Common elements of adolescent prevention programs: minimizing burden while maximizing reach.

Science.gov (United States)

Boustani, Maya M; Frazier, Stacy L; Becker, Kimberly D; Bechor, Michele; Dinizulu, Sonya M; Hedemann, Erin R; Ogle, Robert R; Pasalich, Dave S

2015-03-01

A growing number of evidence-based youth prevention programs are available, but challenges related to dissemination and implementation limit their reach and impact. The current review identifies common elements across evidence-based prevention programs focused on the promotion of health-related outcomes in adolescents. We reviewed and coded descriptions of the programs for common practice and instructional elements. Problem-solving emerged as the most common practice element, followed by communication skills, and insight building. Psychoeducation, modeling, and role play emerged as the most common instructional elements. In light of significant comorbidity in poor outcomes for youth, and corresponding overlap in their underlying skills deficits, we propose that synthesizing the prevention literature using a common elements approach has the potential to yield novel information and inform prevention programming to minimize burden and maximize reach and impact for youth.

The Spatial-temperal Distribution of Phosphorus Species and the Main Factors Influencing on Phosphorus Transportation in Middle Reaches of the Yarlung Zangbo River, China

Science.gov (United States)

Pu, X.; An, R.; Li, R.; Huang, W.; Li, J.

2017-12-01

The objectives of the current study are to investigate the spatial, temperal variation of phisphorus (P) fraction in middle reaches of the Yarlung Zangbo River of China. Samples were collected in April (dry season), August (wet season), and Octber (normal season) along with the middle reaches from Lazi site to Nuxia sitewhich which is about 1000km long. Sequential extraction were applied to determine the forms of phosphorus in suspended particles and to assess the potential bioavailability of particulate P. The results indicated that the distribution of suspended particle size inflenced not only the total phosphorus concentration, but also the proportions of different forms of phosphorus. The exchangeable phosphorus (Ex-P), Fe-bound-P, Ca-bound-P were the most aboundant forms and the highest proportions of total P. The total P concentrations were closely relative to the concentration of suspended particles. According to the characteristics of suspended particles in the Yarlung Zangbo River, the relationship between the suspended particles size and species of phosphorus was established though statistical analysis. The Ex-P increased with the decreasing of suspended particulate size. The content of bioavailable particulate phosphorus varied greatly with the proportions of particulate size. In genral, the higher the proportion of smaller particle size, the higher the content of bioavailable phosphorus. The main factors which affect the phosphorus transportation in Yarlung Zangbo River had also been discussed.

A Rapid Method to Score Stream Reaches Based on the Overall Performance of Their Main Ecological Functions

Science.gov (United States)

Rowe, David K.; Parkyn, Stephanie; Quinn, John; Collier, Kevin; Hatton, Chris; Joy, Michael K.; Maxted, John; Moore, Stephen

2009-06-01

A method was developed to score the ecological condition of first- to third-order stream reaches in the Auckland region of New Zealand based on the performance of their key ecological functions. Such a method is required by consultants and resource managers to quantify the reduction in ecological condition of a modified stream reach relative to its unmodified state. This is a fundamental precursor for the determination of fair environmental compensation for achieving no-net-loss in overall stream ecological value. Field testing and subsequent use of the method indicated that it provides a useful measure of ecological condition related to the performance of stream ecological functions. It is relatively simple to apply compared to a full ecological study, is quick to use, and allows identification of the degree of impairment of each of the key ecological functions. The scoring system was designed so that future improvements in the measurement of stream functions can be incorporated into it. Although the methodology was specifically designed for Auckland streams, the principles can be readily adapted to other regions and stream types.

Reaching everyone: Promoting the inclusion of youth with disabilities in evaluating foster care outcomes

Science.gov (United States)

Blakeslee, Jennifer E.; Quest, A. Del; Powers, Jennifer; Powers, Laurie E.; Geenen, Sarah; Nelson, May; Dalton, Lawrence D.; McHugh, Elizabeth

2013-01-01

Efforts to evaluate foster care outcomes must avoid systematic exclusion of particular groups. Although often unrecognized as such, youth with disabilities are highly overrepresented in the U.S. foster care system, and yet youth with some disabilities, including those with intellectual, serious emotional, and physical impairments may be underrepresented in research and evaluation studies evaluating foster care outcomes. The recruitment and retention of youth with various disabilities in such studies can be impeded by under-identification of disability and relatively high placement and school mobility. Furthermore, youth with various disabilities may experience more disappointing outcomes than foster youth overall, underscoring the importance of including these youth in outcome tracking efforts. This is especially relevant given the recent implementation of the National Youth in Transition Database (NYTD), which requires that state child welfare agencies gather baseline information about youth in foster care at age 17, and then survey outcomes at 19 and 21. To promote the full participation of foster youth with disabilities in such outcome evaluation, this paper describes successful strategies for identifying and retaining participants that were used in three separate longitudinal intervention studies. These strategies include the systematic recruitment of foster youth by special education status, and creative use of validated tracking and retention strategies incorporating minor accommodations as needed. PMID:24273364

Efficacy of REACH Forgiveness across cultures.

Science.gov (United States)

Lin, Yin; Worthington, Everett L; Griffin, Brandon J; Greer, Chelsea L; Opare-Henaku, Annabella; Lavelock, Caroline R; Hook, Joshua N; Ho, Man Yee; Muller, Holly

2014-09-01

This study investigates the efficacy of the 6-hour REACH Forgiveness intervention among culturally diverse undergraduates. Female undergraduates (N = 102) and foreign extraction (46.2%) and domestic (43.8%) students in the United States were randomly assigned to immediate treatment or waitlist conditions. Treatment efficacy and the effect of culture on treatment response were assessed using measures of emotional and decisional forgiveness across 3 time periods. Students in the treatment condition reported greater improvement in emotional forgiveness, but not decisional forgiveness, relative to those in the waitlist condition. Gains were maintained at a 1-week follow-up. Although culture did not moderate the effect of treatment, a main effect of culture on emotional forgiveness and marginally significant interaction effect of culture on decisional forgiveness were found. The REACH Forgiveness intervention was efficacious for college students from different cultural backgrounds when conducted in the United States. However, some evidence may warrant development of culturally adapted forgiveness interventions. © 2014 Wiley Periodicals, Inc.

Facebook as an effective recruitment strategy for mental health research of hard to reach populations

Directory of Open Access Journals (Sweden)

Rony Kayrouz

2016-05-01

Full Text Available Recent reports indicate that Facebook (FB may facilitate recruitment of hard to reach participants into mental health research. The present study aimed to contribute to this emerging literature by exploring recruitment data from a recently completed trial of online treatment for symptoms of anxiety and depression that targeted Arab people. The present study compared traditional recruitment strategies such as media releases, emails, and print advertisements with Facebook strategies including boosting posts, promoting websites, events and FB public fan pages. The main outcomes of interest were the number of started applications and the time and cost per application associated with the FB and traditional recruitment strategies. A target sample of 350 was sought and a total of 81 participants applied to participate over the 42-week recruitment period. Overall, 86% of the resultant applications occurred via FB recruitment and a Poisson regression analysis indicated the FB strategies were more time-effective, recruiting participants 2.5 times faster than the traditional strategies. However, there were no differences in cost-effectiveness for FB ($US37 per participant and traditional strategies ($US40 per participant. The findings of the current study add to existing literature detailing the value of FB recruitment strategies, alongside more traditional strategies, as a way of recruiting hard-to-reach populations for research. However, more research is needed to explore alternative and optimal strategies for the successful recruitment of hard to reach populations via FB and other online social media platforms.

Reach on sound: a key to object permanence in visually impaired children.

Science.gov (United States)

Fazzi, Elisa; Signorini, Sabrina Giovanna; Bomba, Monica; Luparia, Antonella; Lanners, Josée; Balottin, Umberto

2011-04-01

The capacity to reach an object presented through sound clue indicates, in the blind child, the acquisition of object permanence and gives information over his/her cognitive development. To assess cognitive development in congenitally blind children with or without multiple disabilities. Cohort study. Thirty-seven congenitally blind subjects (17 with associated multiple disabilities, 20 mainly blind) were enrolled. We used Bigelow's protocol to evaluate "reach on sound" capacity over time (at 6, 12, 18, 24, and 36 months), and a battery of clinical, neurophysiological and cognitive instruments to assess clinical features. Tasks n.1 to 5 were acquired by most of the mainly blind children by 12 months of age. Task 6 coincided with a drop in performance, and the acquisition of the subsequent tasks showed a less agehomogeneous pattern. In blind children with multiple disabilities, task acquisition rates were lower, with the curves dipping in relation to the more complex tasks. The mainly blind subjects managed to overcome Fraiberg's "conceptual problem"--i.e., they acquired the ability to attribute an external object with identity and substance even when it manifested its presence through sound only--and thus developed the ability to reach an object presented through sound. Instead, most of the blind children with multiple disabilities presented poor performances on the "reach on sound" protocol and were unable, before 36 months of age, to develop the strategies needed to resolve Fraiberg's "conceptual problem". Copyright © 2011 Elsevier Ltd. All rights reserved.

Performance reach in the LHC for 2012

International Nuclear Information System (INIS)

Arduini, G.

2012-01-01

Based on the 2011 experience and Machine Development study results, the performance reach of the LHC with 25 and 50 ns beams will be addressed for operation at 3.5 and 4 TeV. The possible scrubbing scenarios and potential intensity limitations resulting from vacuum, heating will be taken into account wherever possible. The paper mainly covers the performance of the two high luminosity regions in IR1 and IR5. (author)

Main outcomes from the EURATOM-ROSATOM ERCOSAM SAMARA parallel projects for hydrogen safety of LWR - 15357

International Nuclear Information System (INIS)

Paladino, D.; Kiselev, A.

2015-01-01

ERCOSAM and SAMARA are the acronyms for 2 parallel projects co-financed respectively by EURATOM and ROSATOM during the 2010-2014 period with the general aim to advance the knowledge on the phenomenology associated to the hydrogen and steam spreading and stratification in the LWR containment during a severe accident. The important peculiarity of the project was its experimental and analytical investigation of the impact of safety systems such as spray, coolers and PAR (Passive Autocatalytic Recombiners) on the distribution of gas species (hydrogen, steam and air). The main outcomes of the ERCOSAM-SAMARA projects are presented in this paper. The research needs, which could be considered in follow-up activities, are also identified. (authors)

The effect of illicit financial flows on time to reach the fourth Millennium Development Goal in Sub-Saharan Africa: a quantitative analysis

Science.gov (United States)

Makuta, Innocent; Bar-Zeev, Naor; Chiwaula, Levison; Cobham, Alex

2014-01-01

Objectives This paper sets out to estimate the cost of illicit financial flows (IFF) in terms of the amount of time it could take to reach the fourth Millennium Development Goal (MDG) in 34 African countries. Design We have calculated the percentage increase in gross domestic product (GDP) if IFFs were curtailed using IFF/GDP ratios. We applied the income (GDP) elasticity of child mortality to the increase in GDP to estimate the reduction in time to reach the fourth MDG in 34 African countries. Participants children aged under five years. Settings 34 countries in SSA. Main outcome measures Reduction in time to reach the first indicator of the fourth MDG, under-five mortality rate in the absence of IFF. Results We found that in the 34 SSA countries, six countries will achieve their fourth MDG target at the current rates of decline. In the absence of IFF, 16 countries would reach their fourth MDG target by 2015 and there would be large reductions for all other countries. Conclusions This drain on development is facilitated by financial secrecy in other jurisdictions. Rich and poor countries alike must stem the haemorrhage of IFF by taking decisive steps towards improving financial transparency. PMID:24334911

A case study evaluation of an intervention aiming to strengthen the midwifery professional role in Morocco: anticipated barriers to reaching outcomes

Science.gov (United States)

Abou Malham, Sabina; Hatem, Marie; Leduc, Nicole

2015-01-01

Background In order to reduce the high maternal mortality ratio, Morocco is strongly committed to strengthen its midwifery professional role. This study aimed to identify barriers that could potentially hinder an action plan to strengthen the midwifery professional role from achieving desired outcomes. We used a conceptual framework, which is derived from Hatem-Asmar’s (1997) framework on the interaction of educational, professional, and sociocultural systems in which a professional role evolves and from Damschroder et al’s (2009) framework for the implementation analysis. Methods This paper builds on a qualitative case study on the factors affecting the action plan’s implementation process that also revealed rich data about anticipated barriers to reaching outcomes. Data were collected through training sessions, field observations, documents, focus groups (n=20), and semistructured interviews (n=11) with stakeholders pertaining to the three systems under study. Content analysis was used to identify themes related to barriers. Results Seven barriers that may compromise the achievement of desired results were found. They relate to the legal framework, social representations, and media support in the sociocultural system and the practice environment, networks and communication mechanisms, and characteristics related to the role and the readiness in the professional system. Conclusion Disregarding sociocultural and professional system level, barriers may impede efforts to strengthen the midwife’s role and to provide qualified midwives who can improve the quality of maternal care. Making changes in the educational system cannot be thought of as an isolated process. Its success is closely tied with multiple contextual factors pertaining to the two other systems. Activities recommended to address these barriers may have great potential to build a competent midwifery workforce that contributes to positive maternal and neonatal health outcomes. PMID:26445547

Channel evolution under changing hydrological regimes in anabranching reaches downstream of the Three Gorges Dam

Science.gov (United States)

Han, Jianqiao; Zhang, Wei; Yuan, Jing; Fan, Yongyang

2018-03-01

Elucidating the influence of dams on fluvial processes can benefit river protection and basin management. Based on hydrological and topographical data, we analyzed channel evolution in anabranching reaches under changing hydrological regimes influenced by the Three Gorges Dam. The main conclusions are as follows: 1) the channels of specific anabranching reaches were defined as flood trend channels or low-flow trend channels according to the distribution of their flow characteristics. The anabranching reaches were classified as T1 or T2. The former is characterized by the correspondence between the flood trend and branch channels, and the latter is characterized by the correspondence between the flood trend and main channels; 2) on the basis of the new classification, the discrepant patterns of channel evolution seen in anabranching reaches were unified into a pattern that showed flood trend channels shrinking and low-flow trend channels expanding; 3) flood abatement and the increased duration of moderate flow discharges are the main factors that affect channel adjustments in anabranching reaches after dam construction; and 4) in the next few decades, the pattern of channel evolution will remain the same as that of the Three Gorges Dam operation. That is, the morphology will fully adapt to a flow with a low coefficient of variation. Our results are of interest in the management of the Yangtze River and other rivers influenced by dams.

Assessments in outcome evaluation in aphasia therapy

DEFF Research Database (Denmark)

Isaksen, Jytte; Brouwer, Catherine E.

2015-01-01

Abstract Outcomes of aphasia therapy in Denmark are documented in evaluation sessions in which both the person with aphasia and the speech-language therapist take part. The participants negotiate agreements on the results of therapy. By means of conversation analysis, we study how such agreements...... on therapy outcome are reached interactionally. The sequential analysis of 34 video recordings focuses on a recurrent method for reaching agreements in these outcome evaluation sessions. In and through a special sequence of conversational assessment it is claimed that the person with aphasia has certain...

Decoding natural reach-and-grasp actions from human EEG

Science.gov (United States)

Schwarz, Andreas; Ofner, Patrick; Pereira, Joana; Ioana Sburlea, Andreea; Müller-Putz, Gernot R.

2018-02-01

Objective. Despite the high number of degrees of freedom of the human hand, most actions of daily life can be executed incorporating only palmar, pincer and lateral grasp. In this study we attempt to discriminate these three different executed reach-and-grasp actions utilizing their EEG neural correlates. Approach. In a cue-guided experiment, 15 healthy individuals were asked to perform these actions using daily life objects. We recorded 72 trials for each reach-and-grasp condition and from a no-movement condition. Main results. Using low-frequency time domain features from 0.3 to 3 Hz, we achieved binary classification accuracies of 72.4%, STD  ±  5.8% between grasp types, for grasps versus no-movement condition peak performances of 93.5%, STD  ±  4.6% could be reached. In an offline multiclass classification scenario which incorporated not only all reach-and-grasp actions but also the no-movement condition, the highest performance could be reached using a window of 1000 ms for feature extraction. Classification performance peaked at 65.9%, STD  ±  8.1%. Underlying neural correlates of the reach-and-grasp actions, investigated over the primary motor cortex, showed significant differences starting from approximately 800 ms to 1200 ms after the movement onset which is also the same time frame where classification performance reached its maximum. Significance. We could show that it is possible to discriminate three executed reach-and-grasp actions prominent in people’s everyday use from non-invasive EEG. Underlying neural correlates showed significant differences between all tested conditions. These findings will eventually contribute to our attempt of controlling a neuroprosthesis in a natural and intuitive way, which could ultimately benefit motor impaired end users in their daily life actions.

Reaching everyone: Promoting the inclusion of youth with disabilities in evaluating foster care outcomes

OpenAIRE

Blakeslee, Jennifer E.; Quest, A. Del; Powers, Jennifer; Powers, Laurie E.; Geenen, Sarah; Nelson, May; Dalton, Lawrence D.; McHugh, Elizabeth

2013-01-01

Efforts to evaluate foster care outcomes must avoid systematic exclusion of particular groups. Although often unrecognized as such, youth with disabilities are highly overrepresented in the U.S. foster care system, and yet youth with some disabilities, including those with intellectual, serious emotional, and physical impairments may be underrepresented in research and evaluation studies evaluating foster care outcomes. The recruitment and retention of youth with various disabilities in such ...

Dynamic channel adjustments in the Jingjiang Reach of the Middle Yangtze River

Science.gov (United States)

Xia, Junqiang; Deng, Shanshan; Lu, Jinyou; Xu, Quanxi; Zong, Quanli; Tan, Guangming

2016-03-01

Significant channel adjustments have occurred in the Jingjiang Reach of the Middle Yangtze River, because of the operation of the Three Gorges Project (TGP). The Jingjiang Reach is selected as the study area, covering the Upper Jingjiang Reach (UJR) and Lower Jingjiang Reach (LJR). The reach-scale bankfull channel dimensions in the study reach were calculated annually from 2002 to 2013 by means of a reach-averaged approach and surveyed post-flood profiles at 171 sections. We find from the calculated results that: the reach-scale bankfull widths changed slightly in the UJR and LJR, with the corresponding depths increasing by 1.6 m and 1.0 m the channel adjustments occurred mainly with respect to bankfull depth because of the construction of large-scale bank revetment works, although there were significant bank erosion processes in local regions without the bank protection engineering. The reach-scale bankfull dimensions in the UJR and LJR generally responded to the previous five-year average fluvial erosion intensity during flood seasons, with higher correlations being obtained for the depth and cross-sectional area. It is concluded that these dynamic adjustments of the channel geometry are a direct result of recent human activities such as the TGP operation.

The Influence of Parental Health Literacy Status on Reach, Attendance, Retention, and Outcomes in a Family-Based Childhood Obesity Treatment Program, Virginia, 2013-2015.

Science.gov (United States)

Zoellner, Jamie M; Hill, Jennie; You, Wen; Brock, Donna; Frisard, Madlyn; Alexander, Ramine; Silva, Fabiana; Price, Bryan; Marshall, Ruby; Estabrooks, Paul A

2017-09-28

Few interventions have evaluated the influence of parent health literacy (HL) status on weight-related child outcomes. This study explores how parent HL affects the reach, attendance, and retention of and outcomes in a 3-month multicomponent family-based program to treat childhood obesity (iChoose). This pre-post, quasiexperimental trial occurred in the Dan River Region, a federally designated medically underserved area. iChoose research protocol and intervention strategies were designed using an HL universal precautions approach. We used validated measures, standardized data collection techniques, and generalized linear mixed-effect parametric models to determine the moderation effect of parent HL on outcomes. No significant difference in HL scores were found between parents who enrolled their child in the study and those who did not. Of 94 enrolled parents, 34% were low HL, 49% had an annual household income of less than $25,000, and 39% had a high school education or less. Of 101 enrolled children, 60% were black, and the mean age was 9.8 (standard deviation, 1.3) years. Children of parents with both low and high HL attended and were retained at similar rates. Likewise, parent HL status did not significantly influence improvements in effectiveness outcomes (eg, child body mass index [BMI] z scores, parent BMI, diet and physical activity behaviors, quality of life), with the exception of child video game/computer screen time; low HL decreased and high HL increased screen time (coefficient = 0.52, standard error, 0.11, P parents, children of parents with low HL engaged in and benefited from a family-based childhood obesity treatment program similar to children of parents with high HL.

Peer Support for the Hardly Reached: A Systematic Review.

Science.gov (United States)

Sokol, Rebeccah; Fisher, Edwin

2016-07-01

Health disparities are aggravated when prevention and care initiatives fail to reach those they are intended to help. Groups can be classified as hardly reached according to a variety of circumstances that fall into 3 domains: individual (e.g., psychological factors), demographic (e.g., socioeconomic status), and cultural-environmental (e.g., social network). Several reports have indicated that peer support is an effective means of reaching hardly reached individuals. However, no review has explored peer support effectiveness in relation to the circumstances associated with being hardly reached or across diverse health problems. To conduct a systematic review assessing the reach and effectiveness of peer support among hardly reached individuals, as well as peer support strategies used. Three systematic searches conducted in PubMed identified studies that evaluated peer support programs among hardly reached individuals. In aggregate, the searches covered articles published from 2000 to 2015. Eligible interventions provided ongoing support for complex health behaviors, including prioritization of hardly reached populations, assistance in applying behavior change plans, and social-emotional support directed toward disease management or quality of life. Studies were excluded if they addressed temporally isolated behaviors, were limited to protocol group classes, included peer support as the dependent variable, did not include statistical tests of significance, or incorporated comparison conditions that provided appreciable social support. We abstracted data regarding the primary health topic, categorizations of hardly reached groups, program reach, outcomes, and strategies employed. We conducted a 2-sample t test to determine whether reported strategies were related to reach. Forty-seven studies met our inclusion criteria, and these studies represented each of the 3 domains of circumstances assessed (individual, demographic, and cultural-environmental). Interventions

Inactivation of Parietal Reach Region Affects Reaching But Not Saccade Choices in Internally Guided Decisions.

Science.gov (United States)

Christopoulos, Vassilios N; Bonaiuto, James; Kagan, Igor; Andersen, Richard A

2015-08-19

The posterior parietal cortex (PPC) has traditionally been considered important for awareness, spatial perception, and attention. However, recent findings provide evidence that the PPC also encodes information important for making decisions. These findings have initiated a running argument of whether the PPC is critically involved in decision making. To examine this issue, we reversibly inactivated the parietal reach region (PRR), the area of the PPC that is specialized for reaching movements, while two monkeys performed a memory-guided reaching or saccade task. The task included choices between two equally rewarded targets presented simultaneously in opposite visual fields. Free-choice trials were interleaved with instructed trials, in which a single cue presented in the peripheral visual field defined the reach and saccade target unequivocally. We found that PRR inactivation led to a strong reduction of contralesional choices, but only for reaches. On the other hand, saccade choices were not affected by PRR inactivation. Importantly, reaching and saccade movements to single instructed targets remained largely intact. These results cannot be explained as an effector-nonspecific deficit in spatial attention or awareness, since the temporary "lesion" had an impact only on reach choices. Hence, the PPR is a part of a network for reach decisions and not just reach planning. There has been an ongoing debate on whether the posterior parietal cortex (PPC) represents only spatial awareness, perception, and attention or whether it is also involved in decision making for actions. In this study we explore whether the parietal reach region (PRR), the region of the PPC that is specialized for reaches, is involved in the decision process. We inactivated the PRR while two monkeys performed reach and saccade choices between two targets presented simultaneously in both hemifields. We found that inactivation affected only the reach choices, while leaving saccade choices intact

Phenomena and characteristics of barrier river reaches in the middle and lower Yangtze River, China

Science.gov (United States)

You, Xingying; Tang, Jinwu

2017-06-01

Alluvial river self-adjustment describes the mechanism whereby a river that was originally in an equilibrium state of sediment transport encounters some disturbance that destroys the balance and results in responses such as riverbed deformation. A systematic study of historical and recent aerial photographs and topographic maps in the Middle and Lower Reaches of the Yangtze River (MLYR) shows that river self-adjustment has the distinguishing feature of transferring from upstream to downstream, which may affect flood safety, waterway morphology, bank stability, and aquatic environmental safety over relatively long reaches downstream. As a result, it is necessary to take measures to control or block this transfer. Using the relationship of the occurrence time of channel adjustments between the upstream and downstream, 34 single-thread river reaches in the MLYR were classified into four types: corresponding, basically corresponding, basically not corresponding, not corresponding. The latter two types, because of their ability to prevent upstream channel adjustment from transferring downstream, are called barrier river reaches in this study. Statistics indicate that barrier river reaches are generally single thread and slightly curved, with a narrow and deep cross-sectional morphology, and without flow deflecting nodes in the upper and middle parts of reaches. Moreover, in the MLYR, barrier river reaches have a hydrogeometric coefficient of {}1.2‱, a silty clay content of the concave bank {>}{9.5}%, and a median diameter of the bed sediment {>}{0.158} mm. The barrier river reach mechanism lies in that can effectively centralise the planimetric position of the main stream from different upstream directions, meaning that no matter how the upper channel adjusts, the main stream shows little change, providing relatively stable inflow conditions for the lower reaches. Regarding river regulation, it is necessary to optimise the benefits of barrier river reaches; long river

The Use of Functional Electrical Stimulation on the Upper Limb and Interscapular Muscles of Patients with Stroke for the Improvement of Reaching Movements: A Feasibility Study

Directory of Open Access Journals (Sweden)

Alicia Cuesta-Gómez

2017-05-01

Full Text Available IntroductionReaching movements in stroke patients are characterized by decreased amplitudes at the shoulder and elbow joints and greater displacements of the trunk, compared to healthy subjects. The importance of an appropriate and specific contraction of the interscapular and upper limb (UL muscles is crucial to achieving proper reaching movements. Functional electrical stimulation (FES is used to activate the paretic muscles using short-duration electrical pulses.ObjectiveTo evaluate whether the application of FES in the UL and interscapular muscles of stroke patients with motor impairments of the UL modifies patients’ reaching patterns, measured using instrumental movement analysis systems.DesignA cross-sectional study was carried out.SettingThe VICON Motion System® was used to conduct motion analysis.ParticipantsTwenty-one patients with chronic stroke.InterventionThe Compex® electric stimulator was used to provide muscle stimulation during two conditions: a placebo condition and a FES condition.Main outcome measuresWe analyzed the joint kinematics (trunk, shoulder, and elbow from the starting position until the affected hand reached the glass.ResultsParticipants receiving FES carried out the movement with less trunk flexion, while shoulder flexion elbow extension was increased, compared to placebo conditions.ConclusionThe application of FES to the UL and interscapular muscles of stroke patients with motor impairment of the UL has improved reaching movements.

Reach Address Database (RAD)

Data.gov (United States)

U.S. Environmental Protection Agency — The Reach Address Database (RAD) stores the reach address of each Water Program feature that has been linked to the underlying surface water features (streams,...

Left main percutaneous coronary intervention.

Science.gov (United States)

Teirstein, Paul S; Price, Matthew J

2012-10-23

The introduction of drug-eluting stents and advances in catheter techniques have led to increasing acceptance of percutaneous coronary intervention (PCI) as a viable alternative to coronary artery bypass graft (CABG) for unprotected left main disease. Current guidelines state that it is reasonable to consider unprotected left main PCI in patients with low to intermediate anatomic complexity who are at increased surgical risk. Data from randomized trials involving patients who are candidates for either treatment strategy provide novel insight into the relative safety and efficacy of PCI for this lesion subset. Herein, we review the current data comparing PCI with CABG for left main disease, summarize recent guideline recommendations, and provide an update on technical considerations that may optimize clinical outcomes in left main PCI. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Reaching national consensus on the core clinical skill outcomes for family medicine postgraduate training programmes in South Africa.

Science.gov (United States)

Akoojee, Yusuf; Mash, Robert

2017-05-26

Family physicians play a significant role in the district health system and need to be equipped with a broad range of clinical skills in order to meet the needs and expectations of the communities they serve. A previous study in 2007 reached national consensus on the clinical skills that should be taught in postgraduate family medicine training prior to the introduction of the new speciality. Since then, family physicians have been trained, employed and have gained experience of working in the district health services. The national Education and Training Committee of the South African Academy of Family Physicians, therefore, requested a review of the national consensus on clinical skills for family medicine training. A Delphi technique was used to reach national consensus in a panel of 17 experts: family physicians responsible for training, experienced family physicians in practice and managers responsible for employing family physicians. Consensus was reached on 242 skills from which the panel decided on 211 core skills, 28 elective skills and 3 skills to be deleted from the previous list. The panel was unable to reach consensus on 11 skills. The findings will guide training programmes on the skills to be addressed and ensure consistency across training programmes nationally. The consensus will also guide formative assessment as documented in the national portfolio of learning and summative assessment in the national exit examination. The consensus will be of interest to other countries in the region where training programmes in family medicine are developing.

The German REACH Congress 2016: a workshop report.

Science.gov (United States)

Reihlen, Antonia; Jepsen, Dirk; Broschinski, Lutz; Luch, Andreas; Schulte, Agnes

2018-03-01

In October 2016, the German REACH Congress was held at the German Federal Institute for Risk Assessment (BfR) in Berlin. Here, the associated improvement made in the fields of consumer protection and the progress in and experiences gained from the implementation of the authorisation procedure were discussed. Several speakers from EU institutions, German authorities, industry, and civil society organisations were invited to present their views. There was a shared consensus that REACH contributes to the advancement of consumer protection against chemical risks, mainly because more and higher quality information on substance-related hazards and potential exposures becomes available. In addition, risk management measures, particularly regarding restrictions on uses, scale down consumer exposures to chemicals. Opportunities for improvements identified at the congress include the quality of registration dossiers and the management of and communication on substances of very high concern (SVHC) that may be present in consumer articles. Although regarded as being in an early implementation phase, the authorisation process was generally found to be operational and progressing well. Criticism was expressed with regard to the consistency of authorisation decisions and the costs and uncertainties related to authorisation applications. Consumer protection legislation consists of several legal provisions which are interlinked. The congress participants agreed that REACH is an important element of this legal framework as it enhances and complements other legal provisions.

Reach, engagement, and effectiveness: a systematic review of evaluation methodologies used in health promotion via social networking sites.

Science.gov (United States)

Lim, Megan S C; Wright, Cassandra J C; Carrotte, Elise R; Pedrana, Alisa E

2016-02-01

Issue addressed Social networking sites (SNS) are increasingly popular platforms for health promotion. Advancements in SNS health promotion require quality evidence; however, interventions are often not formally evaluated. This study aims to describe evaluation practices used in SNS health promotion. Methods A systematic review was undertaken of Medline, PsycINFO, Scopus, EMBASE, CINAHL Plus, Communication and Mass Media Complete, and Cochrane Library databases. Articles published between 2006 and 2013 describing any health promotion intervention delivered using SNS were included. Results Forty-seven studies were included. There were two main evaluation approaches: closed designs (n=23), which used traditional research designs and formal recruitment procedures; and open designs (n=19), which evaluated the intervention in a real-world setting, allowing unknown SNS users to interact with the content without enrolling in research. Closed designs were unable to assess reach and engagement beyond their research sample. Open designs often relied on weaker study designs with no use of objective outcome measures and yielded low response rates. Conclusions Barriers to evaluation included low participation rates, high attrition, unknown representativeness and lack of comparison groups. Acceptability was typically assessed among those engaged with the intervention, with limited population data available to accurately assess intervention reach. Few studies were able to assess uptake of the intervention in a real-life setting while simultaneously assessing effectiveness of interventions with research rigour. So what? Through use of quasi-experimental or well designed before-after evaluations, in combination with detailed engagement metrics, it is possible to balance assessment of effectiveness and reach to evaluate SNS health promotion.

Outcome Mapping Virtual Learning Community - Phase II | IDRC ...

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

The first phase of the project (103520) focused on developing the Outcome ... as distance learning) and strategically communicating Outcome Mapping to key ... an organization based in India with South Asian reach, to facilitate exchange ...

ANC A-Associated Glomerulonephritis: Relationship of main ANCA subtypes to renal outcome, age and sex of patients

International Nuclear Information System (INIS)

Rais-Jalali, G.; Khajehdehi, P.

1999-01-01

Antineutrophil cytoplasmic antibodies (ANCA) have been proven to be useful diagnostic tool in patients with systemic vasculitis with systemic vasculitis and glomerulonephritis. These antibodies exist in two types, a cytoplasmic pattern (cANCA) and a perineuclear pattern (pANCA). The effect of the main ANCA subtypes on renal outcome and its relationship to demographic findings and clinical features of patients with ANCA-associated glomerulonephritis has not been adequately studied. In this prospective study, we compared the clinical features at presentation and the renal outcome after 1 year of follow-up between two group of patients with cANCA (n=22) and pANCA (n=29) consecutively encountered over a one year period. At presentation, rapidly progressive glomerulonephritis (RPGN), and after 1 year of follow-up, end stage renal disease (ESRD) were seen more commonly in patients with pANCA than cases with cANCA (P=0.001 and P=0.04, respectively). Seropositivity for cANCA was more common in male and pANCA in female patients (P=0.05). Occurrence of the pulmonary-renal syndrome or extra-renal manifestations, such as sinusitis and skin rash, did not differ significantly among the two groups of patients with cANCA and pANCA. Patients with pANCA present more frequently with RPGN, leading to a poorer renal survival compared to cases with cANCA. RPGN and pANCA are more common in females. (author)

Faculty Promotion and Attrition: The Importance of Coauthor Network Reach at an Academic Medical Center.

Science.gov (United States)

Warner, Erica T; Carapinha, René; Weber, Griffin M; Hill, Emorcia V; Reede, Joan Y

2016-01-01

Business literature has demonstrated the importance of networking and connections in career advancement. This is a little-studied area in academic medicine. To examine predictors of intra-organizational connections, as measured by network reach (the number of first- and second-degree coauthors), and their association with probability of promotion and attrition. Prospective cohort study between 2008 and 2012. Academic medical center. A total of 5787 Harvard Medical School (HMS) faculty with a rank of assistant professor or full-time instructor as of January 1, 2008. Using negative binomial models, multivariable-adjusted predictors of continuous network reach were assessed according to rank. Poisson regression was used to compute relative risk (RR) and 95 % confidence intervals (CI) for the association between network reach (in four categories) and two outcomes: promotion or attrition. Models were adjusted for demographic, professional and productivity metrics. Network reach was positively associated with number of first-, last- and middle-author publications and h-index. Among assistant professors, men and whites had greater network reach than women and underrepresented minorities (p advancement and retention in academic medicine. They can and should be investigated at other institutions.

Travel ticket sales optimization at Prague Main Railway Station

OpenAIRE

Kuběnová, Eva

2010-01-01

This Master's Thesis concerns the travel ticket sales at Prague Main Railway Station. Based on a detailed analysis of provided data, its aim is to put forward suggestions on how to optimize travel ticket sales. Through evaluating the volume of travel tickets sold within the given time period and the number of open cash-desks, along with a cost analysis of sales channels, this thesis reaches its final conclusions. Microsoft Excel was the main analysis tool for compiling graphs. A sound knowled...

High Precision Current Control for the LHC Main Power Converters

CERN Document Server

Thiesen, H; Hudson, G; King, Q; Montabonnet, V; Nisbet, D; Page, S

2010-01-01

Since restarting at the end of 2009, the LHC has reached a new energy record in March 2010 with the two 3.5 TeV beams. To achieve the performance required for the good functioning of the accelerator, the currents in the main circuits (Main Bends and Main Quadrupoles) must be controlled with a higher precision than ever previously requested for a particle accelerator at CERN: a few parts per million (ppm) of nominal current. This paper describes the different challenges that were overcome to achieve the required precision for the current control of the main circuits. Precision tests performed during the hardware commissioning of the LHC illustrate this paper.

Physics reach of β-beams and ν-factories: the problem of degeneracies

International Nuclear Information System (INIS)

Rigolin, S.

2006-01-01

We discuss the physics reach of β-Beams and ν-Factories from a theoretical perspective, having as a guideline the problem of degeneracies. The presence of degenerate solutions in the measure of the neutrino oscillation parameters θ 13 and δ is, in fact, the main problem that have to be addressed in planning future neutrino oscillation experiments. If degeneracies are not (at least partially) solved, it will be almost impossible to perform, at any future facility, precise measurements of θ 13 and/or δ. After a pedagogical introduction on why degenerate solutions arise and how we can get rid of them, we analyze the physics reach of current β-beam and ν-factory configurations. The physics reach of the 'standard' β-Beam is severely affected by degeneracies while a better result can be obtained by higher-γ setups. At the ν-Factory the combination of Golden and Silver channels can solve the eightfold degeneracy down to sin 2 θ 13 = -3

Morphological adjustments in a meandering reach of the middle Yangtze River caused by severe human activities

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Zhou, Meirong; Xia, Junqiang; Lu, Jinyou; Deng, Shanshan; Lin, Fenfen

2017-05-01

In the past 50 years, the Shishou reach in the middle Yangtze River underwent significant channel evolution owing to the implementation of an artificial cutoff, the construction of bank revetment works and the operation of the Three Gorges Project (TGP). Based on the measured hydrological data and topographic data, the processes of channel evolution in this reach were investigated mainly from the adjustments in planform and cross-sectional geometries. The variation in planform geometry obtained in this study indicates that (i) the artificial cutoff at Zhongzhouzi caused the river regime to adjust drastically, with the mean rate of thalweg migration at reach scale of 42.0 m/a over the period 1966-1975; (ii) then the effect of this artificial cutoff reduced gradually, with the mean migration rate decreasing to 40 m/a owing to the occurrence of high water levels in 1993-1998; and (iii) the average annual rate of thalweg migration decreased to 29.3 m/a because of the impacts of various bank protection engineering and the TGP operation during the period 2002-2015. However, remarkable thalweg migration processes still occurred in local regions after the TGP operation, which resulted in significant bankline migration in local reaches of Beimenkou, Shijiatai, and Tiaoxiankou. In addition, the adjustments of bankfull channel geometry were investigated at section and reach scales after the TGP operation. Calculated results show that lateral channel migration in this reach was restricted by various river regulation works and that channel evolution was mainly characterized by an increase in bankfull depth and cross-sectional area. Empirical relationships were developed between the reach-scale bankfull dimensions (depth and area), the bankfull widths at specified sections, and the previous 5-year average fluvial erosion intensity during flood seasons, with high correlation degrees between them being obtained.

Challenges of the ILC Main Linac

International Nuclear Information System (INIS)

Ross, Marc

2007-01-01

With the completion of the ILC Reference Design Report (RDR), we begin the next phase of the project - development of the Engineering Design. Our strategy and priorities come from the identification, contained in the RDR, of scientific and engineering challenges of the ILC. First among these is the cost of the main linac which, including the associated earthworks and cooling/power systems, amounts to 60% of the ILC total cost. Next is the challenge to reach the highest practical gradient since this R and D has the largest cost leverage of any of the ongoing programs. Finally, we have to understand the beam dynamics and beam tuning processes in the main linac, as we will not have the opportunity to do full (or even large) scale tests of these before the linac is constructed.

REACH MUSC: A Telemedicine Facilitated Network for Stroke: Initial Operational Experience

Science.gov (United States)

Adams, Robert J.; Debenham, Ellen; Chalela, Julio; Chimowitz, Marc; Hays, Angela; Hill, Cody; Holmstedt, Christine; Jauch, Edward; Kitch, Alec; Lazaridis, Christos; Turan, Tanya N.

2012-01-01

REACH Medical University of South Carolina (MUSC) provides stroke consults via the internet in South Carolina. From May 2008 to April 2011 231 patients were treated with intravenous (IV) thrombolysis and 369 were transferred to MUSC including 42 for intra-arterial revascularization [with or without IV tissue plasminogen activator (tPA)]. Medical outcomes and hemorrhage rates, reported elsewhere, were good (Lazaridis et al., 2011). Here we report operational features of REACH MUSC which covers 15 sites with 2,482 beds and 471,875 Emergency Department (ED) visits per year. Eight Academic Faculty from MUSC worked with 165 different physicians and 325 different nurses in the conduct of 1085 consults. For the 231 who received tPA, time milestones (in minutes) were: Onset to Door: 62 (mean), 50 (median); Door to REACH Consult: 43 and 33, Consult Request to Consult Start: was 9 and 7, Consult Start to tPA Decision: 31 and 25; Decision to Infusion: 20 and 14, and total Door to Needle: 98 and 87. The comparable times for the 854 not receiving tPA were: Onset to Door: 140 and 75; Door to REACH Consult: 61 and 41; Consult Request to Consult Start: 9 and 7, Consult Start to tPA Decision: 27 and 23. While the consultants respond to consult requests in <10, there is a long delay between arrival and Consult request. Tracking of operations indicates if we target shortening Door to Call time and time from tPA decision to start of drug infusion we may be able to improve Door to Needle times to target of <60. The large number of individuals involved in the care of these patients, most of whom had no training in REACH usage, will require novel approaches to staff education in ED based operations where turnover is high. Despite these challenges, this robust system delivered tPA safely and in a high fraction of patients evaluated using the REACH MUSC system. PMID:22435064

REACH MUSC: A telemedicine facilitated network for urgent stroke: initial experience

Directory of Open Access Journals (Sweden)

Robert J. Adams

2012-03-01

Full Text Available REACH MUSC provides stroke consults via the internet in South Carolina. From May 2008 to April 2011 231 patients were treated with intravenous (IV thrombolysis and 369 were transferred to Medical University of South Carolina (MUSC including 42 for intra-arterial revascularization (with or without IV tPA. Medical outcomes and hemorrhage rates, reported elsewhere, were good (Lazaridis et al. 2011, in press. Here we report operational features of REACH MUSC which covers 15 sites with 2,482 beds and 471,875 Emergency Department (ED visits per year. Eight Academic Faculty from MUSC worked with 165 different physicians and 325 different nurses in the conduct of 1085 consults. For the 231 who received tissue plasminogen activator (tPA, time milestones were: Onset to Door: 62 min (mean, 50 (median; Door to REACH Consult: 43 and 33, Consult Request to Consult Start: was 9 and 7 minutes, Consult Start to tPA Decision: 31 and 25 minutes; Decision to Infusion: 20 and 14 minutes, and total Door to Needle: 98 and 87 minutes. The comparable times for the 854 not receiving tPA were: Onset to Door: 140 and 75 minutes; Door to REACH Consult: 61 and 41 minutes; Consult Request to Consult Start 9 and 7 minutes, Consult Start to tPA Decision 27 and 23 minutes. While the consultants respond to consult requests in < 10 minutes, there is a long delay between arrival and Consult request. Tracking of operations indicates if we target shortening Door to Call time and time from tPA decision to start of drug infusion we may be able to improve Door to Needle times to target of < 60 minutes. The large number of individuals involved in the care of these patients, most of whom had no training in REACH usage,will require novel approaches to staff education in ED based operations where turnover is high. Despite these challenges this robust system delivered tPA safely and in a high fraction of patients evaluated using the REACH MUSC system.

Functional reach and lateral reach tests adapted for aquatic physical therapy

Directory of Open Access Journals (Sweden)

Ana Angélica Ribeiro de Lima

Full Text Available Abstract Introduction: Functional reach (FR and lateral reach (LR tests are widely used in scientific research and clinical practice. Assessment tools are useful in assessing subjects with greater accuracy and are usually adapted according to the limitations of each condition. Objective: To adapt FR and LR tests for use in an aquatic environment and assess the performance of healthy young adults. Methods: We collected anthropometric data and information on whether the participant exercised regularly or not. The FR and LR tests were adapted for use in an aquatic environment and administered to 47 healthy subjects aged 20-30 years. Each test was repeated three times. Results: Forty-one females and six males were assessed. The mean FR test score for men was 24.06 cm, whereas the mean value for right lateral reach (RLR was 10.94 cm and for left lateral reach (LLR was 9.78 cm. For females, the mean FR score was 17.57 cm, while the mean values for RLR was 8.84cm and for LLR was 7.76 cm. Men performed better in the FR (p < 0.001 and RLR tests than women (p = 0.037. Individuals who exercised regularly showed no differences in performance level when compared with their counterparts. Conclusion: The FR and LR tests were adapted for use in an aquatic environment. Males performed better on the FR and RLR tests, when compared to females. There was no correlation between the FR and LR tests and weight, height, Body Mass Index (BMI, foot length or length of the dominant upper limb.

Outcomes After Orbital Atherectomy of Severely Calcified Left Main Lesions: Analysis of the ORBIT II Study.

Science.gov (United States)

Lee, Michael S; Shlofmitz, Evan; Shlofmitz, Richard; Sahni, Sheila; Martinsen, Brad; Chambers, Jeffrey

2016-09-01

The ORBIT II trial reported excellent outcomes in patients with severely calcified coronary lesions treated with orbital atherectomy. Severe calcification of the left main (LM) artery represents a complex coronary lesion subset. This study evaluated the safety and efficacy of coronary orbital atherectomy to prepare severely calcified protected LM artery lesions for stent placement. The ORBIT II trial was a prospective, multicenter clinical trial that enrolled 443 patients with severely calcified coronary lesions in the United States. The major adverse cardiac event (MACE) rate through 2 years post procedure, defined by cardiac death, myocardial infarction (CK-MB >3x upper limit of normal with or without a new pathologic Q-wave) and target-vessel revascularization, was compared in the LM and non-left main (NLM) groups. Among the 443 patients, a total of 10 underwent orbital atherectomy of protected LM artery lesions. At 2 years, there was no significant difference in the 2-year MACE rate in the LM and NLM groups (30.0% vs 19.1%, respectively; P=.36). Cardiac death was low in both groups (0% vs 4.4%, respectively; P=.99). Myocardial infarction occurred within 30 days in both groups (10.0% vs 9.7%, respectively; P=.99). Severe dissection, perforation, persistent slow flow, and persistent no reflow did not occur in the LM group. Abrupt closure occurred in 1 patient in the LM group. Orbital atherectomy for patients with heavily calcified LM coronary artery lesions is safe and feasible. Further studies are needed to assess the safety and efficacy of orbital atherectomy in patients with severely calcified LM artery lesions.

Training using a new multidirectional reach tool improves balance in individuals with stroke.

Science.gov (United States)

Khumsapsiri, Numpung; Siriphorn, Akkradate; Pooranawatthanakul, Kanokporn; Oungphalachai, Tanyarut

2018-04-01

Previous studies suggested that limits of stability (LOS) training with visual feedback using commercial equipment could be used to improve balance ability in individuals with stroke. However, this system is expensive. In this study, we created a new tool from inexpensive elements based on LOS training using visual feedback. The aim of this study was to investigate the effect of training using a new multidirectional reach tool on balance in individuals with stroke. A single-blind randomized control trial was conducted. Individuals with stroke (n = 16; age range 38-72 years) were recruited. Participants in the experimental group were trained with the multidirectional reach training for 30 min and conventional physical therapy for 30 min per day, 3 days a week for 4 weeks. Participants in the control group received conventional physical therapy for 30 min per day, 3 days a week for 4 weeks. The outcomes were LOS, weight-bearing squat, and Fullerton Advanced Balance scale. All of the outcome measures were measured at pretraining, post-training, and 1 month follow-up. At post-training and 1-month follow-up, the participants in the experimental group had an improvement of dynamic balance than the control group. Furthermore, the activity assessment by Fullerton Advanced Balance scale was more improved at 1 month follow-up in the experimental group than control group. The results of this study provide evidence that training using a new multidirectional reach tool is effective for improving balance in individuals with stroke. Copyright © 2018 John Wiley & Sons, Ltd.

Methodology to estimate variations in solar radiation reaching densely forested slopes in mountainous terrain.

Science.gov (United States)

Sypka, Przemysław; Starzak, Rafał; Owsiak, Krzysztof

2016-12-01

Solar radiation reaching densely forested slopes is one of the main factors influencing the water balance between the atmosphere, tree stands and the soil. It also has a major impact on site productivity, spatial arrangement of vegetation structure as well as forest succession. This paper presents a methodology to estimate variations in solar radiation reaching tree stands in a small mountain valley. Measurements taken in three inter-forest meadows unambiguously showed the relationship between the amount of solar insolation and the shading effect caused mainly by the contour of surrounding tree stands. Therefore, appropriate knowledge of elevation, aspect and tilt angles of the analysed planes had to be taken into consideration during modelling. At critical times, especially in winter, the diffuse and reflected components of solar radiation only reached some of the sites studied as the beam component of solar radiation was totally blocked by the densely forested mountain slopes in the neighbourhood. The cross-section contours and elevation angles of all obstructions are estimated from a digital surface model including both digital elevation model and the height of tree stands. All the parameters in a simplified, empirical model of the solar insolation reaching a given horizontal surface within the research valley are dependent on the sky view factor (SVF). The presented simplified, empirical model and its parameterisation scheme should be easily adaptable to different complex terrains or mountain valleys characterised by diverse geometry or spatial orientation. The model was developed and validated (R 2  = 0.92 , σ = 0.54) based on measurements taken at research sites located in the Silesian Beskid Mountain Range. A thorough understanding of the factors determining the amount of solar radiation reaching woodlands ought to considerably expand the knowledge of the water exchange balance within forest complexes as well as the estimation of site

Access to expert stroke care with telemedicine: REACH MUSC

Directory of Open Access Journals (Sweden)

Abby Swanson Kazley

2012-03-01

Full Text Available Stroke is a leading cause of death and disability, and rtPA can significantly reduce the long-term impact of acute ischemic stroke (AIS if given within 3 hours of symptom onset. South Carolina is located in the stroke belt and has a high rate of stroke and stroke mortality. Many small rural SC hospitals do not maintain the expertise needed to treat AIS patients with rtPA. MUSC is an academic medical center using REACH MUSC telemedicine to deliver stroke care to 15 hospitals in the state, increasing the likelihood of timely treatment with rtPA. The purpose of this study is to determine the increase in access to rtPA through the use of telemedicine for AIS in the general population and in specific segments of the population based on age, gender, race, ethnicity, education, urban/rural residence, poverty, and stroke mortality.We used a retrospective cross-sectional design examining Census data from 2000 and Geographic Information Systems (GIS analysis to identify South Carolina residents that live within 30 or 60 minutes of a Primary Stroke Center (PSC or a REACH MUSC site. We include all South Carolina citizens in our analysis and specifically examine the population’s age, gender, race, ethnicity, education, urban/rural residence, poverty, and stroke mortality. Our sample includes 4,012,012 South Carolinians. The main measure is access to expert stroke care at a Primary Stroke Center (PSC or a REACH MUSC hospital within 30 or 60 minutes. We find that without REACH MUSC, only 38% of the population has potential access to expert stroke care in SC within sixty minutes given that most PSCs will maintain expert stroke coverage. REACH MUSC allows 76% of the population to be within sixty minutes of expert stroke care, and 43% of the population to be within 30 minute drive time of expert stroke care. These increases in access are especially significant for groups that have faced disparities in care and high rates of AIS. The use of telemedicine can

The main decisions which the Parliament and Government will have to take from summer 2012 in order France be able to reach its energy policy objectives. Report to the Prime Minister

International Nuclear Information System (INIS)

Blum, Roland

2012-01-01

Based on several hearings, this report aims at formulating a set of propositions of decisions which the French Parliament and Government should take during the 2012-2017 term to reach France's energy policy objectives. After having recalled the context and outlined why years to come are crucial for energy policy, in France and in the rest of Europe as well, the author discusses the European and French commitments in relationship with investment programs, perspectives of electricity price increase and radioactive waste management. Then, he addresses the main energy challenges to be faced, more particularly with respect to energy efficiency, renewable energies, power grids, gas (including shale gas) and electronuclear production. He also discusses transverse issues like research and development, carbon tax, energy precariousness, and other issues related to sustainable development

Unmatched U.S. Allopathic Seniors in the 2015 Main Residency Match: A Study of Applicant Behavior, Interview Selection, and Match Outcome.

Science.gov (United States)

Liang, Mei; Curtin, Laurie S; Signer, Mona M; Savoia, Maria C

2017-07-01

The application and interview behaviors of unmatched U.S. allopathic medical school senior students (U.S. seniors) participating in the 2015 National Resident Matching Program (NRMP) Main Residency Match were studied in conjunction with their United States Medical Licensing Examination (USMLE) Step 1 scores and ranking preferences to understand their effects on Match outcome. USMLE Step 1 score and preferred specialty information were reviewed for U.S. seniors who responded to the 2015 NRMP Applicant Survey. Unmatched U.S. seniors were categorized as "strong," "solid," "marginal," or "weak" based on the perceived competitiveness of their Step 1 scores compared with U.S. seniors who matched in the same preferred specialty. The numbers of applications sent, interviews obtained, and programs ranked also were examined by Match outcome. Strong unmatched U.S. seniors submitted significantly more applications to achieve and attend approximately the same number of interviews as strong matched U.S. seniors. Strong unmatched seniors ranked fewer programs than their matched counterparts. As a group, unmatched U.S. seniors were less likely than their matched counterparts to rank a mix of competitive and less competitive programs and more likely to rank programs based on their perceived likelihood of matching. A small number of unmatched U.S. seniors would have matched if they had ranked programs that ranked them. U.S. seniors' Match outcomes may be affected by applicant characteristics that negatively influence their selection for interviews, and their difficulties may be exacerbated by disadvantageous ranking behaviors.

The main factors influencing canine demodicosis treatment outcome and determination of optimal therapy.

Science.gov (United States)

Arsenović, Milica; Pezo, Lato; Vasić, Nebojša; Ćirić, Rodoljub; Stefanović, Milan

2015-07-01

The main idea of this research was to evaluate the efficacy of canine demodicosis conventional treatments using mathematical analyses. All available papers published between 1980 and 2014 were used in this study. One hundred six clinical trials enrolling 3414 cases of generalized demodicosis in dogs are studied. Dogs entered in the analysis were only the ones in which the disease occurred naturally, excluding the studies in which transplantation of Demodex canis mites was done from other animals. In conventional acaricide treatments, sorted according to active substances (moxidectin, amitraz, doramectin, ivermectin, and milbemycin oxime), the way of application (spot-on, dips, orally, or subcutaneous), concentration, and interval of application were used as input parameters in mathematical modeling. Data of interest were the treatment outcome, the number of dogs that went into remission, the number of animals not responding to treatment microscopically, the average duration of therapy, the follow-up period, the number of patients with disease recurrence, the number of adverse effects, and the number of animals with side effects. Dogs lost to follow-up or when the treatment was discontinued, due to various reasons not in connection with the therapy protocol, were not considered. Statistical and mathematical analyses were applied for prediction of the drugs' effectiveness. Developed mathematical models showed satisfactorily r (2), higher than 0.87. Good evidence for recommending the use of milbemycin oxime PO (0.5 mg/kg, daily) and moxidectin spot-on (Advocate®, Bayer) weekly is found. A bit less effective therapies were based on ivermectin PO (0.5 mg/kg, daily), moxidectin PO (0.35 mg/kg, daily), and amitraz dips (0.05 % solution, weekly), respectively. It is important to keep in mind that Advocate® is recommended by the manufacturer for use in milder cases.

Hyporheic invertebrate assemblages at reach scale in a Neotropical stream in Brazil.

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Mugnai, R; Messana, G; Di Lorenzo, T

2015-11-01

In the Neotropical Region, information concerning hyporheic communities is virtually non-existent. We carried out a sampling survey in the hyporheic zone of the Tijuca River, in the Tijuca National Park, located in the urban area of the city of Rio de Janeiro. Biological samples from the hyporheic zone were collected in three different stream reaches, in June 2012. The main objectives were: 1) to describe the structure of invertebrate assemblages in the hyporheic zone of a neotropical stream; 2) to apply a reach-scale approach in order to investigate spatial patterns of the hyporheic assemblages in relation to hydrology, depth and microhabitat typology. A total of 1460 individuals were collected and identified in 31 taxa belonging to Nematoda, Annelida, Crustacea, Hydrachnidia and Insecta. The class Insecta dominated the upper layer of the hyporheic zone. Copepods were the most abundant taxon among crustaceans and occurred mostly in the upwelling areas of the reaches. The results of this study represent one of the few contributions so far about hyporheic invertebrate assemblages of the Neotropical Region.

An investigation of the neural circuits underlying reaching and reach-to-grasp movements: from planning to execution.

Directory of Open Access Journals (Sweden)

Chiara eBegliomini

2014-09-01

Full Text Available Experimental evidence suggests the existence of a sophisticated brain circuit specifically dedicated to reach-to-grasp planning and execution, both in human and non human primates (Castiello, 2005. Studies accomplished by means of neuroimaging techniques suggest the hypothesis of a dichotomy between a reach-to-grasp circuit, involving the intraparietal area (AIP, the dorsal and ventral premotor cortices (PMd and PMv - Castiello and Begliomini, 2008; Filimon, 2010 and a reaching circuit involving the medial intraparietal area (mIP and the Superior Parieto-Occipital Cortex (SPOC (Culham et al., 2006. However, the time course characterizing the involvement of these regions during the planning and execution of these two types of movements has yet to be delineated. A functional magnetic resonance imaging (fMRI study has been conducted, including reach-to grasp and reaching only movements, performed towards either a small or a large stimulus, and Finite Impulse Response model (FIR - Henson, 2003 was adopted to monitor activation patterns from stimulus onset for a time window of 10 seconds duration. Data analysis focused on brain regions belonging either to the reaching or to the grasping network, as suggested by Castiello & Begliomini (2008.Results suggest that reaching and grasping movements planning and execution might share a common brain network, providing further confirmation to the idea that the neural underpinnings of reaching and grasping may overlap in both spatial and temporal terms (Verhagen et al., 2013.

Supersymmetry Reach of Tevatron Upgrades and LHC in Gauge-mediated Supersymmetry-breaking Models

CERN Document Server

Wang, Y

2002-01-01

We examine signals for sparticle production at the Fermilab Tevatron and the CERN Large Hadron Collider (LHC) within the framework of gauge mediated supersymmetry breaking models. We divide our analysis into four different model lines, each of which leads to qualitatively different signatures. We identify cuts to enhance the signal above Standard Model backgrounds, and use ISAJET to evaluate the SUSY reach of experiments at the Fermilab Main Injector and at its luminosity upgrades and also at the LHC. We examine the reach of the LHC via the canonical E/ and multilepton channels that have been advocated within the mSUGRA framework. For the model lines that we have examined, we find that the reach is at least as large, and frequently larger, than in the mSUGRA framework. For two of these model lines, we find that the ability to identify b-quarks and τ-leptons with high efficiency and purity is essential for the detection of the signal.

Classification of different reaching movements from the same limb using EEG

Science.gov (United States)

Shiman, Farid; López-Larraz, Eduardo; Sarasola-Sanz, Andrea; Irastorza-Landa, Nerea; Spüler, Martin; Birbaumer, Niels; Ramos-Murguialday, Ander

2017-08-01

Objective. Brain-computer-interfaces (BCIs) have been proposed not only as assistive technologies but also as rehabilitation tools for lost functions. However, due to the stochastic nature, poor spatial resolution and signal to noise ratio from electroencephalography (EEG), multidimensional decoding has been the main obstacle to implement non-invasive BCIs in real-live rehabilitation scenarios. This study explores the classification of several functional reaching movements from the same limb using EEG oscillations in order to create a more versatile BCI for rehabilitation. Approach. Nine healthy participants performed four 3D center-out reaching tasks in four different sessions while wearing a passive robotic exoskeleton at their right upper limb. Kinematics data were acquired from the robotic exoskeleton. Multiclass extensions of Filter Bank Common Spatial Patterns (FBCSP) and a linear discriminant analysis (LDA) classifier were used to classify the EEG activity into four forward reaching movements (from a starting position towards four target positions), a backward movement (from any of the targets to the starting position and rest). Recalibrating the classifier using data from previous or the same session was also investigated and compared. Main results. Average EEG decoding accuracy were significantly above chance with 67%, 62.75%, and 50.3% when decoding three, four and six tasks from the same limb, respectively. Furthermore, classification accuracy could be increased when using data from the beginning of each session as training data to recalibrate the classifier. Significance. Our results demonstrate that classification from several functional movements performed by the same limb is possible with acceptable accuracy using EEG oscillations, especially if data from the same session are used to recalibrate the classifier. Therefore, an ecologically valid decoding could be used to control assistive or rehabilitation mutli-degrees of freedom (DoF) robotic devices

Hydrogeology and water quality of the Pepacton Reservoir Watershed in southeastern New York. Part 4. Quantity and quality of ground-water and tributary contributions to stream base flow in selected main-valley reaches

Science.gov (United States)

Heisig, Paul M.

2004-01-01

Estimates of the quantity and quality of ground-water discharge from valley-fill deposits were calculated for nine valley reaches within the Pepacton watershed in southeastern New York in July and August of 2001. Streamflow and water quality at the upstream and downstream end of each reach and at intervening tributaries were measured under base-flow conditions and used in mass-balance equations to determine quantity and quality of ground-water discharge. These measurements and estimates define the relative magnitudes of upland (tributary inflow) and valley-fill (ground-water discharge) contributions to the main-valley streams and provide a basis for understanding the effects of hydrogeologic setting on these contributions. Estimates of the water-quality of ground-water discharge also provide an indication of the effects of road salt, manure, and human wastewater from villages on the water quality of streams that feed the Pepacton Reservoir. The most common contaminant in ground-water discharge was chloride from road salt; concentrations were less than 15 mg/L.Investigation of ground-water quality within a large watershed by measurement of stream base-flow quantity and quality followed by mass-balance calculations has benefits and drawbacks in comparison to direct ground-water sampling from wells. First, sampling streams is far less expensive than siting, installing, and sampling a watershed-wide network of wells. Second, base-flow samples represent composite samples of ground-water discharge from the most active part of the ground-water flow system across a drainage area, whereas a well network would only be representative of discrete points within local ground-water flow systems. Drawbacks to this method include limited reach selection because of unfavorable or unrepresentative hydrologic conditions, potential errors associated with a large number of streamflow and water-quality measurements, and limited ability to estimate concentrations of nonconservative

The effects of urgency to reach agreement on the process and outcome of multi-party natural resource negotiations

Science.gov (United States)

Lamb, B.L.; Taylor, J.G.; Burkardt, N.; Gillette, S.C.

