEB)

Bryant, N.L.; Parry, W.T.

1977-09-01

Hot waters of the Roosevelt Thermal Area, Utah, have altered granitic rocks and detritus of the Mineral Range pluton, Utah. Alteration and mineral deposition recognized in a 200' drill core from DDH 1-76 is most intense in the upper 100 feet which consists of altered alluvium and opal deposits; the lower 100 feet is weakly altered quartz monzonite. Petrographic, x-ray, and chemical methods were used to characterize systematic changes in chemistry and mineralogy. Comparison of the alteration mineral assemblages with known water chemistry and equilibrium activity diagrams suggests that a simple solution equilibrium model cannot account for the alteration. A model is proposed in which upward moving thermal water supersaturated with respect to quartz and a downward moving cool water undersaturated with respect to quartz produces the observed alteration. An estimate of the heat flow contributions from hydrothermal alteration was made by calculating reaction enthalpies for alteration reactions at each depth. The estimated heat flow varied from .02 HFU (for 200' depth, 400,000 yr duration, and no sulfur oxidation) to 67 HFU (for 5,000' depth, 1,000 yr duration, and all sulfur oxidized from sulfide). Heat flow contributions from hydrothermal alteration are comparable with those from a cooling granitic magma.

Methods for Estimation of Radiation Risk in Epidemiological Studies Accounting for Classical and Berkson Errors in Doses

KAUST Repository

Kukush, Alexander; Shklyar, Sergiy; Masiuk, Sergii; Likhtarov, Illya; Kovgan, Lina; Carroll, Raymond J; Bouville, Andre

2011-01-01

thyroid dose of a person i is expressed as Dimes=fiQi(mes)/Mi(mes). Here, Qi(mes) is the measured content of radioiodine in the thyroid gland of person i at time t(mes), Mi(mes) is the estimate of the thyroid mass, and f(i) is the normalizing multiplier

Training Psychiatry Residents in Quality Improvement: An Integrated, Year-Long Curriculum

Science.gov (United States)

Arbuckle, Melissa R.; Weinberg, Michael; Cabaniss, Deborah L.; Kistler; Susan C.; Isaacs, Abby J.; Sederer, Lloyd I.; Essock, Susan M.

2013-01-01

Objective: The authors describe a curriculum for psychiatry residents in Quality Improvement (QI) methodology. Methods: All PGY3 residents (N=12) participated in a QI curriculum that included a year-long group project. Knowledge and attitudes were assessed before and after the curriculum, using a modified Quality Improvement Knowledge Assessment…

75 FR 21329 - Medicaid Program; State Allotments for Payment of Medicare Part B Premiums for Qualifying...

Science.gov (United States)

2010-04-23

... includes payment for premiums for Medicare Part B. Section 4732 of the Balanced Budget Act of 1997 (BBA... formula for determining State allotments. However, since certain States projected a deficit in their... minimize the impact on States with FY QI allotments that might be greater than their QI expenditures for...

A Longitudinal, Experiential Quality Improvement Curriculum Meeting ACGME Competencies for Geriatrics Fellows: Lessons Learned

Science.gov (United States)

Callahan, Kathryn E.; Rogers, Matthew T.; Lovato, James F.; Fernandez, Helen M.

2013-01-01

Quality improvement (QI) initiatives are critical in the care of older adults who are more vulnerable to substandard care. QI education meets aspects of core Accreditation Council of Graduate Medical Education competencies and prepares learners for the rising focus on performance measurement in health care. The authors developed, implemented, and…

Hypergravity-induced altered behavior in Drosophila

Science.gov (United States)

Hosamani, Ravikumar; Wan, Judy; Marcu, Oana; Bhattacharya, Sharmila

2012-07-01

Microgravity and mechanical stress are important factors of the spaceflight environment, and affect astronaut health and behavior. Structural, functional, and behavioral mechanisms of all cells and organisms are adapted to Earth's gravitational force, 1G, while altered gravity can pose challenges to their adaptability to this new environment. On ground, hypergravity paradigms have been used to predict and complement studies on microgravity. Even small changes that take place at a molecular and genetic level during altered gravity may result in changes in phenotypic behavior. Drosophila provides a robust and simple, yet very reliable model system to understand the complexity of hypergravity-induced altered behavior, due to availability of a plethora of genetic tools. Locomotor behavior is a sensitive parameter that reflects the array of molecular adaptive mechanisms recruited during exposure to altered gravity. Thus, understanding the genetic basis of this behavior in a hypergravity environment could potentially extend our understanding of mechanisms of adaptation in microgravity. In our laboratory we are trying to dissect out the cellular and molecular mechanisms underlying hypergravity-induced oxidative stress, and its potential consequences on behavioral alterations by using Drosophila as a model system. In the present study, we employed pan-neuronal and mushroom body specific knock-down adult flies by using Gal4/UAS system to express inverted repeat transgenes (RNAi) to monitor and quantify the hypergravity-induced behavior in Drosophila. We established that acute hypergravity (3G for 60 min) causes a significant and robust decrease in the locomotor behavior in adult Drosophila, and that this change is dependent on genes related to Parkinson's disease, such as DJ-1α , DJ-1β , and parkin. In addition, we also showed that anatomically the control of this behavior is significantly processed in the mushroom body region of the fly brain. This work links a molecular

Review of Pre-Analytical Errors in Oral Glucose Tolerance Testing in a Tertiary Care Hospital.