2005-01-01

We studied seven hydropower license consultations to examine the role of a sense of urgency to reach agreement. Hydropower licensing consultations were studied because the statutory requirement for consultation encourages negotiation, all such consultations are similar, and a negotiated settlement is not a foregone result. Cases selected for analysis met screening criteria. Structured interviews were conducted with participants after the negotiations had been concluded. Respondent recollections were checked against the documentary record. A sense of urgency to reach agreement was a significant factor in the completion of these negotiations; where there was no shared sense of urgency, purposeful delay adversely affected the negotiations. Although a sense of urgency was experienced by at least one party in each case, only a shared sense of urgency at the end of the process proved significant. Delay did not prevent ultimate agreement but a shared sense of urgency brought speedier agreement and greater satisfaction with the negotiation.

The main outcomes of the OECD Behaviour of Iodine (BIP) Project

International Nuclear Information System (INIS)

Glowa, Glenn A.; Moore, Chris J.; Ball, Joanne M.

2013-01-01

(FP) tests. In this paper, the main outcomes of the BIP project will be outlined, and their relevance to the Phébus FP project will be examined. In addition to the new experiments performed on adsorption of iodine onto paint, and production of organic iodides from iodine adsorbed on paint, Atomic Energy of Canada Limited (AECL) provided the results from five Radioiodine Test Facility (RTF) experiments. The RTF was an intermediate-scale test facility that operated at AECL’s Whiteshell laboratories in the 1990s. It is expected that BIP members will use this data for code development and verification

Involving Latina/o parents in patient-centered outcomes research: Contributions to research study design, implementation and outcomes.

Science.gov (United States)

Pérez Jolles, Mónica; Martinez, Maria; Garcia, San Juanita; Stein, Gabriela L; Thomas, Kathleen C

2017-10-01

Comparative effectiveness research (CER) is supported by policymakers as a way to provide service providers and patients with evidence-based information to make better health-care decisions and ultimately improve services for patients. However, Latina/o patients are rarely involved as study advisors, and there is a lack of documentation on how their voices contribute to the research process when they are included as collaborators. The purpose of this article was to contribute to the literature by presenting concrete contributions of Latina/o parent involvement to study design, implementation and outcomes in the context of a CER study called Padres Efectivos (Parent Activation). Researchers facilitated a collaborative relationship with parents by establishing a mentor parent group. The contributions of parent involvement in the following stages of the research process are described: (i) proposal development, (ii) implementation of protocols, (iii) analysis plan and (iv) dissemination of results. Mentor parents' contributions helped tailor the content of the intervention to their needs during proposal, increased recruitment, validated the main outcome measure and added two important outcome measures, emphasized the importance of controlling for novice treatment status and developed innovative dissemination strategies. Mentor parents' guidance to the researchers has contributed to reaching recruitment goals, strengthened the study protocol, expanded findings, supported broad ownership of study implications and enriched the overall study data collection efforts. These findings can inform future research efforts seeking an active Latino parent collaboration and the timely incorporation of parent voices in each phase of the research process. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Effect of feedback from a socially interactive humanoid robot on reaching kinematics in children with and without cerebral palsy: A pilot study.

Science.gov (United States)

Chen, Yuping; Garcia-Vergara, Sergio; Howard, Ayanna M

2017-08-17

To examine whether children with or without cerebral palsy (CP) would follow a humanoid robot's (i.e., Darwin) feedback to move their arm faster when playing virtual reality (VR) games. Seven children with mild CP and 10 able-bodied children participated. Real-time reaching was evaluated by playing the Super Pop VR TM system, including 2-game baseline, 3-game acquisition, and another 2-game extinction. During acquisition, Darwin provided verbal feedback to direct the child to reach a kinematically defined target goal (i.e., 80% of average movement time in baseline). Outcome variables included the percentage of successful reaches ("% successful reaches"), movement time (MT), average speed, path, and number of movement units. All games during acquisition and extinction had larger "%successful reaches," faster speeds, and faster MTs than the 2 games during baseline (p robot's feedback for changing their reaching kinematics when playing VR games.

The database for reaching experiments and models.

Directory of Open Access Journals (Sweden)

Ben Walker

Full Text Available Reaching is one of the central experimental paradigms in the field of motor control, and many computational models of reaching have been published. While most of these models try to explain subject data (such as movement kinematics, reaching performance, forces, etc. from only a single experiment, distinct experiments often share experimental conditions and record similar kinematics. This suggests that reaching models could be applied to (and falsified by multiple experiments. However, using multiple datasets is difficult because experimental data formats vary widely. Standardizing data formats promises to enable scientists to test model predictions against many experiments and to compare experimental results across labs. Here we report on the development of a new resource available to scientists: a database of reaching called the Database for Reaching Experiments And Models (DREAM. DREAM collects both experimental datasets and models and facilitates their comparison by standardizing formats. The DREAM project promises to be useful for experimentalists who want to understand how their data relates to models, for modelers who want to test their theories, and for educators who want to help students better understand reaching experiments, models, and data analysis.

Reach and get capability in a computing environment

Science.gov (United States)

Bouchard, Ann M [Albuquerque, NM; Osbourn, Gordon C [Albuquerque, NM

2012-06-05

A reach and get technique includes invoking a reach command from a reach location within a computing environment. A user can then navigate to an object within the computing environment and invoke a get command on the object. In response to invoking the get command, the computing environment is automatically navigated back to the reach location and the object copied into the reach location.

The International Dermatology Outcome Measures Group: formation of patient-centered outcome measures in dermatology.

Science.gov (United States)

Gottlieb, Alice B; Levin, Adriane A; Armstrong, April W; Abernethy, April; Duffin, Kristina Callis; Bhushan, Reva; Garg, Amit; Merola, Joseph F; Maccarone, Mara; Christensen, Robin

2015-02-01

As quality standards are increasingly in demand throughout medicine, dermatology needs to establish outcome measures to quantify the effectiveness of treatments and providers. The International Dermatology Outcome Measures Group was established to address this need. Beginning with psoriasis, the group aims to create a tool considerate of patients and providers using the input of all relevant stakeholders in assessment of disease severity and response to treatment. Herein, we delineate the procedures through which consensus is being reached and the future directions of the project. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Reaching the unreached.

Science.gov (United States)

Ariyaratne, A T

1989-01-01

Embodied in the child survival revolution are ideological, methodological, and organizational innovations aimed at radical change in the condition of the world's children as rapidly as possible. In countries such as Sri Lanka, child survival and health for all by the year 2000 often seem to be impossible goals, given the tumultuous socioeconomic and political conditions. In Sri Lanka, the quality of life has been eroded, not enhanced, by the importation of Western technology and managerial capitalism and the destruction of indigenous processes. The chaos and violence that have been brought into the country have made it difficult to reach the poor children, women, and refugees in rural areas with primary health care interventions. Sri Lanka's unreachable--the decision making elites--have blocked access to the unreached--the urban and rural poor. If governments are to reach the unreached, they must remove the obstacles to a people-centered, community development process. It is the people themselves, and the institutions of their creation, that can reach the children amidst them in greatest need. To achieve this task, local communities must be provided with basic human rights, the power to make decisions that affect their lives, necessary resources, and appropriate technologies. Nongovernmental organizations can play a crucial role as bridges between the unreached and the unreachable by promoting community empowerment, aiding in the formation of networks of community organizations, and establishing linkages with government programs. If the ruling elites in developing countries can be persuaded to accommodate the needs and aspirations of those who, to date, have been excluded from the development process, the child survival revolution can be a nonviolent one.

C, N, P export regimes from headwater catchments to downstream reaches

Science.gov (United States)

Dupas, R.; Musolff, A.; Jawitz, J. W.; Rao, P. S.; Jaeger, C. G.; Fleckenstein, J. H.; Rode, M.; Borchardt, D.

2017-12-01

Excessive amounts of nutrients and dissolved organic matter in freshwater bodies affect aquatic ecosystems. In this study, the spatial and temporal variability in nitrate (NO3), dissolved organic carbon (DOC) and soluble reactive phosphorus (SRP) was analyzed in the Selke river continuum from headwaters draining 1 - 3 km² catchments to downstream reaches representing spatially integrated signals from 184 - 456 km² catchments (part of TERENO - Terrestrial Environmental Observatories, in Germany). Three headwater catchments were selected as archetypes of the main landscape units (land use x lithology) present in the Selke catchment. Export regimes in headwater catchments were interpreted in terms of NO3, DOC and SRP land-to-stream transfer processes. Headwater signals were subtracted from downstream signals, with the differences interpreted in terms of in-stream processes and contribution of point-source emissions. The seasonal dynamics for NO3 were opposite those of DOC and SRP in all three headwater catchments, and spatial differences also showed NO3 contrasting with DOC and SRP. These dynamics were interpreted as the result of the interplay of hydrological and biogeochemical processes, for which riparian zones were hypothesized to play a determining role. In the two downstream reaches, NO3 was transported almost conservatively, whereas DOC was consumed and produced in the upper and lower river sections, respectively. The natural export regime of SRP in the three headwater catchments mimicked a point-source signal, which may lead to overestimation of domestic contributions in the downstream reaches. Monitoring the river continuum from headwaters to downstream reaches proved effective to investigate jointly land-to-stream and in-stream transport and transformation processes.

Clinical Outcome After DK Crush Versus Culotte Stenting of Distal Left Main Bifurcation Lesions: The 3-Year Follow-Up Results of the DKCRUSH-III Study.

Science.gov (United States)

Chen, Shao-Liang; Xu, Bo; Han, Ya-Ling; Sheiban, Imad; Zhang, Jun-Jie; Ye, Fei; Kwan, Tak W; Paiboon, Chitprapai; Zhou, Yu-Jie; Lv, Shu-Zheng; Dangas, George D; Xu, Ya-Wei; Wen, Shang-Yu; Hong, Lang; Zhang, Rui-Yan; Wang, Hai-Chang; Jiang, Tie-Ming; Wang, Yan; Sansoto, Teguh; Chen, Fang; Yuan, Zu-Yi; Li, Wei-Min; Leon, Martin B

2015-08-24

The present study aimed to investigate the difference in major adverse cardiac events (MACE) at 3 years after double-kissing (DK) crush versus culotte stenting for unprotected left main distal bifurcation lesions (LMDBLs). The multicenter and randomized DKCRUSH-III (Comparison of double kissing crush versus culotte stenting for unprotected distal left main bifurcation lesions: results from a multicenter, randomized, prospective study) showed that DK crush stenting was associated with fewer MACE at 1-year follow-up in patients with LMDBLs compared with culotte stenting. Here, we report the 3-year clinical outcome of the DKCRUSH-III study. A total of 419 patients with LMDBLs who were randomly assigned to either the DK crush or culotte group in the DKCRUSH-III study were followed for 3 year. The primary endpoint was the occurrence of a MACE at 3 years. Stent thrombosis (ST) was the safety endpoint. Patients were classified by simple and complex LMDBLs according to the DEFINITION (Definition and Impact of Complex Bifurcation Lesions on Clinical Outcomes After Percutaneous Coronary Intervention Using Drug-Eluting Stents) study criteria. At 3 years, MACE occurred in 49 patients the culotte group and in 17 patients in the DK crush group (cumulative event rates of 23.7% and 8.2%, respectively; p DK crush group (p = 0.007). Complex LMDBLs were associated with a higher rate of MACE (35.3%) at 3 years compared with a rate of 8.1% in patients with simple LMDBLs (p DK] Crush Versus Culotte Stenting for the Treatment of Unprotected Distal Left Main Bifurcation Lesions: DKCRUSH-III, a Multicenter Randomized Study Comparing Double-Stent Techniques; ChiCTR-TRC-11001877). Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

A COMPARISON OF THE SIT-AND-REACH TEST AND THE BACK-SAVER SIT-AND-REACH TEST IN UNIVERSITY STUDENTS

Directory of Open Access Journals (Sweden)

Pedro A. López-Miñarro

2009-03-01

Full Text Available This study compares the forward reach score, spine and pelvis postures, and hamstring criterion-related validity (concurrent validity between the sit-and-reach test (SR and the back-saver sit-and-reach test (BS. Seventy-six men (mean age ± SD: 23.45 ± 3.96 years and 67 women (mean age ± SD: 23.85 ± 5.36 years were asked to perform three trials of SR, BS left (BSl, right (BSr, and passive straight leg raise (PSLR right and left (hamstring criterion measure in a randomized order. The thoracic, lumbar, and pelvis angles (measured with a Uni-level inclinometer and forward reach scores were recorded once the subjects reached forward as far as possible without flexing the knees. A repeated measure ANOVA was performed followed by Bonferroni´s post hoc test. Pearson correlation coefficients were used to define the relationships between SR and BS scores with respect to PSLR. In both men and women, the thoracic angle in BS was significantly greater than in SR (p<0.016. However, no significant differences were found between the tests in lumbar angle, pelvic angle, and forward reach scores. The concurrent validity of the forward reach score as a measure of hamstring extensibility was moderate in women (0.66 0. 76 and weak to moderate in men (0.51 0.59. The concurrent validity was slightly higher in SR than in BS, although no significant differences between the correlation values were observed. There were significant differences in the thoracic angle between the SR and BS, but not in the forward reach score. There was no difference in concurrent validity between the two tests. However, the traditional SR was preferred because it reached better concurrent validity than the BS

Decision theory, motor planning, and visual memory: deciding where to reach when memory errors are costly.

Science.gov (United States)

Lerch, Rachel A; Sims, Chris R

2016-06-01

Limitations in visual working memory (VWM) have been extensively studied in psychophysical tasks, but not well understood in terms of how these memory limits translate to performance in more natural domains. For example, in reaching to grasp an object based on a spatial memory representation, overshooting the intended target may be more costly than undershooting, such as when reaching for a cup of hot coffee. The current body of literature lacks a detailed account of how the costs or consequences of memory error influence what we encode in visual memory and how we act on the basis of remembered information. Here, we study how externally imposed monetary costs influence behavior in a motor decision task that involves reach planning based on recalled information from VWM. We approach this from a decision theoretic perspective, viewing decisions of where to aim in relation to the utility of their outcomes given the uncertainty of memory representations. Our results indicate that subjects accounted for the uncertainty in their visual memory, showing a significant difference in their reach planning when monetary costs were imposed for memory errors. However, our findings indicate that subjects memory representations per se were not biased by the imposed costs, but rather subjects adopted a near-optimal post-mnemonic decision strategy in their motor planning.

Space Shuttle Main Engine Public Test Firing

Science.gov (United States)

2000-01-01

A new NASA Space Shuttle Main Engine (SSME) roars to the approval of more than 2,000 people who came to John C. Stennis Space Center in Hancock County, Miss., on July 25 for a flight-certification test of the SSME Block II configuration. The engine, a new and significantly upgraded shuttle engine, was delivered to NASA's Kennedy Space Center in Florida for use on future shuttle missions. Spectators were able to experience the 'shake, rattle and roar' of the engine, which ran for 520 seconds - the length of time it takes a shuttle to reach orbit.

Planning of the Extended Reach well Dieksand 2; Planung der Extended Reach Bohrung Dieksand 2

Energy Technology Data Exchange (ETDEWEB)

Frank, U.; Berners, H. [RWE-DEA AG, Hamburg (Germany). Drilling Team Mittelplate und Dieksand; Hadow, A.; Klop, G.; Sickinger, W. [Wintershall AG Erdoelwerke, Barnstdorf (Germany); Sudron, K.

1998-12-31

The Mittelplate oil field is located 7 km offshore the town of Friedrichskoog. Reserves are estimated at 30 million tonnes of oil. At a production rate of 2,500 t/d, it will last about 33 years. The transport capacity of the offshore platform is limited, so that attempts were made to enhance production by constructing the extended reach borehole Dieksand 2. Details are presented. (orig.) [Deutsch] Das Erdoelfeld Mittelplate liegt am suedlichen Rand des Nationalparks Schleswig Holsteinisches Wattenmeer, ca. 7000 m westlich der Ortschaft Friedrichskoog. Die gewinnbaren Reserven betragen ca. 30 Millionen t Oel. Bei einer Foerderkapazitaet von 2.500 t/Tag betraegt die Foerderdauer ca. 33 Jahre. Aufgrund der begrenzten Transportkapazitaeten von der Insel, laesst sich durch zusaetzliche Bohrungen von der kuenstlichen Insel Mittelplate keine entscheidende Erhoehung der Foerderkapazitaet erzielen. Ab Sommer 1996 wurde erstmals die Moeglichkeit der Lagerstaettenerschliessung von Land untersucht. Ein im Mai 1997 in Hamburg etabliertes Drilling Team wurde mit der Aufgabe betraut, die Extended Reach Bohrung Dieksand 2 zu planen und abzuteufen. Die Planungsphasen fuer die Extended Reach Bohrung Dieksand 2 wurden aufgezeigt. Die fuer den Erfolg einer Extended Reach Bohrung wichtigen Planungsparameter wurden erlaeutert. Es wurden Wege gezeigt, wie bei diesem Projekt technische und geologische Risiken in der Planung mit beruecksichtigt und nach Beginn der Bohrung weiter bearbeitet werden koennen. (orig.)

Three-Year Major Clinical Outcomes of Angiography-Guided Single Stenting Technique in Non-Complex Left Main Coronary Artery Diseases.

Science.gov (United States)

Kim, Yong Hoon; Her, Ae-Young; Rha, Seung-Woon; Choi, Byoung Geol; Shim, Minsuk; Choi, Se Yeon; Byun, Jae Kyeong; Li, Hu; Kim, Woohyeun; Kang, Jun Hyuk; Choi, Jah Yeon; Park, Eun Jin; Park, Sung Hun; Lee, Sunki; Na, Jin Oh; Choi, Cheol Ung; Lim, Hong Euy; Kim, Eung Ju; Park, Chang Gyu; Seo, Hong Seog; Oh, Dong Joo

2017-10-12

There is limited long-term comparative clinical outcome data concerning angiography- versus intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) in non-complex left main coronary artery (LMCA) disease treated with the single stenting technique in the drug-eluting stent (DES) era.The aim of this study was to investigate whether angiography-guided stenting is comparable to IVUS-guided stenting during 3-year clinical follow-up periods in patients with non-complex LM disease treated with the single stenting technique.A total of 196 patients treated with either angiography-guided (n = 74) or IVUS-guided (n = 122) PCI were included. The primary outcome was the occurrence of major adverse cardiac events (MACE) defined as total death, non-fatal myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), and non-target vessel revascularization (Non-TVR). To adjust for any potential confounders, propensity score (PS) adjusted analysis was performed.During 3-year follow-up, the PS adjusted Cox-proportional hazard ratio (HR) was not significantly different between the two groups for total death, cardiac death, and MI. Also, TLR and the combined rates of TVR and non-TVR were not significantly different. Finally, MACE was not significantly different between the two groups (HR: 0.63, 95% Confidence interval (CI): 0.33-1.17; P = 0.149).Angiography-guided PCI for non-complex LMCA diseases treated with the single stenting technique showed comparable results compared with IVUS-guided PCI in reducing clinical events during 3-year clinical follow-up in the DES era. Although IVUS guided PCI is the ideal strategy, angiography-guided PCI can be an option for LMCA PCI in some selected cases.

Teratology testing under REACH.

Science.gov (United States)

Barton, Steve

2013-01-01

REACH guidelines may require teratology testing for new and existing chemicals. This chapter discusses procedures to assess the need for teratology testing and the conduct and interpretation of teratology tests where required.

REACH: Evaluation Report and Executive Summary

Science.gov (United States)

Sibieta, Luke

2016-01-01

REACH is a targeted reading support programme designed to improve reading accuracy and comprehension in pupils with reading difficulties in Years 7 and 8. It is based on research by the Centre for Reading and Language at York and is delivered by specially trained teaching assistants (TAs). This evaluation tested two REACH interventions, one based…

Global reach and engagement

Science.gov (United States)

2016-09-01

Popular culture reflects both the interests of and the issues affecting the general public. As concerns regarding climate change and its impacts grow, is it permeating into popular culture and reaching that global audience?

Online Advertising to Reach and Recruit Latino Smokers to an Internet Cessation Program: Impact and Costs

Science.gov (United States)

Fang, Ye; Moreno, Jose L; Streiff, Shawn L; Villegas, Jorge; Muñoz, Ricardo F; Tercyak, Kenneth P; Mandelblatt, Jeanne S; Vallone, Donna M

2012-01-01

Background Tobacco cessation among Latinos is a public health priority in the United States, particularly given the relatively high growth of this population segment. Although a substantial percentage of American Latinos use the Internet, they have not engaged in Web-based cessation programs as readily as other racial/ethnic subgroups. A lack of culturally specific advertising efforts may partly explain this disparity. Objective Phase I of this study focused on the development of four Spanish-language online banner advertisements to promote a free Spanish-language smoking cessation website (es.BecomeAnEX.org). Phase II examined the relative effectiveness of the four banner ads in reaching and recruiting Latino smokers to the cessation website. Methods In Phase I, 200 Spanish-speaking Latino smokers completed an online survey to indicate their preference for Spanish-language banner ads that incorporated either the cultural value of family (familismo) or fatalism (fatalismo). Ads included variations on message framing (gain vs loss) and depth of cultural targeting (surface vs deep). In Phase II, a Latin square design evaluated the effectiveness of the four preferred ads from Phase I. Ads were systematically rotated across four popular Latino websites (MySpace Latino, MSN Latino, MiGente, and Yahoo! en Español) over four months from August to November 2009. Tracking software recorded ad clicks and registrants on the cessation website. Negative binomial regression and general linear modeling examined the main and interacting effects of message framing and depth of cultural targeting for four outcomes: number of clicks, click-through rate, number of registrants, and cost per registrant. Results In Phase I, smokers preferred the four ads featuring familismo. In Phase II, 24,829,007 impressions were placed, yielding 24,822 clicks, an overall click-through rate of 0.10%, and 500 registrants (2.77% conversion rate). Advertising costs totaled US $104,669.49, resulting in an

Online advertising to reach and recruit Latino smokers to an internet cessation program: impact and costs.

Science.gov (United States)

Graham, Amanda L; Fang, Ye; Moreno, Jose L; Streiff, Shawn L; Villegas, Jorge; Muñoz, Ricardo F; Tercyak, Kenneth P; Mandelblatt, Jeanne S; Vallone, Donna M

2012-08-27

Tobacco cessation among Latinos is a public health priority in the United States, particularly given the relatively high growth of this population segment. Although a substantial percentage of American Latinos use the Internet, they have not engaged in Web-based cessation programs as readily as other racial/ethnic subgroups. A lack of culturally specific advertising efforts may partly explain this disparity. Phase I of this study focused on the development of four Spanish-language online banner advertisements to promote a free Spanish-language smoking cessation website (es.BecomeAnEX.org). Phase II examined the relative effectiveness of the four banner ads in reaching and recruiting Latino smokers to the cessation website. In Phase I, 200 Spanish-speaking Latino smokers completed an online survey to indicate their preference for Spanish-language banner ads that incorporated either the cultural value of family (familismo) or fatalism (fatalismo). Ads included variations on message framing (gain vs loss) and depth of cultural targeting (surface vs deep). In Phase II, a Latin square design evaluated the effectiveness of the four preferred ads from Phase I. Ads were systematically rotated across four popular Latino websites (MySpace Latino, MSN Latino, MiGente, and Yahoo! en Español) over four months from August to November 2009. Tracking software recorded ad clicks and registrants on the cessation website. Negative binomial regression and general linear modeling examined the main and interacting effects of message framing and depth of cultural targeting for four outcomes: number of clicks, click-through rate, number of registrants, and cost per registrant. In Phase I, smokers preferred the four ads featuring familismo. In Phase II, 24,829,007 impressions were placed, yielding 24,822 clicks, an overall click-through rate of 0.10%, and 500 registrants (2.77% conversion rate). Advertising costs totaled US $104,669.49, resulting in an overall cost per click of US $4

The dilatation of main pulmonary artery and right ventricle observed by enhanced chest computed tomography predict poor outcome in inoperable chronic thromboembolic pulmonary hypertension.

Science.gov (United States)

Ema, Ryogo; Sugiura, Toshihiko; Kawata, Naoko; Tanabe, Nobuhiro; Kasai, Hajime; Nishimura, Rintaro; Jujo, Takayuki; Shigeta, Ayako; Sakao, Seiichiro; Tatsumi, Koichiro

2017-09-01

Dilatation of the pulmonary artery and right ventricle on chest computed tomography images is often observed in patients with pulmonary hypertension. The clinical significance of these image findings has not been defined in chronic thromboembolic pulmonary hypertension. We investigated whether the pulmonary arterial and right ventricle dilatation was associated with poor outcome in chronic thromboembolic pulmonary hypertension. This was a retrospective cohort investigation in 60 subjects with inoperable chronic thromboembolic pulmonary hypertension diagnosed consecutively between 1997 and 2010 at Chiba University Hospital. Digital scout multi-detector chest computed tomography images were obtained. The main pulmonary arterial to ascending aortic diameter ratio and the right ventricular to left ventricular diameter ratio were calculated. Main pulmonary arterial to ascending aortic diameter ratio ranged from 0.85 to 1.84, and right ventricular to left ventricular diameter ratio ranged from 0.71 to 2.88. During the observation period of 1284.5days (range, 21-4550days), 13 patients required hospitalization due to worsening; 6 of them died. Kaplan-Meier analysis showed significant differences in hospitalization between the patients with main pulmonary arterial to ascending aortic diameter ratio of ≥1.1 and pulmonary hypertension. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

A Method for Reducing Misclassification in the Extended Glasgow Outcome Score

OpenAIRE

Lu, Juan; Marmarou, Anthony; Lapane, Kate; Turf, Elizabeth; Wilson, Lindsay

2010-01-01

The eight-point extended Glasgow Outcome Scale (GOSE) is commonly used as the primary outcome measure in traumatic brain injury (TBI) clinical trials. The outcome is conventionally collected through a structured interview with the patient alone or together with a caretaker. Despite the fact that using the structured interview questionnaires helps reach agreement in GOSE assessment between raters, significant variation remains among different raters. We introduce an alternate GOSE rating syste...

Why and how to make a REACH registration of combustion ash; Moejligheter vid REACH-registrering av energiaskor

Energy Technology Data Exchange (ETDEWEB)

Loevgren, Linnea; Wik, Ola

2009-10-15

The new chemical regulation, REACH (1997/2006/EC), Registration, Evaluation, Authorization and restriction of Chemicals, took effect the 1st of June 2007. The background to this report was the introduction of REACH and the difficulties to understand the implications for ash. The most important consequence of REACH is that all chemical substances that are manufactured, handled and used above one tonne per annum per legal entity shall be registered according to this regulation. The registration includes specifying the chemical, physical, toxicity and ecotoxicity properties of the substance and risk assessing the identified areas of use. The report describes the use of ash in connection to the waste legislation and its planned end-of-waste-criteria, the chemical legislation and the Construction Products Directive. The target audience of this report is companies producing ashes and having a use or seeing a use for its ash. The report describes how to make a REACH registration of ash independent if a company did or did not pre-register ash during 2008. It describes how to change from one ash registration into another if the pre-registration was done for one type of ash but the company changes opinion during the sameness check, i.e. changing SIEF (Appendix A). Taking part in REACH registration projects during 2009-2010 can be advantageous since knowledge and financing are shared. Ash can be REACH registered also in the future but it is important to know that the registration have to be done prior the production and marketing starts. If ash is consider to be a waste the handling is covered by the community and national waste legislation. In Sweden ashes are by and large being regarded as waste, and recycling is risk assessed and permits are given case by case. End-of-waste criteria for different waste material are being elaborated within the EU. Such criteria will among other details cover chemical safety. When a material fulfils the end-of-waste criteria such material

Stream Habitat Reach Summary - NCWAP [ds158

Data.gov (United States)

California Natural Resource Agency — The Stream Habitat - NCWAP - Reach Summary [ds158] shapefile contains in-stream habitat survey data summarized to the stream reach level. It is a derivative of the...

Impact of maternal age on delivery outcomes following spontaneous labour at term.

Science.gov (United States)

Omih, Edwin Eseoghene; Lindow, Stephen

2016-10-01

Pregnancy in women of advancing maternal age is linked to incrementally worsening perinatal outcome. The aim of this study is to assess the impact of maternal age on delivery outcome in women that spontaneously labour at term. This was a retrospective study of women that spontaneously labour at term. Women with singletons in spontaneous onset labour beyond 37 weeks of gestation were divided into five maternal age groups: 35 years by their age at delivery. The main outcome variables are augmentation of labour, caesarean section, assisted vaginal delivery, and perineal trauma, while admission of the newborn into the neonatal unit within 24 h following delivery was the secondary outcome measure. A total of 30,022 met the inclusion criteria with primiparae and multiparae accounting for 46 and 54%, respectively. Increasing age in primiparae was associated with; augmentation of labour OR 2.05 (95% CI 1.73-2.43), second degree perineal tear 1.35 (1.12-1.61), assisted vaginal delivery 1.92 (1.53-2.41) and caesarean section 4.23 (3.19-5.12). While that for multiparae; augmentation of labour OR 1.93 (1.05-3.52), perineal trauma 2.50 (1.85-3.34), assisted vaginal delivery 4.95 (91.82-13.35) and caesarean section 1.64 (1.13-2.38). The secondary outcome measure did not reach statistical significance. Increasing maternal age is an independent risk factor for operative delivery, and perineal trauma. However, maternal age has no significant effect on admission of infants into the NICU during the first 24 h following delivery.

Operational Reach: Is Current Army Doctrine Adequate?

National Research Council Canada - National Science Library

Heintzelman, Scott

2003-01-01

The term operational reach, an element of operational design, is new to U.S. Army doctrine. Operational reach is not found in the previous edition of the Army's basic operational doctrine, Field Manual...

Differences between late preterm and full-term infants: comparing effects of a short bout of practice on early reaching behavior.

Science.gov (United States)

de Almeida Soares, Daniele; Cunha, Andréa Baraldi; Tudella, Eloisa

2014-11-01

This study compared the effects of a short bout of practice on reaching behavior between late preterm and full-term infants at the onset of goal-directed reaching. Twelve late preterm infants and twelve full-term infants received reaching practice based on a serial schedule. Late preterm and full-term infants were assessed in 3.3±1.4 and 2.6±1.0 days after the onset of goal-directed reaching in two measures in a single day: immediately before practice (pre-test) and immediately after practice (post-test). During the assessments, the infants were placed in a baby chair and a rubber toy was presented at their midline within reaching distance for 2 min. Between assessments, the infants received practice of toy-oriented reaching in 3 activities repeated for approximately 4 min. The activities were elicited in a pre-established serial sequence and were applied by a physical therapist. During the pre-test, late preterm infants presented lower range of proximal adjustments, greater proportion of reaches with semi-open hand, and greater proportion of reaches without grasping than the full-term infants. During the post-test, late preterm infants presented greater motor variability of proximal adjustments, but explored and selected distal control and grasping outcomes less compared to the full-term group. Differences in reaching and gross motor behavior between late preterm and full-term infants can be found at the age of reaching onset. Practice provided new opportunities for late preterm infants to improve perception-action coupling to reach; however, relative to full-terms, they seemed less advanced in benefiting from the experience for more refined manual tasks. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Dynamics of soil erosion at upper reaches of Minjiang River based on GIS].

Science.gov (United States)

He, Xingyuan; Hu, Zhibi; Li, Yuehui; Hu, Yuanman

2005-12-01

Based on TM and ETM imagines, and employing GIS technique and empirical Revised Universal Soil Loss Equation (RUSLE) model, this paper studied the dynamics of soil erosion at the upper reaches of Minjiang River during three typical periods, with the main affecting factors analyzed. The results showed that the soil erosion area was increased by 1.28%, 1.84 % and 1.70% in 1986, 1995 and 2000, respectively. The average erosion modulus was increased from 832.64 t x km(-2) x yr(-1) in 1986 to 1048.74 t x km(-2) yr(-2) in 1995 and reached 1362.11 t x km(-2) yr(-1) in 2000, and soil loss was mainly of slight and light erosion, companying with a small quantity of middling erosion. The area of soil erosion was small, and the degree was light. There was a significant correlation between slope and soil loss, which mainly happened in the regions with a slope larger than 25 degrees, and accounted for 93.65%, 93.81% and 92.71% of the total erosion in 1986, 1995 and 2000, respectively. As for the altitude, middling, semi-high and high mountains and dry valley were liable to soil erosion, which accounted for 98.21%, 97.63% and 99.27% of the total erosion in 1986, 1995 and 2000, respectively. Different vegetation had a significant effect on soil erosion, and shrub and newly restored forest were the main erosion area. Excessive depasture not only resulted in the degradation of pasture, but also led to slight soil erosion. Land use type and soil type also contributed to soil loss, among which, dry-cinnamon soil and calcic gray-cinnamon soil were the most dangerous ones needing more protection. Soil loss was also linearly increased with increasing population and households, which suggested that the increase of population and households was the driving factor for soil loss increase in this area.

Approaches to Recruiting 'Hard-To-Reach' Populations into Re-search: A Review of the Literature.

Science.gov (United States)

Shaghaghi, Abdolreza; Bhopal, Raj S; Sheikh, Aziz

2011-01-01

'Hard-to-reach' is a term used to describe those sub-groups of the population that may be difficult to reach or involve in research or public health programmes. Application of a single term to call these sub-sections of populations implies a homogeneity within distinct groups, which does not necessarily exist. Different sampling techniques were introduced so far to recruit hard-to-reach populations. In this article, we have reviewed a range of ap-proaches that have been used to widen participation in studies. We performed a Pubmed and Google search for relevant English language articles using the keywords and phrases: (hard-to-reach AND population* OR sampl*), (hidden AND population* OR sample*) and ("hard to reach" AND population* OR sample*) and a consul-tation of the retrieved articles' bibliographies to extract empirical evidence from publications that discussed or examined the use of sampling techniques to recruit hidden or hard-to-reach populations in health studies. Reviewing the literature has identified a range of techniques to recruit hard-to-reach populations, including snowball sampling, respondent-driven sampling (RDS), indigenous field worker sampling (IFWS), facility-based sampling (FBS), targeted sampling (TS), time-location (space) sampling (TLS), conventional cluster sampling (CCS) and capture re-capture sampling (CR). The degree of compliance with a study by a certain 'hard-to-reach' group de-pends on the characteristics of that group, recruitment technique used and the subject of inter-est. Irrespective of potential advantages or limitations of the recruitment techniques reviewed, their successful use depends mainly upon our knowledge about specific characteristics of the target populations. Thus in line with attempts to expand the current boundaries of our know-ledge about recruitment techniques in health studies and their applications in varying situa-tions, we should also focus on possibly all contributing factors which may have an impact on

Motor Cortical Networks for Skilled Movements Have Dynamic Properties That Are Related to Accurate Reaching

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David F. Putrino

2011-01-01

Full Text Available Neurons in the Primary Motor Cortex (MI are known to form functional ensembles with one another in order to produce voluntary movement. Neural network changes during skill learning are thought to be involved in improved fluency and accuracy of motor tasks. Unforced errors during skilled tasks provide an avenue to study network connections related to motor learning. In order to investigate network activity in MI, microwires were implanted in the MI of cats trained to perform a reaching task. Spike trains from eight groups of simultaneously recorded cells (95 neurons in total were acquired. A point process generalized linear model (GLM was developed to assess simultaneously recorded cells for functional connectivity during reaching attempts where unforced errors or no errors were made. Whilst the same groups of neurons were often functionally connected regardless of trial success, functional connectivity between neurons was significantly different at fine time scales when the outcome of task performance changed. Furthermore, connections were shown to be significantly more robust across multiple latencies during successful trials of task performance. The results of this study indicate that reach-related neurons in MI form dynamic spiking dependencies whose temporal features are highly sensitive to unforced movement errors.

THE IMPLEMENTATION OF JOBSHEET-BASED STUDENT TEAMS ACHIEVEMENT DIVISION LEARNING MODEL TO IMPROVE STUDENTS LEARNING OUTCOMES

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Kadek Dodi Permana

2016-09-01

Full Text Available This study aims to improve the Information and Communications Technology (ICT learning outcomes of the students in SMA N 2 Singaraja through the learning model of Job sheet-based Student Team Achievement Division (STAD. This is a classroom action research. The data analysis reveals that learning outcomes in cycle I gain a mean score of 80. 51 and a classical provisions of 15%. There are three students who pass with a minimum score of 85 in cycle I. From these categories, the students’ learning outcomes in the first cycle have not met the criterion of 85%. The mean score of cycle II is 88. 57 and the classical provisions is 90%. In the second cycle, there are 18 students who gain a minimum score of 85. Based on the success criterion, a research study is successful if the minimum completeness criterion reaches 85 and the minimum classical completeness criterion reaches 85%. From the categories, the students’ learning outcomes have been successfully improved since the percentage of classical completeness in the second cycle has reached its expected results.

New Stream-reach Development: A Comprehensive Assessment of Hydropower Energy Potential in the United States

Energy Technology Data Exchange (ETDEWEB)

Kao, Shih-Chieh [ORNL; McManamay, Ryan A [ORNL; Stewart, Kevin M [ORNL; Samu, Nicole M [ORNL; Hadjerioua, Boualem [ORNL; DeNeale, Scott T [ORNL; Yeasmin, Dilruba [California State University, Fresno; Pasha, M. Fayzul K. [California State University, Fresno; Oubeidillah, Abdoul A [ORNL; Smith, Brennan T [ORNL

2014-04-01

The rapid development of multiple national geospatial datasets related to topography, hydrology, and environmental characteristics in the past decade have provided new opportunities for the refinement of hydropower resource potential from undeveloped stream-reaches. Through 2011 to 2013, the Oak Ridge National Laboratory (ORNL) was tasked by the Department of Energy (DOE) Water Power Program to evaluate the new stream-reach development (NSD) resource potential for more than 3 million US streams. A methodology was designed that contains three main components: (1) identification of stream-reaches with high energy density, (2) topographical analysis of stream-reaches to estimate inundated surface area and reservoir storage, and (3) environmental attribution to spatially join information related to the natural ecological systems, social and cultural settings, policies, management, and legal constraints to stream-reaches of energy potential. An initial report on methodology (Hadjerioua et al., 2013) was later reviewed and revised based on the comments gathered from two peer review workshops. After implementing the assessment across the entire United States, major findings were summarized in this final report. The estimated NSD capacity and generation, including both higher-energy-density (>1 MW per reach) and lower-energy-density (<1 MW per reach) stream-reaches is 84.7 GW, around the same size as the existing US conventional hydropower nameplate capacity (79.5 GW; NHAAP, 2013). In terms of energy, the total undeveloped NSD generation is estimated to be 460 TWh/year, around 169% of average 2002 2011 net annual generation from existing conventional hydropower plants (272 TWh/year; EIA, 2013). Given the run-of-river assumption, NSD stream-reaches have higher capacity factors (53 71%), especially compared with conventional larger-storage peaking-operation projects that usually have capacity factors of around 30%. The highest potential is identified in the Pacific Northwest

Development of a health promotion programme to improve awareness of factors that affect fertility, and evaluation of its reach in the first 5 years

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Karin Hammarberg

2017-06-01

Full Text Available Awareness among people of reproductive age about the factors that influence fertility and reproductive outcomes, including medically assisted reproduction outcomes, is generally low. To improve awareness about the potentially modifiable factors that affect fertility and reproductive outcomes, ‘Your Fertility’, a fertility health promotion programme funded by the Australian Government, was established in 2011. This paper describes the development and evaluation of the reach of the Your Fertility programme from its inception in 2011 to June 2016. Systematically recorded outcomes for the programme’s key focus areas and Google Analytics data were collated. Key achievements include developing and maintaining an internationally renowned website that experiences high growth and demand for fertility-related information; by 2016, over 5 million users had viewed more than 10 million webpages, and over 96,000 users had engaged in programme messages across social media. Programme messages have reached more than 4 million Australian social media users, and a potential audience of 150 million through media coverage across more than 320 media features. More than 4200 education and health professionals have completed online learning modules, and external partnerships have been established with 14 separate organizations. Data collected over 5 years indicate that the Your Fertility programme meets a need for targeted, evidence-based, accessible fertility-related information.

Complex hydro- and sediment dynamics survey of two critical reaches on the Hungarian part of river Danube

International Nuclear Information System (INIS)

Baranya, Sandor; Jozsa, Janos; Goda, Laszlo; Rakoczi, Laszlo

2008-01-01

Detailed hydrodynamic survey of two critical river reaches has been performed from hydro- and sediment dynamics points of view, in order to explore the main features, moreover, provide calibration and verification data to related 3D flow and sediment transport modelling. Special attention has been paid to compare moving and fix boat measurement modes for estimating various flow and large-scale bed form features, resulting in recommendations e.g. on the time period needed in stationary mode operation to obtain sufficiently stabilized average velocity profiles and related parameter estimations. As to the study reaches, the first comprises a 5 km long sandy-gravel bed reach of river Danube located in Central-Hungary, presenting problems for navigation. As a conventional remedy, groyne fields have been implemented to make and maintain the reach sufficiently deep, navigable even in low flow periods. As is usually the case, these works resulted in rather complex flow characteristics and related bed topography at places. The second site is another 5 km long reach of river Danube, close to the southern border to Serbia. There the river presents navigational problems similar to the previously mentioned reach, however, having entirely sand bed conditions, abundant in a variety of dunes, especially in the shallower parts. In both study reaches ADCP measurements were done with around 2.5 Hz sampling frequency both in moving boat operation mode providing overall, though locally moderately representative picture, and in fixed boat mode at a considerable number of selected verticals with 10 minutes long measuring time.

A Systematic Review of Animal-Assisted Therapy on Psychosocial Outcomes in People with Intellectual Disability.

Science.gov (United States)

Maber-Aleksandrowicz, Sarah; Avent, Cerian; Hassiotis, Angela

2016-01-01

The aim of the study was to review the literature on animal assisted therapy (AAT) in people with intellectual disabilities (ID) measuring psychosocial outcomes (behavioural, social, cognitive and emotional). Quantitative studies were found through a systematic search that identified studies using AAT in people with ID and measuring psychosocial outcomes (behavioural, cognitive, emotional and social). The quality of studies was assessed using a standardised tool and rated as strong, moderate or weak. Only published articles from peer-reviewed journals were included. No language or age restrictions were applied. Over half of the included studies were identified outside standard database searches (e.g. hand searching reference lists from included articles, references from AAT websites and using Google Scholar and a Grey Literature Database). Ten studies were included in the final review; two were rated as moderate quality and eight were rated as weak quality. Overall there was a positive improvement reported from studies for all psychosocial outcomes (with some cognitive, behavioural, social, emotional components reaching statistical significance p ≤ 0.01). Despite having no age restrictions, the included studies had participants that were mainly children and adolescents, in particular favouring male participants, which may limit generalisation. More rigorous methodology is required to improve the quality of future studies including in the main multicentre randomised designs and improved reporting according to CONSORT criteria. Further research should expand to include adults with ID and specific disorders such as challenging behaviour or mental illness. Copyright © 2015 Elsevier Ltd. All rights reserved.

Interaction torque contributes to planar reaching at slow speed

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Hoshi Fumihiko

2008-10-01

Full Text Available Abstract Background How the central nervous system (CNS organizes the joint dynamics for multi-joint movement is a complex problem, because of the passive interaction among segmental movements. Previous studies have demonstrated that the CNS predictively compensates for interaction torque (INT which is arising from the movement of the adjacent joints. However, most of these studies have mainly examined quick movements, presumably because the current belief is that the effects of INT are not significant at slow speeds. The functional contribution of INT for multijoint movements performed in various speeds is still unclear. The purpose of this study was to examine the contribution of INT to a planer reaching in a wide range of motion speeds for healthy subjects. Methods Subjects performed reaching movements toward five targets under three different speed conditions. Joint position data were recorded using a 3-D motion analysis device (50 Hz. Torque components, muscle torque (MUS, interaction torque (INT, gravity torque (G, and net torque (NET were calculated by solving the dynamic equations for the shoulder and elbow. NET at a joint which produces the joint kinematics will be an algebraic sum of torque components; NET = MUS - G - INT. Dynamic muscle torque (DMUS = MUS-G was also calculated. Contributions of INT impulse and DMUS impulse to NET impulse were examined. Results The relative contribution of INT to NET was not dependent on speed for both joints at every target. INT was additive (same direction to DMUS at the shoulder joint, while in the elbow DMUS counteracted (opposed to INT. The trajectory of reach was linear and two-joint movements were coordinated with a specific combination at each target, regardless of motion speed. However, DMUS at the elbow was opposed to the direction of elbow movement, and its magnitude varied from trial to trial in order to compensate for the variability of INT. Conclusion Interaction torque was important at

Perceiver as polar planimeter: Direct perception of jumping, reaching, and jump-reaching affordances for the self and others.

Science.gov (United States)

Thomas, Brandon J; Hawkins, Matthew M; Nalepka, Patrick

2017-03-30

Runeson (Scandanavian Journal of Psychology 18:172-179, 1977) suggested that the polar planimeter might serve as an informative model system of perceptual mechanism. The key aspect of the polar planimeter is that it registers a higher order property of the environment without computational mediation on the basis of lower order properties, detecting task-specific information only. This aspect was posited as a hypothesis for the perception of jumping and reaching affordances for the self and another person. The findings supported this hypothesis. The perception of reaching while jumping significantly differed from an additive combination of jump-without-reaching and reach-without-jumping perception. The results are consistent with Gibson's (The senses considered as perceptual systems, Houghton Mifflin, Boston, MA; Gibson, The senses considered as perceptual systems, Houghton Mifflin, Boston, MA, 1966; The ecological approach to visual perception, Houghton Mifflin, Boston, MA; Gibson, The ecological approach to visual perception, Houghton Mifflin, Boston, MA, 1979) theory of information-that aspects of the environment are specified by patterns in energetic media.

[Effect of hydrochemistry characteristics under impact of human activity: a case study in the upper reaches of the Xijiang River basin].

Science.gov (United States)

Yu, Shil; Sun, Ping-an; Du, Wen-yue; He, Shi-yi; Li, Rui

2015-01-01

In this paper, observation and sampling were taken three times a month in a hydrological year for three typical sections of the middle and upper reaches of the Xijiang River basin, based on the data of hydrochemistry and flow, the article mainly discusses the evolution process of hydrochemistry in river under natural process and impact of human activity. Hydrochemical characteristics of 116. samples were analyzed in the study area. The hydrochemistry type in the middle and upper reaches of the Xijiang River basin belonged to HCO3- -Ca2+ type, and the chemical weathering type mainly came from carbonate rock weathering. Ca2+ and HCO3- were the main cations and anions, which reflected that hydrochemical characteristics of river in karst area mainly affected by the dissolution of carbonate rock. Na, Mg2, Ca2+ and Cl- mainly affected by natural conditions, the impact of human activity was little. K+, NO3-, SO4(2-) and HCO3- were affected by human activity in different degrees, and it showed different influence ways. This study had an important significance for the change of river hydrochemistry, water quality characteristics, and the effect on substance transported fluxes in the downstream of Pearl River and water quality protection in South China Monsoon Area.

Mapping health outcomes from ecosystem services

NARCIS (Netherlands)

Keune, Hans; Oosterbroek, Bram; Derkzen, Marthe; Subramanian, Suneetha; Payyappalimana, Unnikrishnan; Martens, Pim; Huynen, Maud; Burkhard, Benjamin; Maes, Joachim

The practice of mapping ecosystem services (ES) in relation to health outcomes is only in its early developing phases. Examples are provided of health outcomes, health proxies and related biophysical indicators. This chapter also covers main health mapping challenges, design options and

RECORDS REACHING RECORDING DATA TECHNOLOGIES

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G. W. L. Gresik

2013-07-01

Full Text Available The goal of RECORDS (Reaching Recording Data Technologies is the digital capturing of buildings and cultural heritage objects in hard-to-reach areas and the combination of data. It is achieved by using a modified crane from film industry, which is able to carry different measuring systems. The low-vibration measurement should be guaranteed by a gyroscopic controlled advice that has been , developed for the project. The data were achieved by using digital photography, UV-fluorescence photography, infrared reflectography, infrared thermography and shearography. Also a terrestrial 3D laser scanner and a light stripe topography scanner have been used The combination of the recorded data should ensure a complementary analysis of monuments and buildings.

Records Reaching Recording Data Technologies

Science.gov (United States)

Gresik, G. W. L.; Siebe, S.; Drewello, R.

2013-07-01

The goal of RECORDS (Reaching Recording Data Technologies) is the digital capturing of buildings and cultural heritage objects in hard-to-reach areas and the combination of data. It is achieved by using a modified crane from film industry, which is able to carry different measuring systems. The low-vibration measurement should be guaranteed by a gyroscopic controlled advice that has been , developed for the project. The data were achieved by using digital photography, UV-fluorescence photography, infrared reflectography, infrared thermography and shearography. Also a terrestrial 3D laser scanner and a light stripe topography scanner have been used The combination of the recorded data should ensure a complementary analysis of monuments and buildings.

SVHC in imported articles: REACH authorisation requirement justified under WTO rules.

Science.gov (United States)

Schenten, Julian; Führ, Martin

2016-01-01

The purpose of the REACH Regulation is to ensure a high level of protection of human health and the environment as well as the free circulation of substances on the internal market while enhancing competitiveness and innovation. To this end, REACH introduces, among other instruments, the authorisation regime for substances of very high concern (SVHC) that are listed on Annex XIV of the regulation. After expiration of the transitional period for each Annex XIV-SVHC, articles, such as most products of daily use, produced in the European Economic Area (EEA) may not contain such substances unless an authorisation was granted for the specific use or this use falls within the scope of an exemption from the authorisation requirement. The authorisation scheme does, however, only apply to SVHC used in the EEA. As a consequence, REACH does not regulate SVHC entering the European market as part of imported articles which burden human health and the environment. Moreover, from an economic perspective, domestic articles are subject to stricter requirements than those which are produced abroad, putting actors from within the EEA at competitive disadvantage and thus impeding the intention of REACH to enhance competitiveness and innovation. One option to close this regulatory gap could be to extend the authorisation requirement to SVHC present in imported articles. A legal appraisal on behalf of the German Environment Agency (UBA) assesses whether such option would be in accordance with the specifications of WTO world trade law. It concludes that, measured by the standards of the WTO dispute settlement practice, such an extended authorisation scheme would neither violate the principles of national treatment and most-favoured nation treatment. Also, such regulation would not constitute an unnecessary obstacle to trade, since the extended authorisation requirement would pursue a legitimate objective covered by the regulatory autonomy of the EU and, furthermore, the regulation would

Useful properties of spinal circuits for learning and performing planar reaches

Science.gov (United States)

Tsianos, George A.; Goodner, Jared; Loeb, Gerald E.

2014-10-01

Objective. We developed a detailed model of the spinal circuitry plus musculoskeletal system (SC + MS) for the primate arm and investigated its role in sensorimotor control, learning and storing of movement repertoires. Approach. Recently developed models of spinal circuit connectivity, neurons and muscle force/energetics were integrated and in some cases refined to construct the most comprehensive model of the SC + MS to date. The SC + MS’s potential contributions to center-out reaching movement were assessed by employing an extremely simple model of the brain that issued only step commands. Main results. The SC + MS was able to generate physiological muscle dynamics underlying reaching across different directions, distances, speeds, and even in the midst of strong dynamic perturbations (i.e. viscous curl field). For each task, there were many different combinations of brain inputs that generated physiological performance. Natural patterns of recruitment and low metabolic cost emerged for about half of the learning trials when a purely kinematic cost function was used and for all of the trials when an estimate of metabolic energy consumption was added to the cost function. Solutions for different tasks could be interpolated to generate intermediate movement and the range over which interpolation was successful was consistent with experimental reports. Significance. This is the first demonstration that a realistic model of the SC + MS is capable of generating the required dynamics of center-out reaching. The interpolability observed is important for the feasibility of storing motor programs in memory rather than computing them from internal models of the musculoskeletal plant. Successful interpolation of command programs required them to have similar muscle recruitment patterns, which are thought by many to arise from hard-wired muscle synergies rather than learned as in our model system. These properties of the SC + MS along with its tendency to generate

Assessment of quality of life and functional outcome in patients sustaining moderate and major trauma: a multicentre, prospective cohort study.

Science.gov (United States)

Rainer, T H; Yeung, J H H; Cheung, S K C; Yuen, Y K Y; Poon, W S; Ho, H F; Kam, C W; Cattermole, G N; Chang, A; So, F L; Graham, C A

2014-05-01

Trauma care systems aim to reduce both death and disability, yet there is little data on post-trauma health status and functional outcome. To evaluate baseline, discharge, six month and 12 month post-trauma quality of life, functional outcome and predictors of quality of life in Hong Kong. Multicentre, prospective cohort study using data from the trauma registries of three regional trauma centres in Hong Kong. Trauma patients with an ISS≥9 and aged≥18 years were included. The main outcome measures were the physical component summary (PCS) score and mental component summary (MCS) scores of the Short-Form 36 (SF36) for health status, and the extended Glasgow Outcome Scale (GOSE) for functional outcome. Between 1 January 2010 and 31 September 2010, 400 patients (mean age 53.3 years; range 18-106; 69.5% male) were recruited to the study. There were no statistically significant differences in baseline characteristics between responders (N=177) and surviving non-responders (N=163). However, there were significant differences between these groups and the group of patients who died (N=60). Only 16/400 (4%) cases reported a GOSE≥7. 62/400 (15.5%) responders reached the HK population norm for PCS. 125/400 (31%) responders reached the HK population norm for MCS. If non-responders had similar outcomes to responders, then the percentages for GOSE≥7 would rise from 4% to 8%, for PCS from 15.5% to 30%, and for MCS from 31% to 60%. Univariate analysis showed that 12-month poor quality of life was significantly associated with age>65 years (OR 4.77), male gender (OR 0.44), pre-injury health problems (OR 2.30), admission to ICU (OR 2.15), ISS score 26-40 (OR 3.72), baseline PCS (OR 0.89), one-month PCS (OR 0.89), one-month MCS (OR 0.97), 6-month PCS (OR 0.76) and 6-month MCS (OR 0.97). For patients sustaining moderate or major trauma in Hong Kong at 12 months after injury<1 in 10 patients had an excellent recovery, ≤3 in 10 reached a physical health status score�

Reaching Hard-to-Reach Individuals: Nonselective Versus Targeted Outbreak Response Vaccination for Measles

Science.gov (United States)

Minetti, Andrea; Hurtado, Northan; Grais, Rebecca F.; Ferrari, Matthew

2014-01-01

Current mass vaccination campaigns in measles outbreak response are nonselective with respect to the immune status of individuals. However, the heterogeneity in immunity, due to previous vaccination coverage or infection, may lead to potential bias of such campaigns toward those with previous high access to vaccination and may result in a lower-than-expected effective impact. During the 2010 measles outbreak in Malawi, only 3 of the 8 districts where vaccination occurred achieved a measureable effective campaign impact (i.e., a reduction in measles cases in the targeted age groups greater than that observed in nonvaccinated districts). Simulation models suggest that selective campaigns targeting hard-to-reach individuals are of greater benefit, particularly in highly vaccinated populations, even for low target coverage and with late implementation. However, the choice between targeted and nonselective campaigns should be context specific, achieving a reasonable balance of feasibility, cost, and expected impact. In addition, it is critical to develop operational strategies to identify and target hard-to-reach individuals. PMID:24131555

The Impact of Maternal Obesity and Excessive Gestational Weight Gain on Maternal and Infant Outcomes in Maine: Analysis of Pregnancy Risk Assessment Monitoring System Results from 2000 to 2010.

Science.gov (United States)

Baugh, Nancy; Harris, David E; Aboueissa, AbouEl-Makarim; Sarton, Cheryl; Lichter, Erika

2016-01-01

The objective of this study is to understand the relationships between prepregnancy obesity and excessive gestational weight gain (GWG) and adverse maternal and fetal outcomes. Pregnancy risk assessment monitoring system (PRAMS) data from Maine for 2000-2010 were used to determine associations between demographic, socioeconomic, and health behavioral variables and maternal and infant outcomes. Multivariate logistic regression analysis was performed on the independent variables of age, race, smoking, previous live births, marital status, education, BMI, income, rurality, alcohol use, and GWG. Dependent variables included maternal hypertension, premature birth, birth weight, infant admission to the intensive care unit (ICU), and length of hospital stay of the infant. Excessive prepregnancy BMI and excessive GWG independently predicted maternal hypertension. A high prepregnancy BMI increased the risk of the infant being born prematurely, having a longer hospital stay, and having an excessive birth weight. Excessive GWG predicted a longer infant hospital stay and excessive birth weight. A low pregnancy BMI and a lower than recommended GWG were also associated with poor outcomes: prematurity, low birth weight, and an increased risk of the infant admitted to ICU. These findings support the importance of preconception care that promotes achievement of a healthy weight to enhance optimal reproductive outcomes.

The Impact of Maternal Obesity and Excessive Gestational Weight Gain on Maternal and Infant Outcomes in Maine: Analysis of Pregnancy Risk Assessment Monitoring System Results from 2000 to 2010

Directory of Open Access Journals (Sweden)

Nancy Baugh

2016-01-01

Full Text Available The objective of this study is to understand the relationships between prepregnancy obesity and excessive gestational weight gain (GWG and adverse maternal and fetal outcomes. Pregnancy risk assessment monitoring system (PRAMS data from Maine for 2000–2010 were used to determine associations between demographic, socioeconomic, and health behavioral variables and maternal and infant outcomes. Multivariate logistic regression analysis was performed on the independent variables of age, race, smoking, previous live births, marital status, education, BMI, income, rurality, alcohol use, and GWG. Dependent variables included maternal hypertension, premature birth, birth weight, infant admission to the intensive care unit (ICU, and length of hospital stay of the infant. Excessive prepregnancy BMI and excessive GWG independently predicted maternal hypertension. A high prepregnancy BMI increased the risk of the infant being born prematurely, having a longer hospital stay, and having an excessive birth weight. Excessive GWG predicted a longer infant hospital stay and excessive birth weight. A low pregnancy BMI and a lower than recommended GWG were also associated with poor outcomes: prematurity, low birth weight, and an increased risk of the infant admitted to ICU. These findings support the importance of preconception care that promotes achievement of a healthy weight to enhance optimal reproductive outcomes.

Patient-reported outcome after fast-track hip arthroplasty: a prospective cohort study

Directory of Open Access Journals (Sweden)

Hansen Torben B

2010-11-01

Full Text Available Abstract Background A fast-track intervention with a short preoperative optimization period and short postoperative hospitalization has a potential for reduced convalescence and thereby a reduced need for postoperative rehabilitation. The purpose of this study was to describe patient-related outcomes, the need for additional rehabilitation after a fast-track total hip arthroplasty (THA, and the association between generic and disease specific outcomes. Methods The study consisted of 196 consecutive patients of which none received additional rehabilitation beyond an instructional exercise plan at discharge, which was adjusted at one in-patient visit. The patients filled in 3 questionnaires to measure health-related quality-of-life (HRQOL and hip specific function (EQ-5 D, SF36, and Harris Hip Score (HHS at 2 time points pre- and 2 time points postoperatively. The observed results were compared to normative population data for EQ-5 D, SF36, and HHS. Results 3-months postoperatively patients had reached a HRQOL level of 0.84 (SD, 0.14, which was similar to the population norm (P = 0.33, whereas they exceeded the population norm at 12 months postoperatively (P P P = 0.35. For HHS, patients never reached the population norm within 12 months postoperatively. Generic and disease specific outcomes were strongly associated. Conclusions If HRQOL is considered the primary outcome after THA, the need for additional postoperative rehabilitation for all THA patients following a fast-track intervention is questionable. However, a pre- or early postoperative physical intervention seems relevant if the PF of the population norm should be reached at 3 months. If disease specific outcome is considered the primary outcome after fast-track THA, clear goals for the rehabilitation must be established before patient selection, intervention type and timing of intervention can be made.

Isolating valve, especially in main-steam pipes of power plants

International Nuclear Information System (INIS)

Karpenko, A.N.

1977-01-01

The valve for PWRs and BWRs, with diameters up to 1.25 m, for temperatures from -180 0 C to about 600 0 C and pressures up to over 50 bar, is designed for high reliability and long useful life. Two circular valve discs are moved as isolating elements in their plane across the steam direction and brought before the valve seat within a valve chamber. Shortly before reaching this final position, each disc is rotated by a small amount about its axis. Only after reaching the final position a double-wedge, further pushed forward between both discs, produces the necessary contact pressure. By revolving and frictionless closing caking together at high stresses and temperature variation is prevented and permanent tightness assured. The valve body is moved in a cylinder, cast on the valve housing, by means of a stepped piston. Its larger diameter is guided in a second cylinder flanged on above. In the cover of the second cylinder a pilot valve is mounted being controlled over 2 parallel solenoid valves by means of compressed air. In normal operation process steam from the valve chamber serves to move the stepped piston with the valve chamber. On closing of a bore, connecting both cylinder spaces, by the pilot valve the main valve is opened. If the pilot valve is opened the steam through the connecting bore is acting on both piston stages and closing the main valve. On loss of steam (pipe break) or for testing purposes one or the other cylinder space over solenoid valves is acted upon by auxiliary energy or evacuated, the main valve thus being controlled. (HP) [de

Long-term outcome of major depressive disorder in psychiatric patients is variable.

Science.gov (United States)

Holma, K Mikael; Holma, Irina A K; Melartin, Tarja K; Rytsälä, Heikki J; Isometsä, Erkki T

2008-02-01

The prevailing view of outcome of major depressive disorder (MDD), based on mostly inpatient cohorts sampled from tertiary centers, emphasizes chronicity and frequent recurrences. We investigated the long-term outcome of a regionally representative psychiatric MDD cohort comprising mainly outpatients. The Vantaa Depression Study included 163 patients with DSM-IV MDD (71.5% of those eligible) diagnosed using structured and semistructured interviews and followed up at 6 months, 18 months, and 5 years with a life chart between February 1, 1997, and April 30, 2004. The effects of comorbid disorders and other predictors on outcome were comprehensively investigated. Over the 5-year follow-up, 98.8% of patients achieved a symptom state below major depressive episode (MDE) criteria, and 88.4% reached full remission, with the median time to full remission being 11.0 months. Nearly one third (29.3%) had no recurrences, whereas 30.0% experienced 1, 12.9% experienced 2, and 27.9% experienced 3 or more recurrences. Preceding dysthymic disorder (p = .028), cluster C personality disorder (p = .041), and longer MDE duration prior to entry (p = .011) were the most significant predictors of longer time in achieving full remission. Severity of MDD and comorbidity, especially social phobia, predicted probability of, shorter time to, and number of recurrences. Previous literature on mostly inpatient MDD may have, by generalizing from patients with the most severe psychopathology, overemphasized chronicity of MDD. The long-term outcome of MDD in psychiatric care is variable, with about one tenth of patients having poor, one third having intermediate, and one half having favorable outcomes. In addition to known predictors, cluster C personality disorders and social phobia warrant further attention as predictors of MDD outcome among outpatients.