Science.gov (United States)

Nanda, Rachita; Patel, Suprava; Sahoo, Sibashish; Mohapatra, Eli

2018-03-13

The pre-pre-analytical and pre-analytical phases form a major chunk of the errors in a laboratory. The process has taken into consideration a very common procedure which is the oral glucose tolerance test to identify the pre-pre-analytical errors. Quality indicators provide evidence of quality, support accountability and help in the decision making of laboratory personnel. The aim of this research is to evaluate pre-analytical performance of the oral glucose tolerance test procedure. An observational study that was conducted overa period of three months, in the phlebotomy and accessioning unit of our laboratory using questionnaire that examined the pre-pre-analytical errors through a scoring system. The pre-analytical phase was analyzed for each sample collected as per seven quality indicators. About 25% of the population gave wrong answer with regard to the question that tested the knowledge of patient preparation. The appropriateness of test result QI-1 had the most error. Although QI-5 for sample collection had a low error rate, it is a very important indicator as any wrongly collected sample can alter the test result. Evaluating the pre-analytical and pre-pre-analytical phase is essential and must be conducted routinely on a yearly basis to identify errors and take corrective action and to facilitate their gradual introduction into routine practice.

Water Extract of Deer Bones Activates Macrophages and Alleviates Neutropenia

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Han-Seok Choi

2013-01-01

Full Text Available Extracts from deer bones, called nok-gol in Korean, have long been used to invigorate Qi. While neutropenia is not well detected in normal physiological condition, it could be a cause of severe problems to develop diseases such as infectious and cancerous diseases. Thus, a prevention of neutropenia in normal physiology and pathophysiological states is important for maintaining Qi and preventing disease progress. In cell biological aspects, activated macrophages are known to prevent neutropenia. In this study, we demonstrate that water extract of deer bone (herein, NG prevents neutropenia by activating macrophages. In mouse neutropenia model system in vivo where ICR mice were treated with cyclophosphamide to immunosuppress, an oral administration of NG altered the number of blood cells including lymphocytes, neutrophils, basophils, and eosinophils. This in vivo effect of NG was relevant to that of granulocyte colony stimulating factor (G-CSF that was known to improve neutropenia. Our in vitro studies further showed that NG treatment increased intracellular reactive oxygen species (ROS and promoted macrophagic differentiation of mouse monocytic Raw264.7 cells in a dose-dependent manner. In addition, NG enhanced nitric oxide (NO synthesis and secretions of cytokines including IL-6 and TNF-α. Consistently, NG treatment induced phosphorylation of ERK, JNK, IKK, IκBα, and NF-κB in Raw264.7 cells. Thus, our data suggest that NG is helpful for alleviating neutropenia.

Geochemical behaviour of uranium in the cycle of alteration; Comportement geochimique de l'uranium dans le cycle d'alteration

Energy Technology Data Exchange (ETDEWEB)

Chervet, J; Coulomb, R [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires; Soudan, P [Centre d' Etude de Lalumine, Compagnie Pechiney (France)

1958-07-01

The investigation of the genesis of secondary mineralized accumulations, and the prospecting of deposits from microchemical anomalies in the surface material, is requiring a well-developed knowledge of the geochemical properties of the uranium during the alteration phase. In the present work, the authors tried to track the uranium history during a part of his natural creeping. a) They describe some most typical mineralogical observations of alteration phenomena and material migration, picked up in place on the deposits. b) They give experimental results concerning the solubilities of the uranium minerals and the factors affecting this solubility. c) They study the water circulation in granitic batholites, and the influence of the occurrence of the uranium deposits on their composition. d) They observe the amplitude of phenomena restricting the dispersions: fixations, precipitations, etc., and the behaviour of growth in uraniferous areas. e) Finally, the opposition chemical alteration-radioactive equilibrium results in an important imbalance in altered materials. The authors tried to use the measurement of this imbalance to explain geochemical processes. (author) [French] L'etude des conditions de genese des accumulations minerales secondaires, ainsi que la prospection des gisements a partir d'anomalies microchimiques dans les materiaux de surface, necessite une connaissance approfondie des proprietes geochimiques fondamentales de l'uranium dans la phase d'alteration. Nous essayons, dans ce travail, de suivre l'histoire de l'uranium dans une partie de son cheminement naturel. a) Nous decrivons quelques observations mineralogiques particulierement typiques de phenomenes d'alteration et de migration de matiere, prises 'in situ' dans les gisements. b) Nous donnons les resultats d'experiences de laboratoire sur les solubilites de mineraux d'uranium et sur les facteurs influen nt cette solubilite. c) Nous etudions les circulations d'eaux sur les massifs granitiques et

Improving the Quality of Care for Patients Diagnosed With Glioma During the Perioperative Period

Science.gov (United States)

Riblet, Natalie B.V.; Schlosser, Evelyn M.; Homa, Karen; Snide, Jennifer A.; Jarvis, Lesley A.; Simmons, Nathan E.; Sargent, David H.; Mason, Linda P.; Cooney, Tobi J.; Kennedy, Nancy L.; Fadul, Camilo E.

2014-01-01

Purpose: Although there is agreement on the oncologic management of patients with glioma, few guidelines exist to standardize other aspects of care, including supportive care. Methods: A quality improvement (QI) project was chartered to improve the care provided to patients with glioma. A multidisciplinary team was convened and identified 10 best-practice measures. Using a plan-do-study-act framework, the team brainstormed and implemented various improvement interventions between June 2011 and October 2012. Statistical process control charts were used to evaluate progress. A dashboard of quality measures was generated to allow for ongoing measurement and reporting. Results: The retrospective assessment phase consisted of 43 patients with diagnosis of glioma. A manual medical record review for these patients showed that compliance with 10 best-practice measures ranged from 23% to 100%. Several factors contributed to less-than-ideal process performance, including poor communication among disciplines and lack of familiarity with the larger system of care. After implementing improvement interventions, performance was measured in 96 consecutive patients with glioma. The proportion of patients who met criteria for 10 practice measures significantly improved (pre-QI work, 63%; post-QI work, 85%; P = .003). The largest improvement was observed in the measure assessing for preoperative notification of the neuro-oncology program (pre-QI work, 39%; post-QI work, 97%; P sustaining process improvements. PMID:25294392

Innovative model of delivering quality improvement education for trainees – a pilot project

Directory of Open Access Journals (Sweden)