Seventh meeting of the Global Alliance to Eliminate Lymphatic Filariasis: reaching the vision by scaling up, scaling down, and reaching out

Science.gov (United States)

2014-01-01

This report summarizes the 7th meeting of the Global Alliance to Eliminate Lymphatic Filariasis (GAELF), Washington DC, November 18–19, 2012. The theme, “A Future Free of Lymphatic Filariasis: Reaching the Vision by Scaling Up, Scaling Down and Reaching Out”, emphasized new strategies and partnerships necessary to reach the 2020 goal of elimination of lymphatic filariasis (LF) as a public-health problem. PMID:24450283

Periodontal treatment for preventing adverse pregnancy outcomes

DEFF Research Database (Denmark)

Schwendicke, Falk; Karimbux, Nadeem; Allareddy, Veerasathpurush

2015-01-01

OBJECTIVES: Periodontal treatment might reduce adverse pregnancy outcomes. The efficacy of periodontal treatment to prevent preterm birth, low birth weight, and perinatal mortality was evaluated using meta-analysis and trial sequential analysis. METHODS: An existing systematic review was updated...... risk of random errors. RESULTS: Thirteen randomized clinical trials evaluating 6283 pregnant women were meta-analyzed. Four and nine trials had low and high risk of bias, respectively. Overall, periodontal treatment had no significant effect on preterm birth (odds ratio [95% confidence interval] 0.......79 [0.57-1.10]) or low birth weight (0.69 [0.43-1.13]). Trial sequential analysis demonstrated that futility was not reached for any of the outcomes. For populations with moderate occurrence (periodontal treatment was not efficacious for any of the outcomes...

Stereotypical reaching movements of the octopus involve both bend propagation and arm elongation.

Science.gov (United States)

Hanassy, S; Botvinnik, A; Flash, T; Hochner, B

2015-05-13

The bend propagation involved in the stereotypical reaching movement of the octopus arm has been extensively studied. While these studies have analyzed the kinematics of bend propagation along the arm during its extension, possible length changes have been ignored. Here, the elongation profiles of the reaching movements of Octopus vulgaris were assessed using three-dimensional reconstructions. The analysis revealed that, in addition to bend propagation, arm extension movements involve elongation of the proximal part of the arm, i.e., the section from the base of the arm to the propagating bend. The elongations are quite substantial and highly variable, ranging from an average strain along the arm of -0.12 (i.e. shortening) up to 1.8 at the end of the movement (0.57 ± 0.41, n = 64 movements, four animals). Less variability was discovered in an additional set of experiments on reaching movements (0.64 ± 0.28, n = 30 movements, two animals), where target and octopus positions were kept more stationary. Visual observation and subsequent kinematic analysis suggest that the reaching movements can be broadly segregated into two groups. The first group involves bend propagation beginning at the base of the arm and propagating towards the arm tip. In the second, the bend is formed or present more distally and reaching is achieved mainly by elongation and straightening of the segment proximal to the bend. Only in the second type of movements is elongation significantly positively correlated with the distance of the bend from the target. We suggest that reaching towards a target is generated by a combination of both propagation of a bend along the arm and arm elongation. These two motor primitives may be combined to create a broad spectrum of reaching movements. The dynamical model, which recapitulates the biomechanics of the octopus muscular hydrostatic arm, suggests that achieving the observed elongation requires an extremely low ratio of longitudinal to transverse muscle

REACH: next step to a sound chemicals management.

Science.gov (United States)

Van der Wielen, Arnold

2007-12-01

REACH is the new European Regulation for Registration, Evaluation, Authorisation and Restriction of Chemicals. It entered into force on 1st June 2007 to streamline and improve the former legislative framework on new and on existing chemical substances of the European Union. Companies which manufacture or import more than 1 tonne of a substance per year will be required to register the substance at the new EU Chemicals Agency located in Helsinki. REACH places greater responsibility on industry to manage the risks that chemicals may pose to the health and the environment and to provide safety information that will be passed down the supply chain. In principle, REACH applies to all chemicals as such, as components in preparations and as used in articles. REACH is a radical step forward in the EU chemicals management. The onus will move from the authorities to industry. In addition, REACH will allow the further evaluation of substances where there are grounds for concern, foresees an authorisation system for the use of substances of very high concern and a system of restrictions, where applicable, for substances of concern. The Authorisation system will require companies to switch progressively to safer alternatives where a suitable alternative exists. Current use restrictions will remain under REACH system.

Clinimetrics & determinants of outcome after stroke

NARCIS (Netherlands)

Schepers, V.P.M.

2006-01-01

This thesis is based on findings of the Functional Prognostication and disability study on stroke, which had two main objectives: (1) to examine which outcome measures are most appropriate, and especially most responsive, for the assessment of functional outcome in stroke patients and (2) to study

Reaching ignition in the tokamak

International Nuclear Information System (INIS)

Furth, H.P.

1985-06-01

This review covers the following areas: (1) the physics of burning plasmas, (2) plasma physics requirements for reaching ignition, (3) design studies for ignition devices, and (4) prospects for an ignition project

Do working environment interventions reach shift workers?

Science.gov (United States)

Nabe-Nielsen, Kirsten; Jørgensen, Marie Birk; Garde, Anne Helene; Clausen, Thomas

2016-01-01

Shift workers are exposed to more physical and psychosocial stressors in the working environment as compared to day workers. Despite the need for targeted prevention, it is likely that workplace interventions less frequently reach shift workers. The aim was therefore to investigate whether the reach of workplace interventions varied between shift workers and day workers and whether such differences could be explained by the quality of leadership exhibited at different times of the day. We used questionnaire data from 5361 female care workers in the Danish eldercare sector. The questions concerned usual working hours, quality of leadership, and self-reported implementation of workplace activities aimed at stress reduction, reorganization of the working hours, and participation in improvements of working procedures or qualifications. Compared with day workers, shift workers were less likely to be reached by workplace interventions. For example, night workers less frequently reported that they had got more flexibility (OR 0.5; 95 % CI 0.3-0.7) or that they had participated in improvements of the working procedures (OR 0.6; 95 % CI 0.5-0.8). Quality of leadership to some extent explained the lack of reach of interventions especially among fixed evening workers. In the light of the evidence of shift workers' stressful working conditions, we suggest that future studies focus on the generalizability of results of the present study and on how to reach this group and meet their needs when designing and implementing workplace interventions.

Prison mental health in-reach teams in England: the care programme approach and sexual abuse/violence.

Science.gov (United States)

Brooker, Charles G D; Forrester, Andrew

2017-12-01

Prison mental health in-reach teams have doubled in size over the past decade and case-loads have reduced. Since 2010 it has been mandatory for keyworkers to ask whether prisoners with serious mental illness being treated under the care programme approach have experienced sexual or physical abuse. This is known as routine enquiry and should take place for these prisoners but NHS England, the commissioners, do not audit this activity. It is time to review current interventions and their associated outcomes. © The Royal College of Psychiatrists 2017.

Cost-effectiveness of increasing the reach of smoking cessation interventions in Germany: results from the EQUIPTMOD.

Science.gov (United States)

Huber, Manuel B; Präger, Maximilian; Coyle, Kathryn; Coyle, Doug; Lester-George, Adam; Trapero-Bertran, Marta; Nemeth, Bertalan; Cheung, Kei Long; Stark, Renee; Vogl, Matthias; Pokhrel, Subhash; Leidl, Reiner

2017-12-15

To evaluate costs, effects and cost-effectiveness of increased reach of specific smoking cessation interventions in Germany. A Markov-based state transition return on investment model (EQUIPTMOD) was used to evaluate current smoking cessation interventions as well as two prospective investment scenarios. A health-care perspective (extended to include out-of-pocket payments) with life-time horizon was considered. A probabilistic analysis was used to assess uncertainty concerning predicted estimates. Germany. Cohort of current smoking population (18+ years) in Germany. Interventions included group-based behavioural support, financial incentive programmes and varenicline. For prospective scenario 1 the reach of group-based behavioral support, financial incentive programme and varenicline was increased by 1% of yearly quit attempts (= 57 915 quit attempts), while prospective scenario 2 represented a higher reach, mirroring the levels observed in England. EQUIPTMOD considered reach, intervention cost, number of quitters, quality-of-life years (QALYs) gained, cost-effectiveness and return on investment. The highest returns through reduction in smoking-related health-care costs were seen for the financial incentive programme (€2.71 per €1 invested), followed by that of group-based behavioural support (€1.63 per €1 invested), compared with no interventions. Varenicline had lower returns (€1.02 per €1 invested) than the other two interventions. At the population level, prospective scenario 1 led to 15 034 QALYs gained and €27 million cost-savings, compared with current investment. Intervention effects and reach contributed most to the uncertainty around the return-on-investment estimates. At a hypothetical willingness-to-pay threshold of only €5000, the probability of being cost-effective is approximately 75% for prospective scenario 1. Increasing the reach of group-based behavioural support, financial incentives and varenicline for smoking cessation by

Guaranteed performance in reaching mode of sliding mode ...

Indian Academy of Sciences (India)

R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

addresses the design of constant plus proportional rate reaching law-based SMC for second-order ... Reaching mode; sliding mode controlled systems; output tracking ... The uncertainty in the input distribution function g is expressed as.

HIV prevention in Latin America: reaching youth in Colombia.

Science.gov (United States)

Perez, F; Dabis, F

2003-02-01

The aim of this paper is to describe and evaluate a school-based peer education programme on HIV primary prevention implemented in urban marginal districts of three cities of Colombia from 1997 to 1999. Its main objective was to promote risk awareness and safe sexual behaviours among urban youth populations. Methodology included the collection of baseline information through qualitative methods (focus groups and in-depth interviews), a knowledge, attitudes and practices (KAP) survey, a health education intervention, and post-intervention data collection. Direct beneficiaries were adolescents 10 to 19 years of age, and secondary school teachers of 6th to 9th grades. Main strategies used were peer education and classroom sessions conducted by trained teachers. Short-term results suggest that the programme had a positive effect on knowledge and attitudes related to HIV/AIDS (as the mean knowledge summary indicator among adolescents and secondary school teachers increased 24% and 21%, respectively). The main outcome has been the development of a sex education programme, emphasizing the role of schools in the promotion of sexual and reproductive health. Mass education by a combination of interventions and events at school level, backed up by effective interpersonal communication such as peer education, classroom teaching and community actions are effective primary prevention strategies for HIV sexual transmission and should be more extensively considered.

One-year Outcomes in Patients with ST-segment Elevation Myocardial Infarction Caused by Unprotected Left Main Coronary Artery Occlusion Treated by Primary Percutaneous Coronary Intervention.

Science.gov (United States)

Liu, Hai-Wei; Han, Ya-Ling; Jin, Quan-Min; Wang, Xiao-Zeng; Ma, Ying-Yan; Wang, Geng; Wang, Bin; Xu, Kai; Li, Yi; Chen, Shao-Liang

2018-06-20

Very few data have been reported for ST-segment elevation myocardial infarction (STEMI) caused by unprotected left main coronary artery (ULMCA) occlusion, and very little is known about the results of this subgroup of patients who underwent primary percutaneous coronary intervention (PCI). The aim of this study was to determine the clinical features and outcomes of patients with STEMI who underwent primary PCI for acute ULMCA occlusion. From January 2000 to February 2014, 372 patients with STEMI caused by ULMCA acute occlusion (ULMCA-STEMI) who underwent primary PCI at one of two centers were enrolled. The 230 patients with non-ST-segment elevation MI (NSTEMI) caused by ULMCA lesion (ULMCA-NSTEMI) who underwent emergency PCI were designated the control group. The main indexes were the major adverse cardiac events (MACEs) in-hospital, at 1 month, and at 1 year. Compared to the NSTEMI patients, the patients with STEMI had significantly higher rates of Killip class≥III (21.2% vs. 3.5%, χ 2 = 36.253, P 0.05) and TVR (all P > 0.05) in the intervals of 0-1 month as well as 1 month to 1 year. The results of Cox regression analysis showed that the differences in the independent predictors for MACE included the variables of Killip class ≥ III and intra-aortic balloon pump support for the STEMI patients and the variables of previous MI, ULMCA distal bifurcation, and 2-stent for distal ULMCA lesions for the NSTEMI patients. Compared to the NSTEMI patients, the patients with STEMI and ULMCA lesions still remain at a much higher risk for adverse events at 1 year, especially on 1 month. If a successful PCI procedure is performed, the 1-year outcomes in those patients might improve.

Action plans can interact to hinder or facilitate reach performance.

Science.gov (United States)

Fournier, Lisa R; Wiediger, Matthew D; Taddese, Ezana F

2015-11-01

Executing a reach action can be delayed while retaining another action in working memory (WM) if the two action plans partly overlap rather than do not overlap. This delay (partial repetition cost) occurs when reach responses are under cognitive control. In this study, we investigated whether facilitation (a partial repetition benefit) occurs when reach responses are automatic. We also examined whether the hemisphere controlling the limb or selection of the preferred limb (based on a free-reach task) influences reach performance when the actions partly overlap. Left- and right-handers reached to different stimulus locations to the left and right of body midline with their ipsilateral hand while maintaining an action plan in WM that required the same or the different hand. The results showed a partial repetition benefit for spatially compatible reaches to left and right stimulus locations far from the body midline, but not for those near the body midline. Also, no partial repetition cost was found at any of the stimulus-reach locations. This indicates that automatic reach responses that partly overlap with an action plan maintained in WM are not delayed, but instead can be facilitated (partial repetition benefit). The roles of hemisphere and reach-hand preference in action control and the importance of the degree of feature overlap in obtaining a partial repetition benefit (and cost) are discussed.

Changes in Purkinje cell simple spike encoding of reach kinematics during adaption to a mechanical perturbation.

Science.gov (United States)

Hewitt, Angela L; Popa, Laurentiu S; Ebner, Timothy J

2015-01-21

The cerebellum is essential in motor learning. At the cellular level, changes occur in both the simple spike and complex spike firing of Purkinje cells. Because simple spike discharge reflects the main output of the cerebellar cortex, changes in simple spike firing likely reflect the contribution of the cerebellum to the adapted behavior. Therefore, we investigated in Rhesus monkeys how the representation of arm kinematics in Purkinje cell simple spike discharge changed during adaptation to mechanical perturbations of reach movements. Monkeys rapidly adapted to a novel assistive or resistive perturbation along the direction of the reach. Adaptation consisted of matching the amplitude and timing of the perturbation to minimize its effect on the reach. In a majority of Purkinje cells, simple spike firing recorded before and during adaptation demonstrated significant changes in position, velocity, and acceleration sensitivity. The timing of the simple spike representations change within individual cells, including shifts in predictive versus feedback signals. At the population level, feedback-based encoding of position increases early in learning and velocity decreases. Both timing changes reverse later in learning. The complex spike discharge was only weakly modulated by the perturbations, demonstrating that the changes in simple spike firing can be independent of climbing fiber input. In summary, we observed extensive alterations in individual Purkinje cell encoding of reach kinematics, although the movements were nearly identical in the baseline and adapted states. Therefore, adaption to mechanical perturbation of a reaching movement is accompanied by widespread modifications in the simple spike encoding. Copyright © 2015 the authors 0270-6474/15/351106-19$15.00/0.

Task-dependent vestibular feedback responses in reaching.

Science.gov (United States)

Keyser, Johannes; Medendorp, W Pieter; Selen, Luc P J

2017-07-01

When reaching for an earth-fixed object during self-rotation, the motor system should appropriately integrate vestibular signals and sensory predictions to compensate for the intervening motion and its induced inertial forces. While it is well established that this integration occurs rapidly, it is unknown whether vestibular feedback is specifically processed dependent on the behavioral goal. Here, we studied whether vestibular signals evoke fixed responses with the aim to preserve the hand trajectory in space or are processed more flexibly, correcting trajectories only in task-relevant spatial dimensions. We used galvanic vestibular stimulation to perturb reaching movements toward a narrow or a wide target. Results show that the same vestibular stimulation led to smaller trajectory corrections to the wide than the narrow target. We interpret this reduced compensation as a task-dependent modulation of vestibular feedback responses, tuned to minimally intervene with the task-irrelevant dimension of the reach. These task-dependent vestibular feedback corrections are in accordance with a central prediction of optimal feedback control theory and mirror the sophistication seen in feedback responses to mechanical and visual perturbations of the upper limb. NEW & NOTEWORTHY Correcting limb movements for external perturbations is a hallmark of flexible sensorimotor behavior. While visual and mechanical perturbations are corrected in a task-dependent manner, it is unclear whether a vestibular perturbation, naturally arising when the body moves, is selectively processed in reach control. We show, using galvanic vestibular stimulation, that reach corrections to vestibular perturbations are task dependent, consistent with a prediction of optimal feedback control theory. Copyright © 2017 the American Physiological Society.

Assessing the reach and effectiveness of mHealth: evidence from a reproductive health program for adolescent girls in Ghana.

Science.gov (United States)

Rokicki, Slawa; Fink, Günther

2017-12-20

While mobile health (mHealth) programs are increasingly used to provide health information and deliver interventions, little is known regarding the relative reach and effectiveness of these programs across sociodemographic characteristics. We use data from a recent trial of a text-messaging intervention on adolescent sexual and reproductive health (SRH) to assess the degree to which mHealth programs reach target adolescent subpopulations who may be at higher risk of poor SRH outcomes. The study was conducted among girls aged 14-24 in 22 secondary schools in Accra, Ghana. The mHealth intervention was an interactive mobile phone quiz in which participants could win phone credit for texting correct answers to SRH questions. We use detailed data on individuals' level of engagement with the program, SRH knowledge scores, and self-reported pregnancy collected as part of the original trial to assess the extent to which engagement and program impact vary across parental education, sexual experience, SRH knowledge deficit, and parental support. Eighty-one percent of participants engaged with the mHealth program, with no evidence that the program disproportionally reached better-off groups. The program was effective at increasing knowledge of SRH across all strata. Higher levels of engagement were associated with higher knowledge scores up to year later. There was no significant impact of the program on self-reported pregnancy within subgroups. mHealth programs for adolescents have the potential to engage and increase SRH knowledge of adolescent girls across sociodemographic strata, including those who may be at higher risk of poor SRH outcomes. ClinicalTrials.gov NCT02031575 . Registered 07 Jan 2014.

Outcomes following the main treatment options in patients with a leaking esophagus: a systematic literature review.

Science.gov (United States)

Persson, S; Rouvelas, I; Irino, T; Lundell, L

2017-12-01

Leakage from the esophagus and gastroesophageal junction can be lethal due to uncontrolled contamination of the mediastinum. The most predominant risk factors for the subsequent clinical outcome are the patients' delay as well as the delay of diagnosis. Two major therapeutic concepts have been advocated: either prompt closure of the leakage by insertion of a self-expandable metal stent (SEMS) or more traditionally, surgical exploration. The objective of this review is to carefully scrutinize the recent literature and assess the outcomes of these two therapeutic alternatives in the management of iatrogenic perforation-spontaneous esophageal rupture as separated from those with anastomotic leak. A systematic web-based search using PubMed and the Cochrane Library was performed, reviewing literature published between January 2005 and December 2015. Eligible studies included all studies that presented data on the outcome of SEMS or surgical exploration in case of esophageal leak (including >3 patients). Only patients older than 15 years of age by the time of admission were included. Articles in other languages but English were excluded. Treatment failure was defined as a need for change in therapeutic strategy due to uncontrolled sepsis and mediastinitis, which usually meant rescue esophagectomy with end esophagostomy, death occurring as a consequence of the leakage or development of an esophagorespiratory fistula and/or other serious life threatening complications. Accordingly, the corresponding success rate is composed of cases where none of the failures above occurred. Regarding SEMS treatment, 201 articles were found, of which 48 were deemed relevant and of these, 17 articles were further analyzed. As for surgical management, 785 articles were retrieved, of which 82 were considered relevant, and 17 were included in the final analysis. It was not possible to specifically extract detailed clinical outcomes in sufficient numbers, when we tried to separately analyze the

Nanomaterials under REACH. Nanosilver as a case study

NARCIS (Netherlands)

Pronk MEJ; Wijnhoven SWP; Bleeker EAJ; Heugens EHW; Peijnenburg WJGM; Luttik R; Hakkert BC; SEC; SIR; LER

2009-01-01

Om de risico's van nanomaterialen te kunnen inschatten en beheersen, zijn enkele aanpassingen nodig in de Europese chemicalienwetgeving REACH. De gegevens over stoffen waar REACH standaard om vraagt, zijn namelijk onvoldoende om de specifieke eigenschappen van nanomaterialen te bepalen. Hetzelfde

Clinical and psychological risk factors for aggressive behavior in minors with delinquent behavior , have not reached the age of criminal responsibility

OpenAIRE

Martynova I.R.

2016-01-01

The results of empirical studies of clinical and psychological risk factors for aggressive behavior in adolescents. The main sample and comparison group - juveniles with delinquent behavior, not reached (n = 60) and age of criminal responsibility (n = 60). The control group of adolescents with conventionally normative behavior (n = 20). It is shown that the main group examinees have a number of serious problems that increase the risk of aggressive behavior. Reduced mood, anxiety, emotional in...

Missing depth cues in virtual reality limit performance and quality of three dimensional reaching movements.

Science.gov (United States)

Gerig, Nicolas; Mayo, Johnathan; Baur, Kilian; Wittmann, Frieder; Riener, Robert; Wolf, Peter

2018-01-01

Goal-directed reaching for real-world objects by humans is enabled through visual depth cues. In virtual environments, the number and quality of available visual depth cues is limited, which may affect reaching performance and quality of reaching movements. We assessed three-dimensional reaching movements in five experimental groups each with ten healthy volunteers. Three groups used a two-dimensional computer screen and two groups used a head-mounted display. The first screen group received the typically recreated visual depth cues, such as aerial and linear perspective, occlusion, shadows, and texture gradients. The second screen group received an abstract minimal rendering lacking those. The third screen group received the cues of the first screen group and absolute depth cues enabled by retinal image size of a known object, which realized with visual renderings of the handheld device and a ghost handheld at the target location. The two head-mounted display groups received the same virtually recreated visual depth cues as the second or the third screen group respectively. Additionally, they could rely on stereopsis and motion parallax due to head-movements. All groups using the screen performed significantly worse than both groups using the head-mounted display in terms of completion time normalized by the straight-line distance to the target. Both groups using the head-mounted display achieved the optimal minimum in number of speed peaks and in hand path ratio, indicating that our subjects performed natural movements when using a head-mounted display. Virtually recreated visual depth cues had a minor impact on reaching performance. Only the screen group with rendered handhelds could outperform the other screen groups. Thus, if reaching performance in virtual environments is in the main scope of a study, we suggest applying a head-mounted display. Otherwise, when two-dimensional screens are used, achievable performance is likely limited by the reduced depth

Long-term outcomes of coronary artery bypass grafting versus stent-PCI for unprotected left main disease: a meta-analysis.

Science.gov (United States)

De Rosa, Salvatore; Polimeni, Alberto; Sabatino, Jolanda; Indolfi, Ciro

2017-09-06

Coronary artery bypass graft (CABG) surgery has traditionally represented the standard of care for left main coronary artery (LMCA) disease. However, percutaneous coronary intervention with stent implantation (PCI) has more recently emerged as a valuable alternative. The long-time awaited results of the largest randomized trials on the long-term impact of PCI versus CABG in LMCA disease, the newly published NOBLE and EXCEL studies, revealed contrasting results. Thus, aim of the present meta-analysis was to review the most robust evidence from randomized comparisons of CABG versus PCI for revascularization of LMCA. Randomized studies comparing long-term clinical outcomes of CABG or Stent-PCI for the treatment of LMCA disease were searched for in PubMed, the Chochrane Library and Scopus electronic databases. A total of 5 randomized studies were selected, including 4499 patients. No significant difference between CABG and PCI was found in the primary analysis on the composite endpoint of death, stroke and myocardial infarction (OR = 1·06 95% CI 0·80-1·40; p = 0·70). Similarly, no differences were observed between CABG and PCI for all-cause death (OR = 1·03 95% CI 0·81-1·32; p = 0·81). Although not statistically significant, a lower rate of stroke was registered in the PCI arm (OR = 0·86; p = 0·67), while a lower rate of myocardial infarction was found in the CABG arm (OR = 1·43; p = 0·17). On the contrary, a significantly higher rate of repeat revascularization was registered in the PCI arm (OR = 1·76 95% CI 1·45-2·13; p PCI and CABG for the treatment of LMCA disease in the composite endpoint of death, stroke and myocardial infarction. Hence, a large part of patients with unprotected left main coronary artery disease can be managed equally well by means of both these revascularization strategies.

Main theorems of thermodynamics focused on future energy supply

Energy Technology Data Exchange (ETDEWEB)

Knizia, K

1983-09-01

Proceeding from the ethical aim to minimize sufferings, we have to develop rules of conduct which take into account the effects of our actions which in our complex world reach spatially as well as temporally further than in previous times. The basic laws of nature which govern our activities include the first and the second main theorems of thermodynamics. It is especially the second main theorem which also represent the creative principle of shaping and maintaining order and structures. In general, this is achieved by the use of the production factors: energy - information - matter. This also applies to the human creativity, including specific adjustment of these production factors related to man and his environment. It is only the correct use which can achieve an adequate supply of goods for a still growing world population, together with its peaceful and humane numerical stabilisation, satisfactory environment protection and careful consumption of raw material reserves.

Reaching those most in need: a review of diabetes self-management interventions in disadvantaged populations.

Science.gov (United States)

Eakin, Elizabeth G; Bull, Sheana S; Glasgow, Russell E; Mason, Mondi

2002-01-01

There has been increased recognition of the importance of developing diabetes self-management education (DSME) interventions that are effective with under-served and minority populations. Despite several recent studies in this area, there is to our knowledge no systematic review or synthesis of what has been learned from this research. An electronic literature search identified five formative evaluations and ten controlled DSME intervention trials focused on under-served (low-income, minority or aged) populations. The RE-AIM (Reach, Efficacy, Adoption, Implementation, Maintenance) evaluation framework was used to evaluate the controlled studies on the dimensions of reach, efficacy, adoption, implementation, and maintenance. Fifty percent of the studies identified reported on the percentage of patients who participated, and the percentages were highly variable. The methodological quality of the articles was generally good and the short-term results were encouraging, especially on behavioral outcomes. Data on adoption (representativeness of settings and clinicians who participate) and implementation were almost never reported. Studies of modalities in addition to group meetings are needed to increase the reach of DSME with under-served populations. The promising formative evaluation work that has been conducted needs to be extended for more systematic study of the process of intervention implementation and adaptation with special populations. Studies that explicitly address the community context and that address multiple issues related to public health impact of DSME interventions are recommended to enhance long-term results. Copyright 2002 John Wiley & Sons, Ltd.

Outcomes after adrenalectomy for unilateral primary aldosteronism: an international consensus on outcome measures and analysis of remission rates in an international cohort.

Science.gov (United States)

Williams, Tracy A; Lenders, Jacques W M; Mulatero, Paolo; Burrello, Jacopo; Rottenkolber, Marietta; Adolf, Christian; Satoh, Fumitoshi; Amar, Laurence; Quinkler, Marcus; Deinum, Jaap; Beuschlein, Felix; Kitamoto, Kanako K; Pham, Uyen; Morimoto, Ryo; Umakoshi, Hironobu; Prejbisz, Aleksander; Kocjan, Tomaz; Naruse, Mitsuhide; Stowasser, Michael; Nishikawa, Tetsuo; Young, William F; Gomez-Sanchez, Celso E; Funder, John W; Reincke, Martin

2017-09-01

Although unilateral primary aldosteronism is the most common surgically correctable cause of hypertension, no standard criteria exist to classify surgical outcomes. We aimed to create consensus criteria for clinical and biochemical outcomes and follow-up of adrenalectomy for unilateral primary aldosteronism and apply these criteria to an international cohort to analyse the frequency of remission and identify preoperative determinants of successful outcome. The Primary Aldosteronism Surgical Outcome (PASO) study was an international project to develop consensus criteria for outcomes and follow-up of adrenalectomy for unilateral primary aldosteronism. An international panel of 31 experts from 28 centres, including six endocrine surgeons, used the Delphi method to reach consensus. We then retrospectively analysed follow-up data from prospective cohorts for outcome assessment of patients diagnosed with unilateral primary aldosteronism by adrenal venous sampling who had undergone a total adrenalectomy, consecutively included from 12 referral centres in nine countries. On the basis of standardised criteria, we determined the proportions of patients achieving complete, partial, or absent clinical and biochemical success in accordance with the consensus. We then used logistic regression analyses to identify preoperative factors associated with clinical and biochemical outcomes. Consensus was reached for criteria for six outcomes (complete, partial, and absent success of clinical and biochemical outcomes) based on blood pressure, use of antihypertensive drugs, plasma potassium and aldosterone concentrations, and plasma renin concentrations or activities. Consensus was also reached for two recommendations for the timing of follow-up assessment. For the international cohort analysis, we analysed clinical data from 705 patients recruited between 1994 and 2015, of whom 699 also had biochemical data. Complete clinical success was achieved in 259 (37%) of 705 patients, with a

Reaching the hard to reach.

Science.gov (United States)

Bhiwandi, P; Campbell, M; Potts, M

1994-01-01

The 1994 International Conference on Population and Development proposed increasing contraceptive couple protection from 550 million in 1995 to 880 million in 2015. The task for family planning (FP) programs is to provide access to services for, sometimes, inaccessible rural populations. FP need based on desire for no more children has ranged from under 20% in Senegal to almost 80% in Peru. Socioeconomic development was found not to be a prerequisite for fertility change. Gender inequalities in education and social autonomy must be changed. FP access is very important among women with a disadvantaged background or among women unsure about FP. Bangladesh is a good example of a country with increased contraceptive prevalence despite low income. The rule of thumb is that contraception increases of 15% contribute to a drop in family size of about one child. Program effectiveness is related to a variety of factors: contraceptive availability at many locations, acceptable price of contraception, delivery of the oral contraceptives without prescriptions, and other strategies. FP is a service not a medical treatment. A range of methods must be promoted and available from a range of facilities. Contraceptive use is dependent on the woman's stage in her lifecycle and is dependent on informed choice. Community-based distribution systems are effective, whereas free distribution by poorly-trained field workers is not always very effective because patient payment of all or part of the cost assures quality and freedom of choice. Effective programs for underprivileged groups involve aggressive, easy to manage programs that can be replicated rapidly. FP serves a useful function in depressing maternal mortality among the poor in Africa, who have no access to quality health services. Social marketing is an effective strategy for reaching remote areas. Political will and robust management are necessary commodities.

Ebstein's anomaly in pregnancy: maternal and neonatal outcomes.

Science.gov (United States)

Chopra, Seema; Suri, Vanita; Aggarwal, Neelam; Rohilla, Meenakshi; Vijayvergiya, Rajesh; Keepanasseril, Anish

2010-04-01

Ebstein's anomaly is a rare congenital cardiac abnormality, associated with cyanosis and arrhythmia. Patients often reach childbearing age and pregnant women pose a challenge to the treating physician. We describe the course and outcome of pregnancy in women with Ebstein's anomaly and discuss the related management issues. Analysis of pregnancies in four women with Ebstein's anomaly was carried out in a referral institute in northern India. Data of two women were analyzed retrospectively and the other two women were prospectively followed in their pregnancies during the study period. The course of the pregnancy, disease and perinatal outcome in each woman were analyzed. Four women had eight pregnancies all resulting in vaginal deliveries. There were two premature deliveries. The mean birth weight was 2.54 + or - 0.88 kg. Of the eight babies, six did not have any cardiac anomalies; one was an unexplained neonatal death and for another, no data was available. Pregnancy was well tolerated in two patients, while one had right heart failure during early pregnancy, and one had arrhythmia during labor, which was managed medically; one patient had arrhythmia in the postpartum period, which was managed medically. When a woman with Ebstein's anomaly reaches childbearing age, fertility is not affected, even in cyanotic women. Under close supervision by the woman's obstetrician and cardiologist, the pregnancy outcome is usually favorable.

Blood Pressure Response to Main Renal Artery and Combined Main Renal Artery Plus Branch Renal Denervation in Patients With Resistant Hypertension.

Science.gov (United States)

Fengler, Karl; Ewen, Sebastian; Höllriegel, Robert; Rommel, Karl-Philipp; Kulenthiran, Saaraaken; Lauder, Lucas; Cremers, Bodo; Schuler, Gerhard; Linke, Axel; Böhm, Michael; Mahfoud, Felix; Lurz, Philipp

2017-08-10

Single-electrode ablation of the main renal artery for renal sympathetic denervation showed mixed blood pressure (BP)-lowering effects. Further improvement of the technique seems crucial to optimize effectiveness of the procedure. Because sympathetic nerve fibers are closer to the lumen in the distal part of the renal artery, treatment of the distal main artery and its branches has been shown to reduce variability in treatment effects in preclinical studies and a recent randomized trial. Whether this optimized technique improves clinical outcomes remains uncertain. We report a 2-center experience of main renal artery and combined main renal artery plus branches renal denervation in patients with resistant hypertension using a multielectrode catheter. Twenty-five patients with therapy-resistant hypertension underwent renal sympathetic denervation with combined main renal artery and renal branch ablation and were compared to matched controls undergoing an ablation of the main renal artery only. BP change was assessed by ambulatory measurement at baseline and after 3 months. At baseline, BP was balanced between the groups. After 3 months, BP changed significantly in the combined ablation group (systolic/diastolic 24-hour mean and daytime mean BP -8.5±9.8/-7.0±10.7 and -9.4±9.8/-7.1±13.5 mm Hg, P renal artery and branches appears to improve BP-lowering efficacy and should be further investigated. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Researching effective approaches to cleaning in hospitals: protocol of the REACH study, a multi-site stepped-wedge randomised trial.

Science.gov (United States)

Hall, Lisa; Farrington, Alison; Mitchell, Brett G; Barnett, Adrian G; Halton, Kate; Allen, Michelle; Page, Katie; Gardner, Anne; Havers, Sally; Bailey, Emily; Dancer, Stephanie J; Riley, Thomas V; Gericke, Christian A; Paterson, David L; Graves, Nicholas

2016-03-24

The Researching Effective Approaches to Cleaning in Hospitals (REACH) study will generate evidence about the effectiveness and cost-effectiveness of a novel cleaning initiative that aims to improve the environmental cleanliness of hospitals. The initiative is an environmental cleaning bundle, with five interdependent, evidence-based components (training, technique, product, audit and communication) implemented with environmental services staff to enhance hospital cleaning practices. The REACH study will use a stepped-wedge randomised controlled design to test the study intervention, an environmental cleaning bundle, in 11 Australian hospitals. All trial hospitals will receive the intervention and act as their own control, with analysis undertaken of the change within each hospital based on data collected in the control and intervention periods. Each site will be randomised to one of the 11 intervention timings with staggered commencement dates in 2016 and an intervention period between 20 and 50 weeks. All sites complete the trial at the same time in 2017. The inclusion criteria allow for a purposive sample of both public and private hospitals that have higher-risk patient populations for healthcare-associated infections (HAIs). The primary outcome (objective one) is the monthly number of Staphylococcus aureus bacteraemias (SABs), Clostridium difficile infections (CDIs) and vancomycin resistant enterococci (VRE) infections, per 10,000 bed days. Secondary outcomes for objective one include the thoroughness of hospital cleaning assessed using fluorescent marker technology, the bio-burden of frequent touch surfaces post cleaning and changes in staff knowledge and attitudes about environmental cleaning. A cost-effectiveness analysis will determine the second key outcome (objective two): the incremental cost-effectiveness ratio from implementation of the cleaning bundle. The study uses the integrated Promoting Action on Research Implementation in Health Services (i

Cerebellar inactivation impairs memory of learned prism gaze-reach calibrations.

Science.gov (United States)

Norris, Scott A; Hathaway, Emily N; Taylor, Jordan A; Thach, W Thomas

2011-05-01

Three monkeys performed a visually guided reach-touch task with and without laterally displacing prisms. The prisms offset the normally aligned gaze/reach and subsequent touch. Naive monkeys showed adaptation, such that on repeated prism trials the gaze-reach angle widened and touches hit nearer the target. On the first subsequent no-prism trial the monkeys exhibited an aftereffect, such that the widened gaze-reach angle persisted and touches missed the target in the direction opposite that of initial prism-induced error. After 20-30 days of training, monkeys showed long-term learning and storage of the prism gaze-reach calibration: they switched between prism and no-prism and touched the target on the first trials without adaptation or aftereffect. Injections of lidocaine into posterolateral cerebellar cortex or muscimol or lidocaine into dentate nucleus temporarily inactivated these structures. Immediately after injections into cortex or dentate, reaches were displaced in the direction of prism-displaced gaze, but no-prism reaches were relatively unimpaired. There was little or no adaptation on the day of injection. On days after injection, there was no adaptation and both prism and no-prism reaches were horizontally, and often vertically, displaced. A single permanent lesion (kainic acid) in the lateral dentate nucleus of one monkey immediately impaired only the learned prism gaze-reach calibration and in subsequent days disrupted both learning and performance. This effect persisted for the 18 days of observation, with little or no adaptation.

Trend-outflow method for understanding interactions of surface water with groundwater and atmospheric water for eight reaches of the Upper Rio Grande

Science.gov (United States)

Liu, Yi; Sheng, Zhuping

2011-11-01

SummaryAtmospheric water, surface water, and groundwater interact very actively through hydrologic processes such as precipitation, infiltration, seepage, irrigation, drainage, evaporation, and evapotranspiration in the Upper Rio Grande Basin. A trend-outflow method has been developed in this paper to gain a better understanding of the interactions based on cumulated inflow and outflow data for any river reaches of interest. A general trend-outflow equation was derived by associating the net interaction of surface water with atmospheric water as a polynomial of inflow and the net interaction of surface water with groundwater as a constant based on surface water budget. Linear and quadratic relations are probably two common trend-outflow types in the real world. It was found that trend-outflows of the Upper Rio Grande reaches, Española, Albuquerque, Socorro-Engle, Palomas, and Rincon are linear with inflow, while those of reaches, Belen, Mesilla and Hueco are quadratic. Reaches Belen, Mesilla and Hueco are found as water deficit reaches mainly for irrigated agriculture in extreme drought years.

High construal level can help negotiators to reach integrative agreements: The role of information exchange and judgement accuracy.

Science.gov (United States)

Wening, Stefanie; Keith, Nina; Abele, Andrea E

2016-06-01

In negotiations, a focus on interests (why negotiators want something) is key to integrative agreements. Yet, many negotiators spontaneously focus on positions (what they want), with suboptimal outcomes. Our research applies construal-level theory to negotiations and proposes that a high construal level instigates a focus on interests during negotiations which, in turn, positively affects outcomes. In particular, we tested the notion that the effect of construal level on outcomes was mediated by information exchange and judgement accuracy. Finally, we expected the mere mode of presentation of task material to affect construal levels and manipulated construal levels using concrete versus abstract negotiation tasks. In two experiments, participants negotiated in dyads in either a high- or low-construal-level condition. In Study 1, high-construal-level dyads outperformed dyads in the low-construal-level condition; this main effect was mediated by information exchange. Study 2 replicated both the main and mediation effects using judgement accuracy as mediator and additionally yielded a positive effect of a high construal level on a second, more complex negotiation task. These results not only provide empirical evidence for the theoretically proposed link between construal levels and negotiation outcomes but also shed light on the processes underlying this effect. © 2015 The British Psychological Society.

Probing the reaching-grasping network in humans through multivoxel pattern decoding.

Science.gov (United States)

Di Bono, Maria Grazia; Begliomini, Chiara; Castiello, Umberto; Zorzi, Marco

2015-11-01

The quest for a putative human homolog of the reaching-grasping network identified in monkeys has been the focus of many neuropsychological and neuroimaging studies in recent years. These studies have shown that the network underlying reaching-only and reach-to-grasp movements includes the superior parieto-occipital cortex (SPOC), the anterior part of the human intraparietal sulcus (hAIP), the ventral and the dorsal portion of the premotor cortex, and the primary motor cortex (M1). Recent evidence for a wider frontoparietal network coding for different aspects of reaching-only and reach-to-grasp actions calls for a more fine-grained assessment of the reaching-grasping network in humans by exploiting pattern decoding methods (multivoxel pattern analysis--MVPA). Here, we used MPVA on functional magnetic resonance imaging (fMRI) data to assess whether regions of the frontoparietal network discriminate between reaching-only and reach-to-grasp actions, natural and constrained grasping, different grasp types, and object sizes. Participants were required to perform either reaching-only movements or two reach-to-grasp types (precision or whole hand grasp) upon spherical objects of different sizes. Multivoxel pattern analysis highlighted that, independently from the object size, all the selected regions of both hemispheres contribute in coding for grasp type, with the exception of SPOC and the right hAIP. Consistent with recent neurophysiological findings on monkeys, there was no evidence for a clear-cut distinction between a dorsomedial and a dorsolateral pathway that would be specialized for reaching-only and reach-to-grasp actions, respectively. Nevertheless, the comparison of decoding accuracy across brain areas highlighted their different contributions to reaching-only and grasping actions. Altogether, our findings enrich the current knowledge regarding the functional role of key brain areas involved in the cortical control of reaching-only and reach-to-grasp actions

[Cleaning and disinfection in nursing homes. Data on quality of structure, process and outcome in nursing homes in Frankfurt am Main, Germany, 2011].

Science.gov (United States)

Heudorf, U; Gasteyer, S; Samoiski, Y; Voigt, K

2012-08-01

Due to the Infectious Disease Prevention Act, public health services in Germany are obliged to check the infection prevention in hospitals and other medical facilities as well as in nursing homes. In Frankfurt/Main, Germany, standardized control visits have been performed for many years. In 2011 focus was laid on cleaning and disinfection of surfaces. All 41 nursing homes were checked according to a standardized checklist covering quality of structure (i.e. staffing, hygiene concept), quality of process (observation of the cleaning processes in the homes) and quality of output, which was monitored by checking the cleaning of fluorescent marks which had been applied some days before and should have been removed via cleaning in the following days before the final check. In more than two thirds of the homes, cleaning personnel were salaried, in one third external personnel were hired. Of the homes 85% provided service clothing and all of them offered protective clothing. All homes had established hygiene and cleaning concepts, however, in 15% of the homes concepts for the handling of Norovirus and in 30% concepts for the handling of Clostridium difficile were missing. Regarding process quality only half of the processes observed, i.e. cleaning of hand contact surfaces, such as handrails, washing areas and bins, were correct. Only 44% of the cleaning controls were correct with enormous differences between the homes (0-100%). The correlation between quality of process and quality of output was significant. There was good quality of structure in the homes but regarding quality of process and outcome there was great need for improvement. This was especially due to faults in communication and coordination between cleaning personnel and nursing personnel. Quality outcome was neither associated with the number of the places for residents nor with staffing. Thus, not only quality of structure but also quality of process and outcome should be checked by the public health

The Influence of Heating Mains on Yeast Communities in Urban Soils

Science.gov (United States)

Tepeeva, A. N.; Glushakova, A. M.; Kachalkin, A. V.

2018-04-01

The number and species diversity of yeasts in urban soils (urbanozems) affected by heating mains and in epiphytic yeast complexes of grasses growing above them were studied. The number of yeasts in the soil reached 103-104 CFU/g; on the plants, 107 CFU/g. Significant (by an order of magnitude) increase in the total number of soil yeasts in the zone of heating mains in comparison with the surrounding soil was found in winter period. Overall, 25 species of yeasts were isolated in our study. Yeast community of studied urbanozems was dominated by the Candida sake, an eurybiont of the temperate zone and other natural ecotopes with relatively low temperatures, but its share was minimal in the zone of heating mains. In general, the structure of soil and epiphytic yeast complexes in the zones of heating mains differed from that in the surrounding area by higher species diversity and a lower share of pigmented species among the epiphytic yeasts. The study demonstrated that the number and species structure of soil yeast communities in urban soils change significantly under the influence of the temperature factor and acquire a mosaic distribution pattern.

Lit and unlit side temperatures of the Main Rings of Saturn.

Science.gov (United States)

Flandes, A.; Garcia, A.; Deau, E.; Spilker, L. J.

2017-12-01

The differences in the temperatures of both the lit and unlit sides of the main rings of Saturn can reveal important information about their structure. In general, the temperature of the main rings strongly depends upon the distribution and the general structure of the ensembles of particles that compose them, mainly due to shadowing effects that modulate how much energy reaches the individual particles -granted that the direct solar energy is the main driver of the rings' temperature-. In order to reproduce the temperatures of both sides of the rings, we use a semi-analytical energy balance model (considering solar direct and Saturn reflected energy, Saturn thermal energy and particles' thermal energies), where the shadowed fractional areas of the rings are removed through a shadowing function. We obtain this function (dependent on the solar elevation angle) for 13 different regions (for the A, CD, B and C rings) along the radial direction that are simulated using arrays of lambertian spherical particles based on the average properties of the structure of these regions derived from the Cassini UVIS observations. The obtained synthetic temperatures are compared to the Cassini CIRS measured temperatures (from -22º to equinox) with good agreement.

Differential Recruitment to and Outcomes of Solidarity Activism

DEFF Research Database (Denmark)

Toubøl, Jonas

This dissertation is the first major academic analysis of the Danish refugee solidarity movement that mobilized more than 100,000 citizens in the fall 2015 when the European refugee crisis reached Denmark. The dissertation makes four main contribution to the two questions of differential recruitm......This dissertation is the first major academic analysis of the Danish refugee solidarity movement that mobilized more than 100,000 citizens in the fall 2015 when the European refugee crisis reached Denmark. The dissertation makes four main contribution to the two questions of differential...... in a group culture that focuses on the political and contentious dimension of the matter. Fourth and finally, for activists engaged in the legal cases of refugees, experiencing an immigration-bureaucracy with little or no care for the human beings behind the dossiers combined with an experience of systematic...

GAP-REACH

Science.gov (United States)

Lewis-Fernández, Roberto; Raggio, Greer A.; Gorritz, Magdaliz; Duan, Naihua; Marcus, Sue; Cabassa, Leopoldo J.; Humensky, Jennifer; Becker, Anne E.; Alarcón, Renato D.; Oquendo, María A.; Hansen, Helena; Like, Robert C.; Weiss, Mitchell; Desai, Prakash N.; Jacobsen, Frederick M.; Foulks, Edward F.; Primm, Annelle; Lu, Francis; Kopelowicz, Alex; Hinton, Ladson; Hinton, Devon E.

2015-01-01

Growing awareness of health and health care disparities highlights the importance of including information about race, ethnicity, and culture (REC) in health research. Reporting of REC factors in research publications, however, is notoriously imprecise and unsystematic. This article describes the development of a checklist to assess the comprehensiveness and the applicability of REC factor reporting in psychiatric research publications. The 16-itemGAP-REACH© checklist was developed through a rigorous process of expert consensus, empirical content analysis in a sample of publications (N = 1205), and interrater reliability (IRR) assessment (N = 30). The items assess each section in the conventional structure of a health research article. Data from the assessment may be considered on an item-by-item basis or as a total score ranging from 0% to 100%. The final checklist has excellent IRR (κ = 0.91). The GAP-REACH may be used by multiple research stakeholders to assess the scope of REC reporting in a research article. PMID:24080673

Transformational leadership: application of magnet's new empiric outcomes.

Science.gov (United States)

Meredith, Erin K; Cohen, Elaine; Raia, Lucille V

2010-03-01

The many benefits to hospitals throughout the world that achieved Magnet designation is well documented. This status of recognition demands the support of leadership during the Magnet journey. In 2008, the American Nurses Credentialing Center (ANCC) announced a new model for the Magnet Recognition Program that translates the original 14 Forces of Magnetism into Five Model Components. Specifically, this new model includes sources of evidence and empiric outcomes that by definition accentuates transformational nursing leadership. The day-to-day impact of this change places an even greater emphasis on demonstrated outcomes and innovation that may potentially transform nursing practice, quality and safety of care, and the population served. This article provides tangible examples and outcomes for reaching nursing excellence through leadership support and engagement. Published by Elsevier Inc.

Effects of modified constraint-induced movement therapy on reach-to-grasp movements and functional performance after chronic stroke: a randomized controlled study.

Science.gov (United States)

Lin, K-C; Wu, C-Y; Wei, T-H; Lee, C-Y; Liu, J-S

2007-12-01

To evaluate changes in (1) motor control characteristics of the hemiparetic hand during the performance of a functional reach-to-grasp task and (2) functional performance of daily activities in patients with stroke treated with modified constraint-induced movement therapy. Two-group randomized controlled trial with pretreatment and posttreatment measures. Rehabilitation clinics. Thirty-two chronic stroke patients (21 men, 11 women; mean age=57.9 years, range=43-81 years) 13-26 months (mean 16.3 months) after onset of a first-ever cerebrovascular accident. Thirty-two patients were randomized to receive modified constraint-induced movement therapy (restraint of the unaffected limb combined with intensive training of the affected limb) or traditional rehabilitation for three weeks. Kinematic analysis was used to assess motor control characteristics as patients reached to grasp a beverage can. Functional outcomes were evaluated using the Motor Activity Log and Functional Independence Measure. There were moderate and significant effects of modified constraint-induced movement therapy on some aspects of motor control of reach-to-grasp and on functional ability. The modified constraint-induced movement therapy group preplanned reaching and grasping (P=0.018) more efficiently and depended more on the feedforward control of reaching (P=0.046) than did the traditional rehabilitation group. The modified constraint-induced movement therapy group also showed significantly improved functional performance on the Motor Activity Log (Pcontrol strategy during goal-directed reaching, a possible mechanism for the improved movement performance of stroke patients undergoing this therapy.

Reach/frequency for printed media: Personal probabilities or models

DEFF Research Database (Denmark)

Mortensen, Peter Stendahl

2000-01-01

The author evaluates two different ways of estimating reach and frequency of plans for printed media. The first assigns reading probabilities to groups of respondents and calculates reach and frequency by simulation. the second estimates parameters to a model for reach/frequency. It is concluded ...... and estiamtes from such models are shown to be closer to panel data. the problem, however, is to get valid input for such models from readership surveys. Means for this are discussed....

[The REACH legislation: the consumer and environment protection perspective].

Science.gov (United States)

Gundert-Remy, Ursula

2008-12-01

REACH has been initiated with the aim of improving existing legislation. In order to assist in the interpretation of the REACH legislation, guidance documents have been developed, which have only lately become available. According to the REACH annexes and supported by guidance documents, waiving of test requirements will be possible, thus, opening the possibility that under REACH no new (eco)toxicological data will be required. Concerning products, a guidance document was released in April 2008 stating that the substance concentration threshold of 0.1 % (w/w) applies to the article as produced or imported and it does not relate to the homogeneous materials or parts of an article, but relates to the article as such (i.e., as produced or imported). Hence, notification will not be required for many products containing chemicals with properties which place them on the candidate list for authorization. In summary, it is at present not foreseeable whether the expected benefit of the REACH legislation will materialise for the environment and for the health of consumers and at the work place.

Beam-induced quench test of LHC main quadrupole

CERN Document Server

Priebe, A; Dehning, B; Effinger, E; Emery, J; Holzer, E B; Kurfuerst, C; Nebot Del Busto, E; Nordt, A; Sapinski, M; Steckert, J; Verweij, A; Zamantzas, C

2011-01-01

Unexpected beam loss might lead to a transition of the accelerator superconducting magnet to a normal conducting state. The LHC beam loss monitoring (BLM) system is designed to abort the beam before the energy deposited in the magnet coils reach a quench-provoking level. In order to verify the threshold settings generated by simulation, a series of beam-induced quench tests at various beam energies has been performed. The beam losses are generated by means of an orbital bump peaked in one of main quadrupole magnets (MQ). The analysis includes not only BLM data but also the quench protection system (QPS) and cryogenics data. The measurements are compared to Geant4 simulations of energy deposition inside the coils and corresponding BLM signal outside the cryostat.

Procedures for the design of the main mechanical components of a wind system; Dimensionamento dos componentes mecanicos principais de aerogeradores

Energy Technology Data Exchange (ETDEWEB)

Hirata, M.H.; Marco Filho, F. de [Universidade Federal, Rio de Janeiro, RJ (Brazil). Coordenacao dos Programas de Pos-graduacao de Engenharia

1990-12-31

Procedures for the design of the main mechanical components of a wind system were developed. One of the main concerns was related to the possibility of its use in small micro-computers. This goal was reached and an APPLE II computer was used. The resulting algorithm permits a friendly interaction between man and machine. 5 refs., 12 figs

Treatment outcomes in undocumented Hispanic immigrants with HIV infection.

Directory of Open Access Journals (Sweden)

Kenneth K Poon

Full Text Available OBJECTIVE: Little is known about the treatment outcomes of undocumented Hispanic immigrants with HIV infection. We sought to compare the treatment outcomes of undocumented and documented patients 12-months after entering HIV care. METHODS: We conducted a retrospective cohort study of antiretroviral-naive patients 18 years and older attending their first visit at Thomas Street Health Center in Houston, Texas, between 1/1/2003 and 6/30/2008. The study population of 1,620 HIV-infected adults included 186 undocumented Hispanic, 278 documented Hispanic, 986 Black, and 170 White patients. The main outcome measures were retention in care (quarter years with at least one completed HIV primary care provider visit and HIV suppression (HIV RNA <400 copies/mL, both measured 12-months after entering HIV care. RESULTS: Undocumented Hispanic patients had lower median initial CD4 cell count (132 cells/mm(3 than documented Hispanic patients (166 cells/mm(3; P = 0.186, Black patients (226 cells/mm(3; P<0.001, and White patients (264 cells/mm(3; P = 0.001. However, once in care, undocumented Hispanic patients did as well or better than their documented counterparts. One year after entering HIV care, undocumented Hispanics achieved similar rates of retention in care and HIV suppression as documented Hispanic and White patients. Of note, black patients were significantly less likely to have optimal retention in care (adjusted odds ratio [aOR] 0.65, CI = 0.45-0.94 or achieve HIV suppression (aOR 0.32, CI = 0.17-0.61 than undocumented Hispanics. CONCLUSIONS: Undocumented Hispanic persons with HIV infection enter care with more advanced disease than documented persons, suggesting testing and/or linkage to care efforts for this difficult-to-reach population need intensification. Once diagnosed, however, undocumented Hispanics have outcomes as good as or better than other racial/ethnic groups. Safety net providers for undocumented immigrants are vital for maintaining

The Landscape Change of Qiang’s Settlements in the Upper Reaches of Minjiang River after Wenchuan Earthquake

OpenAIRE

Xiaofei Wen; Ying Meng; Changliu Wang

2015-01-01

Qiang ethnic group is one of the oldest ethnic groups in China, mainly living in upper reaches of Minjiang River in southwest of China. Qiang’s traditional settlements are valuable cultural heritages. Unfortunately, most of Qiang’s settlements were damaged during Wenchuan earthquake in 2008 in different degree. After the earthquake, settlements were reconstructed in different ways. The landscape of Qiang’s settlements had been changed greatly by dual influences, the destruction of earthquake ...

Increasing reach by offering choices: Results from an innovative model for statewide services for smoking cessation.

Science.gov (United States)

Keller, Paula A; Schillo, Barbara A; Kerr, Amy N; Lien, Rebecca K; Saul, Jessie; Dreher, Marietta; Lachter, Randi B

2016-10-01

Although state quitlines provide free telephone counseling and often include nicotine replacement therapy (NRT), reach remains limited (1-2% in most states). More needs to be done to engage all smokers in the quitting process. A possible strategy is to offer choices of cessation services through quitlines and to reduce registration barriers. In March 2014, ClearWay Minnesota SM implemented a new model for QUITPLAN® Services, the state's population-wide cessation services. Tobacco users could choose the QUITPLAN® Helpline or one or more Individual QUITPLAN® Services (NRT starter kit, text messaging, email program, or quit guide). The program website was redesigned, online enrollment was added, and a new advertising campaign was created and launched. In 2014-2015, we evaluated whether these changes increased reach. We also assessed quit attempts, quit outcomes, predictors of 30-day abstinence, and average cost per quit via a seven-month follow-up survey. Between March 2014-February 2015, 15,861 unique tobacco users registered, which was a 169% increase over calendar year 2013. The majority of participants made a quit attempt (83.7%). Thirty-day point prevalence abstinence rates (responder rates) were 26.1% for QUITPLAN Services overall, 29.6% for the QUITPLAN Helpline, and 25.5% for Individual QUITPLAN Services. Several variables predicted quit outcomes, including receiving only one call from the Helpline and using both the Helpline and the NRT starter kit. Providing greater choice of cessation services and reducing registration barriers have the potential to engage more tobacco users, foster more quit attempts, and ultimately lead to long-term cessation and reductions in prevalence. Copyright © 2016 Elsevier Inc. All rights reserved.

Main Issues in Big Data Security

Directory of Open Access Journals (Sweden)

Julio Moreno

2016-09-01

Full Text Available Data is currently one of the most important assets for companies in every field. The continuous growth in the importance and volume of data has created a new problem: it cannot be handled by traditional analysis techniques. This problem was, therefore, solved through the creation of a new paradigm: Big Data. However, Big Data originated new issues related not only to the volume or the variety of the data, but also to data security and privacy. In order to obtain a full perspective of the problem, we decided to carry out an investigation with the objective of highlighting the main issues regarding Big Data security, and also the solutions proposed by the scientific community to solve them. In this paper, we explain the results obtained after applying a systematic mapping study to security in the Big Data ecosystem. It is almost impossible to carry out detailed research into the entire topic of security, and the outcome of this research is, therefore, a big picture of the main problems related to security in a Big Data system, along with the principal solutions to them proposed by the research community.

Do working environment interventions reach shift workers?

DEFF Research Database (Denmark)

Nabe-Nielsen, Kirsten; Jørgensen, Marie Birk; Garde, Anne Helene

2016-01-01

PURPOSE: Shift workers are exposed to more physical and psychosocial stressors in the working environment as compared to day workers. Despite the need for targeted prevention, it is likely that workplace interventions less frequently reach shift workers. The aim was therefore to investigate whether...... the reach of workplace interventions varied between shift workers and day workers and whether such differences could be explained by the quality of leadership exhibited at different times of the day. METHODS: We used questionnaire data from 5361 female care workers in the Danish eldercare sector...

Reaching Adolescents and Youth in Burkina Faso, Guinea-Bissau

African Journals Online (AJOL)

AJRH Managing Editor

typical profile of individuals in contact with peer educators or attending youth ... being reached (versus not reached) by programs ... characteristics in order to serve groups that may be ... places for counseling services but the frequency of.

Macaques can predict social outcomes from facial expressions.

Science.gov (United States)

Waller, Bridget M; Whitehouse, Jamie; Micheletta, Jérôme

2016-09-01

There is widespread acceptance that facial expressions are useful in social interactions, but empirical demonstration of their adaptive function has remained elusive. Here, we investigated whether macaques can use the facial expressions of others to predict the future outcomes of social interaction. Crested macaques (Macaca nigra) were shown an approach between two unknown individuals on a touchscreen and were required to choose between one of two potential social outcomes. The facial expressions of the actors were manipulated in the last frame of the video. One subject reached the experimental stage and accurately predicted different social outcomes depending on which facial expressions the actors displayed. The bared-teeth display (homologue of the human smile) was most strongly associated with predicted friendly outcomes. Contrary to our predictions, screams and threat faces were not associated more with conflict outcomes. Overall, therefore, the presence of any facial expression (compared to neutral) caused the subject to choose friendly outcomes more than negative outcomes. Facial expression in general, therefore, indicated a reduced likelihood of social conflict. The findings dispute traditional theories that view expressions only as indicators of present emotion and instead suggest that expressions form part of complex social interactions where individuals think beyond the present.

Memory-guided reaching in a patient with visual hemiagnosia.

Science.gov (United States)

Cornelsen, Sonja; Rennig, Johannes; Himmelbach, Marc

2016-06-01

The two-visual-systems hypothesis (TVSH) postulates that memory-guided movements rely on intact functions of the ventral stream. Its particular importance for memory-guided actions was initially inferred from behavioral dissociations in the well-known patient DF. Despite of rather accurate reaching and grasping movements to visible targets, she demonstrated grossly impaired memory-guided grasping as much as impaired memory-guided reaching. These dissociations were later complemented by apparently reversed dissociations in patients with dorsal damage and optic ataxia. However, grasping studies in DF and optic ataxia patients differed with respect to the retinotopic position of target objects, questioning the interpretation of the respective findings as a double dissociation. In contrast, the findings for reaching errors in both types of patients came from similar peripheral target presentations. However, new data on brain structural changes and visuomotor deficits in DF also questioned the validity of a double dissociation in reaching. A severe visuospatial short-term memory deficit in DF further questioned the specificity of her memory-guided reaching deficit. Therefore, we compared movement accuracy in visually-guided and memory-guided reaching in a new patient who suffered a confined unilateral damage to the ventral visual system due to stroke. Our results indeed support previous descriptions of memory-guided movements' inaccuracies in DF. Furthermore, our data suggest that recently discovered optic-ataxia like misreaching in DF is most likely caused by her parieto-occipital and not by her ventral stream damage. Finally, multiple visuospatial memory measurements in HWS suggest that inaccuracies in memory-guided reaching tasks in patients with ventral damage cannot be explained by visuospatial short-term memory or perceptual deficits, but by a specific deficit in visuomotor processing. Copyright © 2016 Elsevier Ltd. All rights reserved.

Future planning: default network activity couples with frontoparietal control network and reward-processing regions during process and outcome simulations.

Science.gov (United States)

Gerlach, Kathy D; Spreng, R Nathan; Madore, Kevin P; Schacter, Daniel L

2014-12-01

We spend much of our daily lives imagining how we can reach future goals and what will happen when we attain them. Despite the prevalence of such goal-directed simulations, neuroimaging studies on planning have mainly focused on executive processes in the frontal lobe. This experiment examined the neural basis of process simulations, during which participants imagined themselves going through steps toward attaining a goal, and outcome simulations, during which participants imagined events they associated with achieving a goal. In the scanner, participants engaged in these simulation tasks and an odd/even control task. We hypothesized that process simulations would recruit default and frontoparietal control network regions, and that outcome simulations, which allow us to anticipate the affective consequences of achieving goals, would recruit default and reward-processing regions. Our analysis of brain activity that covaried with process and outcome simulations confirmed these hypotheses. A functional connectivity analysis with posterior cingulate, dorsolateral prefrontal cortex and anterior inferior parietal lobule seeds showed that their activity was correlated during process simulations and associated with a distributed network of default and frontoparietal control network regions. During outcome simulations, medial prefrontal cortex and amygdala seeds covaried together and formed a functional network with default and reward-processing regions. © The Author (2014). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

A random walk down Main Street

Directory of Open Access Journals (Sweden)

David Matthew Levinson

2016-08-01

Full Text Available US suburbs have often been characterized by their relatively low walk accessibility compared to more urban environments, and US urban environments have been char- acterized by low walk accessibility compared to cities in other countries. Lower overall density in the suburbs implies that activities, if spread out, would have a greater distance between them. But why should activities be spread out instead of developed contiguously? This brief research note builds a positive model for the emergence of contiguous development along “Main Street” to illustrate the trade-offs that result in the built environment we observe. It then suggests some policy interventions to place a “thumb on the scale” to choose which parcels will develop in which sequence to achieve socially preferred outcomes.

REACH and nanomaterials: current status

International Nuclear Information System (INIS)

Alessandrelli, Maria; Di Prospero Fanghella, Paola; Polci, Maria Letizia; Castelli, Stefano; Pettirossi, Flavio

2015-01-01

New challenges for regulators are emerging about a specific assessment and appropriate management of the potential risks of nanomaterials. In the framework of European legislation on chemicals, Regulation (EC) No. 1907/2006 REACH aims to ensure the safety of human health and the environment through the collection of information on the physico-chemical characteristics of the substances and on their profile (eco) toxicological and the identification of appropriate risk management linked to 'exposure to these substances without impeding scientific progress and the competitiveness of industry. In order to cover the current shortage of information on the safety of nanomaterials and tackle the acknowledged legal vacuum, are being a rich activities, carried out both by regulators both by stake holders, and discussions on the proposals for adapting the European regulatory framework for chemicals . The European Commission is geared to strengthen the REACH Regulation by means of updates of its annexes. The importance of responding to the regulatory requirements has highlighted the need for cooperation between European organizations, scientists and industries to promote and ensure the safe use of nanomaterials. [it

Implementing Evidence-Based Teen Pregnancy-Prevention Interventions in a Community-Wide Initiative: Building Capacity and Reaching Youth.

Science.gov (United States)

House, L Duane; Tevendale, Heather D; Martinez-Garcia, Genevieve

2017-03-01

To describe efforts to implement evidence-based interventions (EBIs) within multicomponent, community-wide initiatives to reduce teen pregnancy. During 2011-2014, we collected information about the capacity (i.e., knowledge, confidence, training, and experience) of state and community-based organizations to support implementation of the following: EBIs, number and characteristics of youth served by EBIs, type of EBIs implemented, EBI settings, hours of training, and technical assistance provided. State and community-based organizations reported these data annually; however, training and technical assistance was reported monthly. We used aggregated data from these annual and monthly reports to describe the implementation of EBIs in the community-wide initiative project. From baseline in 2011-2014, state and community-based organizations increased their capacities to support program partners in delivering EBIs. They provided 5,015 hours of technical assistance and training on topics, including ensuring adequate capacity, process and outcome evaluation, program planning, and continuous quality improvement. Program partners increased the number of youth reached by an EBI in targeted communities by 349%, from 4,304 in the first year of implementation in 2012 to 19,344 in 2014. Most youth in 2014 received sexuality education programs (59%), whereas smaller percentages received abstinence-based, youth development, and clinic-based programs. Most youth were reached through schools (72%) and community-based organizations (16%), and smaller numbers were reached in other settings (e.g., faith-based organizations, health centers). Building and monitoring the capacity of program partners to deliver EBIs through technical assistance and training is important. In addition, partnering with schools leads to reaching more youth. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Impact of a multifactorial treatment programme on clinical outcomes and cardiovascular risk estimates

DEFF Research Database (Denmark)

Safai, Narges; Carstensen, Bendix; Vestergaard, Henrik

2018-01-01

), blood pressure (BP) and low-density lipoprotein (LDL) cholesterol as well as proportion reaching treatment targets. Our secondary outcome was to investigate changes in antidiabetic, antihypertensive and lipid-lowering treatment, together with the impact on estimated CVD risk. Linear mixed model....... SETTING: Tertiary diabetes centre in Denmark. PARTICIPANTS: Patients with type 2 diabetes (n=4299) referred to a programme with focus on treatment of hyperglycaemia, hypertension and dyslipidaemia between 1 January 2001 and 1 April 2016. OUTCOMES: Primary outcomes were changes in haemoglobin A1c (HbA1c...

Improving exposure scenario definitions within REACH

DEFF Research Database (Denmark)

Lee, Jihyun; Pizzol, Massimo; Thomsen, Marianne

In recent years, the paradigm of chemical management system has changed from being toxicity oriented and media based to being risk oriented and receptor based. This trend is evident not only regarding environmental quality standards, but also for industrial chemical regulations. Political...... instruments to support a precautionary chemicals management system and to protect receptor’s health have also been increasing. Since 2007, the European Union adopted REACH (the Regulation on Registration, Evaluation, Authorisation and Restriction of Chemicals): REACH makes industry responsible for assessing...... and managing the risks posed by industrial chemicals and providing appropriate safety information to their users (EC, 2007). However, to ensure a high level of protection of human health and the environment, there is a need to consider ‘aggregate exposure’ including background exposures from environment which...

Main Clinical Outcomes of Feldspathic Porcelain and Glass-Ceramic Laminate Veneers: A Systematic Review and Meta-Analysis of Survival and Complication Rates.

Science.gov (United States)

Morimoto, Susana; Albanesi, Rafael Borges; Sesma, Newton; Agra, Carlos Martins; Braga, Mariana Minatel

2016-01-01

The aim of this study was to perform a systematic review and meta-analysis based on clinical trials that evaluated the main outcomes of glass-ceramic and feldspathic porcelain laminate veneers. A systematic search was carried out in Cochrane and PubMed databases. From the selected studies, the survival rates for porcelain and glass-ceramic veneers were extracted, as were complication rates of clinical outcomes: debonding, fracture/chipping, secondary caries, endodontic problems, severe marginal discoloration, and influence of incisal coverage and enamel/dentin preparation. The Cochran Q test and the I(2) statistic were used to evaluate heterogeneity. Out of the 899 articles initially identified, 13 were included for analysis. Metaregression analysis showed that the types of ceramics and follow-up periods had no influence on failure rate. The estimated overall cumulative survival rate was 89% (95% CI: 84% to 94%) in a median follow-up period of 9 years. The estimated survival for glass-ceramic was 94% (95% CI: 87% to 100%), and for feldspathic porcelain veneers, 87% (95% CI: 82% to 93%). The meta-analysis showed rates for the following events: debonding: 2% (95% CI: 1% to 4%); fracture/chipping: 4% (95% CI: 3% to 6%); secondary caries: 1% (95% CI: 0% to 3%); severe marginal discoloration: 2% (95% CI: 1% to 10%); endodontic problems: 2% (95% CI: 1% to 3%); and incisal coverage odds ratio: 1.25 (95% CI: 0.33 to 4.73). It was not possible to perform meta-analysis of the influence of enamel/dentin preparation on failure rates. Glass-ceramic and porcelain laminate veneers have high survival rates. Fracture/ chipping was the most frequent complication, providing evidence that ceramic veneers are a safe treatment option that preserve tooth structure.

Reactivity of main components and substituent distribution in esterified sugarcane bagasse prepared by effective solid phase reaction.

Science.gov (United States)

Gan, Tao; Zhang, Yanjuan; Chen, Yane; Hu, Huayu; Yang, Mei; Huang, Zuqiang; Chen, Dong; Huang, Aimin

2018-02-01

Three main components of lignocellulose (cellulose, hemicellulose, and lignin isolated from sugarcane bagasse (SCB)) as well as holocellulose and SCB were modified with maleic acid by mechanical activation (MA)-assisted solid phase reaction (MASPR) technology. The order of reactivity was found to be lignin>hemicellulose>cellulose. The amorphous structure of lignin and hemicellulose mainly attributed to their better reactivity, and the modified lignin could reach a maximum degree of esterification (DE) of 93.45%. MA improved the accessibility and reactivity of cellulose, as the DE of modified cellulose gradually increased with milling time and reached the maximum value of 57.30% at 120min, which had significant effect on structure changes and DE of modified holocellulose and SCB. MA enhanced the esterification of all three components in lignocellulose with relatively high substituent distribution in them, and maleated SCB with a maximum DE of 64.17% was successfully prepared by this simple, green, and effective MASPR technology. Copyright © 2017 Elsevier Ltd. All rights reserved.

Application of SWAN+ADCIRC to tide-surge and wave simulation in Gulf of Maine during Patriot's Day storm

Directory of Open Access Journals (Sweden)

Dong-mei Xie

2016-01-01

Full Text Available The southern coast of the Gulf of Maine in the United States is prone to flooding caused by nor'easters. A state-of-the-art fully-coupled model, the Simulating WAves Nearshore (SWAN model with unstructured grids and the ADvanced CIRCulation (ADCIRC model, was used to study the hydrodynamic response in the Gulf of Maine during the Patriot's Day storm of 2007, a notable example of nor'easters in this area. The model predictions agree well with the observed tide-surges and waves during this storm event. Waves and circulation in the Gulf of Maine were analyzed. The Georges Bank plays an important role in dissipating wave energy through the bottom friction when waves propagate over the bank from offshore to the inner gulf due to its shallow bathymetry. Wave energy dissipation results in decreasing significant wave height (SWH in the cross-bank direction and wave radiation stress gradient, which in turn induces changes in currents. While the tidal currents are dominant over the Georges Bank and in the Bay of Fundy, the residual currents generated by the meteorological forcing and waves are significant over the Georges Bank and in the coastal area and can reach 0.3 m/s and 0.2 m/s, respectively. In the vicinity of the coast, the longshore current generated by the surface wind stress and wave radiation stress acting parallel to the coastline is inversely proportional to the water depth and will eventually be limited by the bottom friction. The storm surge level reaches 0.8 m along the western periphery of the Gulf of Maine while the wave set-up due to radiation stress variation reaches 0.2 m. Therefore, it is significant to coastal flooding.

Pre-main sequence masses and the age spread in the Orion cluster

International Nuclear Information System (INIS)

McNamara, B.J.

1975-01-01

The spread in formation times for stars earlier than GO in the Orion cluster is investigated. The range of stellar ages in this cluster is found to extend from at least 10 6 years to about 10 7 years. On the basis of this evidence and the similarity of the color--magnitude diagrams of other young clusters to the Orion cluster, it is suggested that the current method of dating these clusters (from the point at which the most massive stars just reach the zero-age main sequence) might not be valid. The masses of forty-one pre-main sequence stars within the ranges 4.05 less than or equal to log(Te) less than or equal to 3.77 and 0.6 less than or equal to log (L/L/sub sun/) less than or equal to 2.1 are determined from observed effective temperatures, luminosities, and gravities. These masses were then compared with those expected from Iben's (1965) pre-main sequence evolutionary calculations. In most cases, the agreement between these values was found to be within the observational errors. Finally, the pre-main sequence stars possessing infrared excesses are found to be apparently among the most massive and youngest stars still contracting toward the zero-age main sequence

Education and Occupational Outcomes

DEFF Research Database (Denmark)

Johnes, Geraint; Freguglia, Ricardo; Spricigo, Gisele

2016-01-01

Purpose: The purpose of this paper is to examine the dynamic relationship between policies related to educational provision and both educational participation and occupational outcomes in Brazil, using PNAD and RAIS-Migra data. Design/methodology/approach: Outcomes are examined using: static...... multinomial logit analysis, and structural dynamic discrete choice modelling. The latter approach, coupled with the quality of the RAIS-Migra data source, allows the authors to evaluate the education policy impacts over time. Findings: The main results show that the education level raises the propensity...... that the individual will be in formal sector work or still in education, and reduces the probability of the other outcomes. Transition into non-manual formal sector work following education may, however, occur via a spell of manual work. Originality/value: This is the first study of occupational destination...

The Impact of Child Labor on Schooling Outcomes in Nicaragua

Science.gov (United States)

Zabaleta, Mariela Buonomo

2011-01-01

Child labor is considered a key obstacle to reaching the international commitments of Education For All. However, the empirical evidence on the effects of child labor on educational attainments is mostly limited to static measurements. This paper assesses the consequences of child labor on schooling outcomes over time by employing a three-year…

Proprioceptive body illusions modulate the visual perception of reaching distance.

Directory of Open Access Journals (Sweden)

Agustin Petroni

Full Text Available The neurobiology of reaching has been extensively studied in human and non-human primates. However, the mechanisms that allow a subject to decide-without engaging in explicit action-whether an object is reachable are not fully understood. Some studies conclude that decisions near the reach limit depend on motor simulations of the reaching movement. Others have shown that the body schema plays a role in explicit and implicit distance estimation, especially after motor practice with a tool. In this study we evaluate the causal role of multisensory body representations in the perception of reachable space. We reasoned that if body schema is used to estimate reach, an illusion of the finger size induced by proprioceptive stimulation should propagate to the perception of reaching distances. To test this hypothesis we induced a proprioceptive illusion of extension or shrinkage of the right index finger while participants judged a series of LEDs as reachable or non-reachable without actual movement. Our results show that reach distance estimation depends on the illusory perceived size of the finger: illusory elongation produced a shift of reaching distance away from the body whereas illusory shrinkage produced the opposite effect. Combining these results with previous findings, we suggest that deciding if a target is reachable requires an integration of body inputs in high order multisensory parietal areas that engage in movement simulations through connections with frontal premotor areas.

REACH-related substitution within the Danish printing industry

DEFF Research Database (Denmark)

Larsen, Henrik Fred; Bøg, Carsten; Markussen, Helene

are running a substitution project. A major part of the work has been mapping the presence of chemicals which are potential candidates for substitution (e.g. PBT, CMR, vPvB, EDS) within the Danish printing industry. The mapping comprises a combination of a literature study and an investigation of the actual......The accomplishment of the EU REACH regulation will most probably promote substitution within sectors handling a lot of different chemicals like the printing industry. With the aim of being at the cutting edge of this development the Danish EPA together with the Danish printing industry and IPU...... fulfil one or more of the criteria (e.g. CMR, EDS) for the REACH Annex XIV candidate list (authorisation). The paper presents the results of the mapping of chemical candidates and the first results of the actual substitutions. Keywords: REACH, chemicals, substitution, printing industry....

RiverCare communication strategy for reaching beyond

Science.gov (United States)

Cortes Arevalo, Juliette; den Haan, Robert Jan; Berends, Koen; Leung, Nick; Augustijn, Denie; Hulscher, Suzanne J. M. H.

2017-04-01

. The RiverCare newsletters are being distributed mainly through the NCR mailing list. As part of the multimedia product, four videos are in development as 'theaters of river research'. The first video presented our societal contribution to river research. Subsequent videos will be released approximately every six months. The knowledge platform is being designed as a combination of online services including: a content management system in which storylines are the main component; a data repository; and hyperlinks to online sites that present our results via short news articles. A storyline example has been prepared to explain research outputs instead of or in addition to more technical means such as scientific papers and reports. As for the serious gaming environment, a concept is being designed for experimentation in river and floodplain scenarios in regard to maintenance intervals and scaling of floodplains. Early results from the number of viewers of the NCR website, newsletter and first video show that dissemination efforts reach the NCR network but should also address other networks. Furthermore, the videos create interest and visibility in RiverCare. However, the audience should be challenged in different ways to look for additional information. Challenges of our research are to limit the overlap between the different communication approaches and to evaluate the effectiveness of the communication strategy.

Reaching the end of the line: Operational issues with implementing phone-based unannounced pill counts in resource-limited settings.

Directory of Open Access Journals (Sweden)

Yael Hirsch-Moverman

Full Text Available Accurate measurement of adherence is necessary to ensure that therapeutic outcomes can be attributed to the recommended treatment. Phone-based unannounced pill counts were shown to be feasible and reliable measures of adherence in developed settings; and have been further used as part of medication adherence interventions. However, it is not clear whether this method can be implemented successfully in resource-limited settings, where cellular network and mobile phone coverage may be low. Our objective is to describe operational issues surrounding the use of phone-based unannounced pill counts in Lesotho and Ethiopia.Phone-based monthly unannounced pill counts, using an adaptation of a standardized protocol from previous US-based studies, were utilized to measure anti-TB and antiretroviral medication adherence in two implementation science studies in resource-limited settings, START (Lesotho and ENRICH (Ethiopia.In START, 19.6% of calls were completed, with 71.9% of participants reached at least once; majority of failed call attempts were due to phones not being available (54.8% or because participants were away from the pills (32.7%. In ENRICH, 33.5% of calls were completed, with 86.7% of participants reached at least once; the main reasons for failed call attempts were phones being switched off (31.5%, participants not answering (27.3%, participants' discomfort speaking on the phone (15.4%, and network problems (13.2%. Structural, facility-level, participant-level, and data collection challenges were encountered in these settings.Phone-based unannounced pill counts were found to be challenging, and response rates suboptimal. While some of these challenges were specific to local contexts, most of them are generalizable to resource-limited settings. In a research study context, a possible solution to ease operational challenges may be to focus phone-based unannounced pill count efforts on a randomly selected sample from participants who are

Independent development of the Reach and the Grasp in spontaneous self-touching by human infants in the first 6 months.

Science.gov (United States)

Thomas, Brittany L; Karl, Jenni M; Whishaw, Ian Q

2014-01-01

The Dual Visuomotor Channel Theory proposes that visually guided reaching is a composite of two movements, a Reach that advances the hand to contact the target and a Grasp that shapes the digits for target purchase. The theory is supported by biometric analyses of adult reaching, evolutionary contrasts, and differential developmental patterns for the Reach and the Grasp in visually guided reaching in human infants. The present ethological study asked whether there is evidence for a dissociated development for the Reach and the Grasp in nonvisual hand use in very early infancy. The study documents a rich array of spontaneous self-touching behavior in infants during the first 6 months of life and subjected the Reach movements to an analysis in relation to body target, contact type, and Grasp. Video recordings were made of resting alert infants biweekly from birth to 6 months. In younger infants, self-touching targets included the head and trunk. As infants aged, targets became more caudal and included the hips, then legs, and eventually the feet. In younger infants hand contact was mainly made with the dorsum of the hand, but as infants aged, contacts included palmar contacts and eventually grasp and manipulation contacts with the body and clothes. The relative incidence of caudal contacts and palmar contacts increased concurrently and were significantly correlated throughout the period of study. Developmental increases in self-grasping contacts occurred a few weeks after the increase in caudal and palmar contacts. The behavioral and temporal pattern of these spontaneous self-touching movements suggest that the Reach, in which the hand extends to make a palmar self-contact, and the Grasp, in which the digits close and make manipulatory movements, have partially independent developmental profiles. The results additionally suggest that self-touching behavior is an important developmental phase that allows the coordination of the Reach and the Grasp prior to and

Outcomes After Percutaneous Coronary Intervention or Bypass Surgery in Patients With Unprotected Left Main Disease

NARCIS (Netherlands)

Cavalcante, Rafael; Sotomi, Yohei; Lee, Cheol W.; Ahn, Jung-Min; Farooq, Vasim; Tateishi, Hiroki; Tenekecioglu, Erhan; Zeng, Yaping; Suwannasom, Pannipa; Collet, Carlos; Albuquerque, Felipe N.; Onuma, Yoshinobu; Park, Seung-Jung; Serruys, Patrick W.

2016-01-01

Currently available randomized data on the comparison between percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) for the treatment of unprotected left main coronary disease (LMD) lacks statistical power due to low numbers of patients enrolled. This study assessed

Modeling Regional Soil Water Balance in Farmland of the Middle Reaches of Heihe River Basin

Directory of Open Access Journals (Sweden)

Jiang Li

2017-11-01

Full Text Available Quantifying components of soil water balance in farmland of the middle reaches of Heihe River Basin is essential for efficiently scheduling and allocating limited water resources for irrigation in this arid region. A soil water balance model based on empirical assumptions in the vadose zone of farmland was developed and simulation results were compared/validated with results by the numerical model HYDRUS-1D. Results showed a good coherence between the simulated results of the water balance models and the HYDRUS-1D model in soil water storage, evapotranspiration, deep percolation and groundwater recharge, which indicated that the water balance model was suitable for simulating soil water movement in the study area. Considering the spatial distribution of cropping patterns, groundwater depth and agricultural management, ArcGIS was applied for the pre-/post-processing of the water balance model to quantify the spatial distribution of components of soil water balance in the major cropland in middle reaches of Heihe River Basin. Then, distributions of components of soil water balance in the major cropland under different water-saving irrigation practices during the growing season were predicted and discussed. Simulation results demonstrated that evapotranspiration of the main crops would be more prominently influenced by irrigation quota under deep groundwater depth than that under shallow groundwater depth. Groundwater recharge would increase with the increase of irrigation quota and decrease with the increase of groundwater depth. In general, when groundwater depth reached 3 m, groundwater recharge from root zone was negligible for spring wheat. While when it reached 6 m, groundwater recharge was negligible for maize. Water-saving irrigation practices would help to reduce groundwater recharge with a slight decrease of crop water consumption.

Korean Clinic Based Outcome Measure Studies

OpenAIRE

Jongbae Park

2003-01-01

Background: Evidence based medicine has become main tools for medical practice. However, conducting a highly ranked in the evidence hierarchy pyramid is not easy or feasible at all times and places. There remains a room for descriptive clinical outcome measure studies with admitting the limit of the intepretation. Aims: Presents three Korean clinic based outcome measure studies with a view to encouraging Korean clinicians to conduct similar studies. Methods: Three studies are presented...

Environmental stressors afflicting tailwater stream reaches across the United States

Science.gov (United States)

Miranda, Leandro E.; Krogman, R. M.

2014-01-01

The tailwater is the reach of a stream immediately below an impoundment that is hydrologically, physicochemically and biologically altered by the presence and operation of a dam. The overall goal of this study was to gain a nationwide awareness of the issues afflicting tailwater reaches in the United States. Specific objectives included the following: (i) estimate the percentage of reservoirs that support tailwater reaches with environmental conditions suitable for fish assemblages throughout the year, (ii) identify and quantify major sources of environmental stress in those tailwaters that do support fish assemblages and (iii) identify environmental features of tailwater reaches that determine prevalence of key fish taxa. Data were collected through an online survey of fishery managers. Relative to objective 1, 42% of the 1306 reservoirs included in this study had tailwater reaches with sufficient flow to support a fish assemblage throughout the year. The surface area of the reservoir and catchment most strongly delineated reservoirs maintaining tailwater reaches with or without sufficient flow to support a fish assemblage throughout the year. Relative to objective 2, major sources of environmental stress generally reflected flow variables, followed by water quality variables. Relative to objective 3, zoogeography was the primary factor discriminating fish taxa in tailwaters, followed by a wide range of flow and water quality variables. Results for objectives 1–3 varied greatly among nine geographic regions distributed throughout the continental United States. Our results provide a large-scale view of the effects of reservoirs on tailwater reaches and may help guide research and management needs.

Removal of stored particle background via the electric dipole method in the KATRIN main spectrometer

Energy Technology Data Exchange (ETDEWEB)

Hilk, Daniel [Institut fuer Experimentelle Kernphysik, KIT, Karlsruhe (Germany); Collaboration: KATRIN-Collaboration

2016-07-01

The goal of the KArlsruhe TRItium Neutrino (KATRIN) experiment is to determine the effective mass of the electron anti neutrino by measuring the electron energy spectrum of tritium beta decay near the endpoint. The goal is to reach a sensitivity on the neutrino mass of 200 meV for which a low background level of 10{sup -2} counts per second is mandatory. Electrons from single radioactive decays of radon and tritium in the KATRIN main spectrometer with energies in the keV range can be magnetically stored for hours. While cooling down via ionization of residual gas molecules, they produce hundreds of secondary electrons, which can reach the detector and contribute to the background signals. In order to suppress this background component, several methods are investigated to remove stored electrons, such as the application of an electric dipole field and the application of magnetic pulses. This talk introduces the mechanism of background production due to stored electrons and their removal by the electric dipole method in the main spectrometer. In context of the spectrometer- and detector-commissioning phase in summer 2015, measurement results of the application of the electric dipole method are presented.

Statistical Characteristics of Mesoscale Convective Systems over the Middle Reaches area of the Yellow River During 2005-2014

Science.gov (United States)

Zhao, Guixiang

2017-04-01

Based on the hourly TBB and cloud images of FY-2E, meteorological observation data, and NCEP reanalysis data with 1°×1° spatial resolution from May to October during 2005-2014, the climatic characteristics of mesoscale convective systems (MCS) over the middle reaches area of the Yellow River were analyzed, including mesoscale convective complex (MCC), persistent elongated convective systems (PECS), meso-βscale MCC (MβCCS) and Meso-βscale PECS (MβECS). The results are as follows: (1) MCS tended to occur over the middle and south of Gansu, the middle and south of Shanxi, the middle and north of Shaanxi, and the border of Shanxi, Shaanxi and Inner Mongolia. MCS over the middle reaches area of the Yellow River formed in May to October, and was easy to develop the mature in summer. MCC and MβECS were main MCS causing precipitation in summer. (2) The daily variation of MCS was obvious, and usually formed and matured in the afternoon and the evening to early morning of the next day. Most MCS generated fast and dissipated slowly, and were mainly move to the easterly and southeasterly, but the moving of round shape MCS was less than the elongated shape's. (3) The average TBB for the round shape MCS was lower than the elongated shape MCS. The development of MCC was most vigorous and strong, and it was the strongest in August, while that of MβECS wasn't obviously influenced by the seasonal change. The average eccentricity of the mature MCC and PECS over the middle reaches area of the Yellow River was greater than that in USA, and the former was greater than in the lower reaches area of the Yellow River, while the latter was smaller. (4) The characteristics of rainfall caused by MCS were complex over the middle reaches area of the Yellow River, and there were obvious regional difference. There was wider, stronger and longer precipitation when the multiple MCS merged. The rainfall in the center of cloud area was obviously greater than in other region of cloud area. The

Scientific governance and the process for exposure scenario development in REACH

NARCIS (Netherlands)

Money, C.D.; Hemmen, J.J. van; Vermeire, T.G.

2007-01-01

The primary process established by the European Commission to address the science needed to define key REACH concepts and to help rationally implement REACH's ambitions is enshrined in a series of activities known as the REACH Implementation Projects (RIPs). These are projects that aim to define the

Increased Heat Generation in Postcardiac Arrest Patients During Targeted Temperature Management Is Associated With Better Outcomes.

Science.gov (United States)

Uber, Amy J; Perman, Sarah M; Cocchi, Michael N; Patel, Parth V; Ganley, Sarah E; Portmann, Jocelyn M; Donnino, Michael W; Grossestreuer, Anne V

2018-04-03

Assess if amount of heat generated by postcardiac arrest patients to reach target temperature (Ttarget) during targeted temperature management is associated with outcomes by serving as a proxy for thermoregulatory ability, and whether it modifies the relationship between time to Ttarget and outcomes. Retrospective cohort study. Urban tertiary-care hospital. Successfully resuscitated targeted temperature management-treated adult postarrest patients between 2008 and 2015 with serial temperature data and Ttarget less than or equal to 34°C. None. Time to Ttarget was defined as time from targeted temperature management initiation to first recorded patient temperature less than or equal to 34°C. Patient heat generation ("heat units") was calculated as inverse of average water temperature × hours between initiation and Ttarget × 100. Primary outcome was neurologic status measured by Cerebral Performance Category score; secondary outcome was survival, both at hospital discharge. Univariate analyses were performed using Wilcoxon rank-sum tests; multivariate analyses used logistic regression. Of 203 patients included, those with Cerebral Performance Category score 3-5 generated less heat before reaching Ttarget (median, 8.1 heat units [interquartile range, 3.6-21.6 heat units] vs median, 20.0 heat units [interquartile range, 9.0-33.5 heat units]; p = 0.001) and reached Ttarget quicker (median, 2.3 hr [interquartile range, 1.5-4.0 hr] vs median, 3.6 hr [interquartile range, 2.0-5.0 hr]; p = 0.01) than patients with Cerebral Performance Category score 1-2. Nonsurvivors generated less heat than survivors (median, 8.1 heat units [interquartile range, 3.6-20.8 heat units] vs median, 19.0 heat units [interquartile range, 6.5-33.5 heat units]; p = 0.001) and reached Ttarget quicker (median, 2.2 hr [interquartile range, 1.5-3.8 hr] vs median, 3.6 hr [interquartile range, 2.0-5.0 hr]; p = 0.01). Controlling for average water temperature between initiation and Ttarget, the

R.E.A.C.H. to Teach: Making Patient and Family Education "Stick".

Science.gov (United States)

Cutilli, Carolyn Crane

2016-01-01

Healthcare professionals teach patients and families about their health every day. Regulatory and accreditation organizations mandate patient and family education to promote better health outcomes. And recently, financial rewards for healthcare organizations are being tied to patient satisfaction (Hospital Consumer Assessment of Healthcare Providers and Systems-HCAHPS). A University of Pennsylvania Health System group of staff and patients, devoted to excellence in patient and family education, developed the graphic "R.E.A.C.H. to Teach." The purpose of the graphic is to make evidence-based practice (EBP) for patient and family education "stick" with staff. The group used concepts from the marketing book, Made to Stick, to demonstrate how to develop effective staff and patient and family education. Ideas (education) that survive ("stick") have the following attributes: simple, unexpected, concrete, credible, emotional, and narrative (story). This article demonstrates how to apply these principles and EBP to patient and family education.

Application of SWAN+ADCIRC to tide-surge and wave simulation in Gulf of Maine during Patriot’s Day storm

Directory of Open Access Journals (Sweden)

Dong-mei Xie

2016-01-01

Full Text Available The southern coast of the Gulf of Maine in the United States is prone to flooding caused by nor’easters. A state-of-the-art fully-coupled model, the Simulating WAves Nearshore (SWAN model with unstructured grids and the ADvanced CIRCulation (ADCIRC model, was used to study the hydrodynamic response in the Gulf of Maine during the Patriot’s Day storm of 2007, a notable example of nor’easters in this area. The model predictions agree well with the observed tide-surges and waves during this storm event. Waves and circulation in the Gulf of Maine were analyzed. The Georges Bank plays an important role in dissipating wave energy through the bottom friction when waves propagate over the bank from offshore to the inner gulf due to its shallow bathymetry. Wave energy dissipation results in decreasing significant wave height (SWH in the cross-bank direction and wave radiation stress gradient, which in turn induces changes in currents. While the tidal currents are dominant over the Georges Bank and in the Bay of Fundy, the residual currents generated by the meteorological forcing and waves are significant over the Georges Bank and in the coastal area and can reach 0.3 m/s and 0.2 m/s, respectively. In the vicinity of the coast, the longshore current generated by the surface wind stress and wave radiation stress acting parallel to the coastline is inversely proportional to the water depth and will eventually be limited by the bottom friction. The storm surge level reaches 0.8 m along the western periphery of the Gulf of Maine while the wave set-up due to radiation stress variation reaches 0.2 m. Therefore, it is significant to coastal flooding.

How to find the sedimentary archive of fluvial pollution in a bedrock-confined river reach

Science.gov (United States)

Elznicova, Jitka; Matys Grygar, Tomas; Kiss, Timea; Lelkova, Tereza; Balogh, Marton; Sikora, Martin

2016-04-01

The Ohre River springs in the Eastern Germany and it is a tributary of the Labe (Elbe) River in Northwest Bohemia. The river received pollution from several sources during the last five centuries. Most of the pollution sources located along the upper and middle reaches, where the depositional and erosional pattern of the river is highly variable. The upper part of the catchment consists of mainly felsic rocks and the river has a broad floodplain. The middle reach and its right-bank tributaries are deeply incised into the Doupovske Hory Mts., which consists of mafic volcanic rocks; whereas the left-bank tributaries are incised into intrusive and metamorphic rocks of the Krusne Hory Mts. (Ore mountains) with several local ore mines (Ag, Pb and U) in particular in around Olovi and Jachymov. Due to the geologic and geomorphologic complexity, deposition of historical sediments in the middle reach has been spatially limited and uneven, and anomalous background concentrations of risk elements are expected. As a consequence, in the middle reach of the Ohre River it is difficult to find a useful sedimentary archive of historical pollution, though it is desired for two main reasons: (1) to decipher the undocumented and poorly described pollution history from the Krusne Hory Mts. and (2) to better understand the retention of pollutants in the transport zones of a confined river system. Based on historical maps we identified a side-bar (35x320 m) in the middle reach of the river near Straz on Ohre and aimed to describe its formation, its recent erosion/deposition history and to evaluate its sedimentary archive value. In the first half of the 19th century it was an island separated from the valley edge by a side channel. Since then there has been no apparent lateral accretion of the bar (its shape has not been changed), but the upstream part of the side channel aggraded by a sediment plug. We evaluated the current bar topography and geomorphology by a detailed field survey

Solar Hydrogen Reaching Maturity

Directory of Open Access Journals (Sweden)

Rongé Jan

2015-09-01

Full Text Available Increasingly vast research efforts are devoted to the development of materials and processes for solar hydrogen production by light-driven dissociation of water into oxygen and hydrogen. Storage of solar energy in chemical bonds resolves the issues associated with the intermittent nature of sunlight, by decoupling energy generation and consumption. This paper investigates recent advances and prospects in solar hydrogen processes that are reaching market readiness. Future energy scenarios involving solar hydrogen are proposed and a case is made for systems producing hydrogen from water vapor present in air, supported by advanced modeling.

The Cognition of Maximal Reach Distance in Parkinson’s Disease

Directory of Open Access Journals (Sweden)

Satoru Otsuki

2016-01-01

Full Text Available This study aimed to investigate whether the cognition of spatial distance in reaching movements was decreased in patients with Parkinson’s disease (PD and whether this cognition was associated with various symptoms of PD. Estimated and actual maximal reaching distances were measured in three directions in PD patients and healthy elderly volunteers. Differences between estimated and actual measurements were compared within each group. In the PD patients, the associations between “error in cognition” of reaching distance and “clinical findings” were also examined. The results showed that no differences were observed in any values regardless of dominance of hand and severity of symptoms. The differences between the estimated and actual measurements were negatively deviated in the PD patients, indicating that they tended to underestimate reaching distance. “Error in cognition” of reaching distance correlated with the items of posture in the motor section of the Unified Parkinson’s Disease Rating Scale. This suggests that, in PD patients, postural deviation and postural instability might affect the cognition of the distance from a target object.

Experimental study of coexistence of multi-band OFDM-UWB and OFDM-baseband signals in long-reach PONs using directly modulated lasers.

Science.gov (United States)

Morgado, José A P; Fonseca, Daniel; Cartaxo, Adolfo V T

2011-11-07

Transmission of coexisting Orthogonal Frequency Division Multiplexing (OFDM)-baseband (BB) and multi-band OFDM-ultra-wideband (UWB) signals along long-reach passive optical networks using directly modulated lasers (DML) is experimentally demonstrated.When optimized modulation indexes are used, bit error ratios not exceeding 5 × 10⁻⁴ can be achieved by all (OFDM-BB and three OFDM-UWB sub-bands) signals for a reach of 100 km of standard single-mode fiber (SSMF) and optical signal-to-noise ratios not lower than 25dB@0.1 nm. It is experimentally shown that, for the SSMF reach of 100km, the optimized performance of coexisting OFDM-BB and OFDM-UWB signals is mainly imposed by the combination of two effects: the SSMF dispersion-induced nonlinear distortion of the OFDM-UWB signals caused by the OFDM-BB and OFDM-UWB signals, and the further degradation of the OFDM-UWB signals with higher frequency, due to the reduced DML bandwidth.

Brand new hall in the main building

CERN Multimedia

Corinne Pralavorio

2014-01-01

The renovation of the UNIQA and post office premises is getting under way, with their reopening scheduled for the spring.   The renovation of the large hall in the main building (Building 500) has finally reached the home straight. As of this week, building contractors will get to work on the last part – the offices of UNIQA and La Poste. In the last week of November, the two concessions moved their offices across Route Scherrer to the same part of Building 510 where UBS was temporarily housed during the bank’s refurbishment. Their services were therefore unavailable for one day. The renovation work will last until the spring, with the new offices expected to open in May 2015. Between now and then, the windows and insulation will be completely refitted, with a view to reducing heat loss considerably, and, above all, the premises will be modernised to improve customer reception and service. For example, UNIQA’s new premises will feature a confidential area, guarantee...

Children's Visual Processing of Egocentric Cues in Action Planning for Reach

Science.gov (United States)

Cordova, Alberto; Gabbard, Carl

2011-01-01

In this study the authors examined children's ability to code visual information into an egocentric frame of reference for planning reach movements. Children and adults estimated reach distance via motor imagery in immediate and response-delay conditions. Actual maximum reach was compared to estimates in multiple locations in peripersonal and…

Key Design Requirements for Long-Reach Manipulators

Energy Technology Data Exchange (ETDEWEB)

Kwon, D.S.

2001-01-01

Long-reach manipulators differ from industrial robots and teleoperators typically used in the nuclear industry in that the aspect ratio (length to diameter) of links is much greater and link flexibility, as well as joint or drive train flexibility, is likely to be significant. Long-reach manipulators will be required for a variety of applications in the Environmental Restoration and Waste Management Program. While each application will present specific functional, kinematic, and performance requirements, an approach for determining the kinematic applicability and performance characteristics is presented, with a focus on waste storage tank remediation. Requirements are identified, kinematic configurations are considered, and a parametric study of link design parameters and their effects on performance characteristics is presented.

Key design requirements for long-reach manipulators

International Nuclear Information System (INIS)

Kwon, D.S.; March-Leuba, S.; Babcock, S.M.; Hamel, W.R.

1993-09-01

Long-reach manipulators differ from industrial robots and teleoperators typically used in the nuclear industry in that the aspect ratio (length to diameter) of links is much greater and link flexibility, as well as joint or drive train flexibility, is likely to be significant. Long-reach manipulators will be required for a variety of applications in the Environmental Restoration and Waste Management Program. While each application will present specific functional kinematic, and performance requirements an approach for determining the kinematic applicability and performance characteristics is presented, with a focus on waste storage tank remediation. Requirements are identified, kinematic configurations are considered, and a parametric study of link design parameters and their effects on performance characteristics is presented

Key Design Requirements for Long-Reach Manipulators

International Nuclear Information System (INIS)

Kwon, D.S.

2001-01-01

Long-reach manipulators differ from industrial robots and teleoperators typically used in the nuclear industry in that the aspect ratio (length to diameter) of links is much greater and link flexibility, as well as joint or drive train flexibility, is likely to be significant. Long-reach manipulators will be required for a variety of applications in the Environmental Restoration and Waste Management Program. While each application will present specific functional, kinematic, and performance requirements, an approach for determining the kinematic applicability and performance characteristics is presented, with a focus on waste storage tank remediation. Requirements are identified, kinematic configurations are considered, and a parametric study of link design parameters and their effects on performance characteristics is presented

Relap5/Mod3.1 analysis of main steam header rupture in VVER- 440/213 NPP

Energy Technology Data Exchange (ETDEWEB)

Kral, P. [Nuclear Research Inst. Rez (Switzerland)

1995-12-31

The presentation is focused on two main topics. First the applied modelling of PGV-4 steam generator for RELAP5 code are described. The results of steady-state calculation under reference conditions are compared against measured data. The problem of longitudinal subdivision of SG tubes is analysed and evaluated. Secondly, a best-estimate analysis of main steam header (MSH) rupture accident in WWER-440/213 NPP is presented. The low reliability of initiation of ESFAS signal `MSH Rupture` leads in this accident to big loss of secondary coolant, full depressurization of main steam system, extremely fast cool-down of both secondary and primary system, opening of PRZ SV-bypass valve with later liquid outflow, potential reaching of secondary criticality by failure of HPIS. 7 refs.

Relap5/Mod3.1 analysis of main steam header rupture in VVER- 440/213 NPP

Energy Technology Data Exchange (ETDEWEB)

Kral, P [Nuclear Research Inst. Rez (Switzerland)

1996-12-31

The presentation is focused on two main topics. First the applied modelling of PGV-4 steam generator for RELAP5 code are described. The results of steady-state calculation under reference conditions are compared against measured data. The problem of longitudinal subdivision of SG tubes is analysed and evaluated. Secondly, a best-estimate analysis of main steam header (MSH) rupture accident in WWER-440/213 NPP is presented. The low reliability of initiation of ESFAS signal `MSH Rupture` leads in this accident to big loss of secondary coolant, full depressurization of main steam system, extremely fast cool-down of both secondary and primary system, opening of PRZ SV-bypass valve with later liquid outflow, potential reaching of secondary criticality by failure of HPIS. 7 refs.

Relap5/Mod3.1 analysis of main steam header rupture in VVER- 440/213 NPP

International Nuclear Information System (INIS)

Kral, P.

1995-01-01

The presentation is focused on two main topics. First the applied modelling of PGV-4 steam generator for RELAP5 code are described. The results of steady-state calculation under reference conditions are compared against measured data. The problem of longitudinal subdivision of SG tubes is analysed and evaluated. Secondly, a best-estimate analysis of main steam header (MSH) rupture accident in WWER-440/213 NPP is presented. The low reliability of initiation of ESFAS signal 'MSH Rupture' leads in this accident to big loss of secondary coolant, full depressurization of main steam system, extremely fast cool-down of both secondary and primary system, opening of PRZ SV-bypass valve with later liquid outflow, potential reaching of secondary criticality by failure of HPIS

PTK2 expression and immunochemotherapy outcome in chronic lymphocytic leukemia

DEFF Research Database (Denmark)

Weisser, Martin; Yeh, Ru-Fang; Duchateau-Nguyen, Guillemette

2014-01-01

with improved outcomes for CLL patients treated with R-FC vs FC. PTK2 expression may be a useful biomarker for patient selection in future trials. These trials were registered at www.clinicaltrials.gov as #NCT00090051 (REACH) and #NCT00281918 (CLL8)....... assessed genome-wide expression of 300 pretreatment specimens from a subset of 552 patients in REACH, a study of FC or R-FC in relapsed CLL. An independent test set was derived from 282 pretreatment specimens from CLL8, a study of FC or R-FC in treatment-naïve patients. Genes specific for benefit from R-FC...... were determined by assessing treatment-gene interactions in Cox proportional hazards models. REACH patients with higher pretreatment protein tyrosine kinase 2 (PTK2) messenger RNA levels derived greater benefit from R-FC, with significant improvements in progression-free survival, independent of known...

Variation of precipitation for the last 300 years over the middle and lower reaches of the Yellow River

Institute of Scientific and Technical Information of China (English)

ZHENG; Jingyun; HAO; Zhixin; GE; Quansheng

2005-01-01

The precipitation at 17 stations over the middle and lower reaches of the Yellow River is reconstructed during the period of 1736―1910, using the snow and rainfall records in the Qing Dynasty, together with the instrumental observation data of precipitation and farmland soil moisture content. The soil physics model related to rainfall infiltration and the surface water balance equation are taken as main reconstruction methodology. The field infiltration experiment by artificial rainfall is conducted to check the reliability. And the precipitation series over the middle and lower reaches of the Yellow River and its 4 sub-regions are established, going back to 1736. Analysis of the time series indicates that the abrupt change of precipitation from high to low occurs around 1915 over the middle and lower reaches of the Yellow River. During the three periods of 1791―1805, 1816―1830 and 1886―1895, the precipitation is markedly higher than the mean of the series. While both the periods of 1916―1945 and 1981―2000 are characterized by less precipitation. Three periodicities of 22―25a, 3.9a and 2.7a are shown in the precipitation fluctuation over the middle and lower reaches of the Yellow River. Moreover, the periodical signal of 22―25a becomes weaker and weaker since the abrupt change of 1915 and disappears in the late 1940s, and then the periodical signal of 35―40a appears instead.

Differential Recruitment of Parietal Cortex during Spatial and Non-spatial Reach Planning

Directory of Open Access Journals (Sweden)

Pierre-Michel Bernier

2017-05-01

Full Text Available The planning of goal-directed arm reaching movements is associated with activity in the dorsal parieto-frontal cortex, within which multiple regions subserve the integration of arm- and target-related sensory signals to encode a motor goal. Surprisingly, many of these regions show sustained activity during reach preparation even when target location is not specified, i.e., when a motor goal cannot be unambiguously formed. The functional role of these non-spatial preparatory signals remains unresolved. Here this process was investigated in humans by comparing reach preparatory activity in the presence or absence of information regarding upcoming target location. In order to isolate the processes specific to reaching and to control for visuospatial attentional factors, the reaching task was contrasted to a finger movement task. Functional MRI and electroencephalography (EEG were used to characterize the spatio-temporal pattern of reach-related activity in the parieto-frontal cortex. Reach planning with advance knowledge of target location induced robust blood oxygenated level dependent and EEG responses across parietal and premotor regions contralateral to the reaching arm. In contrast, reach preparation without knowledge of target location was associated with a significant BOLD response bilaterally in the parietal cortex. Furthermore, EEG alpha- and beta-band activity was restricted to parietal scalp sites, the magnitude of the latter being correlated with reach reaction times. These results suggest an intermediate stage of sensorimotor transformations in bilateral parietal cortex when target location is not specified.

Trichotillomania: the impact of treatment history on the outcome of an Internet-based intervention.

Science.gov (United States)

Weidt, Steffi; Bruehl, Annette Beatrix; Delsignore, Aba; Zai, Gwyneth; Kuenburg, Alexa; Klaghofer, Richard; Rufer, Michael

2017-01-01

Many patients suffering from trichotillomania (TTM) have never undergone treatment. Without treatment, TTM often presents with a chronic course. Characteristics of TTM individuals who have never been treated (untreated) remain largely unknown. Whether treatment history impacts Internet-based interventions has not yet been investigated. We aimed to answer whether Internet-based interventions can reach untreated individuals and whether treatment history is associated with certain characteristics and impacts on the outcome of an Internet-based intervention. We provided Internet-based interventions. Subjects were characterized at three time points using the Massachusetts General Hospital Hairpulling Scale, Hamilton Depression Rating Scale, and the World Health Organization Quality of Life questionnaire. Of 105 individuals, 34 were untreated. Health-related quality of life (HRQoL) was markedly impaired in untreated and treated individuals. Symptom severity did not differ between untreated and treated individuals. Nontreatment was associated with fewer depressive symptoms ( P =0.002). Treatment history demonstrated no impact on the outcome of Internet-based interventions. Results demonstrate that Internet-based interventions can reach untreated TTM individuals. They show that untreated individuals benefit as much as treated individuals from such interventions. Future Internet-based interventions should focus on how to best reach/support untreated individuals with TTM. Additionally, future studies may examine whether Internet-based interventions can reach and help untreated individuals suffering from other psychiatric disorders.

Short-term forecasting of turbidity in trunk main networks.

Science.gov (United States)

Meyers, Gregory; Kapelan, Zoran; Keedwell, Edward

2017-11-01

Water discolouration is an increasingly important and expensive issue due to rising customer expectations, tighter regulatory demands and ageing Water Distribution Systems (WDSs) in the UK and abroad. This paper presents a new turbidity forecasting methodology capable of aiding operational staff and enabling proactive management strategies. The turbidity forecasting methodology developed here is completely data-driven and does not require hydraulic or water quality network model that is expensive to build and maintain. The methodology is tested and verified on a real trunk main network with observed turbidity measurement data. Results obtained show that the methodology can detect if discolouration material is mobilised, estimate if sufficient turbidity will be generated to exceed a preselected threshold and approximate how long the material will take to reach the downstream meter. Classification based forecasts of turbidity can be reliably made up to 5 h ahead although at the expense of increased false alarm rates. The methodology presented here could be used as an early warning system that can enable a multitude of cost beneficial proactive management strategies to be implemented as an alternative to expensive trunk mains cleaning programs. Copyright © 2017 Elsevier Ltd. All rights reserved.

Study populations and casemix: influence on analysis of postoperative outcomes.

Science.gov (United States)

Isbister, W H

2000-04-01

The importance of patient casemix as a determinant of surgical outcome is now being recognized. The present study was undertaken in order to compare the presentation and outcomes in colorectal patients managed surgically by the same surgeon, in the same way, in different settings. Colorectal outcome data from the University Department of Surgery in Wellington and the King Faisal Specialist Hospital in Riyadh were analysed in order to determine casemix differences between the two hospitals. Data relating to the type of surgery, the surgeon, the patient's disease, the operation performed and the postoperative complications were compared. Specific colorectal clinical indicators were compared for two commonly performed operations for rectal cancer: anterior resection and abdomino-perineal resection of the rectum. Wellington patients were slightly older and there were more females. Emergency surgery was more frequent in Wellington. Left hemicolectomy, sigmoid colectomy, abscess drainage and pilonidal surgery were more common in Wellington whereas abdomino-perineal resection and anterior resection of the rectum, stoma closure, fistula surgery, seton insertion, restorative proctocolectomy and ileostomy were undertaken more frequently in Riyadh. More complex anal fistulas were managed in Riyadh. Condylomata accuminata, pilonidal abscess, anorectal abscess, rectal prolapse and diverticular disease were rarely seen in Riyadh. There were more postoperative pulmonary and cardiac complications in Wellington. Patients having anterior resection of the rectum were younger in Riyadh and there were proportionally more females. There were some obvious numerical outcome differences in postoperative atelectasis, wound infection, anastomotic leak and deep vein thrombosis rates but none of these reached statistical significance except atelectasis. In Riyadh the usual male-to-female ratio of patients undergoing abdomino-perineal resection was reversed but, again, none of the numerical

Independent development of the Reach and the Grasp in spontaneous self-touching by human infants in the first six months

Directory of Open Access Journals (Sweden)

Brittany L Thomas

2015-01-01

Full Text Available The Dual Visuomotor Channel Theory proposes that visually guided reaching is a composite of two movements, a Reach that advances the hand to contact the target and a Grasp that shapes the digits for target purchase. The theory is supported by biometric analyses of adult reaching, evolutionary contrasts, and differential developmental patterns for the Reach and the Grasp in visually guided reaching in human infants. The present ethological study asked whether there is evidence for a dissociated development for the Reach and the Grasp in nonvisual hand use in very early infancy. The study documents a rich array of spontaneous self-touching behavior in infants during the first six months of life and subjects the movements to analyses of body target, contact type, and Grasp. Video recordings were made of resting alert infants biweekly from birth to 6 months. In younger infants, self-touching targets included the head and trunk. As infants aged, targets became more caudal including the hips, legs, and feet. In younger infants hand contact was mainly made with the dorsum of the hand, but as infants aged contacts included palmar and eventually grasp and manipulatory contacts with the body and clothes. The relative incidence of caudal contacts and palmar contacts increased concurrently and were significantly correlated throughout the period of study. In contrast, developmental increases in self grasping emerged a few weeks after the increases observed in caudal and palmar contacts. The behavioral and temporal pattern of these spontaneous self-touching movements suggest that the Reach, in which the hand extends to make a palmar self-contact, and the Grasp, in which the digits close and make manipulatory movements, have partially independent developmental profiles. The results additionally suggest that self-touching behavior is an important developmental phase that allows for the coordination of the Reach and the Grasp prior to their use under visual

Cost-effectiveness analysis in severe mental illness : Outcome measures selection

NARCIS (Netherlands)

Stant, A. Dennis; Buskens, Erik; Jenner, Jack A.; Wiersma, Durk; TenVergert, Elisabeth M.

Background: Most economic evaluations conducted in mental healthcare did not include widely recommended preference-based health outcomes like the QALY (Quality-Adjusted Life Years). Instead, studies have mainly been designed as cost-effectiveness analyses that include single outcome measures aimed

Raising objectives: how global PV production could reach 5 GWp by 2010

International Nuclear Information System (INIS)

Cameron, A.; Jones, J.

2006-01-01

A recent international workshop for the solar photovoltaic (PV) industry organised by the European Photovoltaic Industry Association (EPIA) examined market trends and technological developments. Under a business-as-usual (BAU) scenario, the EPIA predicts that the global PV market would only reach 3.2 GWp by 2010. But workshop participants believe that, given sufficient support measures to encourage investment, the global market could be accelerated to reach 5400 MW per year by 2010, with an achievable annual installed capacity of over 5 GWp and production of 30,000 tonnes of solar-grade silicon per year at a cost of 30-40 euros/kg. Major markets are expected to be Germany, Japan, USA, China and Spain. Examples of the type of policies and strategies necessary for accelerated growth are given and countries with potential for a significant increase in annual PV installation rates are identified. The current main constraint on market growth is the global shortage of suitable silicon, but confidence in the solar market is now sufficient for significant new manufacturing plant to be planned. Investment in other PV technologies is also required, plus a decrease in the price of PV modules. EPIA does not expect a short-term price reduction for PV until after 2007 but the workshop concluded that the PV industry could expect to see an average price reduction of around 5% per year (for cells, modules and complete systems) by 2011

Simulated and observed 2010 flood-water elevations in selected river reaches in the Moshassuck and Woonasquatucket River Basins, Rhode Island

Science.gov (United States)

Zarriello, Phillip J.; Straub, David E.; Westenbroek, Stephen M.

2014-01-01

Heavy persistent rains from late February through March 2010 caused severe flooding and set, or nearly set, peaks of record for streamflows and water levels at many long-term U.S. Geological Survey streamgages in Rhode Island. In response to this flood, hydraulic models were updated for selected reaches covering about 33 river miles in Moshassuck and Woonasquatucket River Basins from the most recent approved Federal Emergency Management Agency flood insurance study (FIS) to simulate water-surface elevations (WSEs) from specified flows and boundary conditions. Reaches modeled include the main stem of the Moshassuck River and its main tributary, the West River, and three tributaries to the West River—Upper Canada Brook, Lincoln Downs Brook, and East Branch West River; and the main stem of the Woonasquatucket River. All the hydraulic models were updated to Hydrologic Engineering Center-River Analysis System (HEC-RAS) version 4.1.0 and incorporate new field-survey data at structures, high-resolution land-surface elevation data, and flood flows from a related study. The models were used to simulate steady-state WSEs at the 1- and 2-percent annual exceedance probability (AEP) flows, which is the estimated AEP of the 2010 flood in the Moshassuck River Basin and the Woonasquatucket River, respectively. The simulated WSEs were compared to the high-water mark (HWM) elevation data obtained in these basins in a related study following the March–April 2010 flood, which included 18 HWMs along the Moshassuck River and 45 HWMs along the Woonasquatucket River. Differences between the 2010 HWMs and the simulated 2- and 1-percent AEP WSEs from the FISs and the updated models developed in this study varied along the reach. Most differences could be attributed to the magnitude of the 2- and 1-percent AEP flows used in the FIS and updated model flows. Overall, the updated model and the FIS WSEs were not appreciably different when compared to the observed 2010 HWMs along the

BROOKHAVEN: Proton goal reached

International Nuclear Information System (INIS)

Anon.

1995-01-01

On March 30 the 35-year old Alternating Gradient Synchrotron (AGS) exceeded its updated design goal of 6 x 10 13 protons per pulse (ppp), by accelerating 6.3 x 10 13 ppp, a world record intensity. This goal was set 11 years ago and achieving it called for the construction of a new booster and the reconstruction of much of the AGS. The booster was completed in 1991, and reached its design intensity of 1.5 x 10 13 ppp in 1993. The AGS reconstruction was finished in 1994, and by July of that year the AGS claimed a new US record intensity for a proton synchrotron of 4 x 10 13 ppp, using four booster pulses. Reaching the design intensity was scheduled for 1995. In 1994, the AGS had seemed to be solidly limited to 4 x 10 13 ppp, but in 1995 the operations crew, working on their own in the quiet of the owl shift, steadily improved the intensity, regularly setting new records, much to the bemusement of the machine physicists. The physicists, however, did contribute. A second harmonic radiofrequency cavity in the booster increased the radiofrequency bucket area for capture, raising the booster intensity from 1.7 to 2.1 x 10 13 ppp. In the AGS, new radiofrequency power supplies raised the available voltage from 8 to 13 kV, greatly enhancing the beam loading capabilities of the system. A powerful new transverse damping system successfully controlled instabilities that otherwise would have destroyed the beam in less than a millisecond. Also in the AGS, 35th harmonic octupole resonances were found

BROOKHAVEN: Proton goal reached

Energy Technology Data Exchange (ETDEWEB)

Anon.

1995-09-15

On March 30 the 35-year old Alternating Gradient Synchrotron (AGS) exceeded its updated design goal of 6 x 10{sup 13} protons per pulse (ppp), by accelerating 6.3 x 10{sup 13} ppp, a world record intensity. This goal was set 11 years ago and achieving it called for the construction of a new booster and the reconstruction of much of the AGS. The booster was completed in 1991, and reached its design intensity of 1.5 x 10{sup 13} ppp in 1993. The AGS reconstruction was finished in 1994, and by July of that year the AGS claimed a new US record intensity for a proton synchrotron of 4 x 10{sup 13} ppp, using four booster pulses. Reaching the design intensity was scheduled for 1995. In 1994, the AGS had seemed to be solidly limited to 4 x 10{sup 13} ppp, but in 1995 the operations crew, working on their own in the quiet of the owl shift, steadily improved the intensity, regularly setting new records, much to the bemusement of the machine physicists. The physicists, however, did contribute. A second harmonic radiofrequency cavity in the booster increased the radiofrequency bucket area for capture, raising the booster intensity from 1.7 to 2.1 x 10{sup 13} ppp. In the AGS, new radiofrequency power supplies raised the available voltage from 8 to 13 kV, greatly enhancing the beam loading capabilities of the system. A powerful new transverse damping system successfully controlled instabilities that otherwise would have destroyed the beam in less than a millisecond. Also in the AGS, 35th harmonic octupole resonances were found.

Channel morphodynamics in four reaches of the Lower Missouri River, 2006-07

Science.gov (United States)

Elliott, Caroline M.; Reuter, Joanna M.; Jacobson, Robert B.

2009-01-01

Channel morphodynamics in response to flow modifications from Gavins Point Dam are examined in four reaches of the Lower Missouri River. Measures include changes in channel morphology and indicators of sediment transport in four 6 kilometer long reaches located downstream from Gavins Point Dam, near Yankton, South Dakota, Kenslers Bend, Nebraska, Little Sioux, Iowa, and Miami, Missouri. Each of the four reaches was divided into 300 transects with a 20-meter spacing and surveyed during the summer in 2006 and 2007. A subset of 30 transects was randomly selected and surveyed 7-10 times in 2006-07 over a wide range of discharges including managed and natural flow events. Hydroacoustic mapping used a survey-grade echosounder and a Real Time Kinematic Global Positioning System to evaluate channel change. Acoustic Doppler current profiler measurements were used to evaluate bed-sediment velocity. Results indicate varying amounts of deposition, erosion, net change, and sediment transport in the four Lower Missouri River reaches. The Yankton reach was the most stable over monthly and annual time-frames. The Kenslers Bend and Little Sioux reaches exhibited substantial amounts of deposition and erosion, although net change was generally low in both reaches. Total, or gross geomorphic change was greatest in the Kenslers Bend reach. The Miami reach exhibited varying rates of deposition and erosion, and low net change. The Yankton, Kenslers Bend, and Miami reaches experienced net erosion during the time period that bracketed the managed May 2006 spring rise event from Gavins Point Dam.

Validated Outcomes in the Grafting of Autologous Fat to the Breast: The VOGUE Study. Development of a Core Outcome Set for Research and Audit.

Science.gov (United States)

Agha, Riaz A; Pidgeon, Thomas E; Borrelli, Mimi R; Dowlut, Naeem; Orkar, Ter-Er K; Ahmed, Maziyah; Pujji, Ojas; Orgill, Dennis P

2018-05-01

Autologous fat grafting is an important part of the reconstructive surgeon's toolbox when treating women affected by breast cancer and subsequent tumor extirpation. The debate over safety and efficacy of autologous fat grafting continues within the literature. However, work performed by the authors' group has shown significant heterogeneity in outcome reporting. Core outcome sets have been shown to reduce heterogeneity in outcome reporting. The authors' goal was to develop a core outcome set for autologous fat grafting in breast reconstruction. The authors published their protocol a priori. A Delphi consensus exercise among key stakeholders was conducted using a list of outcomes generated from their previous work. These outcomes were divided into six domains: oncologic, clinical, aesthetic and functional, patient-reported, process, and radiologic. In the first round, 55 of 78 participants (71 percent) completed the Delphi consensus exercise. Consensus was reached on nine of the 13 outcomes. The clarity of the results and lack of additional suggested outcomes deemed further rounds to be unnecessary. The VOGUE Study has led to the development of a much-needed core outcome set in the active research front and clinical area of autologous fat grafting. The authors hope that clinicians will use this core outcome set to audit their practice, and that researchers will implement these outcomes in their study design and reporting of autologous fat grafting outcomes. The authors encourage journals and surgical societies to endorse and encourage use of this core outcome set to help refine the scientific quality of the debate, the discourse, and the literature. Therapeutic, V.

MAINS: MULTI-AGENT INTELLIGENT SERVICE ARCHITECTURE FOR CLOUD COMPUTING

Directory of Open Access Journals (Sweden)

T. Joshva Devadas

2014-04-01

Full Text Available Computing has been transformed to a model having commoditized services. These services are modeled similar to the utility services water and electricity. The Internet has been stunningly successful over the course of past three decades in supporting multitude of distributed applications and a wide variety of network technologies. However, its popularity has become the biggest impediment to its further growth with the handheld devices mobile and laptops. Agents are intelligent software system that works on behalf of others. Agents are incorporated in many innovative applications in order to improve the performance of the system. Agent uses its possessed knowledge to react with the system and helps to improve the performance. Agents are introduced in the cloud computing is to minimize the response time when similar request is raised from an end user in the globe. In this paper, we have introduced a Multi Agent Intelligent system (MAINS prior to cloud service models and it was tested using sample dataset. Performance of the MAINS layer was analyzed in three aspects and the outcome of the analysis proves that MAINS Layer provides a flexible model to create cloud applications and deploying them in variety of applications.