Kannan Ramar

2015-09-01

Full Text Available Background: After incorporating quality improvement (QI education as a required curriculum for our trainees in 2010, a need arose to readdress our didactic sessions as they were too long, difficult to schedule, and resulting in a drop in attendance. A ‘flipped classroom’ (FC model to deliver QI education was touted to be an effective delivery method as it allows the trainees to view didactic materials on videos, on their own time, and uses the classroom to clarify concepts and employ learned tools on case-based scenarios including workshops. Methods: The Mayo Quality Academy prepared 29 videos that incorporated the previously delivered 17 weekly didactic sessions, for a total duration of 135 min. The half-day session clarified questions related to the videos, followed by case examples and a hands-on workshop on how to perform and utilize a few commonly used QI tools and methods. Results: Seven trainees participated. There was a significant improvement in knowledge as measured by pre- and post-FC model test results [improvement by 40.34% (SD 16.34, p<0.001]. The survey results were overall positive about the FC model with all trainees strongly agreeing that we should continue with this model to deliver QI education. Conclusions: The pilot project of using the FC model to deliver QI education was successful in a small sample of trainees.

A novel approach to leveraging electronic health record data to enhance pediatric surgical quality improvement bundle process compliance.

Science.gov (United States)

Fisher, Jason C; Godfried, David H; Lighter-Fisher, Jennifer; Pratko, Joseph; Sheldon, Mary Ellen; Diago, Thelma; Kuenzler, Keith A; Tomita, Sandra S; Ginsburg, Howard B

2016-06-01

Quality improvement (QI) bundles have been widely adopted to reduce surgical site infections (SSI). Improvement science suggests when organizations achieve high-reliability to QI processes, outcomes dramatically improve. However, measuring QI process compliance is poorly supported by electronic health record (EHR) systems. We developed a custom EHR tool to facilitate capture of process data for SSI prevention with the aim of increasing bundle compliance and reducing adverse events. Ten SSI prevention bundle processes were linked to EHR data elements that were then aggregated into a snapshot display superimposed on weekly case-log reports. The data aggregation and user interface facilitated efficient review of all SSI bundle elements, providing an exact bundle compliance rate without random sampling or chart review. Nine months after implementation of our custom EHR tool, we observed centerline shifts in median SSI bundle compliance (46% to 72%). Additionally, as predicted by high reliability principles, we began to see a trend toward improvement in SSI rates (1.68 to 0.87 per 100 operations), but a discrete centerline shift was not detected. Simple informatics solutions can facilitate extraction of QI process data from the EHR without relying on adjunctive systems. Analyses of these data may drive reductions in adverse events. Pediatric surgical departments should consider leveraging the EHR to enhance bundle compliance as they implement QI strategies. Copyright © 2016 Elsevier Inc. All rights reserved.

Survey on risk perception of radiation following an incident involving a stuck 60Co source in Henan Province, China

International Nuclear Information System (INIS)

Lei, C.; Sun, Q.; Cheng, X.; Zhang, Q.; Fu, Y.; Chu, C.; Zhao, Y.; Qin, W.; Su, X.

2012-01-01

In July 2009, an incident involving a stuck Co-60 source led hundreds of thousands of people to escape Qi County, Henan Province, China, although no medical or environmental consequences were related to the incident. To investigate knowledge about radiation, public risk-perception of radiation, and evaluation of the official response, a survey was conducted in Qi and Hui County (control). Face-to-face questionnaire interviews were conducted among three groups with different educational backgrounds. In total, 1340 valid questionnaires were collected from people interviewed. Knowledge about radiation was low in all groups in both counties, although knowledge in Qi County was higher than that in Hui County (control). More than 40 % respondents supported construction of nuclear power plants (NPPs) in China, while only a few supported constructing NPPs in their vicinity. The main reasons for the mass escape following the incident were assumed to be lack of knowledge about radiation, misinformation, the government's failure to disclose information in time and imitation of group behaviour. Over 60 % in Group I and II trusted the local government. About 64 % disapproved the response of the Qi County government. After the incident, the population in Qi County still knows little about radiation. Although people trust the government, they are dissatisfied with the response of the local government regarding the incident. (authors)

Comparative effectiveness of quality improvement interventions for pressure ulcer prevention in academic medical centers in the United States.

Science.gov (United States)

Padula, William V; Makic, Mary Beth F; Mishra, Manish K; Campbell, Jonathan D; Nair, Kavita V; Wald, Heidi L; Valuck, Robert J

2015-06-01

Prevention of pressure ulcers, one of the hospital-acquired conditions (HACs) targeted by the 2008 nonpayment policy of the Centers for Medicare & Medicaid Services (CMS), is a critical issue. This study was conducted to determine the comparative effectiveness of quality improvement (QI) interventions associated with reduced hospital-acquired pressure ulcer (HAPU) rates. In an quasi-experimental design, interrupted time series analyses were conducted to determine the correlation between HAPU incidence rates and adoption of QI interventions. Among University HealthSystem Consortium hospitals, 55 academic medical centers were surveyed from September 2007 through February 2012 for adoption patterns of QI interventions for pressure ulcer prevention, and hospital-level data for 5,208 pressure ulcer cases were analyzed. Between- and within-hospital reduction significance was tested with t-tests post-CMS policy intervention. Fifty-three (96%) of the 55 hospitals used QI interventions for pressure ulcer prevention. The effect size analysis identified five effective interventions that each reduced pressure ulcer rates by greater than 1 case per 1,000 patient discharges per quarter: leadership initiatives, visual tools, pressure ulcer staging, skin care, and patient nutrition. The greatest reductions in rates occurred earlier in the adoption process (pprevention protocol for pressure ulcers. Hospitals can not only use these findings from this study as part of a QI bundle for preventing HAPUs.

Rare earth impact on glass structure and alteration kinetics

International Nuclear Information System (INIS)

Molieres, E.

2012-01-01

This work is related to the question of the geological deep repository of high-level waste glass. These wastes include fission products and minor actinides, elements which can be simulated by rare earths. As new glass compositions could enable increased rare earth concentrations, it is crucial to know and understand rare earth impact on glass structure on the one hand, and on glass alteration kinetics or their incorporation into an altered layer. This work studied simplified borosilicate glasses in order to limit synergetic effects between rare earths and other elements. Various complementary techniques were used to characterize pristine and altered glasses (solid-high resolution NMR, Raman spectroscopy, fluorescence, SIMS, SAXS). Firstly, the structural role of a rare earth is discussed and is compared to a calcium cation. The local environment of rare earths is also probed. Secondly, rare earth (nature and concentration) impact on several alteration regimes was studied (initial rate, rate drop). Then, after alteration, rare earth elements being retained within the altered layer, the structural impact of rare earth elements (and their local environment) in this alteration layer was also investigated. (author) [fr

Do invasive plant species alter soil health?

Science.gov (United States)

Invasive species may alter soil characteristics or interact with the soil microbial community to yield a competitive advantage. Our objectives were to determine: if invasive plant species alter soil properties important to soil health; and the long-term effects of invasive plant species on soil pro...

An Analysis of the Alteration Specialist Occupation.

Science.gov (United States)

Buerkel, Elaine; Rehling, Joseph H.

The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the textile service occupation. The industry needs properly trained alteration specialists, bushelmen and dressmakers, in the repairing, remodeling, altering or renovating of garments. Their personal…

Smartphone-based assessment of blood alteration severity

Science.gov (United States)

Li, Xianglin; Xue, Jiaxin; Li, Wei; Li, Ting

2018-02-01

Blood quality and safety management is a critical issue for cold chain transportation of blood or blood-based biological reagent. The conventional methods of blood alteration severity assessment mainly rely on kit test or blood-gas analysis required opening the blood package to get samples, which cause possible blood pollution and are complicate, timeconsuming, and expensive. Here we proposed to develop a portable, real-time, safety, easy-operated and low cost method aimed at assessing blood alteration severity. Color images of the blood in transparent blood bags were collected with a smartphone and the alteration severity of the blood was assessed by the smartphone app offered analysis of RGB color values of the blood. The algorithm is based on a large number sample of RGB values of blood at different alteration degree. The blood quality results evaluated by the smartphone are in accordance with the actual data. This study indicates the potential of smart phone in real time, convenient, and reliable blood quality assessment.

Relative importance of pasture size and grazing continuity for the long-term conservation of Europena dung beetles

Czech Academy of Sciences Publication Activity Database

Buse, J.; Šlachta, M.; Sládeček, František Xaver Jiří; Pung, M.; Wagner, T.; Entling, M. H.

2015-01-01

Roč. 187, JUL 01 (2015), s. 112-119 ISSN 0006-3207 Grant - others:GA MZe(CZ) QI111C034 Program:QI Institutional support: RVO:60077344 Keywords : habitat area * habitat continuity * geotrupidae Subject RIV: EH - Ecology, Behaviour Impact factor: 3.985, year: 2015 http://www.sciencedirect.com/science/article/pii/S0006320715001561

Hydrothermal alteration at Roosevelt Hot Springs KGRA - DDH 1976-1

Energy Technology Data Exchange (ETDEWEB)

Bryant, N.L.; Parry, W.T.

1977-09-01

Hot waters of the Roosevelt Thermal Area, Utah, have altered granitic rocks and detritus of the Mineral Range pluton, Utah. Petrographic, x-ray, and chemical methods were used to characterize systematic changes in chemistry and mineralogy. Major alteration zones include: 1) an advanced argillic zone in the upper 30 feet of altered detritus containing alunite, opal, vermiculite, and relic quartz; 2) an argillic zone from 30 feet to 105 feet containing kaolinite, muscovite, and minor alunite; and 3) a propylitic zone from 105 to 200 feet containing muscovite, pyrite, marcasite, montmorillonite, and chlorite in weakly altered quartz monzonite. Comparison of the alternation mineral assemblages with known water chemistry and equilibrium activity diagrams suggests that a simple solution equilibrium model cannot account for the alteration. A model is proposed in which upward moving thermal water supersaturated with respect to quartz and a downward moving cool water undersaturated with respect to quartz produces the observed alteration. An estimate of the heat flow contributions from hydrothermal alteration was made by calculating reaction enthalpies for alteration reactions at each depth.

46 CFR 115.700 - Permission for repairs and alterations.

Science.gov (United States)

2010-10-01

... replacement in kind, of electrical wiring, fuel lines, tanks, boilers and other pressure vessels, and steering... 46 Shipping 4 2010-10-01 2010-10-01 false Permission for repairs and alterations. 115.700 Section... AND CERTIFICATION Repairs and Alterations § 115.700 Permission for repairs and alterations. (a...

Streamflow alteration at selected sites in Kansas

Science.gov (United States)

Juracek, Kyle E.; Eng, Ken

2017-06-26

An understanding of streamflow alteration in response to various disturbances is necessary for the effective management of stream habitat for a variety of species in Kansas. Streamflow alteration can have negative ecological effects. Using a modeling approach, streamflow alteration was assessed for 129 selected U.S. Geological Survey streamgages in the State for which requisite streamflow and basin-characteristic information was available. The assessment involved a comparison of the observed condition from 1980 to 2015 with the predicted expected (least-disturbed) condition for 29 streamflow metrics. The metrics represent various characteristics of streamflow including average flow (annual, monthly) and low and high flow (frequency, duration, magnitude).Streamflow alteration in Kansas was indicated locally, regionally, and statewide. Given the absence of a pronounced trend in annual precipitation in Kansas, a precipitation-related explanation for streamflow alteration was not supported. Thus, the likely explanation for streamflow alteration was human activity. Locally, a flashier flow regime (typified by shorter lag times and more frequent and higher peak discharges) was indicated for three streamgages with urbanized basins that had higher percentages of impervious surfaces than other basins in the State. The combination of localized reservoir effects and regional groundwater pumping from the High Plains aquifer likely was responsible, in part, for diminished conditions indicated for multiple streamflow metrics in western and central Kansas. Statewide, the implementation of agricultural land-management practices to reduce runoff may have been responsible, in part, for a diminished duration and magnitude of high flows. In central and eastern Kansas, implemented agricultural land-management practices may have been partly responsible for an inflated magnitude of low flows at several sites.