Whisker and Nose Tactile Sense Guide Rat Behavior in a Skilled Reaching Task

Directory of Open Access Journals (Sweden)

Pierantonio Parmiani

2018-02-01

Full Text Available Skilled reaching is a complex movement in which a forelimb is extended to grasp food for eating. Video-recordings analysis of control rats enables us to distinguish several components of skilled reaching: Orient, approaching the front wall of the reaching box and poking the nose into the slot to locate the food pellet; Transport, advancing the forelimb through the slot to reach-grasp the pellet; and Withdrawal of the grasped food to eat. Although food location and skilled reaching is guided by olfaction, the importance of whisker/nose tactile sense in rats suggests that this too could play a role in reaching behavior. To test this hypothesis, we studied skilled reaching in rats trained in a single-pellet reaching task before and after bilateral whisker trimming and bilateral infraorbital nerve (ION severing. During the task, bilaterally trimmed rats showed impaired Orient with respect to controls. Specifically, they detected the presence of the wall by hitting it with their nose (rather than their whiskers, and then located the slot through repetitive nose touches. The number of nose touches preceding poking was significantly higher in comparison to controls. On the other hand, macrovibrissae trimming resulted in no change in reaching/grasping or withdrawal components of skilled reaching. Bilaterally ION-severed rats, displayed a marked change in the structure of their skilled reaching. With respect to controls, in ION-severed rats: (a approaches to the front wall were significantly reduced at 3–5 and 6–8 days; (b nose pokes were significantly reduced at 3–5 days, and the slot was only located after many repetitive nose touches; (c the reaching-grasping-retracting movement never appeared at 3–5 days; (d explorative paw movements, equal to zero in controls, reached significance at 9–11 days; and (e the restored reaching-grasping-retracting sequence was globally slower than in controls, but the success rate was the same. These findings

How infants' reaches reveal principles of sensorimotor decision making

Science.gov (United States)

Dineva, Evelina; Schöner, Gregor

2018-01-01

In Piaget's classical A-not-B-task, infants repeatedly make a sensorimotor decision to reach to one of two cued targets. Perseverative errors are induced by switching the cue from A to B, while spontaneous errors are unsolicited reaches to B when only A is cued. We argue that theoretical accounts of sensorimotor decision-making fail to address how motor decisions leave a memory trace that may impact future sensorimotor decisions. Instead, in extant neural models, perseveration is caused solely by the history of stimulation. We present a neural dynamic model of sensorimotor decision-making within the framework of Dynamic Field Theory, in which a dynamic instability amplifies fluctuations in neural activation into macroscopic, stable neural activation states that leave memory traces. The model predicts perseveration, but also a tendency to repeat spontaneous errors. To test the account, we pool data from several A-not-B experiments. A conditional probabilities analysis accounts quantitatively how motor decisions depend on the history of reaching. The results provide evidence for the interdependence among subsequent reaching decisions that is explained by the model, showing that by amplifying small differences in activation and affecting learning, decisions have consequences beyond the individual behavioural act.

Amplified Erosion above Waterfalls and Oversteepened Bedrock Reaches

Science.gov (United States)

Haviv, I.; Enzel, Y.; Whipple, K. X.; Zilberman, E.; Stone, J.; Matmon, A.; Fifield, K. L.

2005-12-01

Although waterfalls are abundant along steep bedrock channels, none of the conventional erosion laws can predict incision at the lip of a waterfall where flow is non-uniform and bed slope can be vertical. Considering the expected increase in flow velocity and shear stress at the lip of a vertical waterfall we determine erosion amplification at a waterfall lip as: Elip/Enormal= (1+0.4/Fr2)3n, where Fr is the Froude number and n ranges between 0.5-1.7. This amplification expression suggests that erosion at the lip could be as much as 2-5 times higher than normally expected in a setting with identical hydraulic geometry. It also demonstrates that a freefall is expected to amplify upstream incision rates even when the flow approaching the waterfall is highly supercritical. Utilizing this erosion amplification expression in numerical simulations in conjunction with a standard detachment-limited incision model we demonstrate its impact on reach-scale morphology above waterfalls. These simulations indicate that amplified erosion at the lip of a waterfall can trigger the formation of an oversteepened reach whose length is longer than the flow acceleration zone, provided incision velocity (Vi) at the edge of the flow acceleration zone is higher than the retreat velocity of the waterfall face. Such an oversteepened reach is expected to be more pronounced when Vi increases with increasing slope. The simulations also suggest that oversteepening can eventually lead to quasi steady-state gradients upstream from a waterfall provided Vi decreases with increasing slope. Flow acceleration above waterfalls can thus account, at least partially, for oversteepened bedrock reaches that are prevalent above waterfalls. Such reaches have been reported for the escarpments of southeast Australia, western Dead Sea, and at Niagara Falls. Using the cosmogenic isotope 36Cl we demonstrate that Vi upstream of a waterfall at the Dead Sea western escarpment is high enough for freefall

Organizational Climate, Services, and Outcomes in Child Welfare Systems

Science.gov (United States)

Glisson, Charles; Green, Philip

2011-01-01

Objective: This study examines the association of organizational climate, casework services, and youth outcomes in child welfare systems. Building on preliminary findings linking organizational climate to youth outcomes over a 3-year follow-up period, the current study extends the follow-up period to 7 years and tests main, moderating and…

Maternal nutrition and birth outcomes.

Science.gov (United States)

Abu-Saad, Kathleen; Fraser, Drora

2010-01-01

In this review, the authors summarize current knowledge on maternal nutritional requirements during pregnancy, with a focus on the nutrients that have been most commonly investigated in association with birth outcomes. Data sourcing and extraction included searches of the primary resources establishing maternal nutrient requirements during pregnancy (e.g., Dietary Reference Intakes), and searches of Medline for "maternal nutrition"/[specific nutrient of interest] and "birth/pregnancy outcomes," focusing mainly on the less extensively reviewed evidence from observational studies of maternal dietary intake and birth outcomes. The authors used a conceptual framework which took both primary and secondary factors (e.g., baseline maternal nutritional status, socioeconomic status of the study populations, timing and methods of assessing maternal nutritional variables) into account when interpreting study findings. The authors conclude that maternal nutrition is a modifiable risk factor of public health importance that can be integrated into efforts to prevent adverse birth outcomes, particularly among economically developing/low-income populations.

The Impossibility of the Counterfactual Computation for all Possible Outcomes

OpenAIRE

Vaidman, Lev

2006-01-01

Recent proposal for counterfactual computation [Hosten et al., Nature, 439, 949 (2006)] is analyzed. It is argued that the method does not provide counterfactual computation for all possible outcomes. The explanation involves a novel paradoxical feature of pre- and post-selected quantum particles: the particle can reach a certain location without being on the path that leads to this location.

Adaptation of reach-to-grasp movement in response to force perturbations.

Science.gov (United States)

Rand, M K; Shimansky, Y; Stelmach, G E; Bloedel, J R

2004-01-01

This study examined how reach-to-grasp movements are modified during adaptation to external force perturbations applied on the arm during reach. Specifically, we examined whether the organization of these movements was dependent upon the condition under which the perturbation was applied. In response to an auditory signal, all subjects were asked to reach for a vertical dowel, grasp it between the index finger and thumb, and lift it a short distance off the table. The subjects were instructed to do the task as fast as possible. The perturbation was an elastic load acting on the wrist at an angle of 105 deg lateral to the reaching direction. The condition was modified by changing the predictability with which the perturbation was applied in a given trial. After recording unperturbed control trials, perturbations were applied first on successive trials (predictable perturbations) and then were applied randomly (unpredictable perturbations). In the early predictable perturbation trials, reach path length became longer and reaching duration increased. As more predictable perturbations were applied, the reach path length gradually decreased and became similar to that of control trials. Reaching duration also decreased gradually as the subjects adapted by exerting force against the perturbation. In addition, the amplitude of peak grip aperture during arm transport initially increased in response to repeated perturbations. During the course of learning, it reached its maximum and thereafter slightly decreased. However, it did not return to the normal level. The subjects also adapted to the unpredictable perturbations through changes in both arm transport and grasping components, indicating that they can compensate even when the occurrence of the perturbation cannot be predicted during the inter-trial interval. Throughout random perturbation trials, large grip aperture values were observed, suggesting that a conservative aperture level is set regardless of whether the

Reaching the Overlooked Student in Physical Education

Science.gov (United States)

Esslinger, Keri; Esslinger, Travis; Bagshaw, Jarad

2015-01-01

This article describes the use of live action role-playing, or "LARPing," as a non-traditional activity that has the potential to reach students who are not interested in traditional physical education.

The Spear: The Main Weapon in Iranian Martial Tradition

Directory of Open Access Journals (Sweden)

Manouchehr Moshtagh Khorasani

2012-07-01

Full Text Available In martial tradition, spears and lances have always played a very important role as main weapons on the battlefield, as exemplified through Iranian military history. Its reach and cheap production were important factors for establishing formations of soldiers equipped with spears and lances. Additionally, the combat techniques of spears and lances were relatively easy and one could learn the techniques of spearfighting and lancefighting much easier than other weapons, such as swords. The first part of the article describes some types of spears and lances that were used in the Islamic period of Iran. Then the method of carrying a spear/lance is analyzed and additionally some offensive techniques, feinting techniques, attacking techniques to the animal carrying the opponent, and defensive techniques using spears/lances are described as documented by Persian manuscripts.

Electron-Cloud Build-up in the FNAL Main Injector

International Nuclear Information System (INIS)

Furman, M.A.

2007-01-01

We present a summary on ongoing simulation results for the electron-cloud buildup in the context of the proposed FNAL Main Injector (MI) intensity upgrade [1] in a fieldfree region at the location of the RFA electron detector [2]. By combining our simulated results for the electron flux at the vacuum chamber wall with the corresponding measurements obtained with the RFA we infer that the peak secondary electron yield (SEY) (delta) max is ∼> 1.4, and the average electron density is n e ∼> 10 10 m -3 at transition energy for the specific fill pattern and beam intensities defined below. The sensitivity of our results to several variables remains to be explored in order to reach more definitive results. Effects from the electron cloud on the beam are being investigated separately [3

Adaptive upstream rate adjustment by RSOA-ONU depending on different injection power of seeding light in standard-reach and long-reach PON systems

Science.gov (United States)

Yeh, C. H.; Chow, C. W.; Shih, F. Y.; Pan, C. L.

2012-08-01

The wavelength division multiplexing-time division multiplexing (WDM-TDM) passive optical network (PON) using reflective semiconductor optical amplifier (RSOA)-based colorless optical networking units (ONUs) is considered as a promising candidate for the realization of fiber-to-the-home (FTTH). And this architecture is actively considered by Industrial Technology Research Institute (ITRI) for the realization of FTTH in Taiwan. However, different fiber distances and optical components would introduce different power budgets to different ONUs in the PON. Besides, due to the aging of optical transmitter (Tx), the power decay of the distributed optical carrier from the central office (CO) could also reduce the injection power into each ONU. The situation will be more severe in the long-reach (LR) PON, which is considered as an option for the future access. In this work, we investigate a WDM-TDM PON using RSOA-based ONU for upstream data rate adjustment depending on different continuous wave (CW) injection powers. Both standard-reach (25 km) and LR (100 km) transmissions are evaluated. Moreover, a detail analysis of the upstream signal bit-error rate (BER) performances at different injection powers, upstream data rates, PON split-ratios under stand-reach and long-reach is presented.

A Participative Approach to Evaluation of Graduates' Professional Outcomes

Science.gov (United States)

Clerici, Renata; Castiglioni, Maria; Grion, Valentina; Zago, Giuseppe; Da Re, Lorenza

2014-01-01

This work discusses the professional outcomes of University of Padova graduates in academic year 2007/08. Its aim was to carry out an overall assessment of higher education professional outcomes, involving all the main actors of the learning process, students, teachers and tutors, in a perspective of participatory evaluation, to improve teaching…

Olefins and chemical regulation in Europe: REACH.

Science.gov (United States)

Penman, Mike; Banton, Marcy; Erler, Steffen; Moore, Nigel; Semmler, Klaus

2015-11-05

REACH (Registration, Evaluation, Authorisation and Restriction of Chemicals) is the European Union's chemical regulation for the management of risk to human health and the environment (European Chemicals Agency, 2006). This regulation entered into force in June 2007 and required manufacturers and importers to register substances produced in annual quantities of 1000 tonnes or more by December 2010, with further deadlines for lower tonnages in 2013 and 2018. Depending on the type of registration, required information included the substance's identification, the hazards of the substance, the potential exposure arising from the manufacture or import, the identified uses of the substance, and the operational conditions and risk management measures applied or recommended to downstream users. Among the content developed to support this information were Derived No-Effect Levels or Derived Minimal Effect Levels (DNELs/DMELs) for human health hazard assessment, Predicted No Effect Concentrations (PNECs) for environmental hazard assessment, and exposure scenarios for exposure and risk assessment. Once registered, substances may undergo evaluation by the European Chemicals Agency (ECHA) or Member State authorities and be subject to requests for additional information or testing as well as additional risk reduction measures. To manage the REACH registration and related activities for the European olefins and aromatics industry, the Lower Olefins and Aromatics REACH Consortium was formed in 2008 with administrative and technical support provided by Penman Consulting. A total of 135 substances are managed by this group including 26 individual chemical registrations (e.g. benzene, 1,3-butadiene) and 13 categories consisting of 5-26 substances. This presentation will describe the content of selected registrations prepared for 2010 in addition to the significant post-2010 activities. Beyond REACH, content of the registrations may also be relevant to other European activities, for

A practical tip to engage the left main coronary artery in patients presenting with aortic aneurysms

Directory of Open Access Journals (Sweden)

Kudret Keskin

2017-09-01

Full Text Available Coronary angiography in patients presenting with ascending aortic aneurysms can be challenging since standard catheters may fail to reach the left main coronary artery. A widely accepted approach is the mother-in-child catheter technique whereby a catheter with a smaller diameter is telescoped through one with a bigger diameter, a procedure that helps to lengthen the catheter. However, this technique is associated with several disadvantages such as thrombus formation within the catheters, inadvertent damage to the left main ostium, and the necessity of manipulation, which the operator may not be familiar with. Therefore, in our case we present a method, which involves the application of a regular Judkins Right 4 catheter for left main engagement. We propose that this method can be safely attempted prior to using telescoping techniques.

Proximal and distal adjustments of reaching behavior in preterm infants.

Science.gov (United States)

de Toledo, Aline Martins; Soares, Daniele de Almeida; Tudella, Eloisa

2011-01-01

The authors aimed to investigate proximal and distal adjustments of reaching behavior and grasping in 5-, 6-, and 7-month-old preterm infants. Nine low-risk preterm and 10 full-term infants participated. Both groups showed the predominance of unimanual reaching, an age-related increase in the frequency of vertical-oriented and open hand movement, and also an increase in successful grasping from 6 to 7 months. The frequency of open hand was higher in the preterm group at 6 months. Intrinsic restrictions imposed by prematurity did not seem to have impaired reaching performance of preterm infants throughout the months of age.

Does workplace health promotion reach shift workers?

DEFF Research Database (Denmark)

Nabe-Nielsen, Kirsten; Garde, Anne Helene; Clausen, Thomas

2015-01-01

OBJECTIVES: One reason for health disparities between shift and day workers may be that workplace health promotion does not reach shift workers to the same extent as it reaches day workers. This study aimed to investigate the association between shift work and the availability of and participation...... in workplace health promotion. METHODS: We used cross-sectional questionnaire data from a large representative sample of all employed people in Denmark. We obtained information on the availability of and participation in six types of workplace health promotion. We also obtained information on working hours, ie......). RESULTS: In the general working population, fixed evening and fixed night workers, and employees working variable shifts including night work reported a higher availability of health promotion, while employees working variable shifts without night work reported a lower availability of health promotion...

Management of Interface between Main Contractor and Subcontractors for Successful Project Outcomes

Directory of Open Access Journals (Sweden)

Harry White

2014-01-01

Full Text Available There has been increased dependence on subcontracting within the construction industry, the operational relationship between the Main Contractor (MC and Subcontractor (SC plays a significant role in successful delivery of projects. Through the literature review this paper argues that despite SCs bring added value to construction projects, the increased reliance on SCs has strained relationships between the MC and SC. Also MCs are more concerned with risk and price reduction which undermine the relationship heavily. Current practices in the construction industry in managing SCs were evaluated through a case study and semi-structured interviews. A questionnaire survey was used to investigate the ways of facilitating the interface between the MC and SC in general. The study highlighted that prevailing adverse relationships and culture in the industry are influencing the success of construction projects. The lack of trust is a key factor affecting the relationships between MC and SCs. However, the proactive involvement of the MC with SCs in maintaining continuity of the team from procurement to construction stage and transparency in the processes were key success factors for successful completion of the project.

Telerobotic operation of structurally flexible, long-reach manipulators

International Nuclear Information System (INIS)

Kwon, D.S.; Hwang, D.H.; Babcock, S.M.

1994-01-01

As a part of the Department of Energy's Environmental Restoration and Waste Management Program, long-reach manipulators are being considered for the retrieval of waste from large storage tanks. Long-reach manipulators may have characteristics significantly different from those of typical industrial robots because of the flexibility of long links needed to cover the large workspace. To avoid structural vibrations during operation, control algorithms employing various types of shaping filters were investigated. A new approach that uses embedded simulation was developed and compared with others. In the new approach, generation of joint trajectories considering link flexibility was also investigated

Academic outcomes of multilingual children in Australia.

Science.gov (United States)

O'Connor, Meredith; O'Connor, Elodie; Tarasuik, Joanne; Gray, Sarah; Kvalsvig, Amanda; Goldfeld, Sharon

2017-02-24

The Australian educational system is increasingly challenged to meet the needs of multilingual students, who comprise a fifth of the student population. Within the context of a monolingual English curriculum, multilingual children who enter school not yet English proficient may be at risk of experiencing inequitable educational outcomes. We examined the relationship between the timing of multilingual children's acquisition of receptive English vocabulary skills and subsequent reading and numeracy outcomes, as well as factors associated with earlier versus later timing of acquisition. Data were drawn from the Kindergarten-cohort (n = 4983) of the Longitudinal Study of Australian Children - a nationally representative, community sample of Australian children. Linear regression analyses revealed that multilingual children who begin school with proficient receptive English vocabulary skills, or who acquire proficiency early in schooling, are indistinguishable from their monolingual peers in literacy and numeracy outcomes by 10-11 years. However, later acquisition of receptive English vocabulary skills (i.e. after 6-7 years) was associated with poorer literacy outcomes. In turn, socioeconomic disadvantage and broader language or learning problems predicted this later acquisition of receptive English vocabulary skills. All children need to be supported during the early years of school to reach their full educational potential.

Compact muon solenoid magnet reaches full field

CERN Multimedia

2006-01-01

Scientist of the U.S. Department of Energy in Fermilab and collaborators of the US/CMS project announced that the world's largest superconducting solenoid magnet has reached full field in tests at CERN. (1 apge)

The Relationship between Parent Expectations and Postschool Outcomes of Adolescents with Disabilities

Science.gov (United States)

Doren, Bonnie; Gau, Jeff M.; Lindstrom, Lauren E.

2012-01-01

A secondary analysis was conducted of the National Longitudinal Transition Study-2 to examine (a) main effects of parents' school and postschool outcome expectations on the actual outcomes achieved, (b) demographic moderators, and (c) adolescent autonomy as a mediator of parent expectations and outcomes. Parent expectations were found to…

Reach-to-grasp movement as a minimization process.

Science.gov (United States)

Yang, Fang; Feldman, Anatol G

2010-02-01

It is known that hand transport and grasping are functionally different but spatially coordinated components of reach-to-grasp (RTG) movements. As an extension of this notion, we suggested that body segments involved in RTG movements are controlled as a coherent ensemble by a global minimization process associated with the necessity for the hand to reach the motor goal. Different RTG components emerge following this process without pre-programming. Specifically, the minimization process may result from the tendency of neuromuscular elements to diminish the spatial gap between the actual arm-hand configuration and its virtual (referent) configuration specified by the brain. The referent configuration is specified depending on the object shape, localization, and orientation. Since the minimization process is gradual, it can be interrupted and resumed following mechanical perturbations, at any phase during RTG movements, including hand closure. To test this prediction of the minimization hypothesis, we asked subjects to reach and grasp a cube placed within the reach of the arm. Vision was prevented during movement until the hand returned to its initial position. As predicted, by arresting wrist motion at different points of hand transport in randomly selected trials, it was possible to halt changes in hand aperture at any phase, not only during hand opening but also during hand closure. Aperture changes resumed soon after the wrist was released. Another test of the minimization hypothesis was made in RTG movements to an object placed beyond the reach of the arm. It has previously been shown (Rossi et al. in J Physiol 538:659-671, 2002) that in such movements, the trunk motion begins to contribute to hand transport only after a critical phase when the shifts in the referent arm configuration have finished (at about the time when hand velocity is maximal). The minimization rule suggests that when the virtual contribution of the arm to hand transport is completed

Should these potential CMR substances have been registered under REACH?

DEFF Research Database (Denmark)

Wedebye, Eva Bay; Nikolov, Nikolai Georgiev; Dybdahl, Marianne

2013-01-01

(Q)SAR models were applied to screen around 68,000 REACH pre-registered substances for CMR properties (carcinogenic, mutagenic or toxic to reproduction). Predictions from 14 relevant models were combined to reach overall calls for C, M and R. Combining predictions may reduce “noise” and increase...

Do children perceive postural constraints when estimating reach or action planning?

Science.gov (United States)

Gabbard, Carl; Cordova, Alberto; Lee, Sunghan

2009-03-01

Estimation of whether an object is reachable from a specific body position constitutes an important aspect in effective motor planning. Researchers who estimate reachability by way of motor imagery with adults consistently report the tendency to overestimate, with some evidence of a postural effect (postural stability hypothesis). This idea suggests that perceived reaching limits depend on an individual's perceived postural constraints. Based on previous work with adults, the authors expected a significant postural effect with the Reach 2 condition, as evidenced by reduced overestimation. Furthermore, the authors hypothesized that the postural effect would be greater in younger children. They then tested these propositions among children aged 7, 9, and 11 years by asking them to estimate reach while seated (Reach 1) and in the more demanding posture of standing on 1 foot and leaning forward (Reach 2). Results indicated no age or condition difference, therefore providing no support for a postural effect. When the authors compared these data to a published report of adults, a developmental difference emerged. That is, adults recognize the perceived postural constraint of the standing position resulting in under- rather than overestimation, as displayed in the seated condition. Although preliminary, these observations suggest that estimates of reach (action planning) continue to be refined between late childhood and young adulthood.

Can coronal hole spicules reach coronal temperatures?

Science.gov (United States)

Madjarska, M. S.; Vanninathan, K.; Doyle, J. G.

2011-08-01

Aims: The present study aims to provide observational evidence of whether coronal hole spicules reach coronal temperatures. Methods: We combine multi-instrument co-observations obtained with the SUMER/SoHO and with the EIS/SOT/XRT/Hinode. Results: The analysed three large spicules were found to be comprised of numerous thin spicules that rise, rotate, and descend simultaneously forming a bush-like feature. Their rotation resembles the untwisting of a large flux rope. They show velocities ranging from 50 to 250 kms-1. We clearly associated the red- and blue-shifted emissions in transition region lines not only with rotating but also with rising and descending plasmas. Our main result is that these spicules although very large and dynamic, are not present in the spectral lines formed at temperatures above 300 000 K. Conclusions: In this paper we present the analysis of three Ca ii H large spicules that are composed of numerous dynamic thin spicules but appear as macrospicules in lower resolution EUV images. We found no coronal counterpart of these and smaller spicules. We believe that the identification of phenomena that have very different origins as macrospicules is due to the interpretation of the transition region emission, and especially the He ii emission, wherein both chromospheric large spicules and coronal X-ray jets are present. We suggest that the recent observation of spicules in the coronal AIA/SDO 171 Å and 211 Å channels probably comes from the existence of transition region emission there. Movie is available in electronic form at http://www.aanda.org

Locations of serial reach targets are coded in multiple reference frames.

Science.gov (United States)

Thompson, Aidan A; Henriques, Denise Y P

2010-12-01

Previous work from our lab, and elsewhere, has demonstrated that remembered target locations are stored and updated in an eye-fixed reference frame. That is, reach errors systematically vary as a function of gaze direction relative to a remembered target location, not only when the target is viewed in the periphery (Bock, 1986, known as the retinal magnification effect), but also when the target has been foveated, and the eyes subsequently move after the target has disappeared but prior to reaching (e.g., Henriques, Klier, Smith, Lowy, & Crawford, 1998; Sorrento & Henriques, 2008; Thompson & Henriques, 2008). These gaze-dependent errors, following intervening eye movements, cannot be explained by representations whose frame is fixed to the head, body or even the world. However, it is unknown whether targets presented sequentially would all be coded relative to gaze (i.e., egocentrically/absolutely), or if they would be coded relative to the previous target (i.e., allocentrically/relatively). It might be expected that the reaching movements to two targets separated by 5° would differ by that distance. But, if gaze were to shift between the first and second reaches, would the movement amplitude between the targets differ? If the target locations are coded allocentrically (i.e., the location of the second target coded relative to the first) then the movement amplitude should be about 5°. But, if the second target is coded egocentrically (i.e., relative to current gaze direction), then the reaches to this target and the distances between the subsequent movements should vary systematically with gaze as described above. We found that requiring an intervening saccade to the opposite side of 2 briefly presented targets between reaches to them resulted in a pattern of reaching error that systematically varied as a function of the distance between current gaze and target, and led to a systematic change in the distance between the sequential reach endpoints as predicted by

The meaning of the body schema in reaching maturity during late adolescence

Directory of Open Access Journals (Sweden)

Mirucka Beata

2016-04-01

Full Text Available The objective of the research presented in this paper was to investigate whether an association existed between the activation of the body schema and reaching adulthood among people in late adolescence. Three activities that are known to enjoy popularity among young people were analysed, namely: dancing, playing computer games that require motor involvement (e.g. Kinect, and playing computer games of an educational and entertaining character. It was assumed that the chosen forms of activity correspond to three levels of activation of the body schema. The following research methods have been applied to this study: the Rosenberg Self-Esteem Scale (SES, the Defence Style Questionnaire (DSQ, and the Bodily Self Representation Questionnaire. The study has proven that the activation of body schema through dance is significantly related to high self-esteem and the use of mainly mature and neurotic defence mechanisms in threat situations.

Analysis of reaching movements of upper arm in robot assisted exercises. Kinematic assessment of robot assisted upper arm reaching single-joint movements.

Science.gov (United States)

Iuppariello, Luigi; D'Addio, Giovanni; Romano, Maria; Bifulco, Paolo; Lanzillo, Bernardo; Pappone, Nicola; Cesarelli, Mario

2016-01-01

Robot-mediated therapy (RMT) has been a very dynamic area of research in recent years. Robotics devices are in fact capable to quantify the performances of a rehabilitation task in treatments of several disorders of the arm and the shoulder of various central and peripheral etiology. Different systems for robot-aided neuro-rehabilitation are available for upper limb rehabilitation but the biomechanical parameters proposed until today, to evaluate the quality of the movement, are related to the specific robot used and to the type of exercise performed. Besides, none study indicated a standardized quantitative evaluation of robot assisted upper arm reaching movements, so the RMT is still far to be considered a standardised tool. In this paper a quantitative kinematic assessment of robot assisted upper arm reaching movements, considering also the effect of gravity on the quality of the movements, is proposed. We studied a group of 10 healthy subjects and results indicate that our advised protocol can be useful for characterising normal pattern in reaching movements.

Urinary tract infection and adverse outcome of pregnancy.

Science.gov (United States)

Dimetry, Shaira R; El-Tokhy, Hanan M; Abdo, Nagla M; Ebrahim, Moustafa A; Eissa, Mohammed

2007-01-01

Urinary tract infections (UTIs) during pregnancy are among the commonest health problems world wide, specially in developing countries, including Egypt. It has several adverse outcomes not only on the mother but also on the fetus as well.. The aim of this study is to determine the incidence of UTIs during pregnancy, study the main risk factors associated with such infections and find the impact of these infections on some pregnancy outcomes namely the gestational age and birth weight. A follow-up study on 249 pregnant women attending the ante natal care clinic at Zagazig university hospital. They were recruited over a period from 1st of September to 30th of or November, 2005. The outcome could be recorded for 201 of them. Data were collected through a pretested questionnaire, repeated urine analyses and recording of outcome of pregnancy. The study revealed that the incidence of UTIs during pregnancy was 31.3%. The commonest organisms were Klebsiella and E-coli. Several socio-demographic characteristics were found significantly associated with UTIs, age being 30 years and more, illiterates and low educational level, low socio-economic level and those with unsatisfactory personal hygiene and those using underwear clothes other than cotton. Significant associations with UTIs were also found in multigravidae 4th and more, those having more than one child and those who previously suffered UTIs. The only predicting variable with UTIs was low socio-economic level. The study revealed that the probability of delivering premature infants and low birth weights was significantly higher among those who experienced UTIs during pregnancy. Multivariate analysis revealed that UTI was one of the main contributors to pre-mature deliveries. Urinary tract infections with pregnancy still constitute a big problem with high incidence. It has a great impact on pregnancy outcome mainly pre-mature labor. So, the study recommends health education about personal hygiene, repeated urine

Perinatal outcomes following an earlier post-term labour induction policy

DEFF Research Database (Denmark)

Hedegaard, M.; Lidegaard, Ø; Skovlund, C W

2015-01-01

: Perinatal outcomes were estimated using a logistic regression analysis with adjustment for gestational age, maternal age, parity, plurality, smoking and body mass index. MAIN OUTCOME MEASURES: Perinatal outcomes. RESULTS: A total of 770 926 infants were included. Labour induction from 37 weeks increased...... from 9.7% in 2000-02 to 22.5% in 2011-12. From 2003-05 to 2011-12, the risk of umbilical cord pH care units...

Estradiol and Antagonist Pretreatment Prior to Microdose Leuprolide in in Vitro Fertilization. Does It Improve IVF Outcomes in Poor Responders as Compared to Oral Contraceptive Pill?

Science.gov (United States)

Elassar, Alyaa; Nulsen, John; Engmann, Lawrence; Benadiva, Claudio

2015-01-01

To compare in vitro fertilization (IVF) outcomes in low responders stimulated with microdose leuprolide protocol (ML) following pretreatment with either oral contraceptive pill (OCP) or luteal estradiol (E2) + GnRH antagonist (E2 + antag) for follicular synchronization prior to controlled ovarian hyperstimulation (COH). This was a retrospective study of 130 women, who were poor responders, undergoing IVF with either OCP/ML or E2+ antag/ML protocols. The main outcome measures were ongoing pregnancy rates, number of oocytes retrieved, and cancellation rate. Both groups were similar in baseline characteristics. There were no significant differences in gonadotropin requirement, cancellation rate, and number of embryos transferred. Ongoing pregnancy rates (40% vs. 15%) were significantly higher in the OCP/ML group. Trends toward greater number of oocytes retrieved (7.7 ± 3.4 vs. 5.9 ± 4.2) and improved implantation rates (20% vs. 12%) were also noted, but these did not reach statistical significance. E2+antag pretreatment does not appear to improve IVF outcomes in ML protocol when compared to the standard OCP in poor responders. Randomized trials with adequate power to study the optimal method of steroid pretreatments appear justified.

Enhancing US Operational Reach in Southeast Asia

National Research Council Canada - National Science Library

Hitchcock, David

2003-01-01

.... While this treat continues to exist, the US Pacific Command (PACOM) must also pursue a neat term methodology to expand its operational reach and ability to respond to contingencies throughout the East Asian littoral, especially within Southeast Asia...

Consequences of ADHD Medication Use for Children’s Outcomes

DEFF Research Database (Denmark)

Dalsgaard, Søren; Nielsen, Helena Skyt; Simonsen, Marianne

2014-01-01

This paper estimates effects of early ADHD medication use on key human capital outcomes for children diagnosed with ADHD while using rarely available register based data on diagnoses and prescription drug purchases. Our main identification strategy exploits plausible exogenous assignment of child...... child is treated. Results show that children diagnosed with ADHD in pharmacological treatment have fewer hospital contacts if treated and that treatment to some extent protects against criminal behavior.......This paper estimates effects of early ADHD medication use on key human capital outcomes for children diagnosed with ADHD while using rarely available register based data on diagnoses and prescription drug purchases. Our main identification strategy exploits plausible exogenous assignment...

Mild Contralesional Hypothermia Reduces Use of the Unimpaired Forelimb in a Skilled Reaching Task After Motor Cortex Injury in Rats.

Science.gov (United States)

Klahr, Ana C; Fagan, Kelly; Aziz, Jasmine R; John, Roseleen; Colbourne, Frederick

2018-06-01

Therapeutic hypothermia (TH) mitigates neuronal injury in models of ischemic stroke. Although this therapy is meant for injured tissue, most protocols cool the whole body, including the contralesional hemisphere. Neuroplasticity responses within this hemisphere can affect functional outcome. Thus, cooling the contralesional hemisphere serves no clear neuroprotective function and may instead be detrimental. In this study, we cooled the contralesional hemisphere to determine whether this harms behavioral recovery after cortical injury in rats. All rats were trained on skilled reaching and walking tasks. Rats then received a motor cortex insult contralateral to their dominant paw after which they were randomly assigned to focal contralesional TH (∼33°C) for 1-48, 1-97, or 48-96 hours postinjury, or to a normothermic control group. Contralesional cooling did not impact lesion volume (p = 0.371) and had minimal impact on neurological outcome of the impaired limb. However, rats cooled early were significantly less likely to shift paw preference to the unimpaired paw (p ≤ 0.043), suggesting that cooling reduced learned nonuse. In a second experiment, we tested whether cooling impaired learning of the skilled reaching task in naive rats. Localized TH applied to the hemisphere contralateral or ipsilateral to the preferred paw did not impair learning (p ≥ 0.677) or dendritic branching/length in the motor cortex (p ≥ 0.105). In conclusion, localized TH did not impair learning or plasticity in the absence of neural injury, but contralesional TH may reduce unwanted shifts in limb preference after stroke.

Muscle activation patterns in acceleration-based phases during reach-to-grasp movement.

Science.gov (United States)

Tokuda, Keisuke; Lee, Bumsuk; Shiihara, Yasufumi; Takahashi, Kazuhiro; Wada, Naoki; Shirakura, Kenji; Watanabe, Hideomi

2016-11-01

[Purpose] An earlier study divided reaching activity into characteristic phases based on hand velocity profiles. By synchronizing muscle activities and the acceleration profile, a phasing approach for reaching movement, based on hand acceleration profiles, was attempted in order to elucidate the roles of individual muscle activities in the different phases of the acceleration profile in reaching movements. [Subjects and Methods] Ten healthy volunteer subjects participated in this study. The aim was to electromyographically evaluate muscles around the shoulder, the upper trapezius, the anterior deltoid, the biceps brachii, and the triceps brachii, most of which have been used to evaluate arm motion, as well as the acceleration of the upper limb during simple reaching movement in the reach-to-grasp task. [Results] Analysis showed the kinematic trajectories of the acceleration during a simple biphasic profile of the reaching movement could be divided into four phases: increasing acceleration (IA), decreasing acceleration (DA), increasing deceleration (ID), and decreasing deceleration (DD). Muscles around the shoulder showed different activity patterns, which were closely associated with these acceleration phases. [Conclusion] These results suggest the important role of the four phases, derived from the acceleration trajectory, in the elucidation of the muscular mechanisms which regulate and coordinate the muscles around the shoulder in reaching movements.

ATLAS Barrel Toroid magnet reached nominal field

CERN Multimedia

2006-01-01

 On 9 November the barrel toroid magnet reached its nominal field of 4 teslas, with an electrical current of 21 000 amperes (21 kA) passing through the eight superconducting coils as shown on this graph

Serum tau and neurological outcome in cardiac arrest

DEFF Research Database (Denmark)

Mattsson, Niklas; Zetterberg, Henrik; Nielsen, Niklas

2017-01-01

OBJECTIVE: To test serum tau as a predictor of neurological outcome after cardiac arrest. METHODS: We measured the neuronal protein tau in serum at 24, 48, and 72 hours after cardiac arrest in 689 patients in the prospective international Target Temperature Management trial. The main outcome...... was poor neurological outcome, defined as Cerebral Performance Categories 3-5 at 6 months. RESULTS: Increased tau was associated with poor outcome at 6 months after cardiac arrest (median = 38.5, interquartile range [IQR] = 5.7-245ng/l in poor vs median = 1.5, IQR = 0.7-2.4ng/l in good outcome, for tau....... The accuracy in predicting outcome by serum tau was equally high for patients randomized to 33 °C and 36 °C targeted temperature after cardiac arrest. INTERPRETATION: Serum tau is a promising novel biomarker for prediction of neurological outcome in patients with cardiac arrest. It may be significantly better...

The Right Mix? Gender Diversity in Top Management Teams and Organizational Outcomes

DEFF Research Database (Denmark)

Opstrup, Niels; Ryom Villadsen, Anders

Recent research has illustrated how human demographic diversity influences the outcomes of public sector organizations. Most studies focus on workforce diversity and little is known about how managerial diversity affects organizational outcomes. This study focuses on top management team gender...... diversity. Theory suggests that diversity can lead to varied outcomes. It may provide knowledge and new ideas used for organizational development. However, team diversity is likely to slow down decision making and make consensus more difficult to reach. In a longitudinal study of top management teams...... in Danish municipalities this study finds diversity to be associated with an increased use of contracting but also higher budgetary instabilities. These results are interpreted in light of existing theory and implications are suggested....

Sequencing bilateral robot-assisted arm therapy and constraint-induced therapy improves reach to press and trunk kinematics in patients with stroke.

Science.gov (United States)

Hsieh, Yu-wei; Liing, Rong-jiuan; Lin, Keh-chung; Wu, Ching-yi; Liou, Tsan-hon; Lin, Jui-chi; Hung, Jen-wen

2016-03-22

The combination of robot-assisted therapy (RT) and a modified form of constraint-induced therapy (mCIT) shows promise for improving motor function of patients with stroke. However, whether the changes of motor control strategies are concomitant with the improvements in motor function after combination of RT and mCIT (RT + mCIT) is unclear. This study investigated the effects of the sequential combination of RT + mCIT compared with RT alone on the strategies of motor control measured by kinematic analysis and on motor function and daily performance measured by clinical scales. The study enrolled 34 patients with chronic stroke. The data were derived from part of a single-blinded randomized controlled trial. Participants in the RT + mCIT and RT groups received 20 therapy sessions (90 to 105 min/day, 5 days for 4 weeks). Patients in the RT + mCIT group received 10 RT sessions for first 2 weeks and 10 mCIT sessions for the next 2 weeks. The Bi-Manu-Track was used in RT sessions to provide bilateral practice of wrist and forearm movements. The primary outcome was kinematic variables in a task of reaching to press a desk bell. Secondary outcomes included scores on the Wolf Motor Function Test, Functional Independence Measure, and Nottingham Extended Activities of Daily Living. All outcome measures were administered before and after intervention. RT + mCIT and RT demonstrated different benefits on motor control strategies. RT + mCIT uniquely improved motor control strategies by reducing shoulder abduction, increasing elbow extension, and decreasing trunk compensatory movement during the reaching task. Motor function and quality of the affected limb was improved, and patients achieved greater independence in instrumental activities of daily living. Force generation at movement initiation was improved in the patients who received RT. A combination of RT and mCIT could be an effective approach to improve stroke rehabilitation outcomes, achieving

Two-dimensional numerical modelling of sediment and chemical constituent transport within the lower reaches of the Athabasca River.

Science.gov (United States)

Kashyap, Shalini; Dibike, Yonas; Shakibaeinia, Ahmad; Prowse, Terry; Droppo, Ian

2017-01-01

Flows and transport of sediment and associated chemical constituents within the lower reaches of the Athabasca River between Fort McMurray and Embarrass Airport are investigated using a two-dimensional (2D) numerical model called Environmental Fluid Dynamics Code (EFDC). The river reach is characterized by complex geometry, including vegetated islands, alternating sand bars and an unpredictable thalweg. The models were setup and validated using available observed data in the region before using them to estimate the levels of cohesive sediment and a select set of chemical constituents, consisting of polycyclic aromatic hydrocarbons (PAHs) and metals, within the river system. Different flow scenarios were considered, and the results show that a large proportion of the cohesive sediment that gets deposited within the study domain originates from the main stem upstream inflow boundary, although Ells River may also contribute substantially during peak flow events. The floodplain, back channels and islands in the river system are found to be the major areas of concern for deposition of sediment and associated chemical constituents. Adsorbed chemical constituents also tend to be greater in the main channel water column, which has higher levels of total suspended sediments, compared to in the flood plain. Moreover, the levels of chemical constituents leaving the river system are found to depend very much on the corresponding river bed concentration levels, resulting in higher outflows with increases in their concentration in the bed sediment.

Application of numerical model simulations for estimation of morphdynamics and vegetation impact on transport of dissolved substances in the Warta river reach

Directory of Open Access Journals (Sweden)

Joanna Wicher-Dysarz

2014-12-01

Full Text Available The main problem analysed in this paper is the impact of sediment accumulation and vegetation growth on transport of dissolved substances in a river. The system studied is the reach of the Warta River located upstream of the Jeziorsko Reservoir inlet. The three processes, namely sediment deposition, vegetation growth, and pollutant transport, are crucial for the functionality of reservoir. Classical HEC-RAS package is used for the reconstruction of steady flow conditions in the river reach. The transport of admixture is simulated by means of convection – dispersion model with additional elements describing storage of solutes in the floodplains. The results that the degree of maximum concentration decreases as the river bed geometry and vegetation cover are changed.

Defining a core outcome set for adolescent and young adult patients with a spinal deformity

DEFF Research Database (Denmark)

de Kleuver, Marinus; Faraj, Sayf S A; Holewijn, Roderick M

2017-01-01

Background and purpose - Routine outcome measurement has been shown to improve performance in several fields of healthcare. National spine surgery registries have been initiated in 5 Nordic countries. However, there is no agreement on which outcomes are essential to measure for adolescent and young...... adult patients with a spinal deformity. The aim of this study was to develop a core outcome set (COS) that will facilitate benchmarking within and between the 5 countries of the Nordic Spinal Deformity Society (NSDS) and other registries worldwide. Material and methods - From August 2015 to September...... consensus rounds were held. Consensus was defined as agreement between at least 5 of the 7 representatives. Data were analyzed qualitatively and quantitatively. Results - Consensus was reached on the inclusion of 13 core outcome domains: "satisfaction with overall outcome of surgery", "satisfaction...

Will the UE, USA, and China reach an agreement in Copenhagen? BIP-Enerpresse, June 23, 2009

International Nuclear Information System (INIS)

2009-01-01

This paper is a synthesis of a debate on the possibilities to reach an international agreement of the greenhouse gas emissions during the Copenhagen meeting in December 2009. The interveners are discussing these opportunities with respect to present political and actual orientations of the European Union, the United States of America, and China. They also recall the objectives of previous international agreement in terms of greenhouse gas emissions. They compare the options and decisions of these three main actors with respect to the climate change threat, and in their different economic situation and context. Thus, they outline the possible incompatibilities between these options and decisions

Patient-important outcomes in randomized controlled trials in critically ill patients: a systematic review.

Science.gov (United States)

Gaudry, Stéphane; Messika, Jonathan; Ricard, Jean-Damien; Guillo, Sylvie; Pasquet, Blandine; Dubief, Emeline; Boukertouta, Tanissia; Dreyfuss, Didier; Tubach, Florence

2017-12-01

Intensivists' clinical decision making pursues two main goals for patients: to decrease mortality and to improve quality of life and functional status in survivors. Patient-important outcomes are gaining wide acceptance in most fields of clinical research. We sought to systematically review how well patient-important outcomes are reported in published randomized controlled trials (RCTs) in critically ill patients. Literature search was conducted to identify eligible trials indexed from January to December 2013. Articles were eligible if they reported an RCT involving critically ill adult patients. We excluded phase II, pilot and physiological crossover studies. We assessed study characteristics. All primary and secondary outcomes were collected, described and classified using six categories of outcomes including patient-important outcomes (involving mortality at any time on the one hand and quality of life, functional/cognitive/neurological outcomes assessed after ICU discharge on the other). Of the 716 articles retrieved in 2013, 112 RCTs met the inclusion criteria. Most common topics were mechanical ventilation (27%), sepsis (19%) and nutrition (17%). Among the 112 primary outcomes, 27 (24%) were patient-important outcomes (mainly mortality, 21/27) but only six (5%) were patient-important outcomes besides mortality assessed after ICU discharge (functional disability = 4; quality of life = 2). Among the 598 secondary outcomes, 133 (22%) were patient-important outcomes (mainly mortality, 92/133) but only 41 (7%) were patient-important outcomes besides mortality assessed after ICU discharge (quality of life = 20, functional disability = 14; neurological/cognitive performance = 5; handicap = 1; post-traumatic stress = 1). Seventy-three RCTs (65%) reported at least one patient-important outcome but only 11 (10%) reported at least one patient-important outcome besides mortality assessed after ICU discharge. Patient-important outcomes are rarely primary

Decoding Grasping Movements from the Parieto-Frontal Reaching Circuit in the Nonhuman Primate.

Science.gov (United States)

Nelissen, Koen; Fiave, Prosper Agbesi; Vanduffel, Wim

2018-04-01

Prehension movements typically include a reaching phase, guiding the hand toward the object, and a grip phase, shaping the hand around it. The dominant view posits that these components rely upon largely independent parieto-frontal circuits: a dorso-medial circuit involved in reaching and a dorso-lateral circuit involved in grasping. However, mounting evidence suggests a more complex arrangement, with dorso-medial areas contributing to both reaching and grasping. To investigate the role of the dorso-medial reaching circuit in grasping, we trained monkeys to reach-and-grasp different objects in the dark and determined if hand configurations could be decoded from functional magnetic resonance imaging (MRI) responses obtained from the reaching and grasping circuits. Indicative of their established role in grasping, object-specific grasp decoding was found in anterior intraparietal (AIP) area, inferior parietal lobule area PFG and ventral premotor region F5 of the lateral grasping circuit, and primary motor cortex. Importantly, the medial reaching circuit also conveyed robust grasp-specific information, as evidenced by significant decoding in parietal reach regions (particular V6A) and dorsal premotor region F2. These data support the proposed role of dorso-medial "reach" regions in controlling aspects of grasping and demonstrate the value of complementing univariate with more sensitive multivariate analyses of functional MRI (fMRI) data in uncovering information coding in the brain.

Ramadan, Fasting and Educational Outcomes

Science.gov (United States)

Oosterbeek, Hessel; van der Klaauw, Bas

2013-01-01

Using a difference-in-differences framework, we estimate the impact of Ramadan on educational outcomes of Muslim students living in a non-Muslim country. For identification we exploit that the number of Ramadan weeks during the course that we study, varies from year to year, ranging from zero to four. Our main finding is that Ramadan observance…

The Ability of Sheep to Reach for Food Through Tombstone Barriers ...

African Journals Online (AJOL)

animal enterprises. (McIntire ... models for predicting forwards and sideways hori- zontal~~ach at different feeding-platform heights. Since the study ... models for predicting horizontal reach included body weight and withers height. Vertical reach.

Effectiveness of interventions for diagnosis and treatment of tuberculosis in hard-to-reach populations in countries of low and medium tuberculosis incidence: a systematic review.

Science.gov (United States)

Heuvelings, Charlotte C; de Vries, Sophia G; Greve, Patrick F; Visser, Benjamin J; Bélard, Sabine; Janssen, Saskia; Cremers, Anne L; Spijker, René; Shaw, Beth; Hill, Ruaraidh A; Zumla, Alimuddin; Sandgren, Andreas; van der Werf, Marieke J; Grobusch, Martin P

2017-05-01

Tuberculosis is over-represented in hard-to-reach (underserved) populations in high-income countries of low tuberculosis incidence. The mainstay of tuberculosis care is early detection of active tuberculosis (case finding), contact tracing, and treatment completion. We did a systematic review with a scoping component of relevant studies published between 1990 and 2015 to update and extend previous National Institute for Health and Care Excellence (NICE) reviews on the effectiveness of interventions for identifying and managing tuberculosis in hard-to-reach populations. The analyses showed that tuberculosis screening by (mobile) chest radiography improved screening coverage and tuberculosis identification, reduced diagnostic delay, and was cost-effective among several hard-to-reach populations. Sputum culture for pre-migration screening and active referral to a tuberculosis clinic improved identification. Furthermore, monetary incentives improved tuberculosis identification and management among drug users and homeless people. Enhanced case management, good cooperation between services, and directly observed therapy improved treatment outcome and compliance. Strong conclusions cannot be drawn because of the heterogeneity of evidence with regard to study population, methodology, and quality. Copyright © 2017 Elsevier Ltd. All rights reserved.

Main Developments and Perspectives of the European Union

Directory of Open Access Journals (Sweden)

Prof. Constantin ANGHELACHE PhD

2017-06-01

Full Text Available In this paper, the authors have analyzed the main economic-financial evolutions of the European Union member countries. First, we have performed the study regarding the evolution of the Gross Domestic Product growth in the European Union, by total and by comparison with other countries that play an important role in the global evolution of the economy. There are emphasized comparative data regarding the economic growth of China, which is the highest in the world. The growth rate of China is net superior to the rates recorded by USA, Japan and European Union (28 members. There can be observed a significant decrease of economic growth during the period 2008-2010, with a negative peak in 2009 (-2%-6% in the case of the United States, EU-28 and Japan. Even if China itself has felt the effects of the economic-financial crisis, the growth rate has reduced from 14% in 2007 to 9% in 2008, the decrease continued in the subsequent period, reaching some 8.5% in 2014. Then, we have analyzed the financial evolution, the exchange rate of the main currencies, the evolution of the inflation and the balance of foreign payments and international commercial exchanges. Particular attention was granted to direct foreign investments in and out the EU member states. The study is focused on the comparison of the foreign investments’ evolution during 2009-2014 for the main 10 partners of the European Union. Through this study, the results achieved by the EU during the specified periods were outlined, at each specific item within the internal, but also external relationships with other states in Europe or on wider global plan. The authors have put additional emphasis on the analysis of the period after 2007, since Romania has become member of the European Union.

75 FR 27863 - Savings Bank of Maine, MHC and Savings Bank of Maine, Gardiner, Maine; Approval of Conversion...

Science.gov (United States)

2010-05-18

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision [AC-38: OTS Nos. 06947 and H 4709] Savings Bank of Maine, MHC and Savings Bank of Maine, Gardiner, Maine; Approval of Conversion Application Notice is hereby given that on May 7, 2010, the Office of Thrift Supervision approved the application of...

Task-dependent vestibular feedback responses in reaching

NARCIS (Netherlands)

Keyser, J.; Medendorp, W.P.; Selen, L.P.J.

2017-01-01

When reaching for an earth-fixed object during self-rotation, the motor system should appropriately integrate vestibular signals and sensory predictions to compensate for the intervening motion and its induced inertial forces. While it is well established that this integration occurs rapidly, it is

Highlights from e-EPS: New milestone reached for the European XFEL construction

CERN Multimedia

Jorge Rivero González

2013-01-01

e-EPS News is an addition to the CERN Bulletin line-up, showcasing articles from e-EPS – the European Physical Society newsletter – as part of a collaboration between the two publications.   In June 2013 an important milestone was reached for the European X-ray free-electron laser [XFEL] with the completion of its underground portion. Located in the Hamburg area (Germany), the European XFEL is one of the largest and most ambitious European projects to date. Starting full operations in 2016, the European XFEL is expected to generate intensive, ultrashort X-ray flashes that will open up entirely new areas of research with X-rays that are currently inaccessible. Organisations from 12 European countries, Denmark, France, Germany, Greece, Hungary, Italy, Poland, Russia, Slovakia, Spain, Sweden and Switzerland are members of the European XFEL consortium, with the Deutsches Elektronen-Synchrotron [DESY] as the main shareholder. The total length of the facility will be 3.4km and ...

Coal-tar pitch high temperature (CTPHT), transitional arrangements and way forward under REACH. REACH-SEA report of scoping study

NARCIS (Netherlands)

Beekman M; Boersma AHR; Sijm DTHM; SEC

2009-01-01

Een beperking of autorisatie binnen de Europese wetgeving REACH is niet de meest geeigende manier om de risico's aan te pakken van PAK-emissies. Deze emissies, die vooral vrijkomen tijdens productie- of verbrandingsprocessen, worden namelijk niet goed ondervangen in deze wetgeving. Dit

International reach of tobacco marketing among young children.

Science.gov (United States)

Borzekowski, Dina L G; Cohen, Joanna E

2013-10-01

Prosmoking messages, delivered through marketing and the media, can reach very young children and influence attitudes and behaviors around smoking. This study examined the reach of tobacco marketing to 5 and 6 year olds in 6 low- and middle-income countries. Researchers worked one-on-one with 5 and 6 year olds in Brazil, China, India, Nigeria, Pakistan, and Russia (N = 2423). The children were asked to match logos with pictures of products, including 8 logos for cigarette brands. Analyses examined, overall and by country, whether gender, age, location, household use of tobacco, and knowledge of media characters were associated with awareness of cigarette brand logos. Additional analyses considered the relationship between cigarette brand logo awareness and intentions to smoke. Overall, 68% of 5 and 6 year olds could identify at least 1 cigarette brand logo, ranging from 50% in Russia to 86% in China. Across countries, being slightly older and having someone in the household who used tobacco, were significantly associated with greater odds of being able to identify at least 1 cigarette brand logo. The majority of young children from low- and middle-income countries are familiar with cigarette brands. This study's findings suggest that more effective measures are needed to restrict the reach of tobacco marketing.

Pre-delivery fibrinogen predicts adverse maternal or neonatal outcomes in patients with placental abruption.

Science.gov (United States)

Wang, Liangcheng; Matsunaga, Shigetaka; Mikami, Yukiko; Takai, Yasushi; Terui, Katsuo; Seki, Hiroyuki

2016-07-01

Placental abruption is a severe obstetric complication of pregnancy that can cause disseminated intravascular coagulation and progress to massive post-partum hemorrhage. Coagulation disorder due to extreme consumption of fibrinogen is considered the main pathogenesis of disseminated intravascular coagulation in patients with placental abruption. The present study sought to determine if the pre-delivery fibrinogen level could predict adverse maternal or neonatal outcomes in patients with placental abruption. This retrospective medical chart review was conducted in a center for maternal, fetal, and neonatal medicine in Japan with 61 patients with placental abruption. Fibrinogen levels prior to delivery were collected and evaluated for the prediction of maternal and neonatal outcomes. The main outcome measures for maternal outcomes were disseminated intravascular coagulation and hemorrhage, and the main outcome measures for neonatal outcomes were Apgar score at 5 min, umbilical artery pH, and stillbirth. The receiver-operator curve and multivariate logistic regression analyses indicated that fibrinogen significantly predicted overt disseminated intravascular coagulation and the requirement of ≥6 red blood cell units, ≥10 fresh frozen plasma units, and ≥20 fresh frozen plasma units for transfusion. Moderate hemorrhage occurred in 71.5% of patients with a decrease in fibrinogen levels to 155 mg/dL. Fibrinogen could also predict neonatal outcomes. Umbilical artery pH neonatal outcomes with placental abruption. © 2016 Japan Society of Obstetrics and Gynecology. © 2016 Japan Society of Obstetrics and Gynecology.

Pilot study to test effectiveness of video game on reaching performance in stroke.

Science.gov (United States)

Acosta, Ana Maria; Dewald, Hendrik A; Dewald, Jules P A

2011-01-01

Robotic systems currently used in upper-limb rehabilitation following stroke rely on some form of visual feedback as part of the intervention program. We evaluated the effect of a video game environment (air hockey) on reaching in stroke with various levels of arm support. We used the Arm Coordination Training 3D system to provide variable arm support and to control the hockey stick. We instructed seven subjects to reach to one of three targets covering the workspace of the impaired arm during the reaching task and to reach as far as possible while playing the video game. The results from this study showed that across subjects, support levels, and targets, the reaching distances achieved with the reaching task were greater than those covered with the video game. This held even after further restricting the mapped workspace of the arm to the area most affected by the flexion synergy (effectively forcing subjects to fight the synergy to reach the hockey puck). The results from this study highlight the importance of designing video games that include specific reaching targets in the workspace compromised by the expression of the flexion synergy. Such video games would also adapt the target location online as a subject's success rate increases.

Morphological Adjustment in the Wandering Reach of the Lower Yellow River in Response to the Changes in Water and Sediment Supply over the Recent Decades

Science.gov (United States)

Xie, Z.; Huang, H. Q.; Yu, G.

2017-12-01

The flow-sediment regime entering into the LYR has changed significantly since the 1970s due to the increasing intensity of human activities. To understand how the wandering reach of the LYR adjusts its channel morphology in response to the change in the flow-sediment regime, this study extracts a series of channel cross-profiles from remote sensing images taken since 1979. It is shown clearly that at one-year timescale, the main flow has shifted significantly, while the sinuosity of the pathways of main flow increased initially, then decreased significantly from 2006 and experienced little variation since 2010. Meanwhile, the width of the wandering belt has been increasing at a very slow stepwise fashion since 2002, and the area of central bars varied with fluctuations before 2009 and yet took a rapidly increasing trend since then. In contrast, the braiding intensity of the wandering reach has shown little change, while the river channel bed and the width/depth ratio of the main channel have taken significant adjustments, with the channel bed being scoured down to a considerable degree and the width/depth ratio varying in a gradually declining trend. These adjustments in the morphology of the Lower Yellow River implicate that the perched situation of the Lower Yellow River can be reversed.

Clinical Manifestations and Outcome of Syphilitic Uveitis.

Science.gov (United States)

Bollemeijer, Jan G; Wieringa, Wietse G; Missotten, Tom O A R; Meenken, Ina; ten Dam-van Loon, Ninette H; Rothova, Aniki; Los, Leonoor I

2016-02-01

To analyze visual outcome, effectiveness of various modes of antibiotic treatment, and prognostic factors in patients with serologically proven syphilitic uveitis. The clinical records of 85 patients (139 eyes) diagnosed with syphilitic uveitis between 1984 and 2013 at tertiary centers in The Netherlands were retrospectively analyzed. Mean age was 47 years (range, 27-73 years), 82.4% were male. HIV positivity was found in 28 (35.9%) patients; 13 were newly diagnosed. Most patients had pan (45.9%) or posterior (31.8%) uveitis. On average, logMAR visual acuity (VA) improved significantly from 0.55 at the start of syphilis treatment to 0.34 at 1 month and to 0.27 at 6 months follow-up. Most patients (86.7%) reached disease remission. No differences in efficacy between the various treatment regimens were found. A high logMAR VA at the start of syphilis treatment and a treatment delay of more than 12 weeks were prognostic for a high logMAR VA at 6 months follow-up. Chronicity was not related to any form of treatment, HIV status, or Venereal Disease Research Laboratory test outcome. In this large cohort of 85 patients with syphilitic uveitis, visual outcomes were favorable in the majority of cases. Visual outcome was dependent on VA at the start of syphilis treatment and treatment delay.

Virtual reality training improves turning capacity and functional reach in stroke patients

International Nuclear Information System (INIS)

Malik, A.N.; Masood, T.

2017-01-01

Objective: To determine the added effects of virtual reality training on turning capacity, gait parameters and functional reach capacity of stroke patients compared to task oriented training alone. Methodology: A randomized control trial was conducted from February 2016 to July 2106 at Physical Rehabilitation Department Pakistan Railway Hospital, Rawalpindi, Pakistan. Twenty stroke patients were selected through purposive sampling. The patients were randomly assigned through sealed envelope method into two groups; Task Oriented Training (TOT) and Virtual Reality Training (VRT) Group. The standardized tools were used for assessment. The TOT was provided for 4 days per week for 6 weeks while VRT group received additional exer-gaming training during sessions. Results: Significant improvement was observed in both groups regarding reaching forward, turning 360, gait pivot turn (p a 0.01) and FRT (p a 0.001). The two groups were statistically different from each other in terms of turning capacity, reaching forward, gait pivot turn and functional reach after 6 weeks of intervention (p a 0.05) Conclusion: Addition of virtual reality training further improves the significant improvement caused by task oriented training on turning capacity, reaching forward, gait pivot turn and functional reach in stroke patients. (author)

Reaching people with energy conservation information: four statewide residential case studies

Energy Technology Data Exchange (ETDEWEB)

Peelle, E.; Braid, R.B.; Jones, D.W.; Reed, J.H.

1983-09-01

Four state residential energy conservation programs are reviewed in terms of their origins, evolutions, purposes and goals, administration, organization, and outcomes. The four programs chosen were selected from among 30 nominated by state energy offices and regional Department of Energy personnel as being illustrative in terms of organization and/or outcomes. While intended primarily for state-level program managers and staff, the profiles of programs, conclusions, and recommendations should be useful to anyone interested in developing viable, action-oriented conservation programs. The four case studies included Oregon's Master Conserver program, Oklahoma's energy education project for low-income and elderly families, Virginia's workshops for heating dealers service and contractors, and Maine's three energy education projects - the Energy Bus, Energy Conservation Month, and the Home Energy Check-up. All four programs utilized Energy Extension Service (EES) funds from the federal government, and three were directly managed through the state EES organization. The findings of the study indicate that these programs (1) had flexibility to experiment, iterate, and reorganize as a result of their initial experiences, (2) made extensive use of networking to involve local groups in program delivery, (3) employed a large variety of delivery methods, and (4) made substantial efforts to tailor literature and handouts to the target audiences.

Dry Stream Reaches in Carbonate Terranes: Surface Indicators of Ground-Water Reservoirs

Science.gov (United States)

Brahana, J.V.; Hollyday, E.F.

1988-01-01

In areas where dry stream reaches occur, subsurface drainage successfully competes with surface drainage, and sheet-like dissolution openings have developed parallel to bedding creating the ground-water reservoir. Union Hollow in south-central Tennessee is the setting for a case study that illustrates the application of the dry stream reach technique. In this technique, dry stream reach identification is based on two types of readily acquired information: remotely sensed black and white infrared aerial photography; and surface reconnaissance of stream channel characteristics. Test drilling in Union Hollow subsequent to identification of the dry reach proved that a localized ground-water reservoir was present.

A Novel Line Coding Pair for Fully Passive Long Reach {WDM-PON}s

DEFF Research Database (Denmark)

Presi, Marco; Proietti, Roberto; Prince, Kamau

2008-01-01

A novel line coding pair allows to use unsaturated flective-SOAs as upstream remodulator in long-reach WDM-PONs. Full-duplex and symmetric 80 km reach is demonstrated without in-line amplification at 1.25 Gb/s......A novel line coding pair allows to use unsaturated flective-SOAs as upstream remodulator in long-reach WDM-PONs. Full-duplex and symmetric 80 km reach is demonstrated without in-line amplification at 1.25 Gb/s...