Power Consumption Evaluation of Distributed Computing Network Considering Traffic Locality

Science.gov (United States)

Ogawa, Yukio; Hasegawa, Go; Murata, Masayuki

When computing resources are consolidated in a few huge data centers, a massive amount of data is transferred to each data center over a wide area network (WAN). This results in increased power consumption in the WAN. A distributed computing network (DCN), such as a content delivery network, can reduce the traffic from/to the data center, thereby decreasing the power consumed in the WAN. In this paper, we focus on the energy-saving aspect of the DCN and evaluate its effectiveness, especially considering traffic locality, i.e., the amount of traffic related to the geographical vicinity. We first formulate the problem of optimizing the DCN power consumption and describe the DCN in detail. Then, numerical evaluations show that, when there is strong traffic locality and the router has ideal energy proportionality, the system's power consumption is reduced to about 50% of the power consumed in the case where a DCN is not used; moreover, this advantage becomes even larger (up to about 30%) when the data center is located farthest from the center of the network topology.

Status and Trends in Networking at LHC Tier1 Facilities

Science.gov (United States)

Bobyshev, A.; DeMar, P.; Grigaliunas, V.; Bigrow, J.; Hoeft, B.; Reymund, A.

2012-12-01

The LHC is entering its fourth year of production operation. Most Tier1 facilities have been in operation for almost a decade, when development and ramp-up efforts are included. LHC's distributed computing model is based on the availability of high capacity, high performance network facilities for both the WAN and LAN data movement, particularly within the Tier1 centers. As a result, the Tier1 centers tend to be on the leading edge of data center networking technology. In this paper, we analyze past and current developments in Tier1 LAN networking, as well as extrapolating where we anticipate networking technology is heading. Our analysis will include examination into the following areas: • Evolution of Tier1 centers to their current state • Evolving data center networking models and how they apply to Tier1 centers • Impact of emerging network technologies (e.g. 10GE-connected hosts, 40GE/100GE links, IPv6) on Tier1 centers • Trends in WAN data movement and emergence of software-defined WAN network capabilities • Network virtualization

Status and Trends in Networking at LHC Tier1 Facilities

International Nuclear Information System (INIS)

Bobyshev, A; DeMar, P; Grigaliunas, V; Bigrow, J; Hoeft, B; Reymund, A

2012-01-01

The LHC is entering its fourth year of production operation. Most Tier1 facilities have been in operation for almost a decade, when development and ramp-up efforts are included. LHC's distributed computing model is based on the availability of high capacity, high performance network facilities for both the WAN and LAN data movement, particularly within the Tier1 centers. As a result, the Tier1 centers tend to be on the leading edge of data center networking technology. In this paper, we analyze past and current developments in Tier1 LAN networking, as well as extrapolating where we anticipate networking technology is heading. Our analysis will include examination into the following areas: • Evolution of Tier1 centers to their current state • Evolving data center networking models and how they apply to Tier1 centers • Impact of emerging network technologies (e.g. 10GE-connected hosts, 40GE/100GE links, IPv6) on Tier1 centers • Trends in WAN data movement and emergence of software-defined WAN network capabilities • Network virtualization

Status and trends in networking at LHC Tier1 facilities

Energy Technology Data Exchange (ETDEWEB)

Bobyshev, A. [Fermilab; DeMar, P. [Fermilab; Grigaliunas, V. [Fermilab; Bigrow, J. [Brookhaven; Hoeft, B. [KIT, Karlsruhe; Reymund, A. [KIT, Karlsruhe

2012-06-22

The LHC is entering its fourth year of production operation. Most Tier1 facilities have been in operation for almost a decade, when development and ramp-up efforts are included. LHC's distributed computing model is based on the availability of high capacity, high performance network facilities for both the WAN and LAN data movement, particularly within the Tier1 centers. As a result, the Tier1 centers tend to be on the leading edge of data center networking technology. In this paper, we analyze past and current developments in Tier1 LAN networking, as well as extrapolating where we anticipate networking technology is heading. Our analysis will include examination into the following areas: Evolution of Tier1 centers to their current state Evolving data center networking models and how they apply to Tier1 centers Impact of emerging network technologies (e.g. 10GE-connected hosts, 40GE/100GE links, IPv6) on Tier1 centers Trends in WAN data movement and emergence of software-defined WAN network capabilities Network virtualization

A large-scale longitudinal study indicating the importance of perceived effectiveness, organizational and management support for innovative culture.

Science.gov (United States)

Cramm, Jane M; Strating, Mathilde M H; Bal, Roland; Nieboer, Anna P

2013-04-01

Teams participating in QI collaboratives reportedly enhance innovative culture in long-term care, but we currently lack empirical evidence of the ability of such teams to enhance (determinants of) innovative culture over time. The objectives of our study are therefore to explore innovative cultures in QI teams over time and identify its determinants. The study included QI teams participating between 2006 and 2011 in a national Dutch quality program (Care for Better), using an adapted version of the Breakthrough Method. Each QI team member received a questionnaire by mail within one week after the second (2-3 months post-implementation of the collaborative = T0) and final conference (12 months post-implementation = T1). A total of 859 (out of 1161) respondents filled in the questionnaire at T0 and 541 at T1 (47% response). A total of 307 team members filled in the questionnaire at both T0 and T1. We measured innovative culture, respondent characteristics (age, gender, education), perceived team effectiveness, organizational support, and management support. Two-tailed paired t-tests showed that innovative culture was slightly but significantly lower at T1 compared to T0 (12 months and 2-3 months after the start of the collaborative, respectively). Univariate analyses revealed that perceived effectiveness, organizational and management support were significantly related to innovative culture at T1 (all at p ≤ 0.001). Multilevel analyses showed that perceived effectiveness, organizational support, and management support predicted innovative culture. Our QI teams were not able to improve innovative culture over time, but their innovative culture scores were higher than non-participant professionals. QI interventions require organizational and management support to enhance innovative culture in long-term care settings. Copyright © 2013 Elsevier Ltd. All rights reserved.