Redesigning Schools to Reach Every Student with Excellent Teachers: Change Management--Key Theories to Consider when Extending Reach

Science.gov (United States)

Barrett, Sharon Kebschull

2012-01-01

As schools, their teachers, and outside facilitators redesign jobs and incorporate technology to extend the reach of excellent teachers to more students and develop an Opportunity Culture for all, choosing the right school models is just one part of the task. The human experience--and experience in education--says that even perfect design will not…

Interactions REACH and other chemical legislation. Setting of environmental quality standards

NARCIS (Netherlands)

Bodar CWM; Janssen MPM; Zweers PGPC; Sijm DTHM; SEC; mev

2010-01-01

Via de Europese wet- en regelgeving REACH wordt aangetoond of het gebruik van chemische stoffen veilig is. De informatie die REACH oplevert is gedeeltelijk bruikbaar voor andere beleidskaders waar normen een rol spelen, zoals de Kaderrichtlijn Water (KRW), het Nederlandse stoffenbeleid en

Proposed Fermilab upgrade main injector project

International Nuclear Information System (INIS)

1992-04-01

The US Department of Energy (DOE) proposes to construct and operate a ''Fermilab Main Injector'' (FMI), a 150 GeV proton injector accelerator, at the Fermi National Accelerator Laboratory (Fermilab) in Batavia, Illinois. The purpose and need for this action are given of this Environmental Assessment (EA). A description of the proposed FMI and construction activities are also given. The proposed FMI would be housed in an underground tunnel with a circumference of approximately 2.1 miles (3.4 kilometers), and the construction would affect approximately 135 acres of the 6,800 acre Fermilab site. The purpose of the proposed FMI is to construct and bring into operation a new 150 GeV proton injector accelerator. This addition to Fermilab's Tevatron would enable scientists to penetrate ever more deeply into the subatomic world through the detection of the super massive particles that can be created when a proton and antiproton collide head-on. The conversion of energy into matter in these collisions makes it possible to create particles that existed only an instant after the beginning of time. The proposed FMI would significantly extend the scientific reach of the Tevatron, the world's first superconducting accelerator and highest energy proton-antiproton collider

The V Band Empirical Mass-Luminosity Relation for Main Sequence Stars

Science.gov (United States)

Xia, F.; Fu, Y. N.

2010-01-01

Stellar mass is an indispensable parameter in the studies of stellar physics and stellar dynamics. On the one hand, the most reliable way to determine the stellar dynamical mass is via orbital determination of binaries. On the other hand, however, most stellar masses have to be estimated by using the mass-luminosity relation (MLR). Therefore, it is important to obtain the empirical MLR through fitting the data of stellar dynamical mass and luminosity. The effect of metallicity can make this relation disperse in the V-band, but studies show that this is mainly limited to the case when the stellar mass is less than 0.6M⊙. Recently, many relevant data have been accumulated for main sequence stars with larger mass, which make it possible to significantly improve the corresponding MLR. Using a fitting method which can reasonably assign weight to the observational data including two quantities with different dimensions, we obtain a V-band MLR based on the dynamical masses and luminosities of 203 main sequence stars. Compared with the previous work, the improved MLR is statistically significant, and the relative error of mass estimation reaches about 5%. Therefore, our MLR is useful not only in studies of statistical nature, but also in studies of concrete stellar systems, such as the long-term dynamical study and the short-term positioning study of a specific multiple star system.

The V-band Empirical Mass-luminosity Relation for Main Sequence Stars

Science.gov (United States)

Xia, Fang; Fu, Yan-Ning

2010-07-01

Stellar mass is an indispensable parameter in the studies of stellar physics and stellar dynamics. On the one hand, the most reliable way to determine the stellar dynamical mass is via orbital determinations of binaries. On the other hand, however, most stellar masses have to be estimated by using the mass luminosity relation (MLR). Therefore, it is important to obtain the empirical MLR through fitting the data of stellar dynamical mass and luminosity. The effect of metallicity can make this relation disperse in the V-band, but studies show that this is mainly limited to the case when the stellar mass is less than 0.6M⊙ Recently, many relevant data have been accumulated for main sequence stars with larger masses, which make it possible to significantly improve the corresponding MLR. Using a fitting method which can reasonably assign weights to the observational data including two quantities with different dimensions, we obtain a V-band MLR based on the dynamical masses and luminosities of 203 main sequence stars. In comparison with the previous work, the improved MLR is statistically significant, and the relative error of mass estimation reaches about 5%. Therefore, our MLR is useful not only in the studies of statistical nature, but also in the studies of concrete stellar systems, such as the long-term dynamical study and the short-term positioning study of a specific multiple star system.

Don'T wag the dog: extending the reach of applied behavior analysis.

Science.gov (United States)

Normand, Matthew P; Kohn, Carolynn S

2013-01-01

We argue that the field of behavior analysis would be best served if behavior analysts worked to extend the reach of behavioral services into a more diverse range of settings and with more varied populations, with an emphasis on the establishment of new career opportunities for graduating students. This is not a new proposal, but it is a tall order; it is not difficult to see why many would choose a surer route to gainful employment. Currently, the most fruitful career path for behavior analysts in practice is in the area of autism and developmental disabilities. For the continued growth of the field of behavior analysis, however, it is important to foster new career opportunities for those trained as behavior analysts. Toward this end, we identify several fields that seem well suited to behavior analysts and summarize the training requirements and likely professional outcomes for behavior analysts who pursue education and certification in these fields. These fields require relatively little additional formal training in the hopes of minimizing the response effort necessary for individuals who have already completed a rigorous program of graduate study in behavior analysis.

Reaching Grid Parity Using BP Solar Crystalline Silicon Technology: A Systems Class Application

Energy Technology Data Exchange (ETDEWEB)

Cunningham, Daniel W; Wohlgemuth, John; Carlson, David E; Clark, Roger F; Gleaton, Mark; Posbic, John P; Zahler, James

2010-12-06

The primary target market for this program was the residential and commercial PV markets, drawing on BP Solar's premium product and service offerings, brand and marketing strength, and unique routes to market. These two markets were chosen because: (1) in 2005 they represented more than 50% of the overall US PV market; (2) they are the two markets that will likely meet grid parity first; and (3) they are the two market segments in which product development can lead to the added value necessary to generate market growth before reaching grid parity. Federal investment in this program resulted in substantial progress toward the DOE TPP target, providing significant advancements in the following areas: (1) Lower component costs particularly the modules and inverters. (2) Increased availability and lower cost of silicon feedstock. (3) Product specifically developed for residential and commercial applications. (4) Reducing the cost of installation through optimization of the products. (5) Increased value of electricity in mid-term to drive volume increases, via the green grid technology. (6) Large scale manufacture of PV products in the US, generating increased US employment in manufacturing and installation. To achieve these goals BP Solar assembled a team that included suppliers of critical materials, automated equipment developers/manufacturers, inverter and other BOS manufacturers, a utility company, and University research groups. The program addressed all aspects of the crystalline silicon PV business from raw materials (particularly silicon feedstock) through installation of the system on the customers site. By involving the material and equipment vendors, we ensured that supplies of silicon feedstock and other PV specific materials like encapsulation materials (EVA and cover glass) will be available in the quantities required to meet the DOE goals of 5 to 10 GW of installed US PV by 2015 and at the prices necessary for PV systems to reach grid parity in 2015

Interrupted object-based updating of reach program leads to a negative compatibility effect.

Science.gov (United States)

Vainio, Lari

2009-07-01

The author investigated how the motor program elicited by an object's orientation is updated by object-based information while a participant reaches for the object. Participants selected the hand of response according to the thickness of the graspable object and then reached toward the location in which the object appeared. Reach initiation times decreased when the handle of the object was oriented toward the responding hand. This positive compatibility effect turned into a negative compatibility effect (NCE) during reach execution when the object was removed from the display 300 ms after object onset or replaced with a mask at movement onset. The results demonstrate that interrupted object-based updating of an ongoing reach movement triggers the NCE.

Stream Habitat Reach Summary - North Coast [ds63

Data.gov (United States)

California Natural Resource Agency — The shapefile is based on habitat unit level data summarized at the stream reach level. The database represents salmonid stream habitat surveys from 645 streams of...

Do older adults perceive postural constraints for reach estimation?

Science.gov (United States)

Cordova, Alberto; Gabbard, Carl

2014-01-01

BACKGROUND/STUDY CONTEXT: Recent evidence indicates that older persons have difficulty mentally representing intended movements. Furthermore, in an estimation of reach paradigm using motor imagery, a form of mental representation, older persons significantly overestimated their ability compared with young adults. The authors tested the notion that older adults may also have difficulty perceiving the postural constraints associated with reach estimation. The authors compared young (Mage = 22 years) and older (Mage = 67) adults on reach estimation while seated and in a more postural demanding standing and leaning forward position. The expectation was a significant postural effect with the standing condition, as evidenced by reduced overestimation. Whereas there was no difference between groups in the seated condition (both overestimated), older adults underestimated whereas the younger group once again overestimated in the standing condition. From one perspective, these results show that older adults do perceive postural constraints in light of their own physical capabilities. That is, that group perceived greater postural demands with the standing posture and elected to program a more conservative strategy, resulting in underestimation.

Prediction of Reach Goals in Depth and Direction from the Parietal Cortex

Directory of Open Access Journals (Sweden)

Matteo Filippini

2018-04-01

Full Text Available Summary: The posterior parietal cortex is well known to mediate sensorimotor transformations during the generation of movement plans, but its ability to control prosthetic limbs in 3D environments has not yet been fully demonstrated. With this aim, we trained monkeys to perform reaches to targets located at various depths and directions and tested whether the reach goal position can be extracted from parietal signals. The reach goal location was reliably decoded with accuracy close to optimal (>90%, and this occurred also well before movement onset. These results, together with recent work showing a reliable decoding of hand grip in the same area, suggest that this is a suitable site to decode the entire prehension action, to be considered in the development of brain-computer interfaces. : Filippini et al. show that it is possible to use parietal cortex activity to predict in which direction the arm will move and how far it will reach. This opens up the possibility of neural prostheses that can accurately guide reach and grasp using signals from this part of the brain. Keywords: neuroprosthetics, offline neural decoding, reaching in depth, monkey, V6A, machine learning, visuomotor transformations, hand guidance, prehension, robotics

Contribution of River Mouth Reach to Sediment Load of the Yangtze River

Directory of Open Access Journals (Sweden)

C. Wang

2015-01-01

Full Text Available This paper examined the sediment gain and loss in the river mouth reach of the Yangtze River by considering sediment load from the local tributaries, erosion/accretion of the river course, impacts of sand mining, and water extraction. A quantitative estimation of the contribution of the river mouth reach to the sediment load of the Yangtze River was conducted before and after impoundment of the Three Gorges Dam (TGD in 2003. The results showed that a net sediment load loss of 1.78 million ton/yr (Mt/yr occurred from 1965 to 2002 in the study area. The contribution of this reach to the sediment discharge into the sea is not as high as what was expected before the TGD. With impoundment of the TGD, channel deposition (29.90 Mt/yr and a net sediment loss of 30.89 Mt/yr occurred in the river mouth reach from 2003 to 2012. The river mouth reach has acted as a sink but not a source of sediment since impoundment of the TGD, which has exacerbated the decrease in sediment load. Technologies should be advanced to measure changes in river channel morphology, as well as in water and sediment discharges at the river mouth reach.

Reaching Reluctant Students: Insights from Torey Hayden.

Science.gov (United States)

Marlowe, Mike

1999-01-01

Illustrates principles of reaching students who fight or avoid adults by using examples drawn from the writings of Torey Hayden. Presents ten concepts that can serve as guidelines for building relationships with resistant children, and gives excerpts from Hayden's works to illustrate each concept. Demonstrates how books provide teachers with…

Following the canyon to reach and remove olfactory groove meningiomas.

Science.gov (United States)

Stefini, Roberto; Zenga, Francesco; Giacomo, Esposito; Bolzoni, Andrea; Tartara, Fulvio; Spena, Giannantonio; Ambrosi, Claudia; Fontanella, Marco M

2017-04-01

Olfactory groove meningiomas (OGMs) represent approximately 10% of all intracranial meningiomas. They arise in the olfactory fossa, a variable depression delimited by the lateral lamella and perpendicular plate. The cribriform plate with the lateral lamella and ethmoidal and orbital roof could be viewed as a 'canyon' with the frontal sinus as the main entrance. Between January 2000 and December 2013, 32 consecutive patients underwent removal of OGMs through this 'canyon' at the Department of Neurosurgery of Brescia and Turin. Complete removal was achieved in all patients with this trans-frontal sinus subcranial approach (Simpson grade I; mean lesion volume, 46.6 cm3). Five patients (15.6%) experienced nasal CSF leakage, treated with external lumbar drain positioning for 4 days and resolved in all cases but one, which was re-operated. Two patients (6.2%) during the CSF leakage experienced meningitis at day 7 after surgery, both successfully treated by intravenous antibiotic therapy. After one month, one patient developed hydrocephalus, treated with a ventricular peritoneal shunt. In one patient, traction on the OGM caused bleeding of the callosomarginal artery, which was coagulated with superior frontal gyrus ischemia without neurological consequences. Glasgow Outcome Scale Score at 6 months was V in 29 patients, IV in one patient, and I in two patients. Advantages with this approach may include easy and early control of blood supply from its insertion in the skull base, minimal frontal lobe retraction, preservation of the frontal veins draining to the sagittal sinus, and a satisfactory aesthetic outcome.

[Distribution and origin of polycyclic aromatic hydrocarbons in sediments of the reaches of Huaihe River (Huainan to Bengbu)].

Science.gov (United States)

Peng, Huan; Yang, Yi; Liu, Min; Li, Yong; Zhang, Qian-dong; Yang, Gang

2010-05-01

Using GC-MS 18 PAHs have been quantified in sediments from water source areas, tributaries and sewage outfalls at the reaches of Huaihe River (Huainan to Bengbu). The results show that the concentrations of total PAHs ranged from 308.12-1090.37 ng/g in sediments from water source areas and tributaries, and 1308.36-8793.16 ng/g in sediments from sewage outfalls. 3-4 rings were the dominant compounds compared to the 5-6 ring PAHs. Black carbon showed better correlation to PAHs than that of TOC. The composition characterization, principal component analysis and particular ratios of PAHs demonstrated that incomplete combustion of fossil fuels was the main source of PAHs in sediments at reaches of Huaihe River (Huainan to Bengbu), as well as a few anthropogenic releases of oil products. Ecological risk assessment indicated that, most of PAHs compounds in sediments have exceeded ER-L and ISQV-L values, among which part PAHs compounds at Yaojiawan even exceeded ER-H and ISQV-H values, showing the significant potential risk of PAHs to the ecosystem in the study area.

Influence of insurance and marital status on outcomes of adolescents and young adults with acute lymphoblastic leukemia.

Science.gov (United States)

Fintel, Andrew E; Jamy, Omer; Martin, Mike G

2015-06-01

Although outcomes for adolescents and young adults (AYA) with acute lymphoblastic leukemia (ALL) are worse when treated according to adult rather than pediatric protocols, one criticism is that this may be due to the emancipation of young adults. Using case listing session of Surveillance, Epidemiology, and End Results (SEER) 18 (1973-2010), we examined outcomes for AYA with ALL defined similar to Cancer and Leukemia Group B (CALGB) 10,403 criteria (age 18-30) predicated on marital and insurance status as surrogates for emancipation (limiting analysis to 2007-2010). Analyses were conducted with SEER*Stat 8.1.2, Microsoft Excel 2007, and GraphPad Prism 6. Comparisons were made by the Fisher exact test and log rank test (Mantel-Cox); all P values were 2-sided. Although age (24 and younger vs. 25 and older) was predictive of median overall survival (OS) (not reached vs. 33; P = .0029) (3-year OS 66% vs. 49%), social factors were not. Three-year OS for insured versus uninsured patients was 61% versus 50%, and median OS was not reached versus 30 months (P = .2334). Three-year OS for single versus married patients was 62% versus 55%, with median OS not reached for both groups (P = .1084). Insurance status and marriage did not influence outcomes for AYA with ALL, suggesting that intrinsic differences in disease and disease-specific therapies are more important than social issues. Copyright © 2015 Elsevier Inc. All rights reserved.

Let's talk sex on the air: ReachOut launches radio campaign.

Science.gov (United States)

This article reports on the launching of the National Radio and Public Relations Campaign to Promote Modern Methods of Contraception by the ReachOut AIDS Foundation Incorporated in the Philippines. ReachOut has tapped radio veteran Tiya Dely Magpayo as the official campaign spokesperson, thus, putting a mother's touch to a serious promotional drive to reach the far-flung areas of the country. It is noted that the project promotes the wider use of modern methods of contraception as its contribution to the Philippines Population Program goals of controlling the population rate. Since radio is the most patronized media in the country, ReachOut hopes that the radio soap opera format will attract the listeners to use contraceptives. The campaign encourages men and women of reproductive age to seek information and services regarding modern methods of contraception from health service providers in their respective areas. The Department of Health will provide the technical support to ensure that the campaign is keeping with the government's programs.

Immediate outcome indicators in perioperative care: a controlled intervention study on quality improvement in hospitals in Tanzania.

Science.gov (United States)

Bosse, Goetz; Mtatifikolo, Ferdinand; Abels, Wiltrud; Strosing, Christian; Breuer, Jan-Philipp; Spies, Claudia

2013-01-01

Outcome assessment is the standard for evaluating the quality of health services worldwide. In this study, outcome has been divided into immediate and final outcome. Aim was to compare an intervention hospital with a Continuous Quality Improvement approach to a control group using benchmark assessments of immediate outcome indicators in surgical care. Results were compared to final outcome indicators. Surgical care quality in six hospitals in Tanzania was assessed from 2006-2011, using the Hospital Performance Assessment Tool. Independent observers assessed structural, process and outcome quality using checklists based on evidence-based guidelines. The number of surgical key procedures over the benchmark of 80% was compared between the intervention hospital and the control group. Results were compared to Case Fatality Rates. In the intervention hospital, in 2006, two of nine key procedures reached the benchmark, one in 2009, and four in 2011. In the control group, one of nine key procedures reached the benchmark in 2006, one in 2009, and none in 2011. Case Fatality Rate for all in-patients in the intervention hospital was 5.5% (n = 12,530) in 2006, 3.5% (n = 21,114) in 2009 and 4.6% (n = 18,840) in 2011. In the control group it was 3.1% (n = 17,827) in 2006, 4.2% (n = 13,632) in 2009 and 3.8% (n = 17,059) in 2011. Results demonstrated that quality assurance improved performance levels in both groups. After the introduction of Continuous Quality Improvement, performance levels improved further in the intervention hospital while quality in the district hospital did not. Immediate outcome indicators appeared to be a better steering tool for quality improvement compared to final outcome indicators. Immediate outcome indicators revealed a need for improvement in pre- and postoperative care. Quality assurance programs based on immediate outcome indicators can be effective if embedded in Continuous Quality Improvement. Nevertheless, final outcome

Defining a set of standardised outcome measures for newly diagnosed patients with multiple myeloma using the Delphi consensus method: the IMPORTA project.

Science.gov (United States)

Blade, Joan; Calleja, Miguel Ángel; Lahuerta, Juan José; Poveda, José Luis; de Paz, Héctor David; Lizán, Luis

2018-02-22

To define a standard set of outcomes and the most appropriate instruments to measure them for managing newly diagnosed patients with multiple myeloma (MM). A literature review and five discussion groups facilitated the design of two-round Delphi questionnaire. Delphi panellists (haematologists, hospital pharmacists and patients) were identified by the scientific committee, the Spanish Program of Haematology Treatments Foundation, the Spanish Society of Hospital Pharmacies and the Spanish Community of Patients with MM. Panellist's perception about outcomes' suitability and feasibility of use was assessed on a seven-point Likert scale. Consensus was reached when at least 75% of the respondents reached agreement or disagreement. A scientific committee led the project. Fifty-one and 45 panellists participated in the first and second Delphi rounds, respectively. Consensus was reached to use overall survival, progression-free survival, minimal residual disease and treatment response to assess survival and disease control. Panellists agreed to measure health-related quality of life, pain, performance status, fatigue, psychosocial status, symptoms, self-perception on body image, sexuality and preferences/satisfaction. However, panellist did not reach consensus about the feasibility of assessing in routine practice psychosocial status, symptoms, self-perception on body image and sexuality. Consensus was reached to collect patient-reported outcomes through the European Organisation for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) Core questionnaire 30 (C30), three items from EORTC-QLQ-Multiple Myeloma (MY20) and EORTC-QLQ-Breast Cancer (BR23), pain Visual Analogue Scale, Morisky-Green and ad hoc questions about patients' preferences/satisfaction. A consensual standard set of outcomes for managing newly diagnosed patients with MM has been defined. The feasibility of its implementation in routine practice will be assessed in a future pilot

Distractor interference during a choice limb reaching task.

Directory of Open Access Journals (Sweden)

Matthew Ray

Full Text Available According to action-centered models of attention, the patterns of distractor interference that emerge in selective reaching tasks are related to the time and effort required to resolve a race for activation between competing target and non-target response producing processes. Previous studies have only used unimanual aiming tasks and, as such, only examined the effects of competition that occurs within a limb. The results of studies using unimanual aiming movements often reveal an "ipsilateral effect"--distractors on the same side of space as the effector cause greater interference than distractors on the opposite side of space. The cost of the competition when response selection is between the limbs has yet to be addressed. Participants in the present study executed reaching movements to 1 of 4 (2 left, 2 right possible target locations with and without a distractor. Participants made ipsilateral reaches (left hand to left targets, right hand to right targets. In contrast to studies using unimanual aiming movements, a "contralateral effect" was observed; distractors affording responses for the other hand (in contralateral space caused more interference than distractors affording responses for the same hand. The findings from the present research demonstrate that when certain portions of response planning must be resolved prior to response initiation, distractors that code for that dimension cause the greatest interference.

The efficacy of interactive, motion capture-based rehabilitation on functional outcomes in an inpatient stroke population: a randomized controlled trial.

Science.gov (United States)

Cannell, John; Jovic, Emelyn; Rathjen, Amy; Lane, Kylie; Tyson, Anna M; Callisaya, Michele L; Smith, Stuart T; Ahuja, Kiran Dk; Bird, Marie-Louise

2018-02-01

To compare the efficacy of novel interactive, motion capture-rehabilitation software to usual care stroke rehabilitation on physical function. Randomized controlled clinical trial. Two subacute hospital rehabilitation units in Australia. In all, 73 people less than six months after stroke with reduced mobility and clinician determined capacity to improve. Both groups received functional retraining and individualized programs for up to an hour, on weekdays for 8-40 sessions (dose matched). For the intervention group, this individualized program used motivating virtual reality rehabilitation and novel gesture controlled interactive motion capture software. For usual care, the individualized program was delivered in a group class on one unit and by rehabilitation assistant 1:1 on the other. Primary outcome was standing balance (functional reach). Secondary outcomes were lateral reach, step test, sitting balance, arm function, and walking. Participants (mean 22 days post-stroke) attended mean 14 sessions. Both groups improved (mean (95% confidence interval)) on primary outcome functional reach (usual care 3.3 (0.6 to 5.9), intervention 4.1 (-3.0 to 5.0) cm) with no difference between groups ( P = 0.69) on this or any secondary measures. No differences between the rehabilitation units were seen except in lateral reach (less affected side) ( P = 0.04). No adverse events were recorded during therapy. Interactive, motion capture rehabilitation for inpatients post stroke produced functional improvements that were similar to those achieved by usual care stroke rehabilitation, safely delivered by either a physical therapist or a rehabilitation assistant.

High Resolution Modelling of the Congo River's Multi-Threaded Main Stem Hydraulics

Science.gov (United States)

Carr, A. B.; Trigg, M.; Tshimanga, R.; Neal, J. C.; Borman, D.; Smith, M. W.; Bola, G.; Kabuya, P.; Mushie, C. A.; Tschumbu, C. L.

2017-12-01

We present the results of a summer 2017 field campaign by members of the Congo River users Hydraulics and Morphology (CRuHM) project, and a subsequent reach-scale hydraulic modelling study on the Congo's main stem. Sonar bathymetry, ADCP transects, and water surface elevation data have been collected along the Congo's heavily multi-threaded middle reach, which exhibits complex in-channel hydraulic processes that are not well understood. To model the entire basin's hydrodynamics, these in-channel hydraulic processes must be parameterised since it is not computationally feasible to represent them explicitly. Furthermore, recent research suggests that relative to other large global rivers, in-channel flows on the Congo represent a relatively large proportion of total flow through the river-floodplain system. We therefore regard sufficient representation of in-channel hydraulic processes as a Congo River hydrodynamic research priority. To enable explicit representation of in-channel hydraulics, we develop a reach-scale (70 km), high resolution hydraulic model. Simulation of flow through individual channel threads provides new information on flow depths and velocities, and will be used to inform the parameterisation of a broader basin-scale hydrodynamic model. The basin-scale model will ultimately be used to investigate floodplain fluxes, flood wave attenuation, and the impact of future hydrological change scenarios on basin hydrodynamics. This presentation will focus on the methodology we use to develop a reach-scale bathymetric DEM. The bathymetry of only a small proportion of channel threads can realistically be captured, necessitating some estimation of the bathymetry of channels not surveyed. We explore different approaches to this bathymetry estimation, and the extent to which it influences hydraulic model predictions. The CRuHM project is a consortium comprising the Universities of Kinshasa, Rhodes, Dar es Salaam, Bristol, and Leeds, and is funded by Royal

Infant manual performance during reaching and grasping for objects moving in depth.

Science.gov (United States)

Domellöf, Erik; Barbu-Roth, Marianne; Rönnqvist, Louise; Jacquet, Anne-Yvonne; Fagard, Jacqueline

2015-01-01

Few studies have investigated manual performance in infants when reaching and grasping for objects moving in directions other than across the fronto-parallel plane. The present preliminary study explored object-oriented behavioral strategies and side preference in 8- and 10-month-old infants during reaching and grasping for objects approaching in depth from three positions (midline, and 27° diagonally from the left and right). Effects of task constraint by using objects of three different types and two sizes were further examined for behavioral strategies and hand opening prior to grasping. Additionally, assessments of hand preference by a dedicated handedness test were performed. Regardless of object starting position, the 8-month-old infants predominantly displayed right-handed reaches for objects approaching in depth. In contrast, the older infants showed more varied strategies and performed more ipsilateral reaches in correspondence with the side of the approaching object. Conversely, 10-month-old infants were more successful than the younger infants in grasping the objects, independent of object starting position. The findings regarding infant hand use strategies when reaching and grasping for objects moving in depth are similar to those from earlier studies using objects moving along a horizontal path. Still, initiation times of reaching onset were generally long in the present study, indicating that the object motion paths seemingly affected how the infants perceived the intrinsic properties and spatial locations of the objects, possibly with an effect on motor planning. Findings are further discussed in relation to future investigations of infant reaching and grasping for objects approaching in depth.

PIT-tagged particle study of bed mobility in a Maine salmon river impacted by logging activities

Science.gov (United States)

Thompson, D. M.; Fixler, S. A.; Roberts, K. E.; McKenna, M.; Marshall, A. E.; Koenig, S.

2017-12-01

Presenting an interim report on a study on the Narraguagus River in Maine, which utilizes laser total stations cross-sectional surveys and tracking of passive integrated transponder (PIT) tags embedded in glass spheres to document changes in channel-bed characteristics associated with large wood (LW) additions and natural spawning activities. In 2016, work was initiated to monitor changes in bed elevation and sediment mobility with the addition of LW to the Narraguagus River as part of a restoration effort. Ten cross-sections, spaced 5-m apart, were established and surveyed with a laser total station in each of three different study reaches. The study sites include a control reach, a section with anticipated spawning activities and a site with ongoing LW placement. A grid of 200 glass spheres embedded with PIT tags, with twenty alternating 25-mm and 40-mm size particles equally spaced along each of the ten transects, were placed to serve as point sensors to detect sediment mobilization within each reach. In 2017, the site was revisited to determine if differences in PIT-tagged tracer particle mobilization reflect locations were LW was added and places where Atlantic salmon (Salmo salar) and sea lamprey (Petromyzon marinus) construct spawning redds. The positions of PIT-tagged tracer particles was recorded, but particles were not disturbed or uncovered to permit study of potential reworking of buried tracer particles the following year. Full tracer particle recovery will be determined in 2018 to determine if depths of tracer burial and changes in bed elevation vary among places near redds, LW and main channel locations. The data will be used to determine if salmon redds are preferentially located in either places with greater evidence of sediment reworking or alternatively in stable areas? The study will help determine the degree of bed disruption associated with spawning activities and whether LW placement encourages similar sediment mobilization processes.

Digital Immigrants, Digital Learning: Reaching Adults through Information Literacy Instruction Online

Science.gov (United States)

Rapchak, Marcia; Behary, Robert

2013-01-01

As information literacy programs become more robust, finding methods of reaching students beyond the traditional undergraduate has become a priority for many institutions. At Duquesne University, efforts have been made to reach adult learners in an accelerated program targeted to nontraditional students, much of which is provided online. This…

Development of Reaching and Grasping skills in infants with Down syndrome

NARCIS (Netherlands)

de Campos, A.C.; Rocha, N.A.C.F.; Savelsbergh, G.J.P.

2010-01-01

Reaching and grasping skills have been described to emerge from a dynamic interaction between intrinsic and extrinsic factors. The aims of the study were to investigate the effect of such intrinsic factors as age and Down syndrome on the development of reaching and grasping skills and on overall

Influence of peer review on the reporting of primary outcome(s) and statistical analyses of randomised trials.

Science.gov (United States)

Hopewell, Sally; Witt, Claudia M; Linde, Klaus; Icke, Katja; Adedire, Olubusola; Kirtley, Shona; Altman, Douglas G

2018-01-11

Selective reporting of outcomes in clinical trials is a serious problem. We aimed to investigate the influence of the peer review process within biomedical journals on reporting of primary outcome(s) and statistical analyses within reports of randomised trials. Each month, PubMed (May 2014 to April 2015) was searched to identify primary reports of randomised trials published in six high-impact general and 12 high-impact specialty journals. The corresponding author of each trial was invited to complete an online survey asking authors about changes made to their manuscript as part of the peer review process. Our main outcomes were to assess: (1) the nature and extent of changes as part of the peer review process, in relation to reporting of the primary outcome(s) and/or primary statistical analysis; (2) how often authors followed these requests; and (3) whether this was related to specific journal or trial characteristics. Of 893 corresponding authors who were invited to take part in the online survey 258 (29%) responded. The majority of trials were multicentre (n = 191; 74%); median sample size 325 (IQR 138 to 1010). The primary outcome was clearly defined in 92% (n = 238), of which the direction of treatment effect was statistically significant in 49%. The majority responded (1-10 Likert scale) they were satisfied with the overall handling (mean 8.6, SD 1.5) and quality of peer review (mean 8.5, SD 1.5) of their manuscript. Only 3% (n = 8) said that the editor or peer reviewers had asked them to change or clarify the trial's primary outcome. However, 27% (n = 69) reported they were asked to change or clarify the statistical analysis of the primary outcome; most had fulfilled the request, the main motivation being to improve the statistical methods (n = 38; 55%) or avoid rejection (n = 30; 44%). Overall, there was little association between authors being asked to make this change and the type of journal, intervention, significance of the

A comparison of two novel antipsychotics in first episode non-affective psychosis: one-year outcome on symptoms, motor side effects and cognition.

Science.gov (United States)

Malla, Ashok; Norman, Ross; Scholten, Derek; Townsend, Laurel; Manchanda, Rahul; Takhar, Jatinder; Haricharan, Raj

2004-12-15

The main objective of this study was to compare 1-year outcome on symptoms, extrapyramidal side effects (EPS) , positive and negative symptoms, and domains of cognition in first episode psychosis (FEP) patients. Drug-naive FEP patients, who were similar on a number of characteristics likely to affect outcome, were treated with only one antipsychotic (risperidone or olanzapine) for at least 1 year and compared at baseline and after 1 year of treatment. Differences in outcome were assessed using an analysis of co-variance with change scores between initial assessment and after 1 year of treatment on levels of psychotic, disorganization and psychomotor poverty symptoms, EPS (parkinsonism, akathesia and dyskineisa) and domains of cognition as the dependent variable, respective baseline scores as covariates, and drug group as the independent variable. While patients in both groups showed substantial improvement, there were no significant differences in the magnitude of change in reality distortion, disorganization and psychomotor poverty symptoms. Trends in change in EPS favouring olanzapine and on some domains of cognition (processing speed and executive functions) favouring risperidone failed to reach statistical significance. The failure to confirm previous claims of greater improvement on either risperidone or olanzapine in patients with a first episode of psychosis may be the result of methodological bias introduced by unequal dosing between the two drugs or the use of chronically ill and treatment-refractory patients in previous studies.

[Relationships of wetland landscape fragmentation with climate change in middle reaches of Heihe River, China].

Science.gov (United States)

Jiang, Peng-Hui; Zhao, Rui-Feng; Zhao, Hai-Li; Lu, Li-Peng; Xie, Zuo-Lun

2013-06-01

Based on the 1975-2010 multi-temporal remotely sensed TM and ETM images and meteorological data, in combining with wavelet analysis, trend surface simulation, and interpolation method, this paper analyzed the meteorological elements' spatial distribution and change characteristics in the middle reaches of Heihe River, and elucidated the process of wetland landscape fragmentation in the study area by using the landscape indices patch density (PD), mean patch size (MPS), and patch shape fragment index (FS). The relationships between the wetland landscape fragmentation and climate change were also approached through correlation analysis and multiple stepwise regression analysis. In 1975-2010, the overall distribution patterns of precipitation and temperature in the study area were low precipitation in high temperature regions and high precipitation in low temperature regions, and the main characteristics of climate change were the conversion from dry to wet and from cold to warm. In the whole study period, the wetland landscape fragmentation was mainly manifested in the decrease of MPS, with a decrement of 48.95 hm2, and the increase of PD, with an increment of 0.006 ind x hm(-2).

Defining a core outcome set for adolescent and young adult patients with a spinal deformity

DEFF Research Database (Denmark)

de Kleuver, Marinus; Faraj, Sayf S A; Holewijn, Roderick M

2017-01-01

2016, 7 representatives (panelists) of the national spinal surgery registries from each of the NSDS countries participated in a modified Delphi study. With a systematic literature review as a basis and the International Classification of Functioning, Disability and Health framework as guidance, 4...... consensus rounds were held. Consensus was defined as agreement between at least 5 of the 7 representatives. Data were analyzed qualitatively and quantitatively. Results - Consensus was reached on the inclusion of 13 core outcome domains: "satisfaction with overall outcome of surgery", "satisfaction...

Long-reach manipulators for decommissioning

International Nuclear Information System (INIS)

Webster, D.A.; Challinor, S.F.

1993-01-01

A survey of redundant facilities at Sellafield has identified that in many cases the conventional means of deploying remote handling equipment are not appropriate and that novel means must be employed. However, decommissioning is not a value adding activity and so expensive one off designs must be avoided. The paper will describe BNFL's approach to the synthesis from proprietary parts of a manipulator which can lift 3 te at a horizontal reach of over 5 metres and yet can still perform the dextrous manipulation necessary to remove small items. It will also cover the development of the manipulator control systems and the adaption of commercial handtools to be manipulator friendly. (author)

Access to healthcare for disabled persons. How are blind people reached by HIV services?

Science.gov (United States)

Saulo, Bryson; Walakira, Eddy; Darj, Elisabeth

2012-03-01

Disabled people are overlooked and marginalised globally. There is a lack of information on blind people and HIV-related services and it is unclear how HIV-services target blind people in a sub-Saharan urban setting. To explore how blind people are reached by HIV-services in Kampala, Uganda. A purposeful sample of blind people and seeing healthcare workers were interviewed, and data on their opinions and experiences were collected. The data were analysed by qualitative content analysis, with a focus on manifest content. Three categories emerged from the study, reaching for HIV information and knowledge, lack of services, and experiences of discrimination. General knowledge on HIV prevention/transmission methods was good; however, there was scepticism about condom use. Blind people mainly relied on others for accessing HIV information, and a lack of special services for blind people to be able to test for HIV was expressed. The health service for blind people was considered inadequate, unequal and discriminatory, and harassment by healthcare staff was expressed, but not sexual abuse. Concerns about disclosure of personal medical information were revealed. Access to HIV services and other healthcare related services for blind people is limited and the objectives of the National Strategic Plan for HIV/AIDS 2007-2012 have not been achieved. There is a need for alternative methods for sensitisation and voluntary counselling and testing (VCT) for blind people. Copyright © 2011 Elsevier B.V. All rights reserved.

Grip type and task goal modify reach-to-grasp performance in post-stroke hemiparesis

Science.gov (United States)

Schaefer, Sydney Y.; DeJong, Stacey L.; Cherry, Kendra M.; Lang, Catherine E.

2011-01-01

This study investigated whether grip type and/or task goal influenced reaching and grasping performance in post-stroke hemiparesis. Sixteen adults with post-stroke hemiparesis and twelve healthy adults reached to and grasped a cylindrical object using one of two grip types (3-finger or palmar) to achieve one of two task goals (hold or lift). Performance of the stroke group was characteristic of hemiparetic limb movement during reach-to-grasp, with more curved handpaths and slower velocities compared to the control group. These effects were present regardless of grip type or task goal. Other measures of reaching (reach time and reach velocity at object contact) and grasping (peak thumb-index finger aperture during the reach and peak grip force during the grasp) were differentially affected by grip type, task goal, or both, despite the presence of hemiparesis, providing new evidence that changes in motor patterns after stroke may occur to compensate for stroke-related motor impairment. PMID:22357103

Grip type and task goal modify reach-to-grasp performance in post-stroke hemiparesis.

Science.gov (United States)

Schaefer, Sydney Y; DeJong, Stacey L; Cherry, Kendra M; Lang, Catherine E

2012-04-01

This study investigated whether grip type and/or task goal influenced reaching and grasping performance in poststroke hemiparesis. Sixteen adults with poststroke hemiparesis and twelve healthy adults reached to and grasped a cylindrical object using one of two grip types (3-finger or palmar) to achieve one of two task goals (hold or lift). Performance of the stroke group was characteristic of hemiparetic limb movement during reach-to-grasp, with more curved handpaths and slower velocities compared with the control group. These effects were present regardless of grip type or task goal. Other measures of reaching (reach time and reach velocity at object contact) and grasping (peak thumb-index finger aperture during the reach and peak grip force during the grasp) were differentially affected by grip type, task goal, or both, despite the presence of hemiparesis, providing new evidence that changes in motor patterns after stroke may occur to compensate for stroke-related motor impairment.

Event-related potential studies of outcome processing and feedback-guided learning

Directory of Open Access Journals (Sweden)

René eSan Martín

2012-11-01

Full Text Available In order to control behavior in an adaptive manner the brain has to learn how some situations and actions predict positive or negative outcomes. During the last decade cognitive neuroscientists have shown that the brain is able to evaluate and learn from outcomes within a few hundred milliseconds of their occurrence. This research has been primarily focused on the feedback-related negativity (FRN and the P3, two event-related potential (ERP components that are elicited by outcomes. The FRN is a frontally distributed negative-polarity ERP component that typically reaches its maximal amplitude 250 ms after outcome presentation and tends to be larger for negative than for positive outcomes. The FRN has been associated with activity in the anterior cingulate cortex. The P3 (~300-600 ms is a parietally distributed positive-polarity ERP component that tends to be larger for large magnitude than for small magnitude outcomes. The neural sources of the P3 are probably distributed over different regions of the cortex. This paper examines the theories that have been proposed to explain the functional role of these two ERP components during outcome processing. Special attention is paid to extant literature addressing how these ERP components are modulated by outcome valence (negative vs. positive, outcome magnitude (large vs. small, outcome probability (unlikely vs. likely and behavioral adjustment. The literature offers few generalizable conclusions, but is beset with a number of inconsistencies across studies. This paper discusses the potential reasons for these inconsistencies and points out some challenges that will shape the field over the next decade.

LTRM Fish Sampling Strata, UMRS La Grange Reach

Data.gov (United States)

Department of the Interior — The data set includes delineation of sampling strata for the six study reaches of the UMRR Program’s LTRM element. Separate strata coverages exist for each of the...

[Encopresis--predictive factors and outcome].

Science.gov (United States)

Mehler-Wex, Claudia; Scheuerpflug, Peter; Peschke, Nicole; Roth, Michael; Reitzle, Karl; Warnke, Andreas

2005-10-01

comparison of diagnostic, clinical and therapeutic features and their predictive value for the outcome of encopresis in children and adolescents. 85 children and adolescents (aged 9.6 +/- 3.2 years) with severe encopresis (ICD 10: F98.1) were investigated during inpatient treatment and 35 of them again 5.5 +/- 1.8 years later. Mentally retarded patients were excluded. Inpatient therapy consisted of treating constipation and/or stool regulation by means of laxatives, behavioural approaches, and the specific therapy of comorbid psychiatric disorders. During inpatient treatment 22% of the patients experienced total remission, 8% an unchanged persistence of symptoms. Of the 35 patients studied at follow-up 5.5 years later, 40% were symptom-free. As main result, prognostic outcome depended significantly on sufficient treatment of obstipation. Another important factor was the specific therapeutic approach to psychiatric comorbidity, especially to ADHD. The outcome for patients with comorbid ICD 10: F43 was significantly better than for the other patients. Those who were symptom-free at discharge had significantly better long-term outcomes. Decisive to the success of encopresis treatment were the stool regulation and the specific therapy of associated psychiatric illnesses, in particular of ADHD. Inpatient treatment revealed significantly better long-term outcomes where total remission had been achieved by the time of discharge from hospital.

Taking family planning services to hard-to-reach populations.

Science.gov (United States)

Donovan, P

1996-01-01

Interviews were conducted in 1995 among 100 US family planning program personnel who serve hard-to-reach populations, such as drug abusers, prisoners, the disabled, homeless persons, and non-English speaking minorities. Findings indicate that a range of services is available for hard-to-reach groups. Most family planning agencies focus on drug abusers because of the severity of HIV infections and the availability of funding. This article describes the activities of various agencies in Michigan, Pennsylvania, and Massachusetts that serve substance abuse centers with family planning services. One recommendation for a service provider is to present services in an environment where it is safe to talk about a person's needs. One other program offered personal greetings upon arrival and the continuity of having a familiar face to oversee all reproductive and health needs. Programs for prisoners ranged from basic sex education classes to comprehensive reproductive health care. Some prisons offered individual counseling. Some programs were presented in juvenile offender facilities. Outreach to the homeless involved services at homeless shelters, outreach workers who recruited women into traditional family planning clinics, and establishment of nontraditional sites for the homeless and other hard-to-reach persons. One provider's suggestion was to offer services where high-risk women already go for other services. Most services to the disabled target the developmentally disabled rather than the physically disabled. Experience has shown that many professionals working with the disabled do not recognize their clients' sexual needs. Other hard-to-reach groups include women in housing projects and shelters for battered women, welfare applicants, and sex workers. Key to service provision is creating trust, overcoming language and cultural differences, and subsidizing the cost of care.

Workspace location influences joint coordination during reaching in post-stroke hemiparesis

Science.gov (United States)

Reisman, Darcy S.; Scholz, John P.

2006-01-01

The purpose of this study was to determine the influence of workspace location on joint coordination in persons with post-stroke hemiparesis when trunk motion was required to complete reaches beyond the arm’s functional reach length. Seven subjects with mild right hemiparesis following a stroke and seven age and gender matched control subjects participated. Joint motions and characteristics of hand and trunk movement were measured over multiple repetitions. The variance (across trials) of joint combinations was partitioned into two components at every point in the hand’s trajectory using the uncontrolled manifold approach; the first component is a measure of the extent to which equivalent joint combinations are used to control a given hand path, and reflects performance flexibility. The second component of joint variance reflects the use of non-equivalent joint combinations, which lead to hand path error. Compared to the control subjects, persons with hemiparesis demonstrated a significantly greater amount of non-equivalent joint variability related to control of the hand’s path and of the hand’s position relative to the trunk when reaching toward the hemiparetic side (ipsilaterally), but not when reaching to the less involved side. The relative timing of the hand and trunk was also altered when reaching ipsilaterally. The current findings support the idea that the previously proposed “arm compensatory synergy” may be deficient in subjects with hemiparesis. This deficiency may be due to one or a combination of factors: changes in central commands that are thought to set the gain of the arm compensatory synergy; a limited ability to combine shoulder abduction and elbow extension that limits the expression of an appropriately set arm compensatory synergy; or a reduction of the necessary degrees-of-freedom needed to adequately compensate for poor trunk control when reaching ipsilaterally. PMID:16328275

Bimanual reach to grasp movements after cervical spinal cord injury.

Directory of Open Access Journals (Sweden)

Laura Britten

Full Text Available Injury to the cervical spinal cord results in bilateral deficits in arm/hand function reducing functional independence and quality of life. To date little research has been undertaken to investigate control strategies of arm/hand movements following cervical spinal cord injury (cSCI. This study aimed to investigate unimanual and bimanual coordination in patients with acute cSCI using 3D kinematic analysis as they performed naturalistic reach to grasp actions with one hand, or with both hands together (symmetrical task, and compare this to the movement patterns of uninjured younger and older adults. Eighteen adults with a cSCI (mean 61.61 years with lesions at C4-C8, with an American Spinal Injury Association (ASIA grade B to D and 16 uninjured younger adults (mean 23.68 years and sixteen uninjured older adults (mean 70.92 years were recruited. Participants with a cSCI produced reach-to-grasp actions which took longer, were slower, and had longer deceleration phases than uninjured participants. These differences were exacerbated during bimanual reach-to-grasp tasks. Maximal grasp aperture was no different between groups, but reached earlier by people with cSCI. Participants with a cSCI were less synchronous than younger and older adults but all groups used the deceleration phase for error correction to end the movement in a synchronous fashion. Overall, this study suggests that after cSCI a level of bimanual coordination is retained. While there seems to be a greater reliance on feedback to produce both the reach to grasp, we observed minimal disruption of the more impaired limb on the less impaired limb. This suggests that bimanual movements should be integrated into therapy.

Luminosity performance reach after LS1

International Nuclear Information System (INIS)

Herr, W.

2012-01-01

Based on past experience (2010/2011), in particular expected limitations from beam-beam effects, and taking into account the expected beam quality from the LHC injectors, the peak and integrated luminosity at top energy is discussed for different scenarios (e.g. bunch spacing, beta*). In particular it will be shown which are the key parameters to reach the nominal luminosity and it is also shown that peak luminosities two times larger than nominal (or higher) are possible. Possible test in 2012 are discussed

The Effect of Principal's Leadership Style on School Environment and Outcome

Science.gov (United States)

Al-Safran, Eissa; Brown, David; Wiseman, Alexander

2014-01-01

The main objective of this study was to investigate the effect of principal's leadership style on school outcome. This study focused on the indirect relationship between the leadership style and the school environment. An additional objective was to investigate the impact of culture on leadership style as related to school environment and outcome.…

Development of Reaching and Grasping Skills in Infants with Down Syndrome

Science.gov (United States)

de Campos, Ana Carolina; Rocha, Nelci Adriana Cicuto Ferreira; Savelsbergh, Geert J. P.

2010-01-01

Reaching and grasping skills have been described to emerge from a dynamic interaction between intrinsic and extrinsic factors. The aims of the study were to investigate the effect of such intrinsic factors as age and Down syndrome on the development of reaching and grasping skills and on overall gross motor skill, and to test the influence of the…

Main Memory DBMS

NARCIS (Netherlands)

P.A. Boncz (Peter); L. Liu (Lei); M. Tamer Özsu

2008-01-01

htmlabstractA main memory database system is a DBMS that primarily relies on main memory for computer data storage. In contrast, normal database management systems employ hard disk based persisntent storage.

Main types of optical beams giving predominant contributions to the light backscatter for the irregular hexagonal columns

Science.gov (United States)

Shishko, Victor A.; Konoshonkin, Alexander V.; Kustova, Natalia V.; Borovoi, Anatoli G.

2017-11-01

This work presents the estimation of contribution of the main types of optical beams to the light backscatter for randomly oriented hexagonal ice column, the right dihedral angle of which was distorted within the range of 0° (regular particle) to 10°. Calculations were obtained within the physical optics approximation. The wavelength was 532 nm and the refractive index was 1.3116. The results showed that the total contribution of the main types of optical beams to the total backscattering cross section reach the value of 85% at small distortion angle of the hexagonal column and at substantial distortion angle the total contribution of the main types of optical beams decrease up to 55% of the total backscattering cross section. The obtained conclusions can significantly reduce the calculation time in the case when there is no need for high accuracy of the calculation.

Factors associated with reaching or not reaching target HbA1c after initiation of basal or premixed insulin in patients with type 2 diabetes.

Science.gov (United States)

Scheen, A J; Schmitt, H; Jiang, H H; Ivanyi, T

2017-02-01

To evaluate factors associated with reaching or not reaching target glycated haemoglobin (HbA 1c ) levels by analysing the respective contributions of fasting hyperglycaemia (FHG), also referred to as basal hyperglycaemia, vs postprandial hyperglycaemia (PHG) before and after initiation of a basal or premixed insulin regimen in patients with type 2 diabetes. This post-hoc analysis of insulin-naïve patients in the DURABLE study randomised to receive either insulin glargine or insulin lispro mix 25 evaluated the percentages of patients achieving a target HbA 1c of <7.0% (<53mmol/mol) per baseline HbA 1c quartiles, and the effect of each insulin regimen on the relative contributions of PHG and FHG to overall hyperglycaemia. Patients had comparable demographic characteristics and similar HbA 1c and FHG values at baseline in each HbA 1c quartile regardless of whether they reached the target HbA 1c . The higher the HbA 1c quartile, the greater was the decrease in HbA 1c , but also the smaller the percentage of patients achieving the target HbA 1c . HbA 1c and FHG decreased more in patients reaching the target, resulting in significantly lower values at endpoint in all baseline HbA 1c quartiles with either insulin treatment. Patients not achieving the target HbA 1c had slightly higher insulin doses, but lower total hypoglycaemia rates. Smaller decreases in FHG were associated with not reaching the target HbA 1c , suggesting a need to increase basal or premixed insulin doses to achieve targeted fasting plasma glucose and improve patient response before introducing more intensive prandial insulin regimens. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Stability of Phase Relationships While Coordinating Arm Reaches with Whole Body Motion.

Directory of Open Access Journals (Sweden)

Romy S Bakker

Full Text Available The human movement repertoire is characterized by the smooth coordination of several body parts, including arm movements and whole body motion. The neural control of this coordination is quite complex because the various body parts have their own kinematic and dynamic properties. Behavioral inferences about the neural solution to the coordination problem could be obtained by examining the emerging phase relationship and its stability. Here, we studied the phase relationships that characterize the coordination of arm-reaching movements with passively-induced whole-body motion. Participants were laterally translated using a vestibular chair that oscillated at a fixed frequency of 0.83 Hz. They were instructed to reach between two targets that were aligned either parallel or orthogonal to the whole body motion. During the first cycles of body motion, a metronome entrained either an in-phase or an anti-phase relationship between hand and body motion, which was released at later cycles to test phase stability. Results suggest that inertial forces play an important role when coordinating reaches with cyclic whole-body motion. For parallel reaches, we found a stable in-phase and an unstable anti-phase relationship. When the latter was imposed, it readily transitioned or drifted back toward an in-phase relationship at cycles without metronomic entrainment. For orthogonal reaches, we did not find a clear difference in stability between in-phase and anti-phase relationships. Computer simulations further show that cost models that minimize energy expenditure (i.e. net torques or endpoint variance of the reach cannot fully explain the observed coordination patterns. We discuss how predictive control and impedance control processes could be considered important mechanisms underlying the rhythmic coordination of arm reaches and body motion.

Infant manual performance during reaching and grasping for objects moving in depth

Directory of Open Access Journals (Sweden)

Erik eDomellöf

2015-08-01

Full Text Available Few studies have observed investigated manual asymmetries performance in infants when reaching and grasping for objects moving in directions other than across the fronto-parallel plane. The present preliminary study explored manual object-oriented behavioral strategies and hand side preference in 8- and 10-month-old infants during reaching and grasping for objects approaching in depth from three positions (midline, and 27° diagonally from the left, and right, midline. Effects of task constraint by using objects of three different types and two sizes were further examined for behavioral strategies and . The study also involved measurements of hand position opening prior to grasping., and Additionally, assessments of general hand preference by a dedicated handedness test were performed. Regardless of object starting position, the 8-month-old infants predominantly displayed right-handed reaches for objects approaching in depth. In contrast, the older infants showed more varied strategies and performed more ipsilateral reaches in correspondence with the side of the approaching object. Conversely, 10-month-old infants were more successful than the younger infants in grasping the objects, independent of object starting position. The findings support the possibility of a shared underlying mechanism regarding for infant hand use strategies when reaching and grasping for horizontally objects moving in depth are similar to those from earlier studies using objects moving along a horizontal pathand vertically moving objects. Still, initiation times of reaching onset were generally long in the present study, indicating that the object motion paths seemingly affected how the infants perceived the intrinsic properties and spatial locations of the objects, possibly with an effect on motor planning. Findings are further discussed in relation to future investigations of infant reaching and grasping for objects approaching in depth.

Action without awareness: reaching to an object you do not remember seeing.

Directory of Open Access Journals (Sweden)

Matthew Heath

Full Text Available BACKGROUND: Previous work by our group has shown that the scaling of reach trajectories to target size is independent of obligatory awareness of that target property and that "action without awareness" can persist for up to 2000 ms of visual delay. In the present investigation we sought to determine if the ability to scale reaching trajectories to target size following a delay is related to the pre-computing of movement parameters during initial stimulus presentation or the maintenance of a sensory (i.e., visual representation for on-demand response parameterization. METHODOLOGY/PRINCIPAL FINDINGS: Participants completed immediate or delayed (i.e., 2000 ms perceptual reports and reaching responses to different sized targets under non-masked and masked target conditions. For the reaching task, the limb associated with a trial (i.e., left or right was not specified until the time of response cuing: a manipulation that prevented participants from pre-computing the effector-related parameters of their response. In terms of the immediate and delayed perceptual tasks, target size was accurately reported during non-masked trials; however, for masked trials only a chance level of accuracy was observed. For the immediate and delayed reaching tasks, movement time as well as other temporal kinematic measures (e.g., times to peak acceleration, velocity and deceleration increased in relation to decreasing target size across non-masked and masked trials. CONCLUSIONS/SIGNIFICANCE: Our results demonstrate that speed-accuracy relations were observed regardless of whether participants were aware (i.e., non-masked trials or unaware (i.e., masked trials of target size. Moreover, the equivalent scaling of immediate and delayed reaches during masked trials indicates that a persistent sensory-based representation supports the unconscious and metrical scaling of memory-guided reaching.

Long-term prognostic value of risk scores after drug-eluting stent implantation for unprotected left main coronary artery: A pooled analysis of the ISAR-LEFT-MAIN and ISAR-LEFT-MAIN 2 randomized clinical trials.

Science.gov (United States)

Xhepa, Erion; Tada, Tomohisa; Kufner, Sebastian; Ndrepepa, Gjin; Byrne, Robert A; Kreutzer, Johanna; Ibrahim, Tareq; Tiroch, Klaus; Valgimigli, Marco; Tölg, Ralf; Cassese, Salvatore; Fusaro, Massimiliano; Schunkert, Heribert; Laugwitz, Karl L; Mehilli, Julinda; Kastrati, Adnan

2017-01-01

To evaluate the long-term prognostic value of risk scores in the setting of drug-eluting stent (DES) implantation for uLMCA. Data on the prognostic value of novel risk scores developed to select the most appropriate revascularization strategy in patients undergoing DES implantation for uLMCA disease are relatively limited. The study represents a patient-level pooled analysis of the ISAR-LEFT-MAIN (607 patients randomized to paclitaxel-eluting or sirolimus-eluting stents) and the ISAR-LEFT-MAIN-2 (650 patients randomized to everolimus-eluting or zotarolimus-eluting stents) randomized trials. The Syntax Score (SxScore) as well the Syntax Score II (SS-II), the EuroSCORE and the Global Risk Classification (GRC) were calculated. The primary outcome was all-cause mortality. At a mean follow-up of 3 years there were 160 deaths (12.7%). The death-incidence was significantly higher in the upper tertiles than in the intermediate or lower ones for all risk scores (log-rank test P risk scores were able to stratify the mortality risk at long-term follow-up. EuroSCORE was the only risk score that significantly improved the discriminatory power of a multivariable model to predict long-term mortality. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Investigation of PAM-4 for extending reach in data center interconnect applications

DEFF Research Database (Denmark)

Vegas Olmos, Juan José; Teipen, Brian; Eiselt, Nicklas

2015-01-01

Optical four-level pulse amplitude modulation (PAM-4) is being widely studied for various short-reach optical interfaces, motivated by the need to keep cost structure low, and to increase link capacity despite various constraints in component bandwidth. When considering PAM-4 in applications...... with reach significantly greater than 10km, such as in extended data center interconnects which require optical amplification, impairments such as chromatic dispersion, optical filtering, and ASE must be controlled. We investigate and report on requirements of PAM-4 for extended-reach, data center...

Direct comparison of risk-adjusted and non-risk-adjusted CUSUM analyses of coronary artery bypass surgery outcomes.

Science.gov (United States)

Novick, Richard J; Fox, Stephanie A; Stitt, Larry W; Forbes, Thomas L; Steiner, Stefan

2006-08-01

We previously applied non-risk-adjusted cumulative sum methods to analyze coronary bypass outcomes. The objective of this study was to assess the incremental advantage of risk-adjusted cumulative sum methods in this setting. Prospective data were collected in 793 consecutive patients who underwent coronary bypass grafting performed by a single surgeon during a period of 5 years. The composite occurrence of an "adverse outcome" included mortality or any of 10 major complications. An institutional logistic regression model for adverse outcome was developed by using 2608 contemporaneous patients undergoing coronary bypass. The predicted risk of adverse outcome in each of the surgeon's 793 patients was then calculated. A risk-adjusted cumulative sum curve was then generated after specifying control limits and odds ratio. This risk-adjusted curve was compared with the non-risk-adjusted cumulative sum curve, and the clinical significance of this difference was assessed. The surgeon's adverse outcome rate was 96 of 793 (12.1%) versus 270 of 1815 (14.9%) for all the other institution's surgeons combined (P = .06). The non-risk-adjusted curve reached below the lower control limit, signifying excellent outcomes between cases 164 and 313, 323 and 407, and 667 and 793, but transgressed the upper limit between cases 461 and 478. The risk-adjusted cumulative sum curve never transgressed the upper control limit, signifying that cases preceding and including 461 to 478 were at an increased predicted risk. Furthermore, if the risk-adjusted cumulative sum curve was reset to zero whenever a control limit was reached, it still signaled a decrease in adverse outcome at 166, 653, and 782 cases. Risk-adjusted cumulative sum techniques provide incremental advantages over non-risk-adjusted methods by not signaling a decrement in performance when preoperative patient risk is high.

The development of PubMed search strategies for patient preferences for treatment outcomes.

Science.gov (United States)

van Hoorn, Ralph; Kievit, Wietske; Booth, Andrew; Mozygemba, Kati; Lysdahl, Kristin Bakke; Refolo, Pietro; Sacchini, Dario; Gerhardus, Ansgar; van der Wilt, Gert Jan; Tummers, Marcia

2016-07-29

The importance of respecting patients' preferences when making treatment decisions is increasingly recognized. Efficiently retrieving papers from the scientific literature reporting on the presence and nature of such preferences can help to achieve this goal. The objective of this study was to create a search filter for PubMed to help retrieve evidence on patient preferences for treatment outcomes. A total of 27 journals were hand-searched for articles on patient preferences for treatment outcomes published in 2011. Selected articles served as a reference set. To develop optimal search strategies to retrieve this set, all articles in the reference set were randomly split into a development and a validation set. MeSH-terms and keywords retrieved using PubReMiner were tested individually and as combinations in PubMed and evaluated for retrieval performance (e.g. sensitivity (Se) and specificity (Sp)). Of 8238 articles, 22 were considered to report empirical evidence on patient preferences for specific treatment outcomes. The best search filters reached Se of 100 % [95 % CI 100-100] with Sp of 95 % [94-95 %] and Sp of 97 % [97-98 %] with 75 % Se [74-76 %]. In the validation set these queries reached values of Se of 90 % [89-91 %] with Sp 94 % [93-95 %] and Se of 80 % [79-81 %] with Sp of 97 % [96-96 %], respectively. Narrow and broad search queries were developed which can help in retrieving literature on patient preferences for treatment outcomes. Identifying such evidence may in turn enhance the incorporation of patient preferences in clinical decision making and health technology assessment.

Gaze anchoring guides real but not pantomime reach-to-grasp: support for the action-perception theory.

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Kuntz, Jessica R; Karl, Jenni M; Doan, Jon B; Whishaw, Ian Q

2018-04-01

Reach-to-grasp movements feature the integration of a reach directed by the extrinsic (location) features of a target and a grasp directed by the intrinsic (size, shape) features of a target. The action-perception theory suggests that integration and scaling of a reach-to-grasp movement, including its trajectory and the concurrent digit shaping, are features that depend upon online action pathways of the dorsal visuomotor stream. Scaling is much less accurate for a pantomime reach-to-grasp movement, a pretend reach with the target object absent. Thus, the action-perception theory proposes that pantomime movement is mediated by perceptual pathways of the ventral visuomotor stream. A distinguishing visual feature of a real reach-to-grasp movement is gaze anchoring, in which a participant visually fixates the target throughout the reach and disengages, often by blinking or looking away/averting the head, at about the time that the target is grasped. The present study examined whether gaze anchoring is associated with pantomime reaching. The eye and hand movements of participants were recorded as they reached for a ball of one of three sizes, located on a pedestal at arms' length, or pantomimed the same reach with the ball and pedestal absent. The kinematic measures for real reach-to-grasp movements were coupled to the location and size of the target, whereas the kinematic measures for pantomime reach-to-grasp, although grossly reflecting target features, were significantly altered. Gaze anchoring was also tightly coupled to the target for real reach-to-grasp movements, but there was no systematic focus for gaze, either in relation with the virtual target, the previous location of the target, or the participant's reaching hand, for pantomime reach-to-grasp. The presence of gaze anchoring during real vs. its absence in pantomime reach-to-grasp supports the action-perception theory that real, but not pantomime, reaches are online visuomotor actions and is discussed in

Emergent coordination underlying learning to reach to grasp with a brain-machine interface.

Science.gov (United States)

Vaidya, Mukta; Balasubramanian, Karthikeyan; Southerland, Joshua; Badreldin, Islam; Eleryan, Ahmed; Shattuck, Kelsey; Gururangan, Suchin; Slutzky, Marc; Osborne, Leslie; Fagg, Andrew; Oweiss, Karim; Hatsopoulos, Nicholas G

2018-04-01

The development of coordinated reach-to-grasp movement has been well studied in infants and children. However, the role of motor cortex during this development is unclear because it is difficult to study in humans. We took the approach of using a brain-machine interface (BMI) paradigm in rhesus macaques with prior therapeutic amputations to examine the emergence of novel, coordinated reach to grasp. Previous research has shown that after amputation, the cortical area previously involved in the control of the lost limb undergoes reorganization, but prior BMI work has largely relied on finding neurons that already encode specific movement-related information. In this study, we taught macaques to cortically control a robotic arm and hand through operant conditioning, using neurons that were not explicitly reach or grasp related. Over the course of training, stereotypical patterns emerged and stabilized in the cross-covariance between the reaching and grasping velocity profiles, between pairs of neurons involved in controlling reach and grasp, and to a comparable, but lesser, extent between other stable neurons in the network. In fact, we found evidence of this structured coordination between pairs composed of all combinations of neurons decoding reach or grasp and other stable neurons in the network. The degree of and participation in coordination was highly correlated across all pair types. Our approach provides a unique model for studying the development of novel, coordinated reach-to-grasp movement at the behavioral and cortical levels. NEW & NOTEWORTHY Given that motor cortex undergoes reorganization after amputation, our work focuses on training nonhuman primates with chronic amputations to use neurons that are not reach or grasp related to control a robotic arm to reach to grasp through the use of operant conditioning, mimicking early development. We studied the development of a novel, coordinated behavior at the behavioral and cortical level, and the neural

Clinical characteristics and outcome of patients with upper ...

African Journals Online (AJOL)

Conclusions: The common presentations were haematemesis and melaena, mainly in middle aged men with mortality in one out of seven patients. The high mortality may be due to co-morbidities and poor support services. Keywords: Upper gastrointestinal bleeding, Emergency department, Characteristics, Outcome ...

Dysmagnesaemia and outcome in a trauma ICU

African Journals Online (AJOL)

concentrated in bone, muscle and soft tissue. It is essential for over 300 enzymatic reactions and is a prerequisite for human life.[1-4] The main absorption ... Serum hypomagnesaemia is associated with several pathologies, ranging from arrhythmias and pre-eclampsia to cerebral ischaemia. [2,8]. Its correlation with outcome ...

Comparison of Health Outcomes Among Children with Different Levels of Motor Competence

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Chagas Daniel V.

2017-06-01

Full Text Available Purpose. While evidence suggests that children with the developmental coordination disorder (DCD have worse health outcomes than their typically developing peers, it remains unclear whether children with low motor competence but without DCD are also characterized by worse health outcomes than those with average motor competence. The main purpose of this study was to compare health outcomes between children with low motor competence without DCD and those with average motor competence.

Mechanical energy expenditures and movement efficiency in full body reaching movements.

Science.gov (United States)

Sha, Daohang; France, Christopher R; Thomas, James S

2010-02-01

The effect of target location, speed, and handedness on the average total mechanical energy and movement efficiency is studied in 15 healthy subjects (7 males and 8 females with age 22.9 +/- 1.79 years old) performing full body reaching movements. The average total mechanical energy is measured as the time average of integration of joint power, potential energy, and kinetic energy respectively. Movement efficiency is calculated as the ratio of total kinetic energy to the total joint power and potential energy. Results show that speed and target location have significant effects on total mechanical energy and movement efficiency, but reaching hand only effects kinetic energy. From our findings we conclude that (1) efficiency in whole body reaching is dependent on whether the height of the body center of mass is raised or lowered during the task; (2) efficiency is increased as movement speed is increased, in part because of greater changes in potential energy; and (3) the CNS does not appear to use movement efficiency as a primary planning variable in full body reaching. It may be dependent on a combination of other factors or constraints.

Sliding Mode Tracking Control of Manipulator Based on the Improved Reaching Law

Directory of Open Access Journals (Sweden)

Wei-Na ZHAI

2013-04-01

Full Text Available Due to the mechanical hand often have serious uncertainty, as the state in which the different and external changes, also its parameters are changing, this is very adverse to achieve precise control. In this paper, the traditional sliding mode variable structure was improved, the sign function is replaced by saturated function based on the double power reaching law, by adjusting the values of e1, e2, a, b, g and k to effectively improve the manipulator joint reaching speed, track expected trajectory fast and shorten the system response time. Finally, the method is used for simulation of manipulator trajectory tracking, compared to two reaching law control algorithms. The simulation results show that the control algorithm has good dynamic performance, which can effectively restrain the chattering and quickly track the desired trajectory. Therefore, the improved reaching law can effectively improve the performance of robotic manipulator.

Turbine main engines

CERN Document Server

Main, John B; Herbert, C W; Bennett, A J S

1965-01-01

Turbine Main Engines deals with the principle of operation of turbine main engines. Topics covered include practical considerations that affect turbine design and efficiency; steam turbine rotors, blades, nozzles, and diaphragms; lubricating oil systems; and gas turbines for use with nuclear reactors. Gas turbines for naval boost propulsion, merchant ship propulsion, and naval main propulsion are also considered. This book is divided into three parts and begins with an overview of the basic mode of operation of the steam turbine engine and how it converts the pressure energy of the ingoing ste

Growth as Product and as Process: Student Learning Outcomes Attained through College Experiences in China

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Cen, Yuhao

2012-01-01

Little empirical research has been done on student learning outcomes and college experiences in China, where the gross enrollment rate in higher education reached 26.5 percent and the undergraduate population exceeded 22 million in 2010. This study seeks to describe, explain, and interpret student learning as perceived from students in Chinese…

Quality Markers in Cardiology. Main Markers to Measure Quality of Results (Outcomes) and Quality Measures Related to Better Results in Clinical Practice (Performance Metrics). INCARDIO (Indicadores de Calidad en Unidades Asistenciales del Área del Corazón): A SEC/SECTCV Consensus Position Paper.

Science.gov (United States)

López-Sendón, José; González-Juanatey, José Ramón; Pinto, Fausto; Cuenca Castillo, José; Badimón, Lina; Dalmau, Regina; González Torrecilla, Esteban; López-Mínguez, José Ramón; Maceira, Alicia M; Pascual-Figal, Domingo; Pomar Moya-Prats, José Luis; Sionis, Alessandro; Zamorano, José Luis

2015-11-01

Cardiology practice requires complex organization that impacts overall outcomes and may differ substantially among hospitals and communities. The aim of this consensus document is to define quality markers in cardiology, including markers to measure the quality of results (outcomes metrics) and quality measures related to better results in clinical practice (performance metrics). The document is mainly intended for the Spanish health care system and may serve as a basis for similar documents in other countries. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Generalizability of EXCEL and NOBLE results to a large registry population with unprotected left main coronary artery disease.

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Lee, Pil Hyung; Kang, Se Hun; Han, Seungbong; Ahn, Jung-Min; Bae, Jae Seok; Lee, Cheol Hyun; Kang, Soo-Jin; Lee, Seung-Whan; Kim, Young-Hak; Lee, Cheol Whan; Park, Seong-Wook; Park, Duk-Woo; Park, Seung-Jung

2017-12-01

The aim of this study was to determine how trial-based findings of EXCEL and NOBLE might be interpreted and generalizable in 'real-world' settings with comparison of data from the large-scaled, all-comer Interventional Research Incorporation Society-Left MAIN Revascularization (IRIS-MAIN) registry. We compared baseline clinical and procedural characteristics and also determined how the relative treatment effect of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) was different in EXCEL and NOBLE, compared with those of the multicenter, IRIS-MAIN registry (n=2481). The primary outcome for between-study comparison was a composite of death, myocardial infarction (MI), or stroke. There were between-study differences in patient risk profiles (age, BMI, diabetes, and clinical presentation), lesion complexities, and procedural characteristics (stent type, the use of off-pump surgery, and radial artery); the proportion of diabetes and acute coronary syndrome was particularly lower in NOBLE than in other studies. Although there was interstudy heterogeneity for the protocol definition of MI, the risks for serious composite outcome of death, MI, or stroke were similar between PCI and CABG in EXCEL [hazard ratio (HR): 1.00; 95% confidence interval (CI): 0.79-1.26; P=0.98] and in the matched cohort of IRIS-MAIN (HR: 1.08; 95%CI: 0.85-1.38; P=0.53), whereas it was significantly higher after PCI than after CABG in NOBLE (HR: 1.47; 95%CI: 1.06-2.05; P=0.02), which was driven by more common MI and stroke after PCI. In the comparison of a large-sized, all-comer registry, the EXCEL trial might represent better generalizability with respect to baseline characteristics and observed clinical outcomes compared with the NOBLE trial.

Patterns of arm muscle activation involved in octopus reaching movements.

Science.gov (United States)

Gutfreund, Y; Flash, T; Fiorito, G; Hochner, B

1998-08-01

The extreme flexibility of the octopus arm allows it to perform many different movements, yet octopuses reach toward a target in a stereotyped manner using a basic invariant motor structure: a bend traveling from the base of the arm toward the tip (Gutfreund et al., 1996a). To study the neuronal control of these movements, arm muscle activation [electromyogram (EMG)] was measured together with the kinematics of reaching movements. The traveling bend is associated with a propagating wave of muscle activation, with maximal muscle activation slightly preceding the traveling bend. Tonic activation was occasionally maintained afterward. Correlation of the EMG signals with the kinematic variables (velocities and accelerations) reveals that a significant part of the kinematic variability can be explained by the level of muscle activation. Furthermore, the EMG level measured during the initial stages of movement predicts the peak velocity attained toward the end of the reaching movement. These results suggest that feed-forward motor commands play an important role in the control of movement velocity and that simple adjustment of the excitation levels at the initial stages of the movement can set the velocity profile of the whole movement. A simple model of octopus arm extension is proposed in which the driving force is set initially and is then decreased in proportion to arm diameter at the bend. The model qualitatively reproduces the typical velocity profiles of octopus reaching movements, suggesting a simple control mechanism for bend propagation in the octopus arm.

Core outcome domains for clinical trials in non-specific low back pain.

Science.gov (United States)

Chiarotto, Alessandro; Deyo, Richard A; Terwee, Caroline B; Boers, Maarten; Buchbinder, Rachelle; Corbin, Terry P; Costa, Leonardo O P; Foster, Nadine E; Grotle, Margreth; Koes, Bart W; Kovacs, Francisco M; Lin, Chung-Wei Christine; Maher, Chris G; Pearson, Adam M; Peul, Wilco C; Schoene, Mark L; Turk, Dennis C; van Tulder, Maurits W; Ostelo, Raymond W

2015-06-01

Inconsistent reporting of outcomes in clinical trials of patients with non-specific low back pain (NSLBP) hinders comparison of findings and the reliability of systematic reviews. A core outcome set (COS) can address this issue as it defines a minimum set of outcomes that should be reported in all clinical trials. In 1998, Deyo et al. recommended a standardized set of outcomes for LBP clinical research. The aim of this study was to update these recommendations by determining which outcome domains should be included in a COS for clinical trials in NSLBP. An International Steering Committee established the methodology to develop this COS. The OMERACT Filter 2.0 framework was used to draw a list of potential core domains that were presented in a Delphi study. Researchers, care providers and patients were invited to participate in three Delphi rounds and were asked to judge which domains were core. A priori criteria for consensus were established before each round and were analysed together with arguments provided by panellists on importance, overlap, aggregation and/or addition of potential core domains. The Steering Committee discussed the final results and made final decisions. A set of 280 experts was invited to participate in the Delphi; response rates in the three rounds were 52, 50 and 45%. Of 41 potential core domains presented in the first round, 13 had sufficient support to be presented for rating in the third round. Overall consensus was reached for the inclusion of three domains in this COS: 'physical functioning', 'pain intensity' and 'health-related quality of life'. Consensus on 'physical functioning' and 'pain intensity' was consistent across all stakeholders, 'health-related quality of life' was not supported by the patients, and all the other domains were not supported by two or more groups of stakeholders. Weighting all possible argumentations, the Steering Committee decided to include in the COS the three domains that reached overall consensus and

Guillain-Barré syndrome: rehabilitation outcome and recent developments.

OpenAIRE

Melillo, E. M.; Sethi, J. M.; Mohsenin, V.

1998-01-01

Guillain-Barré syndrome is the most common polyneuropathy causing major disability and respiratory failure. Respiratory complications are the main cause of death. Improved respiratory care and new treatment strategies such as plasmaphoresis and immunoglobulin have been shown to improve outcome. We studied the course and outcome of 37 patients with Guillain-Barré syndrome who were admitted to a rehabilitation and respiratory care facility over a 10-year period. There were 21 males and 16 femal...

Evaluation of community-level interventions to increase early initiation of antenatal care in pregnancy: protocol for the Community REACH study, a cluster randomised controlled trial with integrated process and economic evaluations.

Science.gov (United States)

Sawtell, Mary; Sweeney, Lorna; Wiggins, Meg; Salisbury, Cathryn; Eldridge, Sandra; Greenberg, Lauren; Hunter, Rachael; Kaur, Inderjeet; McCourt, Christine; Hatherall, Bethan; Findlay, Gail; Morris, Joanne; Reading, Sandra; Renton, Adrian; Adekoya, Ruth; Green, Belinda; Harvey, Belinda; Latham, Sarah; Patel, Kanta; Vanlessen, Logan; Harden, Angela

2018-03-05

The provision of high-quality maternity services is a priority for reducing inequalities in health outcomes for mothers and infants. Best practice includes women having their initial antenatal appointment within the first trimester of pregnancy in order to provide screening and support for healthy lifestyles, well-being and self-care in pregnancy. Previous research has identified inequalities in access to antenatal care, yet there is little evidence on interventions to improve early initiation of antenatal care. The Community REACH trial will assess the effectiveness and cost-effectiveness of engaging communities in the co-production and delivery of an intervention that addresses this issue. The study design is a matched cluster randomised controlled trial with integrated process and economic evaluations. The unit of randomisation is electoral ward. The intervention will be delivered in 10 wards; 10 comparator wards will have normal practice. The primary outcome is the proportion of pregnant women attending their antenatal booking appointment by the 12th completed week of pregnancy. This and a number of secondary outcomes will be assessed for cohorts of women (n = approximately 1450 per arm) who give birth 2-7 and 8-13 months after intervention delivery completion in the included wards, using routinely collected maternity data. Eight hospitals commissioned to provide maternity services in six NHS trusts in north and east London and Essex have been recruited to the study. These trusts will provide anonymised routine data for randomisation and outcomes analysis. The process evaluation will examine intervention implementation, acceptability, reach and possible causal pathways. The economic evaluation will use a cost-consequences analysis and decision model to evaluate the intervention. Targeted community engagement in the research process was a priority. Community REACH aims to increase early initiation of antenatal care using an intervention that is co-produced and

A Randomized Controlled Trial to Compare 2 Scalable Interventions for Lower Urinary Tract Symptom Prevention: Main Outcomes of the TULIP Study.

Science.gov (United States)

Sampselle, Carolyn M; Newman, Diane K; Miller, Janis M; Kirk, Keri; DiCamillo, Mary Ann; Wagner, Todd H; Raghunathan, Trivellor E; Diokno, Ananias C

2017-06-01

We compared 2-year urinary incontinence and urgency scores of older women who attended a 2-hour bladder health class vs those who viewed a 20-minute abbreviated class video for the purpose of urinary incontinence prevention. A randomized, 2-arm, parallel design study was done to test the superiority of the 20-minute video over the 2-hour class. Outcomes at baseline, and 3, 12 and 24 months were the scores on questions 1 to 3 of ICIQ-SF (International Consultation on Incontinence Short Form) as the primary outcome and on IUSS (Indevus Urgency Severity Scale). Intent to treat analysis was done to compare the change from baseline in each intervention group across time and also with each other. Multiple imputation was used for missing data. A total of 647 women participated in the study. Mean age was 63 years and approximately 28% of the participants were African American, primarily from an urban setting. The 2 arms were balanced on body mass index at baseline, age, race/ethnicity, education, employment status, income and marital status. No differences in primary or secondary outcomes were demonstrated between the 2 groups from baseline to the 3, 12 or 24-month visits. The absence of significant differences in the outcome measures of ICIQ-SF and IUSS between the 2-hour class and the 20-minute video groups demonstrates that the 2 interventions were comparable. As urinary incontinence and urgency tend to rise annually in older women, instruction in bladder health self-care provided through either the 2-hour class or the 20-minute video format is a useful intervention to prevent urinary incontinence in older women. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Brachial plexus surgery: the role of the surgical technique for improvement of the functional outcome

Directory of Open Access Journals (Sweden)

Leandro Pretto Flores

2011-08-01

Full Text Available OBJECTIVE: The study aims to demonstrate the techniques employed in surgery of the brachial plexus that are associated to evidence-based improvement of the functional outcome of these patients. METHOD: A retrospective study of one hundred cases of traumatic brachial plexus injuries. Comparison between the postoperative outcomes associated to some different surgical techniques was demonstrated. RESULTS: The technique of proximal nerve roots grafting was associated to good results in about 70% of the cases. Significantly better outcomes were associated to the Oberlin's procedure and the Sansak's procedure, while the improvement of outcomes associated to phrenic to musculocutaneous nerve and the accessory to suprascapular nerve transfer did not reach statistical significance. Reinnervation of the hand was observed in less than 30% of the cases. CONCLUSION: Brachial plexus surgery renders satisfactory results for reinnervation of the proximal musculature of the upper limb, however the same good outcomes are not usually associated to the reinnervation of the hand.

Combining clinical variables to optimize prediction of antidepressant treatment outcomes.

Science.gov (United States)

Iniesta, Raquel; Malki, Karim; Maier, Wolfgang; Rietschel, Marcella; Mors, Ole; Hauser, Joanna; Henigsberg, Neven; Dernovsek, Mojca Zvezdana; Souery, Daniel; Stahl, Daniel; Dobson, Richard; Aitchison, Katherine J; Farmer, Anne; Lewis, Cathryn M; McGuffin, Peter; Uher, Rudolf

2016-07-01

The outcome of treatment with antidepressants varies markedly across people with the same diagnosis. A clinically significant prediction of outcomes could spare the frustration of trial and error approach and improve the outcomes of major depressive disorder through individualized treatment selection. It is likely that a combination of multiple predictors is needed to achieve such prediction. We used elastic net regularized regression to optimize prediction of symptom improvement and remission during treatment with escitalopram or nortriptyline and to identify contributing predictors from a range of demographic and clinical variables in 793 adults with major depressive disorder. A combination of demographic and clinical variables, with strong contributions from symptoms of depressed mood, reduced interest, decreased activity, indecisiveness, pessimism and anxiety significantly predicted treatment outcomes, explaining 5-10% of variance in symptom improvement with escitalopram. Similar combinations of variables predicted remission with area under the curve 0.72, explaining approximately 15% of variance (pseudo R(2)) in who achieves remission, with strong contributions from body mass index, appetite, interest-activity symptom dimension and anxious-somatizing depression subtype. Escitalopram-specific outcome prediction was more accurate than generic outcome prediction, and reached effect sizes that were near or above a previously established benchmark for clinical significance. Outcome prediction on the nortriptyline arm did not significantly differ from chance. These results suggest that easily obtained demographic and clinical variables can predict therapeutic response to escitalopram with clinically meaningful accuracy, suggesting a potential for individualized prescription of this antidepressant drug. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Blood pressure variability in relation to outcome in the International Database of Ambulatory blood pressure in relation to Cardiovascular Outcome

DEFF Research Database (Denmark)

Stolarz-Skrzypek, Katarzyna; Thijs, Lutgarde; Richart, Tom

2010-01-01

Ambulatory blood pressure (BP) monitoring provides information not only on the BP level but also on the diurnal changes in BP. In the present review, we summarized the main findings of the International Database on Ambulatory BP in relation to Cardiovascular Outcome (IDACO) with regard to risk...

For better or worse? Long-term outcome of critical illness in childhood : Long-term outcome of critical illness in childhood

NARCIS (Netherlands)

L. van Zellem (Lennart)

2015-01-01

markdownabstract__Abstract__ The aim of this thesis was to investigate the long-term outcome of critically ill children admitted to the pediatric intensive care unit (PICU) of the Erasmus MC – Sophia Children’s’ Hospital in Rotterdam, the Netherlands. Our main focus was to investigate the

Spatiotemporal variability in salinity and hydraulic relationship with salt intrusion in the tidal reaches of the Minjiang River, Fujian Province, China.

Science.gov (United States)

Xie, Rongrong; Pang, Yong; Luo, Bingrong; Li, Jiabing; Wu, Chunshan; Zheng, Yuyi; Sun, Qiyuan; Zhang, Peng; Wang, Feifeng

2017-04-01

Salinity is one of the most important factors for tidal-affected water bodies including estuaries and tidal river reaches. However, due to the limitations of simultaneous manual monitoring in long-distance areas, studies of estuaries are preferred to tidal reaches. Hence, in this study, we investigated the tidal reach of the Minjiang River and five sets of field observations were used to determine the influence of saltwater intrusion in different seasons. During the dry and wet season with low discharge, the longitudinal salinity profiles showed that a station located about 45 km from the river mouth still suffered from saltwater intrusion especially when the upstream discharge was under 754 m 3  s -1 , where the periodical fluctuation in the salinity remained the same with the water level, but there was a time lag of approximately 4 h compared with the discharge process. However, during the wet season in April and May 2016, the monitored salinity was approximately at the detectable limit of 0.02-0.04 ppt at the station close to the river mouth, which indicated that there was no saltwater exchange into the river, although dual flow directions were observed in the survey periods. The major differences among five survey periods were mainly related to upstream discharge rather than the seasons, the tidal range, and tidal excursion. The conclusions of this study have strategic importance for protecting water sources by guiding the government to assess the optimal freshwater release time and discharge rate to prevent saltwater entering the important tidal-affected river reaches.

Composite Coiled Tubing for Extended Reach in Horizontal Oil Wells

DEFF Research Database (Denmark)

Costache, Andrei; Berggreen, Christian

2017-01-01

Conventional steel coiled tubing cannot reach along the entire length of very long horizontal oil wells. A lighter and more buoyant coiled tube is made possible using composite materials. The high stiffness to weight ratio of fiber reinforced polymers, coupled with a lower coefficient of friction......, has the potential of greatly extending the reach in horizontal oil wells. This study shows how to design composite coiled tubing and gives a comprehensive discussion about the most influential parameters. Several solutions, using glass-fiber and carbon are considered. Finite element models are used...

Land Use/Land Cover Changes and Its Response to Hydrological Characteristics in the Upper Reaches of Minjiang River

Science.gov (United States)

Ma, Kai; Huang, Xiaorong; Guo, Biying; Wang, Yanqiu; Gao, Linyun

2018-06-01

Land use changes alter the hydrological characteristics of the land surface, and have significant impacts on hydrological cycle and water balance, the analysis of complex effects on natural systems has become one of the main concerns. In this study, we generated the land use conversion matrixes using ArcGIS and selected several landscape indexes (contagion index, CONTAG, Shannon's diversity index, SHDI, etc.) to evaluate the impact of land use/cover changes on hydrological process in the upper reaches of Minjiang River. We also used a statistical regression model which was established based on hydrology and precipitation data during the period of 1959-2008 to simulate the impacts of different land use conditions on rainfall and runoff in different periods. Our results showed that the simulated annual mean flow from 1985 to 1995 and 1995 to 2008 are 9.19 and 1.04 m3 s-1 lower than the measured values, respectively, which implied that the ecological protection measures should be strengthened in the study area. Our study could provide a scientific basis for water resource management and proper land use planning of upper reaches of Minjiang River.

Long-term assessment of psychologic outcomes of orthognathic surgery

DEFF Research Database (Denmark)

Lazaridou-Terzoudi, T.; Kiyak, H.A.; Moore, R.

2003-01-01

. The level of body image and self-esteem approximated but did not reach that of a nonpatient population. In view of the current psychologic and social environment, patients should be offered the appropriate treatment to correct a disfigurement if it is subjectively perceived by them as a handicap, in part......This long-term study of post-orthognathic surgery patients aimed at assessing perceptions of problems with physical and psychologic functioning, self-concept, body image, and satisfaction with the surgical outcome based on subjective evaluations. In addition, the patient's perception of self...

Long-term assessment of psychologic outcomes of orthognathic surgery

DEFF Research Database (Denmark)

Lazaridou-Terzoudi, T.; Kiyak, H.A.; Moore, R.

2003-01-01

This long-term study of post-orthognathic surgery patients aimed at assessing perceptions of problems with physical and psychologic functioning, self-concept, body image, and satisfaction with the surgical outcome based on subjective evaluations. In addition, the patient's perception of self-concept....... The level of body image and self-esteem approximated but did not reach that of a nonpatient population. In view of the current psychologic and social environment, patients should be offered the appropriate treatment to correct a disfigurement if it is subjectively perceived by them as a handicap, in part...

Quantitative model of transport-aperture coordination during reach-to-grasp movements.

Science.gov (United States)

Rand, Miya K; Shimansky, Y P; Hossain, Abul B M I; Stelmach, George E

2008-06-01

It has been found in our previous studies that the initiation of aperture closure during reach-to-grasp movements occurs when the hand distance to target crosses a threshold that is a function of peak aperture amplitude, hand velocity, and hand acceleration. Thus, a stable relationship between those four movement parameters is observed at the moment of aperture closure initiation. Based on the concept of optimal control of movements (Naslin 1969) and its application for reach-to-grasp movement regulation (Hoff and Arbib 1993), it was hypothesized that the mathematical equation expressing that relationship can be generalized to describe coordination between hand transport and finger aperture during the entire reach-to-grasp movement by adding aperture velocity and acceleration to the above four movement parameters. The present study examines whether this hypothesis is supported by the data obtained in experiments in which young adults performed reach-to-grasp movements in eight combinations of two reach-amplitude conditions and four movement-speed conditions. It was found that linear approximation of the mathematical model described the relationship among the six movement parameters for the entire aperture-closure phase with very high precision for each condition, thus supporting the hypothesis for that phase. Testing whether one mathematical model could approximate the data across all the experimental conditions revealed that it was possible to achieve the same high level of data-fitting precision only by including in the model two additional, condition-encoding parameters and using a nonlinear, artificial neural network-based approximator with two hidden layers comprising three and two neurons, respectively. This result indicates that transport-aperture coordination, as a specific relationship between the parameters of hand transport and finger aperture, significantly depends on the condition-encoding variables. The data from the aperture-opening phase also fit a

Assessing the role of syringe dispensing machines and mobile van outlets in reaching hard-to-reach and high-risk groups of injecting drug users (IDUs: a review

Directory of Open Access Journals (Sweden)

Islam Md Mofizul

2007-10-01

Full Text Available Abstract Reaching hard-to-reach and high-risk injecting drug users (IDUs is one of the most important challenges for contemporary needle syringe programs (NSPs. The aim of this review is to examine, based upon the available international experience, the effectiveness of syringe vending machines and mobile van/bus based NSPs in making services more accessible to these hard-to-reach and high-risk groups of IDUs. A literature search revealed 40 papers/reports, of which 18 were on dispensing machines (including vending and exchange machines and 22 on mobile vans. The findings demonstrate that syringe dispensing machines and mobile vans are promising modalities of NSPs, which can make services more accessible to the target group and in particular to the harder-to-reach and higher-risk groups of IDUs. Their anonymous and confidential approaches make services attractive, accessible and acceptable to these groups. These two outlets were found to be complementary to each other and to other modes of NSPs. Services through dispensing machines and mobile vans in strategically important sites are crucial elements in continuing efforts in reducing the spread of HIV and other blood borne viruses among IDUs.

Riparian Vegetation Mapping Along the Hanford Reach

International Nuclear Information System (INIS)

FOGWELL, T.W.

2003-01-01

During the biological survey and inventory of the Hanford Site conducted in the mid-1990s (1995 and 1996), preliminary surveys of the riparian vegetation were conducted along the Hanford Reach. These preliminary data were reported to The Nature Conservancy (TNC), but were not included in any TNC reports to DOE or stakeholders. During the latter part of FY2001, PNNL contracted with SEE Botanical, the parties that performed the original surveys in the mid 1990s, to complete the data summaries and mapping associated with the earlier survey data. Those data sets were delivered to PNNL and the riparian mapping by vegetation type for the Hanford Reach is being digitized during the first quarter of FY2002. These mapping efforts provide the information necessary to create subsequent spatial data layers to describe the riparian zone according to plant functional types (trees, shrubs, grasses, sedges, forbs). Quantification of the riparian zone by vegetation types is important to a number of DOE'S priority issues including modeling contaminant transport and uptake in the near-riverine environment and the determination of ecological risk. This work included the identification of vegetative zones along the Reach by changes in dominant plant species covering the shoreline from just to the north of the 300 Area to China Bar near Vernita. Dominant and indicator species included Agropyron dasytachyudA. smithii, Apocynum cannabinum, Aristida longiseta, Artemisia campestris ssp. borealis var scouleriana, Artemisa dracunculus, Artemisia lindleyana, Artemisia tridentata, Bromus tectorum, Chrysothamnus nauseosus, Coreopsis atkinsoniana. Eleocharis palustris, Elymus cinereus, Equisetum hyemale, Eriogonum compositum, Juniperus trichocarpa, Phalaris arundinacea, Poa compressa. Salk exigua, Scirpus acutus, Solidago occidentalis, Sporobolus asper,and Sporobolus cryptandrus. This letter report documents the data received, the processing by PNNL staff, and additional data gathered in FY2002

Riparian Vegetation Mapping Along the Hanford Reach

Energy Technology Data Exchange (ETDEWEB)

FOGWELL, T.W.

2003-07-11

During the biological survey and inventory of the Hanford Site conducted in the mid-1990s (1995 and 1996), preliminary surveys of the riparian vegetation were conducted along the Hanford Reach. These preliminary data were reported to The Nature Conservancy (TNC), but were not included in any TNC reports to DOE or stakeholders. During the latter part of FY2001, PNNL contracted with SEE Botanical, the parties that performed the original surveys in the mid 1990s, to complete the data summaries and mapping associated with the earlier survey data. Those data sets were delivered to PNNL and the riparian mapping by vegetation type for the Hanford Reach is being digitized during the first quarter of FY2002. These mapping efforts provide the information necessary to create subsequent spatial data layers to describe the riparian zone according to plant functional types (trees, shrubs, grasses, sedges, forbs). Quantification of the riparian zone by vegetation types is important to a number of DOE'S priority issues including modeling contaminant transport and uptake in the near-riverine environment and the determination of ecological risk. This work included the identification of vegetative zones along the Reach by changes in dominant plant species covering the shoreline from just to the north of the 300 Area to China Bar near Vernita. Dominant and indicator species included Agropyron dasytachyudA. smithii, Apocynum cannabinum, Aristida longiseta, Artemisia campestris ssp. borealis var scouleriana, Artemisa dracunculus, Artemisia lindleyana, Artemisia tridentata, Bromus tectorum, Chrysothamnus nauseosus, Coreopsis atkinsoniana. Eleocharis palustris, Elymus cinereus, Equisetum hyemale, Eriogonum compositum, Juniperus trichocarpa, Phalaris arundinacea, Poa compressa. Salk exigua, Scirpus acutus, Solidago occidentalis, Sporobolus asper,and Sporobolus cryptandrus. This letter report documents the data received, the processing by PNNL staff, and additional data gathered in FY

Attributions of responsibility and affective reactions to decision outcomes.

Science.gov (United States)

Zeelenberg, M; van der Pligt, J; de Vries, N K

2000-06-01

Immediate affective reactions to outcomes are more intense following decisions to act than following decisions not to act. This finding holds for both positive and negative outcomes. We relate this "actor-effect" to attribution theory and argue that decision makers are seen as more responsible for outcomes when these are the result of a decision to act as compared to a decision not to act. Experiment 1 (N = 80) tests the main assumption underlying our reasoning and shows that affective reactions to decision outcomes are indeed more intense when the decision maker is seen as more responsible. Experiment 2 (N = 40) tests whether the actor effect can be predicted on the basis of differential attributions following action and inaction. Participants read vignettes in which active and passive actors obtained a positive or negative outcome. Action resulted in more intense affect than inaction, and positive outcomes resulted in more intense affect than negative outcomes. Experiment 2 further shows that responsibility attributions and affective reactions to outcomes are highly correlated; that is, more extreme affective reactions are associated with more internal attributions. We discuss the implications for research on post-decisional reactions.

Evaluation of patient self-management outcomes in health care: a systematic review.

Science.gov (United States)

Du, S; Yuan, C

2010-06-01

The importance of self-management and its intervention for improving the ability and skill of self-management has been discussed in literatures. It is, however, unclear how to choose the fitted, objective and accurate evaluation system when assessing the outcome. The aim of this article was to establish a general evaluation system for skill and ability of self-management in chronic diseases through systematic review on different evaluation indicators and scales. A systematic search of six electronic databases was conducted. Two authors independently reviewed each qualified study for relevance and significance. Subsequently, main evaluation indicators and scales were identified and categorized into themes and sub-themes. Nineteen articles were identified in this review. Among them, six main evaluation indicators of self-management, including frequently used scales, were extracted and tabulated. Self-efficacy, health behaviour/attitude, health status, health service utilization, quality of life and psychological indicators were the main indicators in evaluating self-management outcome, and they could be used alone or in combination flexibly according to the different goals of programmes. Accurate evaluation of skill and ability of self-management is crucial not only in baseline data collection but also in proving the effectiveness of intervention. The outcomes of this study provide future researchers or caregivers with a better understanding and a series of good choices in self-management outcome evaluation.

For your eyes only: Effect of confederate's eye level on reach-to-grasp action

Directory of Open Access Journals (Sweden)

Francois eQuesque

2014-12-01

Full Text Available Previous studies have shown that the spatio-temporal parameters of reach-to-grasp movement are influenced by the social context in which the motor action is performed. In particular, when interacting with a confederate, movements are slower, with longer initiation times and more ample trajectories, which has been interpreted as implicit communicative information emerging through voluntary movement to catch the partner’s attention and optimize cooperation (Quesque et al., 2013. Because gaze is a crucial component of social interactions, the present study evaluated the role of a confederate's eye level on the social modulation of trajectory curvature. An actor and a partner facing each other took part in a cooperative task consisting, for one of them, of grasping and moving a wooden dowel under time constraints. Before this Main action, the actor performed a Preparatory action, which consisted of placing the wooden dowel on a central marking. The partner's eye level was unnoticeably varied using an adjustable seat that matched or was higher than the actor’s seat. Our data confirmed the previous effects of social intention on motor responses. Furthermore, we observed an effect of the partner's eye level on the Preparatory action, leading the actors to exaggerate unconsciously the trajectory curvature in relation to their partner's eye level. No interaction was found between the actor's social intention and their partner's eye level. These results suggest that other bodies are implicitly taken into account when a reach-to-grasp movement is produced in a social context.

Survivorship and functional outcomes of patellofemoral arthroplasty: a systematic review.

Science.gov (United States)

van der List, J P; Chawla, H; Zuiderbaan, H A; Pearle, A D

2017-08-01

Historically poor results of survivorship and functional outcomes of patellofemoral arthroplasty (PFA) have been reported in the setting of isolated patellofemoral osteoarthritis. More recently, however, fairly good results of PFA were reported, but the current status of PFA outcomes is unknown. Therefore, a systematic review was performed to assess overall PFA survivorship and functional outcomes. A search was performed using PubMed, Embase and Cochrane systems, and the registries were searched. Twenty-three cohort studies and one registry reported survivorship using Kaplan-Meier curve, while 51 cohort studies reported functional outcomes of PFA. Twelve studies were level II studies, while 45 studies were level III or IV studies. Heterogeneity was mainly seen in type of prosthesis and year the cohort started. Nine hundred revisions in 9619 PFAs were reported yielding 5-, 10-, 15- and 20-year PFA survivorships of 91.7, 83.3, 74.9 and 66.6 %, respectively, and an annual revision rate of 2.18. Functional outcomes were reported in 2587 PFAs with an overall score of 82.2 % of the maximum score. KSS and Knee Function Score were 87.5 and 81.6 %, respectively. This systematic review showed that fairly good results of PFA survivorship and functional outcomes were reported at short- and midterm follow-up in the setting of isolated patellofemoral osteoarthritis. Heterogeneity existed mainly in prosthesis design and year the cohort started. These results provide a clear overview of the current status of PFA in the setting of isolated patellofemoral osteoarthritis. IV.

Phase dependence of transport-aperture coordination variability reveals control strategy of reach-to-grasp movements.

Science.gov (United States)

Rand, Miya K; Shimansky, Y P; Hossain, Abul B M I; Stelmach, George E

2010-11-01

Based on an assumption of movement control optimality in reach-to-grasp movements, we have recently developed a mathematical model of transport-aperture coordination (TAC), according to which the hand-target distance is a function of hand velocity and acceleration, aperture magnitude, and aperture velocity and acceleration (Rand et al. in Exp Brain Res 188:263-274, 2008). Reach-to-grasp movements were performed by young adults under four different reaching speeds and two different transport distances. The residual error magnitude of fitting the above model to data across different trials and subjects was minimal for the aperture-closure phase, but relatively much greater for the aperture-opening phase, indicating considerable difference in TAC variability between those phases. This study's goal is to identify the main reasons for that difference and obtain insights into the control strategy of reach-to-grasp movements. TAC variability within the aperture-opening phase of a single trial was found minimal, indicating that TAC variability between trials was not due to execution noise, but rather a result of inter-trial and inter-subject variability of motor plan. At the same time, the dependence of the extent of trial-to-trial variability of TAC in that phase on the speed of hand transport was sharply inconsistent with the concept of speed-accuracy trade-off: the lower the speed, the larger the variability. Conversely, the dependence of the extent of TAC variability in the aperture-closure phase on hand transport speed was consistent with that concept. Taking into account recent evidence that the cost of neural information processing is substantial for movement planning, the dependence of TAC variability in the aperture-opening phase on task performance conditions suggests that it is not the movement time that the CNS saves in that phase, but the cost of neuro-computational resources and metabolic energy required for TAC regulation in that phase. Thus, the CNS

How effective are interventions to improve social outcomes among offenders with personality disorder: a systematic review.

Science.gov (United States)

Connell, Catriona; Furtado, Vivek; McKay, Elizabeth A; Singh, Swaran P

2017-11-17

Offenders with personality disorder are supported by health, criminal justice, social care and third sector services. These services are tasked with reducing risk, improving health and improving social outcomes. Research has been conducted into interventions that reduce risk or improve health. However, interventions to improve social outcomes are less clearly defined. To review the effectiveness of interventions to improve social outcomes we conducted a systematic review using Cochrane methodology, expanded to include non-randomised trials. Anticipated high heterogeneity of the studies informed narrative synthesis. Eleven studies met inclusion criteria. Five contained extractable data. No high-quality studies were identified. Outcomes measured clustered around employment and social functioning. Interventions vary and their mechanisms for influencing social outcomes are poorly operationalised. Although change was observed in employment rates, there was no evidence for the effectiveness of these interventions. There is a lack of evidence for effective interventions that improve social outcomes. Further research is recommended to reach consensus on the outcomes of importance, identify the factors that influence these and design theoretically-informed and evidence-based interventions.

The Reaches Project : Ecological and Geomorphic Dtudies Supporting Normative Flows in the Yakima River Basin, Washington, Final Report 2002.

Energy Technology Data Exchange (ETDEWEB)

Stanford, Jack A.; Lorang, Mark N.; Matson, Phillip L. (University of Montana, Flathead Lake Biological Station, Poison, MT)

2002-10-01

The Yakima River system historically produced robust annual runs of chinook, sockeye, chum and coho salmon and steelhead. Many different stocks or life history types existed because the physiography of the basin is diverse, ranging from very dry and hot in the high desert of the lower basin to cold and wet in the Cascade Mountains of the headwaters (Snyder and Stanford 2001). Habitat diversity and life history diversity of salmonids are closely correlated in the Yakima Basin. Moreover, habitat diversity for salmonids and many other fishes maximizes in floodplain reaches of river systems (Ward and Stanford 1995, Independent Scientific Group 2000). The flood plains of Yakima River likely were extremely important for spawning and rearing of anadromous salmonids (Snyder and Stanford 2001). However, Yakima River flood plains are substantially degraded. Primary problems are: revetments that disconnect main and side channel habitats; dewatering associated with irrigation that changes base flow conditions and degrades the shallow-water food web; chemical and thermal pollution that prevents proper maturation of eggs and juveniles; and extensive gravel mining within the floodplain reaches that has severed groundwater-channel connectivity, increased thermal loading and increased opportunities for invasions of nonnative species. The Yakima River is too altered from its natural state to allow anything close to the historical abundance and diversity of anadromous fishes. Habitat loss, overharvest and dam and reservoir passage problems in the mainstem Columbia River downstream of the Yakima, coupled with ocean productivity variation, also are implicated in the loss of Yakima fisheries. Nonetheless, in an earlier analysis, Snyder and Stanford (2001) concluded that a significant amount of physical habitat remains in the five floodplain reaches of the mainstem river because habitat-structuring floods do still occur on the remaining expanses of floodplain environment. Assuming main

A Comparative Study of the Perceptions of Professional Staff on Their Contribution to Student Outcomes

Science.gov (United States)

Regan, Julie-Anne; Dollard, Emma; Banks, Nicci

2014-01-01

This study examined the perceptions of professional staff on their contribution to student outcomes. An online Delphi survey method was used to collect data from two expert panels: professional staff based in faculties and professional staff based in central university departments. The aim of this method is for the panels to reach consensus. The…

Reach and uptake of Internet- and phone-based smoking cessation interventions

DEFF Research Database (Denmark)

Skov-Ettrup, L S; Dalum, P; Ekholm, O

2014-01-01

To study whether demographic and smoking-related characteristics are associated with participation (reach) in a smoking cessation trial and subsequent use (uptake) of two specific smoking interventions (Internet-based program and proactive telephone counseling).......To study whether demographic and smoking-related characteristics are associated with participation (reach) in a smoking cessation trial and subsequent use (uptake) of two specific smoking interventions (Internet-based program and proactive telephone counseling)....

FERMILAB: Main Injector

International Nuclear Information System (INIS)

Anon.

1993-01-01

The Fermilab Main Injector (FMI) project is the centerpiece of the Laboratory's Fermilab III programme for the 1990s. Designed to support a luminosity of at least 5x10 31 cm -2 s -1 in the Tevatron collider, it will also provide new capabilities for rare neutral kaon decay and neutrino oscillation studies. The Fermilab Main Injector 8-150 GeV synchrotron is designed to replace the existing Main Ring which seriously limits beam intensities for the Tevatron and the antiproton production target. The project has passed several significant milestones and is now proceeding rapidly towards construction. The project received a $11.65M appropriation in 1992 and has been given $15M for the current fiscal year. Through the Energy Systems Acquisition Advisory Board (ESAAB) process, the US Department of Energy (DoE) has authorized funds for construction of the underground enclosure and service building where the Main Injector will touch the Tevatron, and to the preparation of bids for remaining project construction

Trends in Hospitalization Rates and Outcomes of Endocarditis among Medicare Beneficiaries

Science.gov (United States)

Bikdeli, Behnood; Wang, Yun; Kim, Nancy; Desai, Mayur M.; Quagliarello, Vincent; Krumholz, Harlan M.

2015-01-01

Objectives To determine the hospitalization rates and outcomes of endocarditis among older adults. Background Endocarditis is the most serious cardiovascular infection and is especially common among older adults. Little is known about recent trends for endocarditis hospitalizations and outcomes. Methods Using Medicare inpatient Standard Analytic Files, we identified all Fee-For-Service beneficiaries aged ≥65 years with a principal or secondary diagnosis of endocarditis from 1999-2010. We used Medicare Denominator Files to report hospitalizations per 100,000 person-years. Rates of 30-day and 1-year mortality were calculated using Vital Status Files. We used mixed-effects models to calculate adjusted rates of hospitalization and mortality and to compare the results before and after 2007, when the American Heart Association revised recommendations for endocarditis prophylaxis. Results Overall, 262,658 beneficiaries were hospitalized with endocarditis. The adjusted hospitalization rate increased from 1999-2005, reaching 83.5 per 100,000 person-years in 2005, and declined during 2006-2007. After 2007, the decline continued, reaching 70.6 per 100,000 person-years in 2010. Adjusted 30-day and 1-year mortality rates ranged from 14.2% to 16.5% and from 32.6% to 36.2%, respectively. There were no consistent changes in adjusted rates of 30-day and 1-year mortality after 2007. Trends in rates of hospitalization and outcomes were consistent across demographic subgroups. Adjusted rates of hospitalization and mortality declined consistently in the subgroup with principal diagnosis of endocarditis. Conclusions Our study highlights the high burden of endocarditis among older adults. We did not observe an increase in adjusted rates of hospitalization or mortality associated with endocarditis after publication of the 2007 guidelines. PMID:23994421

Selenium enrichment on Cordyceps militaris link and analysis on its main active components.

Science.gov (United States)

Dong, Jing Z; Lei, C; Ai, Xun R; Wang, Y

2012-03-01

To investigate the effects of selenium on the main active components of Cordyceps militaris fruit bodies, selenium-enriched cultivation of C. militaris and the main active components of the fruit bodies were studied. Superoxide dismutase (SOD) activity and contents of cordycepin, cordycepic acid, and organic selenium of fruit bodies were sodium selenite concentration dependent; contents of adenosine and cordycep polysaccharides were significantly enhanced by adding sodium selenite in the substrates, but not proportional to sodium selenite concentrations. In the cultivation of wheat substrate added with 18.0 ppm sodium selenite, SOD activity and contents of cordycepin, cordycepic acid, adenosine, cordycep polysaccharides, and total amino acids were enhanced by 121/145%, 124/74%, 325/520%, 130/284%, 121/145%, and 157/554%, respectively, compared to NS (non-selenium-cultivated) fruit bodies and wild Cordyceps sinensis; organic selenium contents of fruit bodies reached 6.49 mg/100 g. So selenium-enriched cultivation may be a potential way to produce more valuable medicinal food as a substitute for wild C. sinensis.

PNW River Reach Files -- 1:100k Waterbodies (polygons)

Data.gov (United States)

Pacific States Marine Fisheries Commission — This feature class includes the POLYGON waterbody features from the 2001 version of the PNW River Reach files Arc/INFO coverage. Separate, companion feature classes...

Swath-altimetry measurements of the main stem Amazon River: measurement errors and hydraulic implications

Science.gov (United States)

Wilson, M. D.; Durand, M.; Jung, H. C.; Alsdorf, D.

2015-04-01

The Surface Water and Ocean Topography (SWOT) mission, scheduled for launch in 2020, will provide a step-change improvement in the measurement of terrestrial surface-water storage and dynamics. In particular, it will provide the first, routine two-dimensional measurements of water-surface elevations. In this paper, we aimed to (i) characterise and illustrate in two dimensions the errors which may be found in SWOT swath measurements of terrestrial surface water, (ii) simulate the spatio-temporal sampling scheme of SWOT for the Amazon, and (iii) assess the impact of each of these on estimates of water-surface slope and river discharge which may be obtained from SWOT imagery. We based our analysis on a virtual mission for a ~260 km reach of the central Amazon (Solimões) River, using a hydraulic model to provide water-surface elevations according to SWOT spatio-temporal sampling to which errors were added based on a two-dimensional height error spectrum derived from the SWOT design requirements. We thereby obtained water-surface elevation measurements for the Amazon main stem as may be observed by SWOT. Using these measurements, we derived estimates of river slope and discharge and compared them to those obtained directly from the hydraulic model. We found that cross-channel and along-reach averaging of SWOT measurements using reach lengths greater than 4 km for the Solimões and 7.5 km for Purus reduced the effect of systematic height errors, enabling discharge to be reproduced accurately from the water height, assuming known bathymetry and friction. Using cross-sectional averaging and 20 km reach lengths, results show Nash-Sutcliffe model efficiency values of 0.99 for the Solimões and 0.88 for the Purus, with 2.6 and 19.1 % average overall error in discharge, respectively. We extend the results to other rivers worldwide and infer that SWOT-derived discharge estimates may be more accurate for rivers with larger channel widths (permitting a greater level of cross

Reaching the Unreached - Special Emphasis on the Communication ...

African Journals Online (AJOL)

This paper provides an overview of the existing communication component in the Expanded Program on Immunisation (EPI) training in Zambia and critically analyses the need for a humane touch in the communication process so as to reach the target audience effectively. Interpersonal Communication (IPC) in Zambia has ...

Shaping of Reach-to-Grasp Kinematics by Intentions

DEFF Research Database (Denmark)

Egmose, Ida; Køppe, Simo

2017-01-01

is primarily associated with transporting the hand to the object (i.e., extrinsic object properties), the decelerating part of the reach is used as a preparation for object manipulation (i.e., prepare the grasp or the subsequent action), and the grasp is associated with manipulating the object's intrinsic...

Pulmonary Perfusion and Ventilation During Cardiopulmonary Bypass Are Not Associated with Improved Postoperative Outcomes After Cardiac Surgery

Directory of Open Access Journals (Sweden)

Yiliam F Rodriguez-Blanco

2016-11-01

Full Text Available ObjectivesClinical trials of either pulmonary perfusion or ventilation during cardiopulmonary bypass are equivocal. We hypothesized that to achieve significant improvement in outcomes both interventions had to be concurrent.DesignRetrospective case-control studySettingsMajor academic tertiary referral medical centerParticipants274 consecutive patients who underwent open heart surgery with cardiopulmonary bypass 2009 - 2013.InterventionsThe outcomes of 86 patients who received pulmonary perfusion and ventilation during cardiopulmonary bypass were retrospectively compared to the control group of 188 patients.Measurements and Main ResultsRespiratory complications rates were similar in both groups (33.7% vs. 33.5%, as were the rates of postoperative pneumonia (4.7% vs. 4.3%, pleural effusions (13.9% vs. 12.2% and re-intubations (9.3% vs. 9.1%. Rates of adverse postoperative cardiac events including ventricular tachycardia (9.3% vs. 8.5% and atrial fibrillation (33.7% vs. 28.2% were equivalent in both groups. Incidence of sepsis (8.1% vs. 5.3%, postoperative stroke (2.3% vs. 2.1%, acute kidney injury (2.3% vs. 3.7% and renal failure (5.8% vs. 3.7% were likewise comparable. Despite similar transfusion requirements, coagulopathy (12.8% vs. 5.3%, p=0.031 and the need for mediastinal re-exploration (17.4% vs. 9.6%, p=0.0633 were observed more frequently in the pulmonary perfusion and ventilation group, but the difference did not reach the statistical significance. ICU and hospital stays, and the ICU readmission rates (7.0% vs. 8.0% were similar in both groups.ConclusionsSimultaneous pulmonary perfusion and ventilation during cardiopulmonary bypass were not associated with improved clinical outcomes.

The processing of visual and auditory information for reaching movements.

Science.gov (United States)

Glazebrook, Cheryl M; Welsh, Timothy N; Tremblay, Luc

2016-09-01

Presenting target and non-target information in different modalities influences target localization if the non-target is within the spatiotemporal limits of perceptual integration. When using auditory and visual stimuli, the influence of a visual non-target on auditory target localization is greater than the reverse. It is not known, however, whether or how such perceptual effects extend to goal-directed behaviours. To gain insight into how audio-visual stimuli are integrated for motor tasks, the kinematics of reaching movements towards visual or auditory targets with or without a non-target in the other modality were examined. When present, the simultaneously presented non-target could be spatially coincident, to the left, or to the right of the target. Results revealed that auditory non-targets did not influence reaching trajectories towards a visual target, whereas visual non-targets influenced trajectories towards an auditory target. Interestingly, the biases induced by visual non-targets were present early in the trajectory and persisted until movement end. Subsequent experimentation indicated that the magnitude of the biases was equivalent whether participants performed a perceptual or motor task, whereas variability was greater for the motor versus the perceptual tasks. We propose that visually induced trajectory biases were driven by the perceived mislocation of the auditory target, which in turn affected both the movement plan and subsequent control of the movement. Such findings provide further evidence of the dominant role visual information processing plays in encoding spatial locations as well as planning and executing reaching action, even when reaching towards auditory targets.

Restoring Maximum Vertical Browsing Reach in Sauropod Dinosaurs.

Science.gov (United States)

Paul, Gregory S

2017-10-01

The ongoing controversy centered on neck posture and function in sauropod dinosaurs is misplaced for a number of reasons. Because of an absence of pertinent data it is not possible to accurately restore the posture and range of motion in long necked fossil animals, only gross approximations are possible. The existence of a single "neutral posture" in animals with long, slender necks may not exist, and its relationship to feeding habits is weak. Restorations of neutral osteological neck posture based on seemingly detailed diagrams of cervical articulations are not reliable because the pictures are not sufficiently accurate due to a combination of illustration errors, and distortion of the fossil cervicals. This is all the more true because fossil cervical series lack the critical inter-centra cartilage. Maximum vertical reach is more readily restorable and biologically informative for long necked herbivores. Modest extension of 10° between each caudal cervical allowed high shouldered sauropods to raise the cranial portion of their necks to vertical postures that allowed them to reach floral resources far higher than seen in the tallest mammals. This hypothesis is supported by the dorsally extended articulation of the only known co-fused sauropod cervicals. Many sauropods appear to have been well adapted for rearing in order to boost vertical reach, some possessed retroverted pelves that may have allowed them to walk slowly while bipedal. A combination of improved high browsing abilities and sexual selection probably explains the unusually long necks of tall ungulates and super tall sauropods. Anat Rec, 2017. © 2017 Wiley Periodicals, Inc. Anat Rec, 300:1802-1825, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

PNW River Reach Files -- 1:100k Watercourses (arcs)

Data.gov (United States)

Pacific States Marine Fisheries Commission — This feature class includes the ARC features from the 2001 version of the PNW River Reach files Arc/INFO coverage. Separate, companion feature classes are also...

Early Lance-Adams syndrome after cardiac arrest: Prevalence, time to return to awareness, and outcome in a large cohort.

Science.gov (United States)

Aicua Rapun, Irene; Novy, Jan; Solari, Daria; Oddo, Mauro; Rossetti, Andrea O

2017-06-01

Early myoclonus after cardiac arrest (CA) is traditionally viewed as a poor prognostic sign (status myoclonus). However, some patients may present early Lance-Adams syndrome (LAS): under appropriate treatment, they can reach a satisfactory functional outcome. Our aim was to describe their profile, focusing on pharmacologic management in the ICU, time to return of awareness, and long-term prognosis. Adults with early LAS (defined as generalized myoclonus within 96h, with epileptiform EEG within 48h after CA) were retrospectively identified in our CA registry between 2006 and 2016. Functional outcome was assessed through cerebral performance categories (CPC) at 3 months, CPC 1-2 defined good outcome. Among 458 consecutive patients, 7 (1.5%) developed early LAS (4 women, median age 59 years). Within 72h after CA, in normothemia and off sedation, all showed preserved brainstem reflexes and localized pain. All patients were initially treated with valproate, levetiracetam and clonazepam; additional agents, including propofol and midazolam, were prescribed in the majority. First signs of awareness occurred after 3-23 days (median 11.8); 3/7 reached a good outcome at 3 months. Early after CA, myoclonus together with a reactive, epileptiform EEG, preserved evoked potentials and brainstem reflexes suggests LAS. This condition was managed with a combination of highly dosed, large spectrum antiepileptic agents including propofol and midazolam. Even if awakening was at times delayed, good outcome occurred in a substantial proportion of patients. Copyright © 2017 Elsevier B.V. All rights reserved.

Organisational stressors, coping, and outcomes in competitive sport.

Science.gov (United States)

Arnold, Rachel; Fletcher, David; Daniels, Kevin

2017-04-01

Organisational stressors are associated with positive and negative outcomes in extant literature; however, little is known about which demands predict which outcomes. Extant theory and literature also suggests that coping style may influence an individual's resilience or vulnerability to stressors and, subsequently, their psychological responses and outcomes. The purpose of this study was, therefore, to examine the main effects of organisational stressors and coping styles on various outcomes (e.g., positive and negative affect, performance satisfaction). Sport performers (n = 414) completed measures of organisational stressors, coping styles, positive and negative affect, and performance satisfaction. Multiple regression analyses revealed positive relationships of both goals and development stressors (duration and intensity) and team and culture stressors (frequency and intensity) on negative affect. Furthermore, problem-focused coping was positively related to positive affect, and emotion-focused coping was positively related to negative affect. This study furthers theoretical knowledge regarding the associations that both organisational stressors (and their dimensions) and coping styles can have with various outcomes, and practical understanding regarding the optimal design of stress management interventions.

UX-15 Reaches LEP

CERN Multimedia

2001-01-01

The creation of the world's largest sandstone cavern, not a small feat! At the bottom, cave-in preventing steel mesh can be seen clinging to the top of the tunnel. The digging of UX-15, the cavern that will house ATLAS, reached the upper ceiling of LEP on October 10th. The breakthrough which took place nearly 100 metres underground occurred precisely on schedule and exactly as planned. But much caution was taken beforehand to make the LEP breakthrough clean and safe. To prevent the possibility of cave-ins in the side tunnels that will eventually be attached to the completed UX-15 cavern, reinforcing steel mesh was fixed into the walls with bolts. Obviously no people were allowed in the LEP tunnels below UX-15 as the breakthrough occurred. The area was completely evacuated and fences were put into place to keep all personnel out. However, while personnel were being kept out of the tunnels below, this has been anything but the case for the work taking place up above. With the creation of the world's largest...

Application and outcomes of therapy combining transcranial direct current stimulation and virtual reality: a systematic review.

Science.gov (United States)

Massetti, Thais; Crocetta, Tânia Brusque; Silva, Talita Dias da; Trevizan, Isabela Lopes; Arab, Claudia; Caromano, Fátima Aparecida; Monteiro, Carlos Bandeira de Mello

2017-08-01

To evaluate the methods and major outcomes of transcranial direct current stimulation (tDCS) combined with virtual reality (VR) therapy in randomized controlled trials. A systematic review was performed following PRISMA guidelines using PubMed, PubMed Central, Web of Science and CAPES periodic databases, with no time restriction. The studies were screened for the following inclusion criteria: human subjects, combination of VR and tDCS methods, and randomized controlled study design. All potentially relevant articles were independently reviewed by two researchers, who reached a consensus on which articles met the inclusion criteria. The PEDro scale was used to evaluate the studies. Eleven studies were included, all of which utilized a variety of tDCS and VR application methods. The main outcomes were found to be beneficial in intervention groups of different populations, including improvements in body sway, gait, stroke recovery, pain management and vegetative reactions. The use of tDCS combined with VR showed positive results in both healthy and impaired patients. Future studies with larger sample sizes and homogeneous participants are required to confirm the benefits of tDCS and VR. Implications for Rehabilitation tDCS with VR intervention can be an alternative to traditional rehabilitation programs. tDCS with VR is a promising type of intervention with a variety of positive effects. Application of tDCS with VR is appropriated to both healthy and impaired patients. There is no consensus of tDCS with VR application.

Vestibular feedback maintains reaching accuracy during body movement

Science.gov (United States)

Reynolds, Raymond F.

2016-01-01

Key points Reaching movements can be perturbed by vestibular input, but the function of this response is unclear.Here, we applied galvanic vestibular stimulation concurrently with real body movement while subjects maintained arm position either fixed in space or fixed with respect to their body.During the fixed‐in‐space conditions, galvanic vestibular stimulation caused large changes in arm trajectory consistent with a compensatory response to maintain upper‐limb accuracy in the face of body movement.Galvanic vestibular stimulation responses were absent during the body‐fixed task, demonstrating task dependency in vestibular control of the upper limb.The results suggest that the function of vestibular‐evoked arm movements is to maintain the accuracy of the upper limb during unpredictable body movement, but only when reaching in an earth‐fixed reference frame. Abstract When using our arms to interact with the world, unintended body motion can introduce movement error. A mechanism that could detect and compensate for such motion would be beneficial. Observations of arm movements evoked by vestibular stimulation provide some support for this mechanism. However, the physiological function underlying these artificially evoked movements is unclear from previous research. For such a mechanism to be functional, it should operate only when the arm is being controlled in an earth‐fixed rather than a body‐fixed reference frame. In the latter case, compensation would be unnecessary and even deleterious. To test this hypothesis, subjects were gently rotated in a chair while being asked to maintain their outstretched arm pointing towards either earth‐fixed or body‐fixed memorized targets. Galvanic vestibular stimulation was applied concurrently during rotation to isolate the influence of vestibular input, uncontaminated by inertial factors. During the earth‐fixed task, galvanic vestibular stimulation produced large polarity‐dependent corrections in arm

Exploring REACH as a potential data source for characterizing ecotoxicity in life cycle assessment.

Science.gov (United States)

Müller, Nienke; de Zwart, Dick; Hauschild, Michael; Kijko, Gaël; Fantke, Peter

2017-02-01

Toxicity models in life cycle impact assessment (LCIA) currently only characterize a small fraction of marketed substances, mostly because of limitations in the underlying ecotoxicity data. One approach to improve the current data situation in LCIA is to identify new data sources, such as the European Registration, Evaluation, Authorisation, and Restriction of Chemicals (REACH) database. The present study explored REACH as a potential data source for LCIA based on matching reported ecotoxicity data for substances that are currently also included in the United Nations Environment Programme/Society for Environmental Toxicology and Chemistry (UNEP/SETAC) scientific consensus model USEtox for characterizing toxicity impacts. Data are evaluated with respect to number of data points, reported reliability, and test duration, and are compared with data listed in USEtox at the level of hazardous concentration for 50% of the covered species per substance. The results emphasize differences between data available via REACH and in USEtox. The comparison of ecotoxicity data from REACH and USEtox shows potential for using REACH ecotoxicity data in LCIA toxicity characterization, but also highlights issues related to compliance of submitted data with REACH requirements as well as different assumptions underlying regulatory risk assessment under REACH versus data needed for LCIA. Thus, further research is required to address data quality, pre-processing, and applicability, before considering data submitted under REACH as a data source for use in LCIA, and also to explore additionally available data sources, published studies, and reports. Environ Toxicol Chem 2017;36:492-500. © 2016 SETAC. © 2016 SETAC.

Family Structure Changes and Children's Health, Behavior, and Educational Outcomes

DEFF Research Database (Denmark)

Rasmussen, Astrid Würtz

decreased to 73% in 2005. Hence it is important to improve our understanding of the impact of "shocks" in family structure due to parental relationship dissolution on children. International studies mainly suggest a negative relationship between non-nuclear family structure and child outcomes. There are two...... relation between family structure changes and children's outcomes. Children who have experienced family structure changes during childhood seem to have worse educational outcomes and a higher propensity to being hospitalized and convicted of a crime. The children in the dataset experience up to 13 family...... structure changes during childhood. More family structure changes implies worse outcomes and might actually be more important than the number of years a child has spent in a single parent household. The age at which the family structure change occurs also seems to be important at least for some outcomes....