Characteristics of Quality Improvement Champions in Nursing Homes: A Systematic Review With Implications for Evidence-Based Practice.

Science.gov (United States)

Woo, Kyungmi; Milworm, Gvira; Dowding, Dawn

2017-12-01

Improving care quality while reducing cost has always been a focus of nursing homes. Certified nursing assistants comprise the largest proportion of the workforce in nursing homes and have the potential to contribute to the quality of care provided. Quality improvement (QI) initiatives using certified nursing assistants as champions have the potential to improve job satisfaction, which has been associated with care quality. To identify the role, use and preparation of champions in a nursing home setting as a way of informing future QI strategies in nursing homes. A systematic literature review. Medical Subject Headings and text words for "quality improvement" were combined with those for "champion*" to search Medline, CINAHL, Joanna Briggs Institute, MedLine In-Process, and other Nonindexed Citations. After duplicates were removed, a total of 337 potential articles were identified for further review. After full text review, seven articles from five original studies met inclusion criteria and were included in the synthesis. Various types of QI initiatives and implementation strategies were used together with champions. Champions were identified by study authors as one of the single most effective strategies employed in all studies. The majority of studies described the champion role as that of a leader, who fosters and reinforces changes for improvement. Although all the included studies suggested that implementing nurse or aid champions in their QI initiatives were important facilitators of success, how the champions were selected and trained in their role is either missing or not described in any detail in the studies included in the review. Utilizing certified nursing assistants as QI champions can increase participation in QI projects and has the potential to improve job satisfaction and contribute to improve quality of care and improved patient outcomes in nursing homes. © 2017 Sigma Theta Tau International.

78 FR 48435 - Ocean Transportation Intermediary License Applicants

Science.gov (United States)

2013-08-08

..., Washington, DC 20573, by telephone at (202) 523-5843 or by email at [email protected] . A & J Cargo Logistics Inc... (QI), Application Type: Add Trade Name Arabia Cargo and OFF Service. CMX Global Logistics, LLC (NVO... Transport Co., Ltd. (NVO), 13101 Moore Street, Cerritos, CA 90703, Officers: Ki Hyeon Lee, CFO (QI), Seong...

ARID1B alterations identify aggressive tumors in neuroblastoma.

Science.gov (United States)

Lee, Soo Hyun; Kim, Jung-Sun; Zheng, Siyuan; Huse, Jason T; Bae, Joon Seol; Lee, Ji Won; Yoo, Keon Hee; Koo, Hong Hoe; Kyung, Sungkyu; Park, Woong-Yang; Sung, Ki W

2017-07-11

Targeted panel sequencing was performed to determine molecular targets and biomarkers in 72 children with neuroblastoma. Frequent genetic alterations were detected in ALK (16.7%), BRCA1 (13.9%), ATM (12.5%), and PTCH1 (11.1%) in an 83-gene panel. Molecular targets for targeted therapy were identified in 16 of 72 patients (22.2%). Two-thirds of ALK mutations were known to increase sensitivity to ALK inhibitors. Sequence alterations in ARID1B were identified in 5 of 72 patients (6.9%). Four of five ARID1B alterations were detected in tumors of high-risk patients. Two of five patients with ARID1B alterations died of disease progression. Relapse-free survival was lower in patients with ARID1B alterations than in those without (p = 0.01). In analysis confined to high-risk patients, 3-year overall survival was lower in patients with an ARID1B alteration (33.3 ± 27.2%) or MYCN amplification (30.0 ± 23.9%) than in those with neither ARID1B alteration nor MYCN amplification (90.5 ± 6.4%, p = 0.05). These results provide possibilities for targeted therapy and a new biomarker identifying a subgroup of neuroblastoma patients with poor prognosis.

Hydrothermal Alteration of the Mt Unzen Conduit (Shimabara/Japan)

Science.gov (United States)

Yilmaz, T. I.; Mayer, K.; Hess, K. U.; Janots, E.; Gilg, H. A.; Dingwell, D. B.

2016-12-01

Investigations were carried out on hydrothermally altered coherent dacitic dykes samples from (USDP-4) drill core at Mt Unzen stratovolcano (Shimabara/Japan). XRF, XRD, EMPA, and C-O-isotope analysis led to insights concerning chemistry, mineralogy, and intensity of alteration as well as the origin of carbonate-precipitating fluids. Additionally a textural characterization of the occurring replacement features in the magma conduit zone was performed. The occurrence of the main secondary phases such as chlorite, pyrite, carbonates, and R1 (Reichweite parameter) illite-smectite indicate a weak to moderate propylitic to phyllic hydrothermal alteration. The dacitic samples of the dykes show different hydrothermal alteration features: (i) carbonate pseudomorphs after hornblende as well as core and zonal textures due to replacement of plagioclase by R1 illite-smectite, (ii) colloform banded fracture fillings and fillings in dissolution vugs, and (iii) chlorite and R1 illite-smectite in the groundmass. Carbonates in fractures comprise iron-rich dolomite solid solutions ("ankerite") and calcite. Isotopic values of d13Cvpdb = -4.59 ± 0.6‰ and d18Ovpdb = -21.73 ± 0.5‰ indicate a hydrothermal-magmatic origin for the carbonate formation. The chlorite-carbonate-pyrite index (CCPI) and the Ishikawa alteration index (AI), applied to the investigated samples show significant differences (CCPI=52.7-57.8; AI=36.1-40.6) indicating their different degree of alteration. According to Nakada et al., 2005, the C13 to C16 dykes represent the feeder dyke from the latest eruption (1991-1995) whereas C8 represents an earlier dyke feeder dyke from an older eruption. Weakest conduit alteration, which was obtained in samples C16-1-5 and C13-2-5, correlates with the alteration degree of the pristine dome rocks. Highest CCPI value was determined for sample C14-1-5 and the highest AI value was determined for sample C15-2-6. The degrees of alteration do not indicate highest alteration of the

Relationship between two blood stasis syndromes and inflammatory factors in patients with acute coronary syndrome.

Science.gov (United States)

Ma, Cai-Yun; Liu, Jing-Hua; Liu, Jian-Xun; Shi, Da-Zhuo; Xu, Zhen-Ye; Wang, Shao-Ping; Jia, Min; Zhao, Fu-Hai; Jiang, Yue-Rong; Ma, Qin; Peng, Hong-Yu; Lu, Yuan; Zheng, Ze; Ren, Feng-Xue

2017-11-01

To investigate the relationship between inflammatory factors and two Chinese medicine (CM) syndrome types of qi stagnation and blood stasis (QSBS) and qi deficiency and blood stasis (QDBS) in patients with acute coronary syndrome (ACS). Sixty subjects with ACS, whose pathogenesis changes belongs to qi disturbance blood stasis syndrome, were divided into 2 groups: 30 in the QSBS group and 30 in the QDBS group. The comparative analysis on them was carried out through comparing general information, coronary angiography and inflammatory factors including intracellular adhesion molecule-1 (ICAM-1), chitinase-3-like protein 1 (YKL-40) and lipoprotein-associated phospholipase A2 (Lp-PLA2). Compared with the QSBS group, Lp-PLA2 and YKL-40 levels in the QDBS group showed no-significant difference (P>0.05); ICAM-1 was significantly higher in the QDBS group than in the QSBS group in the pathological processes of qi disturbance and blood stasis syndrome of ACS (Psyndrome typing of QSBS and QDBS, which provides a research direction for standardization research of CM syndrome types.

State landscape in public health planning and quality improvement: results of the ASTHO survey.

Science.gov (United States)

Madamala, Kusuma; Sellers, Katie; Pearsol, Jim; Dickey, Michael; Jarris, Paul E

2010-01-01

Limited data exist on state public health agencies and their use of planning and quality improvement (QI) initiatives. Using the 2007 Association of State and Territorial Health Officials (ASTHO) State Public Health Survey, this article describes how state public health agencies perform tasks related to planning, performance management (PM), and QI. While 82 percent of respondents report having a QI process in place, only 9.8 percent have it fully implemented departmentwide. Seventy-six percent reported having a PM process in place, with 16 percent (n = 8) having it fully implemented departmentwide. A state health improvement plan was used by 80.4 percent of respondents, with 56.9 percent of respondents completing the plan more than 3 years ago. More than two-thirds (68.2%) of the respondents developed the plan by using results of their state health assessment. Analysis of state health department level planning, PM, and QI initiatives can inform states' efforts to ready themselves to meet the proposed national voluntary accreditation standards of the Public Health Accreditation Board.

Buccal alterations in diabetes mellitus

Directory of Open Access Journals (Sweden)

Negrato Carlos

2010-01-01

Full Text Available Abstract Long standing hyperglycaemia besides damaging the kidneys, eyes, nerves, blood vessels, heart, can also impair the function of the salivary glands leading to a reduction in the salivary flow. When salivary flow decreases, as a consequence of an acute hyperglycaemia, many buccal or oral alterations can occur such as: a increased concentration of mucin and glucose; b impaired production and/or action of many antimicrobial factors; c absence of a metalloprotein called gustin, that contains zinc and is responsible for the constant maturation of taste papillae; d bad taste; e oral candidiasis f increased cells exfoliation after contact, because of poor lubrication; g increased proliferation of pathogenic microorganisms; h coated tongue; i halitosis; and many others may occur as a consequence of chronic hyperglycaemia: a tongue alterations, generally a burning mouth; b periodontal disease; c white spots due to demineralization in the teeth; d caries; e delayed healing of wounds; f greater tendency to infections; g lichen planus; h mucosa ulcerations. Buccal alterations found in diabetic patients, although not specific of this disease, have its incidence and progression increased when an inadequate glycaemic control is present.

Buccal alterations in diabetes mellitus.

Science.gov (United States)

Negrato, Carlos Antonio; Tarzia, Olinda

2010-01-15

Long standing hyperglycaemia besides damaging the kidneys, eyes, nerves, blood vessels, heart, can also impair the function of the salivary glands leading to a reduction in the salivary flow. When salivary flow decreases, as a consequence of an acute hyperglycaemia, many buccal or oral alterations can occur such as: a) increased concentration of mucin and glucose; b) impaired production and/or action of many antimicrobial factors; c) absence of a metalloprotein called gustin, that contains zinc and is responsible for the constant maturation of taste papillae; d) bad taste; e) oral candidiasis f) increased cells exfoliation after contact, because of poor lubrication; g) increased proliferation of pathogenic microorganisms; h) coated tongue; i) halitosis; and many others may occur as a consequence of chronic hyperglycaemia: a) tongue alterations, generally a burning mouth; b) periodontal disease; c) white spots due to demineralization in the teeth; d) caries; e) delayed healing of wounds; f) greater tendency to infections; g) lichen planus; h) mucosa ulcerations. Buccal alterations found in diabetic patients, although not specific of this disease, have its incidence and progression increased when an inadequate glycaemic control is present.

Alter(n – ein vielschichtiger Begriff

Directory of Open Access Journals (Sweden)

Nicole Maly-Lukas

2005-07-01

Full Text Available Diese Veröffentlichung, die aus einer Vortragsreihe an der katholischen Fachhochschule Freiburg entstanden ist, führt die Leserinnen und Leser in die verschiedenen Sichtweisen des Alter(ns in der modernen Gesellschaft ein. Es handelt sich um eine gelungene Zusammenstellung von Beiträgen aus unterschiedlichen Disziplinen, die sich alle aus ihrer Sicht dem Thema Alter(n widmen. Die einzelnen Artikel sind zwischen 8 und 38 Seiten lang und recht schnell und einfach zu lesen. Je nach Hintergrund und Interessen werden die einzelnen Leserinnen und Leser dabei sicher unterschiedliche Beiträge favorisieren. Schade ist nur, dass durch die ungleichen Längen der Beiträge bestimmte thematische Schwerpunkte – ob gewollt oder nicht – gesetzt werden. Dies sollte die Leserinnen und Leser, die offen für unterschiedlichste Sichtweisen des Alter(ns sind, jedoch nicht davon abhalten, dieses Buch zu lesen.

LoRa Scalability: A Simulation Model Based on Interference Measurements

Directory of Open Access Journals (Sweden)

Jetmir Haxhibeqiri

2017-05-01

Full Text Available LoRa is a long-range, low power, low bit rate and single-hop wireless communication technology. It is intended to be used in Internet of Things (IoT applications involving battery-powered devices with low throughput requirements. A LoRaWAN network consists of multiple end nodes that communicate with one or more gateways. These gateways act like a transparent bridge towards a common network server. The amount of end devices and their throughput requirements will have an impact on the performance of the LoRaWAN network. This study investigates the scalability in terms of the number of end devices per gateway of single-gateway LoRaWAN deployments. First, we determine the intra-technology interference behavior with two physical end nodes, by checking the impact of an interfering node on a transmitting node. Measurements show that even under concurrent transmission, one of the packets can be received under certain conditions. Based on these measurements, we create a simulation model for assessing the scalability of a single gateway LoRaWAN network. We show that when the number of nodes increases up to 1000 per gateway, the losses will be up to 32%. In such a case, pure Aloha will have around 90% losses. However, when the duty cycle of the application layer becomes lower than the allowed radio duty cycle of 1%, losses will be even lower. We also show network scalability simulation results for some IoT use cases based on real data.

LambdaStation: Exploiting Advance Networks In Data Intensive High Energy Physics Applications

Energy Technology Data Exchange (ETDEWEB)

Harvey B. Newman

2009-09-11

Lambda Station software implements selective, dynamic, secure path control between local storage & analysis facilities, and high bandwidth, wide-area networks (WANs). It is intended to facilitate use of desirable, alternate wide area network paths which may only be intermittently available, or subject to policies that restrict usage to specified traffic. Lambda Station clients gain awareness of potential alternate network paths via Clarens-based web services, including path characteristics such as bandwidth and availability. If alternate path setup is requested and granted, Lambda Station will configure the local network infrastructure to properly forward designated data flows via the alternate path. A fully functional implementation of Lambda Station, capable of dynamic alternate WAN path setup and teardown, has been successfully developed. A limited Lambda Station-awareness capability within the Storage Resource Manager (SRM) product has been developed. Lambda Station has been successfully tested in a number of venues, including Super Computing 2008. LambdaStation software, developed by the Fermilab team, enables dynamic allocation of alternate network paths for high impact traffic and to forward designated flows across LAN. It negotiates with reservation and provisioning systems of WAN control planes, be it based on SONET channels, demand tunnels, or dynamic circuit networks. It creates End-To-End circuit between single hosts, computer farms or networks with predictable performance characteristics, preserving QoS if supported in LAN and WAN and tied security policy allowing only specific traffic to be forwarded or received through created path. Lambda Station project also explores Network Awareness capabilities.

The impact of a large-scale quality improvement programme on work engagement: Preliminary results from a national cross-sectional-survey of the 'Productive Ward'

LENUS (Irish Health Repository)

White, Mark

2014-05-14

Quality improvement (QI) Programmes, like the Productive Ward: Releasing-time-to-care initiative, aim to \\'engage\\' and \\'empower\\' ward teams to actively participate, innovate and lead quality improvement at the front line. However, little is known about the relationship and impact that QI work has on the \\'engagement\\' of the clinical teams who participate and vice-versa.

Castle Gardens Nursing Home, Drumgoold, Enniscorthy, Wexford.

LENUS (Irish Health Repository)

White, Mark

2014-05-14

Quality improvement (QI) Programmes, like the Productive Ward: Releasing-time-to-care initiative, aim to \\'engage\\' and \\'empower\\' ward teams to actively participate, innovate and lead quality improvement at the front line. However, little is known about the relationship and impact that QI work has on the \\'engagement\\' of the clinical teams who participate and vice-versa.

SCOPEOUT: sustainability and spread of quality improvement activities in long-term care- a mixed methods approach.

Science.gov (United States)

Cranley, Lisa A; Hoben, Matthias; Yeung, Jasper; Estabrooks, Carole A; Norton, Peter G; Wagg, Adrian

2018-03-12

Interventions to improve quality of care for residents of long-term care facilities, and to examine the sustainability and spread of such initiatives, remain a top research priority. The purpose of this exploratory study was to assess the extent to which activities initiated in a quality improvement (QI) collaborative study using care aide led teams were sustained or spread following cessation of the initial project and to identify factors that led to its success. This study used an exploratory mixed methods study design and was conducted in seven residential long-term care facilities in two Canadian provinces. Sustainability and spread of QI activities were assessed by a questionnaire over five time points for 18 months following the collaborative study with staff from both intervention with non-intervention units. Semi-structured interviews were conducted with care managers at six and 12 months. QI team success in applying the QI model was ranked as high, medium, or low using criteria developed by the research team. Descriptive statistics, bivariate analyses, and General Estimating Equations were used to analyze the data. Interview data were analyzed using thematic analysis. In total, 683 surveys were received over the five time periods from 476 unique individuals on a facility unit. Seven managers were interviewed. A total of 533 surveys were analyzed. While both intervention and non-intervention units experienced a decline over time in all outcome measures, this decline was significantly less pronounced on intervention units. Facilities with medium and high success ranking had significantly higher scores in all four outcomes than facilities with a low success ranking. Care aides reported significantly less involvement of others in QI activities, less empowerment and less satisfaction with the quality of their work life than regulated care providers. Manager interviews provided evidence of sustainability of QI activities on the intervention units in four of