Improving patient outcomes through registered dietitian order writing.

Science.gov (United States)

Roberts, Susan R

2013-10-01

Traditionally, registered dietitians (RD) have not had order writing privileges in most patient-care facilities and rely on physicians to implement their recommendations. Research has demonstrated that this model results in a high percentage of RD recommendations not being ordered. Timely nutrition interventions are important due to the prevalence of malnutrition in the hospital setting and when RD recommendations are implemented, important outcomes are improved. In addition, several studies have demonstrated that when RDs have order writing privileges, which allows more assurance that an intervention will occur and timely interventions, improved outcomes, such as improved nutrition status, better management of electrolytes and glycemic control, reaching goal calories sooner, reduction in inappropriate parenteral nutrition use, cost savings, and less error with electronic order entry. The process for implementation and outcomes of an RD order writing program at 1 large, urban, tertiary medical center is described. The program has been successful, but the implementation process required multiple years and ongoing monitoring through data collection to ensure success. RDs interested in order writing privileges must consider federal and state regulations, their individual scope of practice (relevant training and competency assessment), and how to obtain approval from the appropriate hospital governing committees. RDs who obtain order writing privileges must understand "with privilege comes responsibility" and should plan to conduct outcomes research to promote the value and acceptance of RD order writing by regulatory agencies at all levels and hospital leaders, for instance physicians and administrators.

Redesigning Schools to Reach Every Student with Excellent Teachers: Financial Planning Summary

Science.gov (United States)

Public Impact, 2012

2012-01-01

This brief summarizes the ways that schools and their teachers can simultaneously reach more students with excellent teaching, expand teachers' career opportunities, and sustainably fund higher pay and other priorities. This is based on Public Impact's school models that use job redesign and technology to extend the reach of excellent teachers to…

Outcome dependency alters the neural substrates of impression formation

Science.gov (United States)

Ames, Daniel L.; Fiske, Susan T.

2015-01-01

How do people maintain consistent impressions of other people when other people are often inconsistent? The present research addresses this question by combining recent neuroscientific insights with ecologically meaningful behavioral methods. Participants formed impressions of real people whom they met in a personally involving situation. fMRI and supporting behavioral data revealed that outcome dependency (i.e., depending on another person for a desired outcome) alters previously identified neural dynamics of impression formation. Consistent with past research, a functional localizer identified a region of dorsomedial PFC previously linked to social impression formation. In the main task, this ROI revealed the predicted patterns of activity across outcome dependency conditions: greater BOLD response when information confirmed (vs. violated) social expectations if participants were outcome-independent and the reverse pattern if participants were outcome-dependent. We suggest that, although social perceivers often discount expectancy-disconfirming information as noise, being dependent on another person for a desired outcome focuses impression-formation processing on the most diagnostic information, rather than on the most tractable information. PMID:23850465

Outcome in Chronic Subdural Hematoma After Subdural vs. Subgaleal Drain.

Science.gov (United States)

Ishfaq, Asim

2017-07-01

To compare the outcome after surgery for chronic subdural hematoma when the drain is placed in subdural space or subgaleal space. Quasi experimental study. Combined Military Hospital, Lahore, from July 2015 to June 2016. Patients with chronic subdural hematoma of both genders and age, ranging between 55 to 85 years, were included. Patients on antiplatelet/anticoagulant therapy and acute on chronic subdural hematoma were excluded. Patients were divided in two equal groups each depending on whether drain was placed in subgaleal space (Group 1), and subdual space (Group 2), (n=31 patients each). Patients were positioned flat in bed after surgery. Clinical and radiological parameters and clinical outcome were compared between the two groups. Statistical test with significance of p hematoma was 15 ±6.5 mm. Patients with subdural drain placement had more complications such as pneumocephalus 11 (35.4%) vs. 6 (19.3%), and intracerebral hemorrhage 4 (12.9%) vs. 2 (6.4%). Clinical outcome was good in both groups 27 (87%) in Group 1 and 28 (90%) in Group 2. Patients of both groups had good outcome after surgery. Complications like pneumocephalus and intracerebral hemorrhage were more common in subdural location of drain, though not reaching statistically significance level to favor one technique over another.

The development of PubMed search strategies for patient preferences for treatment outcomes

Directory of Open Access Journals (Sweden)

Ralph van Hoorn

2016-07-01

Full Text Available Abstract Background The importance of respecting patients’ preferences when making treatment decisions is increasingly recognized. Efficiently retrieving papers from the scientific literature reporting on the presence and nature of such preferences can help to achieve this goal. The objective of this study was to create a search filter for PubMed to help retrieve evidence on patient preferences for treatment outcomes. Methods A total of 27 journals were hand-searched for articles on patient preferences for treatment outcomes published in 2011. Selected articles served as a reference set. To develop optimal search strategies to retrieve this set, all articles in the reference set were randomly split into a development and a validation set. MeSH-terms and keywords retrieved using PubReMiner were tested individually and as combinations in PubMed and evaluated for retrieval performance (e.g. sensitivity (Se and specificity (Sp. Results Of 8238 articles, 22 were considered to report empirical evidence on patient preferences for specific treatment outcomes. The best search filters reached Se of 100 % [95 % CI 100-100] with Sp of 95 % [94–95 %] and Sp of 97 % [97–98 %] with 75 % Se [74–76 %]. In the validation set these queries reached values of Se of 90 % [89–91 %] with Sp 94 % [93–95 %] and Se of 80 % [79–81 %] with Sp of 97 % [96–96 %], respectively. Conclusions Narrow and broad search queries were developed which can help in retrieving literature on patient preferences for treatment outcomes. Identifying such evidence may in turn enhance the incorporation of patient preferences in clinical decision making and health technology assessment.

FERMILAB: Main Injector

Energy Technology Data Exchange (ETDEWEB)

Anon.

1993-06-15

The Fermilab Main Injector (FMI) project is the centerpiece of the Laboratory's Fermilab III programme for the 1990s. Designed to support a luminosity of at least 5x10{sup 31} cm{sup -2} s{sup -1} in the Tevatron collider, it will also provide new capabilities for rare neutral kaon decay and neutrino oscillation studies. The Fermilab Main Injector 8-150 GeV synchrotron is designed to replace the existing Main Ring which seriously limits beam intensities for the Tevatron and the antiproton production target. The project has passed several significant milestones and is now proceeding rapidly towards construction. The project received a $11.65M appropriation in 1992 and has been given $15M for the current fiscal year. Through the Energy Systems Acquisition Advisory Board (ESAAB) process, the US Department of Energy (DoE) has authorized funds for construction of the underground enclosure and service building where the Main Injector will touch the Tevatron, and to the preparation of bids for remaining project construction.

Long term outcomes of new generation drug eluting stents versus coronary artery bypass grafting for multivessel and/or left main coronary artery disease. A Bayesian network meta-analysis of randomized controlled trials.

Science.gov (United States)

Mina, George S; Watti, Hussam; Soliman, Demiana; Shewale, Anand; Atkins, Jessica; Reddy, Pratap; Dominic, Paari

2018-01-05

Most data guiding revascularization of multivessel disease (MVD) and/or left main disease (LMD) favor coronary artery bypass grafting (CABG) over percutaneous coronary intervention (PCI). However, those data are based on trials comparing CABG to bare metal stents (BMS) or old generation drug eluting stents (OG-DES). Hence, it is essential to outcomes of CABG to those of new generation drug eluting stents (NG-DES). We searched PUBMED and Cochrane database for trials evaluating revascularization of MVD and/or LMD with CABG and/or PCI. A Bayesian network meta-analysis was performed to calculate odds ratios (OR) and 95% credible intervals (CrI). Primary outcome was major adverse cardiovascular events (MACE) at 3-5 years. Secondary outcomes were mortality, cerebrovascular accidents (CVA), myocardial infarction (MI) and repeat revascularization. We included 10 trials with a total of 9287 patients. CABG was associated with lower MACE when compared to BMS or OG-DES. However, MACE was not significantly different between CABG and NG-DES (OR 0.79, CrI 0.45-1.40). Moreover, there were no significant differences between CABG and NG-DES in mortality (OR 0.78, CrI 0.45-1.37), CVA (OR 0.93 CrI 0.35-2.2) or MI (OR 0.6, CrI 0.17-2.0). On the other hand, CABG was associated with lower repeat revascularization (OR 0.55, CrI 0.36-0.84). Our study suggests that NG-DES is an acceptable alternative to CABG in patients with MVD and/or LMD. However, repeat revascularization remains to be lower with CABG than with PCI. Copyright © 2018. Published by Elsevier Inc.

The ability of sheep to reach for food through tombstone barriers, as ...

African Journals Online (AJOL)

The ability of sheep to reach for food through tombstone barriers, as affected by position of food, body weight and body dimensions. ... The barrier allowed the neck to pass through, but not the shoulders. It was hypothesised that horizontal reach forwards (F. distance from mid-point of barrier to uneaten meal) and sideways ...

Integrated testing strategy (ITS) for bioaccumulation assessment under REACH

DEFF Research Database (Denmark)

Lombardo, Anna; Roncaglioni, Alessandra; Benfentati, Emilio

2014-01-01

in a dossier. REACH promotes the use of alternative methods to replace, refine and reduce the use of animal (eco)toxicity testing. Within the EU OSIRIS project, integrated testing strategies (ITSs) have been developed for the rational use of non-animal testing approaches in chemical hazard assessment. Here we......REACH (registration, evaluation, authorisation and restriction of chemicals) regulation requires that all the chemicals produced or imported in Europe above 1 tonne/year are registered. To register a chemical, physicochemical, toxicological and ecotoxicological information needs to be reported...... present an ITS for evaluating the bioaccumulation potential of organic chemicals. The scheme includes the use of all available data (also the non-optimal ones), waiving schemes, analysis of physicochemical properties related to the end point and alternative methods (both in silico and in vitro). In vivo...

Fish consumption and prenatal methylmercury exposure: cognitive and behavioral outcomes in the main cohort at 17 years from the Seychelles child development study.

Science.gov (United States)

Davidson, Philip W; Cory-Slechta, Deborah A; Thurston, Sally W; Huang, Li-Shan; Shamlaye, Conrad F; Gunzler, Douglas; Watson, Gene; van Wijngaarden, Edwin; Zareba, Grazyna; Klein, Jonathan D; Clarkson, Thomas W; Strain, J J; Myers, Gary J

2011-12-01

People worldwide depend upon daily fish consumption as a major source of protein and other nutrients. Fish are high in nutrients essential for normal brain development, but they also contain methylmercury (MeHg), a neurotoxicant. Our studies in a population consuming fish daily have indicated no consistent pattern of adverse associations between prenatal MeHg and children's development. For some endpoints we found performance improved with increasing prenatal exposure to MeHg. Follow up studies indicate this association is related to the beneficial nutrients present in fish. To determine if the absence of adverse outcomes and the presence of beneficial associations between prenatal MeHg and developmental outcomes previously reported persists into adolescence. This study was conducted on the Main Cohort of the Seychelles Child Development Study (SCDS). We examined the association between prenatal MeHg exposure and subjects' performance at 17 years of age on 27 endpoints. The test battery included the Wisconsin Card Sorting Test (WCST), the California Verbal Learning Test (CVLT), the Woodcock-Johnson (W-J-II) Achievement Test, subtests of the Cambridge Neuropsychological Test Automated Battery (CANTAB), and measures of problematic behaviors. Analyses for all endpoints were adjusted for postnatal MeHg, sex, socioeconomic status, maternal IQ, and child's age at testing and the child's IQ was added for problematic behavioral endpoints. Mean prenatal MeHg exposure was 6.9 ppm. There was no association between prenatal MeHg and 21 endpoints. Increasing prenatal MeHg was associated with better scores on four endpoints (higher W-J-II math calculation scores, reduced numbers of trials on the Intra-Extradimensional Shift Set of the CANTAB), fewer reports of substance use and incidents of and referrals for problematic behaviors in school. Increasing prenatal MeHg was adversely associated with one level of referrals to a school counselor. At age 17 years there was no consistent

Perforated appendicitis: Risk factors and outcomes of management ...

African Journals Online (AJOL)

The case files of patients with perforated appendicitis were analysed in relation to age, sex, clinical presentation, management and outcome of management. The aim was to detect the main factors that contributed to the perforation of the appendix in these patients and assess the effectiveness of the treatment offered.

Nueva política europea en productos químicos. REACH New European policy on chemical products. REACH

Directory of Open Access Journals (Sweden)

Francisco Vargas Marcos

2005-12-01

Full Text Available En febrero de 2001, la Comisión Europea publicó el Libro Blanco relativo a la estrategia para la futura política en materia de sustancias y preparados químicos, que se fundamenta en una revisión del sistema comunitario actual de regulación de las sustancias y preparados químicos. Como consecuencia, el 29 de octubre de 2003, la Comisión adoptó la propuesta de Reglamento sobre registro, evaluación, autorización y restricción de las sustancias químicas (REACH. Mediante esta propuesta, además de crearse la Agencia Europea de Sustancias Químicas, se establece el sistema REACH que consta de los siguientes elementos:Registro, que exige a la industria que facilite información sobre sus sustancias con el objeto de conseguir una utilización segura de las mismas.Evaluación, que garantiza que la industria cumple sus obligaciones y evita que se realicen ensayos innecesarios.Autorización de sustancias con propiedades extremadamente preocupantes (CMR, PBT, disruptores endocrinos, etc. para unos usos particulares.Restricción, como red de seguridad para la reducción de riesgos que no hayan sido abordados en las etapas anteriores.Este sistema de recogida de información en varias fases permitirá conocer y reducir los riesgos derivados del uso de unas 30.000 sustancias químicas que se producen/importan en la Unión Europea en cantidad superior a una tonelada/año. La información, una vez validada, se almacenará en una base de datos y podrá utilizarse para el establecimiento de un vínculo causal entre los factores medioambientales y los efectos negativos sobre la salud derivados de la producción y utilización de los productos químicos.In February 2001 the European Commission issued a White Paper on a “Strategy for a future Chemicals Policy” based on a review of the current European Union system for regulating the dangerous substances and preparations. As a result, on 29 October 2003, the Commission endorsed a Proposal for a

OUTCOMES OF TICK-BORNE ENCEPHALITIS IN THE TOMSK REGION

Directory of Open Access Journals (Sweden)

T. S. Pinegina

2013-01-01

Full Text Available The results of the study outcomes of tick-borne encephalitis in adults in the Tomsk Region. Patients conducted a comprehensive clinical and laboratory examination. Revealed the prevalence of autonomic disorders in individuals who have had at different periods of tick-borne encephalitis, which is regarded as the effects of tick-borne infection. Residual effects of tick-borne encephalitis occurs mainly in the form of light paresis after suffering a focal forms. Among the chronic (progredient forms of tick-borne encephalitis often formed hyperkinetic options. Most of the study revealed the presence of precipitating factors that could have an influence on the outcome. Fundamental diffe rences in all-clinical and immunological analyses at patients with various outcomes of tick-borne encephalitis it wasn't noted. KEY WORDS: tick-borne encephalitis, Tomsk Region, the outcomes.

Does delayed pushing in the second stage of labor impact perinatal outcomes?

Science.gov (United States)

Frey, Heather A; Tuuli, Methodius G; Cortez, Sarah; Odibo, Anthony O; Roehl, Kimberly A; Shanks, Anthony L; Macones, George A; Cahill, Alison G

2012-11-01

To estimate maternal, neonatal, and labor outcomes associated with delayed pushing. A retrospective cohort study of all consecutive women admitted to a single institution in labor at term who reached the second stage of labor. Pregnancies with multiple fetuses or major anomalies were excluded. Delayed pushing was defined as initiation of pushing ≥60 minutes after complete dilatation. Primary outcome was mode of delivery. Multivariable logistic regression was used to control for confounding. Of the 5290 women who met inclusion criteria, 471 (8.9%) employed delayed pushing, and 4819 (91.1%) pushed immediately. Delayed pushing was associated with increased rates of cesarean, operative vaginal delivery, maternal fever, and lower arterial cord pH. Duration of the second stage and length of time spent pushing were significantly longer with delayed pushing. Delayed pushing is associated with lower rates of spontaneous vaginal delivery and increased adverse maternal and neonatal outcomes. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Effect of Visual Field Presentation on Action Planning (Estimating Reach) in Children

Science.gov (United States)

Gabbard, Carl; Cordova, Alberto

2012-01-01

In this article, the authors examined the effects of target information presented in different visual fields (lower, upper, central) on estimates of reach via use of motor imagery in children (5-11 years old) and young adults. Results indicated an advantage for estimating reach movements for targets placed in lower visual field (LoVF), with all…

LTRM Water Quality Sampling Strata, UMRS La Grange Reach

Data.gov (United States)

Department of the Interior — The data set includes delineation of sampling strata for the six study reaches of the UMRR Program’s LTRM element. Separate strata coverages exist for each of the...

Maintaining Quality While Expanding Our Reach: Using Online Information Literacy Tutorials in the Sciences and Health Sciences

Directory of Open Access Journals (Sweden)

Talitha Rosa Matlin

2017-09-01

Full Text Available Abstract Objective – This article aims to assess student achievement of higher-order information literacy learning outcomes from online tutorials as compared to in-person instruction in science and health science courses. Methods – Information literacy instruction via online tutorials or an in-person one-shot session was implemented in multiple sections of a biology (n=100 and a kinesiology course (n=54. After instruction, students in both instructional environments completed an identical library assignment to measure the achievement of higher-order learning outcomes and an anonymous student survey to measure the student experience of instruction. Results – The data collected from library assignments revealed no statistically significant differences between the two instructional groups in total assignment scores or scores on specific questions related to higher-order learning outcomes. Student survey results indicated the student experience is comparable between instruction groups in terms of clarity of instruction, student confidence in completing the course assignment after library instruction, and comfort in asking a librarian for help after instruction. Conclusions – This study demonstrates that it is possible to replace one-shot information literacy instruction sessions with asynchronous online tutorials with no significant reduction in student learning in undergraduate science and health science courses. Replacing in-person instruction with online tutorials will allow librarians at this university to reach a greater number of students and maintain contact with certain courses that are transitioning to completely online environments. While the creation of online tutorials is initially time-intensive, over time implementing online instruction could free up librarian time to allow for the strategic integration of information literacy instruction into other courses. Additional time savings could be realized by incorporating auto

Characterizing and predicting submovements during human three-dimensional arm reaches.

Directory of Open Access Journals (Sweden)

James Y Liao

Full Text Available We have demonstrated that 3D target-oriented human arm reaches can be represented as linear combinations of discrete submovements, where the submovements are a set of minimum-jerk basis functions for the reaches. We have also demonstrated the ability of deterministic feed-forward Artificial Neural Networks (ANNs to predict the parameters of the submovements. ANNs were trained using kinematic data obtained experimentally from five human participants making target-directed movements that were decomposed offline into minimum-jerk submovements using an optimization algorithm. Under cross-validation, the ANNs were able to accurately predict the parameters (initiation-time, amplitude, and duration of the individual submovements. We also demonstrated that the ANNs can together form a closed-loop model of human reaching capable of predicting 3D trajectories with VAF >95.9% and RMSE ≤4.32 cm relative to the actual recorded trajectories. This closed-loop model is a step towards a practical arm trajectory generator based on submovements, and should be useful for the development of future arm prosthetic devices that are controlled by brain computer interfaces or other user interfaces.

Partnerships: The Key to Sustainability and Reach for E/PO

Science.gov (United States)

Eisenhamer, Bonnie; McCallister, D.; Ryer, H.

2013-06-01

The Space Telescope Science Institute (STScI) is the home institution for the E/PO activities of the Hubble and future James Webb space telescopes. Over time, STScI’s Office of Public Outreach has established the infrastructure needed for an E/PO program that reaches various audiences at the local, regional, and national levels. Partnerships are a critical element of this infrastructure, and sustainability of our E/PO program is ensured through our ongoing partnerships with organizations and institutions with staying power and reach. We have learned from past efforts that strategic partnerships can foster innovation, support diversity initiatives, and increase impact in a cost-effective way while providing target audiences with greater access to NASA SMD science and resources. Partnerships are utilized to field-test educational products and programs, disseminate materials and initiatives, and support professional development activities. Partners are selected based upon specific criteria such as potential for reach, the percentage of underrepresented educators and students served, complementary program goals, and willingness to collect and share evaluation data and results with us. This poster will highlight examples and benefits of strategic partnerships over time.

Delays in using chromatic and luminance information to correct rapid reaches.

Science.gov (United States)

Kane, Adam; Wade, Alex; Ma-Wyatt, Anna

2011-09-07

People can use feedback to make online corrections to movements but only if there is sufficient time to integrate the new information and make the correction. A key variable in this process is therefore the speed at which the new information about the target location is coded. Conduction velocities for chromatic signals are lower than for achromatic signals so it may take longer to correct reaches to chromatic stimuli. In addition to this delay, the sensorimotor system may prefer achromatic information over the chromatic information as delayed information may be less valuable when movements are made under time pressure. A down-weighting of chromatic information may result in additional latencies for chromatically directed reaches. In our study, participants made online corrections to reaches to achromatic, (L-M)-cone, and S-cone stimuli. Our chromatic stimuli were carefully adjusted to minimize stimulation of achromatic pathways, and we equated stimuli both in terms of detection thresholds and also by their estimated neural responses. Similar stimuli were used throughout the subjective adjustments and final reaching experiment. Using this paradigm, we found that responses to achromatic stimuli were only slightly faster than responses to (L-M)-cone and S-cone stimuli. We conclude that the sensorimotor system treats chromatic and achromatic information similarly and that the delayed chromatic responses primarily reflect early conduction delays.

Pembelajaran Sastra Di Sekolah

OpenAIRE

Hidayat, Arif

2009-01-01

Literature learning can be used as student's self development, in form interest and talent realization. This implemented with reading, writing, and appreciation activity. From these three activity, literature learning at school can reach there main learning competence, namely affective, cognitive, and psychomotor competence. But literature learning still not reaches optimal outcome, explicit from lack of Indonesia writer that “born” from literary faculty.

Patient-reported outcome measures in arthroplasty registries

DEFF Research Database (Denmark)

Rolfson, Ola; Eresian Chenok, Kate; Bohm, Eric

2016-01-01

survey (SF-12) or the similar Veterans RAND 12-item health survey (VR-12). The most common specific PROMs were the Hip disability and Osteoarthritis Outcome Score (HOOS), the Knee injury and Osteoarthritis Outcome Score (KOOS), the Oxford Hip Score (OHS), the Oxford Knee Score (OKS), the Western Ontario...... of PROMs for hip and knee arthroplasty in registries worldwide. The 2 main types of PROMs include generic (general health) PROMs, which provide a measure of general health for any health state, and specific PROMs, which focus on specific symptoms, diseases, organs, body regions, or body functions...... all elective hip or knee arthroplasty patients and 6 registries collected PROMs for sample populations; 1 other registry had planned but had not started collection of PROMs. The most common generic instruments used were the EuroQol 5 dimension health outcome survey (EQ-5D) and the Short Form 12 health...

Maine's forests 2008

Science.gov (United States)

George L. McCaskill; William H. McWilliams; Charles J. Barnett; Brett J. Butler; Mark A. Hatfield; Cassandra M. Kurtz; Randall S. Morin; W. Keith Moser; Charles H. Perry; Christopher W. Woodall

2011-01-01

The second annual inventory of Maine's forests was completed in 2008 after more than 3,160 forested plots were measured. Forest land occupies almost 17.7 million acres, which represents 82 percent of the total land area of Maine. The dominant forest-type groups are maple/beech/yellow birch, spruce/fir, white/red/jack pine, and aspen/white birch. Statewide volume...

Characteristics and Outcome of Patients With AIDS in Dutch ICUs Between 1997 and 2014

NARCIS (Netherlands)

Huson, Michaëla A.; Bakhshi-Raiez, Ferishta; Grobusch, Martin P.; de Jonge, Evert; de Keizer, Nicolette F.; van der Poll, Tom

2016-01-01

Knowledge on characteristics and outcome of ICU patients with AIDS is highly limited. We aimed to determine the main reasons for admission and outcome in ICU patients with AIDS and trends over time therein. A retrospective study within the Dutch National Intensive Care Evaluation registry. Dutch

U.S. EPA River Reach File Version 1.0

Data.gov (United States)

Kansas Data Access and Support Center — Reach File Version 1.0 (RF1) is a vector database of approximately 700,000 miles of streams and open waters in the conterminous United States. It is used extensively...

Agreement reached on integrated safeguards in European Union

International Nuclear Information System (INIS)

2010-01-01

Full text: The International Atomic Energy Agency (IAEA), in cooperation with the European Commission, has reached agreement on arrangements to implement 'integrated safeguards' in all non-nuclear-weapon States of the European Union with significant nuclear activities. 'This important milestone is the result of the constructive common efforts of all parties concerned. It is a clear signal of the importance attributed by the EU and its Member States, as well as the IAEA, to the reinforcement of the nuclear non-proliferation regime,' said Andris Piebalgs, Member of the European Commission in charge of Energy. 'Once we have sufficient confidence that a State' s nuclear activities are purely peaceful, we can apply safeguards measures in a less prescriptive, more customised manner. This reduces the inspection burden on the State and the inspection effort of the IAEA, while enabling the IAEA to maintain the conclusion that all nuclear material has remained in peaceful activities,' said Olli Heinonen, Deputy Director General and Head of IAEA Safeguards Department. Background The Nuclear Non-Proliferation Treaty (NPT) is the main international Treaty prohibiting the spread of nuclear weapons. It entrusts the IAEA to verify that nuclear material is not diverted to nuclear weapons or other nuclear explosive devices through the application of 'safeguards'. IAEA safeguards include comprehensive safeguards agreements and additional protocols that enable the IAEA to conclude that all nuclear material has remained in peaceful activities in a State. Integrated Safeguards refers to the optimum combination of all safeguards measures available to the Agency under comprehensive safeguards agreements and additional protocols to achieve maximum effectiveness and efficiency in meeting the Agency ' s safeguards obligations. In the European Union, nuclear safeguards are implemented on the basis of the Euratom Treaty and trilateral agreements between Euratom, its Member States and the IAEA

Diabetes and obesity are the main metabolic drivers of peripheral neuropathy.

Science.gov (United States)

Callaghan, Brian C; Gao, LeiLi; Li, Yufeng; Zhou, Xianghai; Reynolds, Evan; Banerjee, Mousumi; Pop-Busui, Rodica; Feldman, Eva L; Ji, Linong

2018-04-01

To determine the associations between individual metabolic syndrome (MetS) components and peripheral neuropathy in a large population-based cohort from Pinggu, China. A cross-sectional, randomly selected, population-based survey of participants from Pinggu, China was performed. Metabolic phenotyping and neuropathy outcomes were performed by trained personnel. Glycemic status was defined according to the American Diabetes Association criteria, and the MetS using modified consensus criteria (body mass index instead of waist circumference). The primary peripheral neuropathy outcome was the Michigan Neuropathy Screening Instrument (MNSI) examination. Secondary outcomes were the MNSI questionnaire and monofilament testing. Multivariable models were used to assess for associations between individual MetS components and peripheral neuropathy. Tree-based methods were used to construct a classifier for peripheral neuropathy using demographics and MetS components. The mean (SD) age of the 4002 participants was 51.6 (11.8) and 51.0% were male; 37.2% of the population had normoglycemia, 44.0% prediabetes, and 18.9% diabetes. The prevalence of peripheral neuropathy increased with worsening glycemic status (3.25% in normoglycemia, 6.29% in prediabetes, and 15.12% in diabetes, P peripheral neuropathy. Age, diabetes, and weight were the primary splitters in the classification tree for peripheral neuropathy. Similar to previous studies, diabetes and obesity are the main metabolic drivers of peripheral neuropathy. The consistency of these results reinforces the urgent need for effective interventions that target these metabolic factors to prevent and/or treat peripheral neuropathy.

Salinity as the main factor structuring small-bodied fish assemblages in hydrologically altered Mediterranean coastal lagoons

Directory of Open Access Journals (Sweden)

Sílvia Rodríguez-Climent

2013-03-01

Full Text Available In the Ebro Delta coastal lagoons, one of the main anthropogenic pressures is the artificial freshwater input. Each coastal lagoon has different water management schemes causing profound changes in its physicochemical characteristics. The main objective of this water management is to favour some bird species with interest either for conservation or hunting activities. The present study assesses the influence of hydrological alteration on the fish assemblages of three coastal lagoons in the Ebro Delta. The small-bodied fish fauna was mainly composed of five families: Gobiidae, Poecilidae, Cyprinodontidae, Atherinidae and Mugilidae. Salinity was found to be the main factor structuring fish community in the lagoons. The dominant species was the common goby (Pomatochistus microps when the lagoons reached higher salinity values, whereas the invasive eastern mosquitofish (Gambusia holbrooki dominated during the period of higher freshwater inputs. The juveniles of the family Mugilidae showed low catch per unit effort, especially during the period of lower salinity. This same pattern was found for the endangered Spanish toothcarp (Aphanius iberus. Overall, introduced species were favoured by low salinity, which highlights the importance of changing the present water management by reducing the freshwater inputs in order to maintain suitable levels of salinity to favour native species that are important for both commercial and conservation purposes.

NEW METHOD FOR REACHING CONSUMERS OVER THE INTERNET: "SEARCH ENGINE MARKETING”

OpenAIRE

Ergezer, Çağrı

2018-01-01

Internet has become a platform which reached millions of users momentarily with increased use, also become a place where people spent most of their time during the day by gaining consumer and potential customer ID in addition to just being ordinary Internet users. Search engines also have earned the distinction of being the preferred reference for users in the Internet sea which draws attention with usage rate and allowing you to easily reach the sought-after content where millions of content...

Isotopic variation of oxygen in the water of river Solimoes/Amazon and its main tributaries

International Nuclear Information System (INIS)

Mortatti, J.; Martinelli, L.A.; Matsui, E.; Victoria, R.L.; Richey, J.E.

1987-01-01

Eight cruises in the Amazon Basin were realized during the period between April (1982) and August (1984). Waters of main channel of the River Solimoes/Amazon and its tributaries were sampled and analysed for sup(18)0 content by mass spectrometry. A depth integrated sampler coupled to a variable speed hydraulic winch was used. The sampling was accomplished at different river stages, at upper Solimoes, middle and lower Amazon region. The δ sup(18) 0 values obtained in these reaches showed the same seasonal variation pattern. In the dry season, δ sup(18) 0 values become higher than in the rainy season. The isotopic variability in the region may be explained by the origin and dynamics of the water vapour. The spatial variation in δ sup(18) 0 values at the main channel was compared for high and low water stages; it showed an isotopic gradient of 0.052 and 0.048 sup(0)/∞ δ sup(18) 0/100 km, respectively. (author)

The challenges in improving outcome of cataract surgery in low and middle income countries

Science.gov (United States)

Lindfield, Robert; Vishwanath, Kalluru; Ngounou, Faustin; Khanna, Rohit C

2012-01-01

Cataract is the leading cause of blindness globally and surgery is the only known measure to deal with it effectively. Providing high quality cataract surgical services is critical if patients with cataract are to have their sight restored. A key focus of surgery is the outcome of the procedure. In cataract surgery this is measured predominantly, using visual acuity. Population- and hospital-based studies have revealed that the visual outcome of cataract surgery in many low and middle income settings is frequently sub-optimal, often failing to reach the recommended standards set by the World Health Organization (WHO). Another way of measuring outcome of cataract surgery is to ask patients for their views on whether surgery has changed the functioning of their eyes and their quality of life. There are different tools available to capture patient views and now, these patient-reported outcomes are becoming more widely used. This paper discusses the visual outcome of cataract surgery and frames the outcome of surgery within the context of the surgical service, suggesting that the process and outcome of care cannot be separated. It also discusses the components of patient-reported outcome tools and describes some available tools in more detail. Finally, it describes a hierarchy of challenges that need to be addressed before a high quality cataract surgical service can be achieved. PMID:22944761

The challenges in improving outcome of cataract surgery in low and middle income countries

Directory of Open Access Journals (Sweden)

Robert Lindfield

2012-01-01

Full Text Available Cataract is the leading cause of blindness globally and surgery is the only known measure to deal with it effectively. Providing high quality cataract surgical services is critical if patients with cataract are to have their sight restored. A key focus of surgery is the outcome of the procedure. In cataract surgery this is measured predominantly, using visual acuity. Population- and hospital-based studies have revealed that the visual outcome of cataract surgery in many low and middle income settings is frequently sub-optimal, often failing to reach the recommended standards set by the World Health Organization (WHO. Another way of measuring outcome of cataract surgery is to ask patients for their views on whether surgery has changed the functioning of their eyes and their quality of life. There are different tools available to capture patient views and now, these patient-reported outcomes are becoming more widely used. This paper discusses the visual outcome of cataract surgery and frames the outcome of surgery within the context of the surgical service, suggesting that the process and outcome of care cannot be separated. It also discusses the components of patient-reported outcome tools and describes some available tools in more detail. Finally, it describes a hierarchy of challenges that need to be addressed before a high quality cataract surgical service can be achieved.

Deficits of reach-to-grasp coordination following stroke: Comparison of instructed and natural movements.

Science.gov (United States)

Baak, Benjamin; Bock, Otmar; Dovern, Anna; Saliger, Jochen; Karbe, Hans; Weiss, Peter H

2015-10-01

The present work evaluates whether stroke-induced deficits of reach-to-grasp movements, established by typical laboratory paradigms, transfer unconditionally to more natural situations. Sixteen patients with a stroke to the motor-dominant left hemisphere and 16 age- and gender-matched healthy control subjects executed grasping movements with their left (ipsilesional, non-dominant) hand. All movements started in the same position, were aimed at the same object positioned in the same location, and were followed by forward displacement of that object along the same path. Twenty movements were performed as a repetitive, externally triggered task executed for their own sake (context L, as in typical laboratory tasks). Twenty movements were performed as part of a self-initiated action sequence aimed at winning a reward (context E, similar to many everyday situations). The kinematics and dynamics of the transport, grasp and manipulation component of each reach-to-grasp movement were quantified by 41 parameters. Analyses of variance yielded a significant effect of Context for 29 parameters, a significant effect of Group for 9 parameters (mostly related to the coupling of hand transport and grip aperture), and a significant interaction for 5 parameters (all related to the coupling of hand transport and grip aperture). The interaction reflected the fact that stroke patients' movement parameters were more abnormal in context E than in context L. Our data indicate that unilateral stroke degrades the grasp-transport coupling, and that stroke-related motor deficits may be more pronounced in a natural than in a laboratory context. Thus, for stroke patients, assessments and rehabilitation regimes should mainly use activities that are as natural as possible. Copyright © 2015 Elsevier Ltd. All rights reserved.

Predictors of Adoption and Reach Following Dialectical Behavior Therapy Intensive Training™.

Science.gov (United States)

Navarro-Haro, Maria V; Harned, Melanie S; Korslund, Kathryn E; DuBose, Anthony; Chen, Tianying; Ivanoff, André; Linehan, Marsha M

2018-03-05

Dialectical behavior therapy (DBT) is an evidence-based treatment for borderline personality disorder. The DBT Intensive Training™ is widely used to train community clinicians to deliver DBT, but little is known about its effectiveness. This study prospectively evaluated predictors of adoption and reach of DBT among 52 community teams (212 clinicians) after DBT Intensive Training™. Pre-post training questionnaires were completed by trainees and a follow-up survey by team leaders approximately 8 months later. Overall, 75% of teams adopted all DBT modes and delivered DBT to an average of 118 clients. Lower training and program needs, fewer bachelor's-level clinicians, and greater prior DBT experience predicted adoption of more DBT modes. More prior DBT experience, smaller team size, more negative team functioning, and staff with lower job satisfaction, growth, efficacy, and influence predicted greater DBT reach. DBT Intensive Training™ appears effective in promoting DBT adoption and reach in routine clinical practice settings.

Health-related quality of life outcomes and level of evidence in pediatric neurosurgery.

Science.gov (United States)

Hansen, Daniel; Vedantam, Aditya; Briceño, Valentina; Lam, Sandi K; Luerssen, Thomas G; Jea, Andrew

2016-10-01

OBJECTIVE The emphasis on health-related quality of life (HRQOL) outcomes is increasing, along with an emphasis on evidence-based medicine. However, there is a notable paucity of validated HRQOL instruments for the pediatric population. Furthermore, no standardization or consensus currently exists concerning which HRQOL outcome measures ought to be used in pediatric neurosurgery. The authors wished to identify HRQOL outcomes used in pediatric neurosurgery research over the past 10 years, their frequency, and usage trends. METHODS Three top pediatric neurosurgical journals were reviewed for the decade from 2005 to 2014 for clinical studies of pediatric neurosurgical procedures that report HRQOL outcomes. Similar studies in the peer-reviewed journal Pediatrics were also used as a benchmark. Publication year, level of evidence, and HRQOL outcomes were collected for each article. RESULTS A total of 31 HRQOL studies were published in the pediatric neurosurgical literature over the study period. By comparison, there were 55 such articles in Pediatrics. The number of publications using HRQOL instruments showed a significant positive trend over time for Pediatrics (B = 0.62, p = 0.02) but did not increase significantly over time for the 3 neurosurgical journals (B = 0.12, p = 0.5). The authors identified a total of 46 different HRQOL instruments used across all journals. Within the neurosurgical journals, the Hydrocephalus Outcome Questionnaire (HOQ) (24%) was the most frequently used, followed by the Health Utilities Index (HUI) (16%), the Pediatric Quality of Life Inventory (PedsQL) (12%), and the 36-Item Short Form Health Survey (SF-36) (12%). Of the 55 articles identified in Pediatrics, 22 (40%) used a version of the PedsQL. No neurosurgical study reached above Level 4 on the Oxford Centre for Evidence-Based Medicine (OCEBM) system. However, multiple studies from Pediatrics achieved OCEBM Level 3, several were categorized as Level 2, and one reached Level 1

Reaching the Millennium Development Goals : Mauritania Should Care

OpenAIRE

Magnoli Bocchi, Alessandro; Pontara, Nicola; Fall, Khayar; Tejada, Catalina M.; Gallego Cuervo, Pablo

2008-01-01

Mauritania is a resource-rich developing country. As many other African nations, it will not reach most of the Millennium Development Goals, unless the authorities commit to accelerating progress. To succeed by 2015, the government needs to: mobilize additional financial resources, introduce policy changes at the sector level, and strengthen the links between strategic objectives and the b...

Reaching out to the hard to reach: using a science centre model to deliver public engagement with research.

Science.gov (United States)

Gagen, M.; Allton, C.; Bryan, W. A.; O'Leary, M.

2017-12-01

Science communication is at an all-time high but public faith in expertise is low. However, within this climate of suspicion, research scientists remain a publicly trusted expert group. While there is both academic and public appetite for Public Engagement with Research (PER), there are barriers to reaching a wide range of publics. Attempts to connect the public with research often end up targeting the `already engaged'; the hard-to-reach remain just that. Engaging scientific curiosity in a wider demographic is crucial to promote scientific curiosity, itself known to profoundly counter the politically motivated reasoning that threatens informed debate around contemporary environmental issues. This requires the creation of opportunities for the public to engage with research in places in which they feel they belong. We report here on an 8 month pilot of a science centre model for PER. Oriel Science (www.orielscience.co.uk) is a research-led science exhibition in Swansea city centre delivering Swansea University's PER and run by academics and student ambassadors. Oriel Science (Oriel is Gallery in Welsh) received 16,000 visitors in 8 months, 40% of whom had no previous interaction with the university or its research and >40% of whom came from socio-economically deprived areas. We report on the public engagement leadership we enabled, working with 18 research groups over 8 months and our achievements in giving a broad range of publics the most direct access to participate in contemporary science.

Role of limb and target vision in the online control of memory-guided reaches.

Science.gov (United States)

Heath, Matthew

2005-07-01

This investigation tested the proposal that a "highly accurate" and temporally unstable stored target representation is available to the motor system for the online control of memory-guided reaches. Participants reached to a target that was: (a) visible during the response, (b) extinguished at movement onset, and (c) occluded for 0, 500, 1,500 and 2,500 ms in advance of response cueing. Additionally, trials were performed with (i.e., limb visible) and without (i.e., limb occluded) vision of the reaching limb. Results showed that limb occluded trials undershot the target location in each target condition, and were characterized by a primarily offline mode of control. In contrast, limb visible trials showed a consistent level of endpoint accuracy for each target condition and elicited more online reaching corrections than limb occluded trials. It is therefore proposed that a reasonably accurate and temporally stable stored target representation can be combined with vision of the moving limb for the online control of memory-guided reaches.

HRM and its effect on employee, organizational and financial outcomes in health care organizations

OpenAIRE

Vermeeren, Brenda; Steijn, Bram; Tummers, Lars; Lankhaar, Marcel; Poerstamper, Robbert-Jan; Beek, Sandra

2014-01-01

markdownabstractBackground: One of the main goals of Human Resource Management (HRM) is to increase the performance of organizations. However, few studies have explicitly addressed the multidimensional character of performance and linked HR practices to various outcome dimensions. This study therefore adds to the literature by relating HR practices to three outcome dimensions: financial, organizational and employee (HR) outcomes. Furthermore, we will analyze how HR practices influence these o...

City Reach Code Technical Support Document

Energy Technology Data Exchange (ETDEWEB)

Athalye, Rahul A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Chen, Yan [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhang, Jian [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Liu, Bing [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Frankel, Mark [New Buildings Inst., Portland, OR (United States); Lyles, Mark [New Buildings Inst., Portland, OR (United States)

2017-10-31

This report describes and analyzes a set of energy efficiency measures that will save 20% energy over ASHRAE Standard 90.1-2013. The measures will be used to formulate a Reach Code for cities aiming to go beyond national model energy codes. A coalition of U.S. cities together with other stakeholders wanted to facilitate the development of voluntary guidelines and standards that can be implemented in stages at the city level to improve building energy efficiency. The coalition's efforts are being supported by the U.S. Department of Energy via Pacific Northwest National Laboratory (PNNL) and in collaboration with the New Buildings Institute.

Maine Forests 2013

Science.gov (United States)

George L. McCaskill; Thomas Albright; Charles J. Barnett; Brett J. Butler; Susan J. Crocker; Cassandra M. Kurtz; William H. McWilliams; Patrick D. Miles; Randall S. Morin; Mark D. Nelson; Richard H. Widmann; Christopher W. Woodall

2016-01-01

The third 5-year annualized inventory of Maine's forests was completed in 2013 after more than 3170 forested plots were measured. Maine contains more than 17.6 million acres of forest land, an area that has been quite stable since 1960, covering more than 82 percent of the total land area. The number of live trees greater than 1 inch in diameter are approaching 24...

Malaria at Parturition in Nigeria: Current Status and Delivery Outcome

Directory of Open Access Journals (Sweden)

Olugbenga A. Mokuolu

2009-01-01

Conclusion. In Nigeria, maternal age <20 years was the most important predisposing factor to malaria at parturition. The main impacts on pregnancy outcome were a twofold increase in rate of maternal anaemia and higher prevalence of LBW.

Usefulness of the jump-and-reach test in assessment of vertical jump performance.

Science.gov (United States)

Menzel, Hans-Joachim; Chagas, Mauro H; Szmuchrowski, Leszek A; Araujo, Silvia R; Campos, Carlos E; Giannetti, Marcus R

2010-02-01

The objective was to estimate the reliability and criterion-related validity of the Jump-and-Reach Test for the assessment of squat, countermovement, and drop jump performance of 32 male Brazilian professional volleyball players. Performance of squat, countermovement, and drop jumps with different dropping heights was assessed on the Jump-and-Reach Test and the measurement of flight time, then compared across different jump trials. The very high reliability coefficients of both assessment methods and the lower correlation coefficients between scores on the assessments indicate a very high consistency of each method but only moderate covariation, which means that they measure partly different items. As a consequence, the Jump-and-Reach Test has good ecological validity in situations when reaching height during the flight phase is critical for performance (e.g., basketball and volleyball) but only limited accuracy for the assessment of vertical impulse production with different jump techniques and conditions.

The Effect of Competition on Process and Outcome Quality of Hospital Care in the Netherlands

NARCIS (Netherlands)

Shestalova, V.; Bijlsma, M.; Koning, P.W.C.

2013-01-01

We examine the impact of competition on outcome and process indicators of hospital quality. While earlier literature on the relationship between competition and hospital quality mainly focused on outcome indicators, we argue that the inclusion of process indicators in the analysis can provide

Using an accelerometer for analyzing a reach-to-grasp movement after stroke

Directory of Open Access Journals (Sweden)

Stella Maris Michaelsen

2013-12-01

Full Text Available The purpose of this study was using an accelerometer to access the kinematics of reach-to-grasp movements in subjects with hemiparesis. Eight subjects (59.4 ± 6.9 years old with chronic hemiparesis (50.9 ± 25.8 months post-stroke participated in this study. Kinematic assessment was performed using a triaxial accelerometer (EMG Systems, Brazil attached to the subjects' forearm. Ten reach-to-grasp movements of grabbing a 500ml-size bottle were performed by the subjects with the paretic and the non-paretic upper limbs (ULs. The following space-temporal variables were calculated and used to compare the paretic and non-paretic ULs: movement time (MT, time to reach the peak velocity, absolute and relative (TPV and TPV%MT, relative deceleration duration (DEC%MT, time to peak acceleration (TPA and peak hand acceleration (PA. Movements were slower in the paretic UL with increased MT, TPA and DEC. The accelerometer allowed to identify of changes in reaching-to-grasp movements of subjects with hemiparesis. When complex systems are not available, accelerometers can be an alternative to measure UL movements.

Vacuum characteristics of the RF-cavity for TRISTAN main ring

International Nuclear Information System (INIS)

Mizuno, H.

1987-10-01

Vacuum characteristics of the RF-cavity for TRISTAN main ring were tested. An APS (Alternating Periodic Structure) 18-cell cavity unit was made of low carbon steel S25C, and inner surface was electro-plated with copper of 100 μm in a pyrophosphorous-acid bath. After 24-hours bake-out at 140 deg C by a boiler, the outgassing rate of a test cavity was mainly dominated by the hydrogen permeation from the cooling water channel through the low carbon steel wall into the vacuum. By the use of anti-corrosion agent, the outgassing rate of the test cavity was decreased down to 1 x 10 -13 Torr · l/sec · cm 2 , after the bake-out at 140 deg C for 24 hours. After hydrogen degassing at 140 deg C for 10-days, the APS cavity unit was baked at 140 deg C for 24 hours, the ultimate pressure of the cavity reached down to 6 x 10 -10 Torr, and 2.7 x 10 -10 Torr, pumped by four 300 l/sec ion-pumps and by two 300 l/sec ion-pumps and two Ti-sublimation pumps with liquid nitrogen shroud respectively. The APS cavity unit was conditioned up to 250 kW/9-cell for 36 hours pumped by four 300 l/sec ion pumps, the ultimate pressure of the cavity was 5 x 10 -9 Torr with the RF power of 150 kW/9-cell on. (author)

Transcranial magnetic stimulation and preparation of visually-guided reaching movements

Directory of Open Access Journals (Sweden)

Pierpaolo eBusan

2012-08-01

Full Text Available To better define the neural networks related to preparation of reaching, we applied transcranial magnetic stimulation (TMS to the lateral parietal and frontal cortex. TMS did not evoke effects closely related to preparation of reaching, suggesting that neural networks already identified by our group are not larger than previously thought. We also replicated previous TMS/EEG data by applying TMS to the parietal cortex: new analyses were performed to better support reliability of already reported findings (Zanon et al., 2010; Brain Topography 22, 307-317. We showed the existence of neural circuits ranging from posterior to frontal regions of the brain after the stimulation of parietal cortex, supporting the idea of strong connections among these areas and suggesting their possible temporal dynamic. Connection with ventral stream was confirmed.The present work helps to define those areas which are involved in preparation of natural reaching in humans. They correspond to parieto-occipital, parietal and premotor medial regions of the left hemisphere, i.e. the contralateral one with respect to the moving hand, as suggested by previous studies. Behavioral data support the existence of a discrete stream involved in reaching. Besides the serial flow of activation from posterior to anterior direction, a parallel elaboration of information among parietal and premotor areas seems also to exist. Present cortico-cortical interactions (TMS/EEG experiment show propagation of activity to frontal, temporal, parietal and more posterior regions, exhibiting distributed communication among various areas in the brain.The neural system highlighted by TMS/EEG experiments is wider with respect to the one disclosed by the TMS behavioral approach. Further studies are needed to unravel this paucity of overlap. Moreover, the understanding of these mechanisms is crucial for the comprehension of response inhibition and changes in prepared actions, which are common behaviors in

Stream profile analysis using a step backwater model for selected reaches in the Chippewa Creek basin in Medina, Wayne, and Summit Counties, Ohio

Science.gov (United States)

Straub, David E.; Ebner, Andrew D.

2011-01-01

The USGS, in cooperation with the Chippewa Subdistrict of the Muskingum Watershed Conservancy District, performed hydrologic and hydraulic analyses for selected reaches of three streams in Medina, Wayne, Stark, and Summit Counties in northeast Ohio: Chippewa Creek, Little Chippewa Creek, and River Styx. This study was done to facilitate assessment of various alternatives for mitigating flood hazards in the Chippewa Creek basin. StreamStats regional regression equations were used to estimate instantaneous peak discharges approximately corresponding to bankfull flows. Explanatory variables used in the regression equations were drainage area, main-channel slope, and storage area. Hydraulic models were developed to determine water-surface profiles along the three stream reaches studied for the bankfull discharges established in the hydrologic analyses. The HEC-RAS step-backwater hydraulic analysis model was used to determine water-surface profiles for the three streams. Starting water-surface elevations for all streams were established using normal depth computations in the HEC-RAS models. Cross-sectional elevation data, hydraulic-structure geometries, and roughness coefficients were collected in the field and (along with peak-discharge estimates) used as input for the models. Reach-averaged reductions in water-surface elevations ranged from 0.11 to 1.29 feet over the four roughness coefficient reduction scenarios.

Visual outcome of traumatic cataract surgery in Ibadan, Nigeria.

Science.gov (United States)

Bekibele, C O; Fasina, O

2008-12-01

To review the visual outcome of traumatic cataracts operated at the University College Hospital, Ibadan with the view to making recommendations for improved outcome. All patients operated at the University College Hospital Ibadan, Nigeria between May 1999 and April 2004 with traumatic cataract were reviewed retrospectively to determine visual outcome and main causes of poor visual outcome notes of patients 32 patients, age range 2 to 71 years, mean age 25.6 +/- SD 16.1 years were reviewed. 22 (68.8%) were males while 10 (31.2%) were females. Causes of traumatic cataract included wood/stick splinters in 7 (21.9%), cane/whiplash injury 6 (18.8%), and propelled missile injuries, 5 (15.6%). Less important cause of injuries were gun shot, road traffic accident and fist injuries. 11 (35.6%) of the patients had best corrected post operative visual acuity of >6/18, 10 (32.2%) noted.

Automated River Reach Definition Strategies: Applications for the Surface Water and Ocean Topography Mission

Science.gov (United States)

Frasson, Renato Prata de Moraes; Wei, Rui; Durand, Michael; Minear, J. Toby; Domeneghetti, Alessio; Schumann, Guy; Williams, Brent A.; Rodriguez, Ernesto; Picamilh, Christophe; Lion, Christine; Pavelsky, Tamlin; Garambois, Pierre-André

2017-10-01

The upcoming Surface Water and Ocean Topography (SWOT) mission will measure water surface heights and widths for rivers wider than 100 m. At its native resolution, SWOT height errors are expected to be on the order of meters, which prevent the calculation of water surface slopes and the use of slope-dependent discharge equations. To mitigate height and width errors, the high-resolution measurements will be grouped into reaches (˜5 to 15 km), where slope and discharge are estimated. We describe three automated river segmentation strategies for defining optimum reaches for discharge estimation: (1) arbitrary lengths, (2) identification of hydraulic controls, and (3) sinuosity. We test our methodologies on 9 and 14 simulated SWOT overpasses over the Sacramento and the Po Rivers, respectively, which we compare against hydraulic models of each river. Our results show that generally, height, width, and slope errors decrease with increasing reach length. However, the hydraulic controls and the sinuosity methods led to better slopes and often height errors that were either smaller or comparable to those of arbitrary reaches of compatible sizes. Estimated discharge errors caused by the propagation of height, width, and slope errors through the discharge equation were often smaller for sinuosity (on average 8.5% for the Sacramento and 6.9% for the Po) and hydraulic control (Sacramento: 7.3% and Po: 5.9%) reaches than for arbitrary reaches of comparable lengths (Sacramento: 8.6% and Po: 7.8%). This analysis suggests that reach definition methods that preserve the hydraulic properties of the river network may lead to better discharge estimates.

Stratospheric ozone chemistry in the Antarctic: what determines the lowest ozone values reached and their recovery?

Directory of Open Access Journals (Sweden)

J.-U. Grooß

2011-12-01

Full Text Available Balloon-borne observations of ozone from the South Pole Station have been reported to reach ozone mixing ratios below the detection limit of about 10 ppbv at the 70 hPa level by late September. After reaching a minimum, ozone mixing ratios increase to above 1 ppmv on the 70 hPa level by late December. While the basic mechanisms causing the ozone hole have been known for more than 20 yr, the detailed chemical processes determining how low the local concentration can fall, and how it recovers from the minimum have not been explored so far. Both of these aspects are investigated here by analysing results from the Chemical Lagrangian Model of the Stratosphere (CLaMS. As ozone falls below about 0.5 ppmv, a balance is maintained by gas phase production of both HCl and HOCl followed by heterogeneous reaction between these two compounds in these simulations. Thereafter, a very rapid, irreversible chlorine deactivation into HCl can occur, either when ozone drops to values low enough for gas phase HCl production to exceed chlorine activation processes or when temperatures increase above the polar stratospheric cloud (PSC threshold. As a consequence, the timing and mixing ratio of the minimum ozone depends sensitively on model parameters, including the ozone initialisation. The subsequent ozone increase between October and December is linked mainly to photochemical ozone production, caused by oxygen photolysis and by the oxidation of carbon monoxide and methane.

Application of the Learning Curve Analysis to the LHC Main Dipole Production First Assessment

CERN Document Server

Fessia, P; Rossi, L

2006-01-01

About two third of the LHC main dipoles have been delivered by the three suppliers charged of the production. The training of the staff, mostly hired just for this manufacture, and the natural improvement of the procedures with the acquired experience, decrease naturally the time necessary for the assembly of a unit. The aim of this paper is to apply methodologies like the cost-based learning curves and the time-based learning curves to the LHC Main Dipole comparing the estimated learning percentage to the ones experienced in other industries. This type of analysis, still in a preliminary phase and here applied to about 40% of the total production of the LHC magnets that will end by 2006, shows that our production has a relatively high learning percentage and it is similar to aerospace and complex machine tools for new models. Therefore with the LHC project, accelerator magnets seem to have reached industrial maturity and this production can be used as bench mark for other large scientific projects implying s...

Recent severe accident research synthesis of the major outcomes from the SARNET network

Energy Technology Data Exchange (ETDEWEB)

Van Dorsselaere, J.-P., E-mail: jean-pierre.van-dorsselaere@irsn.fr [Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Saint-Paul-lez-Durance (France); Auvinen, A. [VTT Technical Research Centre, Espoo (Finland); Beraha, D. [Gesellschaft für Anlagen- und Reaktorsicherheit mbH (GRS), Köln (Germany); Chatelard, P. [Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Saint-Paul-lez-Durance (France); Herranz, L.E. [Centro de Investigaciones Energéticas MedioAmbientales y Tecnológicas (CIEMAT), Madrid (Spain); Journeau, C. [Commissariat à l’Energie Atomique et aux Energies Alternatives (CEA), Paris (France); Klein-Hessling, W. [Gesellschaft für Anlagen- und Reaktorsicherheit mbH (GRS), Köln (Germany); Kljenak, I. [Jozef Stefan Institute (JSI), Ljubljana (Slovenia); Miassoedov, A. [Karlsruhe Institute of Technology (KIT), Karlsruhe (Germany); Paci, S. [University of Pisa, Pisa (Italy); Zeyen, R. [European Commission Joint Research Centre, Institute for Energy (JRC/IET), Petten (Netherlands)

2015-09-15

Highlights: • SARNET network of excellence integration mid-2013 in the NUGENIA Association. • Progress of knowledge on corium behaviour, hydrogen explosion and source term. • Further development of ASTEC integral code to capitalize knowledge. • Ranking of next R&D high priority issues accounting for international research. • Dissemination of knowledge through education courses and ERMSAR conferences. - Abstract: The SARNET network (Severe Accident Research NETwork of excellence), co-funded by the European Commission from 2004 to 2013, has allowed to significantly improve the knowledge on severe accidents and to disseminate it through courses and ERMSAR conferences. The major investigated topics, involving more than 250 researchers from 22 countries, were in- and ex-vessel corium/debris coolability, molten-core–concrete-interaction, steam explosion, hydrogen combustion and mitigation in containment, impact of oxidising conditions on source term, and iodine chemistry. The ranking of the high priority issues was updated to account for the results of recent international research and for the impact of Fukushima nuclear accidents in Japan. In addition, the ASTEC integral code was further developed to capitalize the new knowledge. The network has reached self-sustainability by integration in mid-2013 into the NUGENIA Association. The main activities and outcomes of the network are presented.

Recent severe accident research synthesis of the major outcomes from the SARNET network

International Nuclear Information System (INIS)

Van Dorsselaere, J.-P.; Auvinen, A.; Beraha, D.; Chatelard, P.; Herranz, L.E.; Journeau, C.; Klein-Hessling, W.; Kljenak, I.; Miassoedov, A.; Paci, S.; Zeyen, R.

2015-01-01

Highlights: • SARNET network of excellence integration mid-2013 in the NUGENIA Association. • Progress of knowledge on corium behaviour, hydrogen explosion and source term. • Further development of ASTEC integral code to capitalize knowledge. • Ranking of next R&D high priority issues accounting for international research. • Dissemination of knowledge through education courses and ERMSAR conferences. - Abstract: The SARNET network (Severe Accident Research NETwork of excellence), co-funded by the European Commission from 2004 to 2013, has allowed to significantly improve the knowledge on severe accidents and to disseminate it through courses and ERMSAR conferences. The major investigated topics, involving more than 250 researchers from 22 countries, were in- and ex-vessel corium/debris coolability, molten-core–concrete-interaction, steam explosion, hydrogen combustion and mitigation in containment, impact of oxidising conditions on source term, and iodine chemistry. The ranking of the high priority issues was updated to account for the results of recent international research and for the impact of Fukushima nuclear accidents in Japan. In addition, the ASTEC integral code was further developed to capitalize the new knowledge. The network has reached self-sustainability by integration in mid-2013 into the NUGENIA Association. The main activities and outcomes of the network are presented

Work Element B: 157. Sampling in Fish-Bearing Reaches [Variation in Productivity in Headwater Reaches of the Wenatchee Subbasin], Final Report for PNW Research Station.

Energy Technology Data Exchange (ETDEWEB)

Polivka, Karl; Bennett, Rita L. [USDA Forest Service, Pacific Northwest Research Station, Wenatchee, WA

2009-03-31

We studied variation in productivity in headwater reaches of the Wenatchee subbasin for multiple field seasons with the objective that we could develop methods for monitoring headwater stream conditions at the subcatchment and stream levels, assign a landscape-scale context via the effects of geoclimatic parameters on biological productivity (macroinvertebrates and fish) and use this information to identify how variability in productivity measured in fishless headwaters is transmitted to fish communities in downstream habitats. In 2008, we addressed this final objective. In collaboration with the University of Alaska Fairbanks we found some broad differences in the production of aquatic macroinvertebrates and in fish abundance across categories that combine the effects of climate and management intensity within the subbasin (ecoregions). From a monitoring standpoint, production of benthic macroinvertebrates was not a good predictor of drifting macroinvertebrates and therefore might be a poor predictor of food resources available to fish. Indeed, there is occasionally a correlation between drifting macroinvertebrate abundance and fish abundance which suggests that headwater-derived resources are important. However, fish in the headwaters appeared to be strongly food-limited and there was no evidence that fishless headwaters provided a consistent subsidy to fish in reaches downstream. Fish abundance and population dynamics in first order headwaters may be linked with similar metrics further down the watershed. The relative strength of local dynamics and inputs into productivity may be constrained or augmented by large-scale biogeoclimatic control. Headwater streams are nested within watersheds, which are in turn nested within ecological subregions; thus, we hypothesized that local effects would not necessarily be mutually exclusive from large-scale influence. To test this we examined the density of primarily salmonid fishes at several spatial and temporal scales

Advanced reach tool (ART) : Development of the mechanistic model

NARCIS (Netherlands)

Fransman, W.; Tongeren, M. van; Cherrie, J.W.; Tischer, M.; Schneider, T.; Schinkel, J.; Kromhout, H.; Warren, N.; Goede, H.; Tielemans, E.

2011-01-01

This paper describes the development of the mechanistic model within a collaborative project, referred to as the Advanced REACH Tool (ART) project, to develop a tool to model inhalation exposure for workers sharing similar operational conditions across different industries and locations in Europe.

The Internet and the Global Reach of EU law

DEFF Research Database (Denmark)

Kuner, Christopher Barth

and learning; international negotiation; coercion and conditionality; and blocking recognition of third country legal measures. The EU’s actions in exercising its global reach implicate important normative issues, such as distinguishing between the furtherance of core EU legal values and the advancement...

On stiffening cables of a long reach manipulator

International Nuclear Information System (INIS)

Wang, S.L.; Santiago, P.

1996-01-01

A long reach manipulator will be used for waste remediation in large underground storage tanks. The manipulator's slenderness makes it flexible and difficult to control. A low-cost and effective method to enhance the manipulator's stiffness is proposed in this research by using suspension cables. These cables can also be used to accurately measure the position of the manipulator's wrist

Oral cholera vaccine coverage in hard-to-reach fishermen communities after two mass Campaigns, Malawi, 2016.

Science.gov (United States)

Sauvageot, Delphine; Saussier, Christel; Gobeze, Abebe; Chipeta, Sikhona; Mhango, Innocent; Kawalazira, Gift; Mengel, Martin A; Legros, Dominique; Cavailler, Philippe; M'bang'ombe, Maurice

2017-09-12

From December 2015 to August 2016, a large epidemic of cholera affected the fishermen of Lake Chilwa in Malawi. A first reactive Oral Cholera Vaccines (OCV) campaign was organized, in February, in a 2km radius of the lake followed by a preemptive one, conducted in November, in a 25km radius. We present the vaccine coverage reached in hard-to-reach population using simplified delivery strategies. We conducted two-stage random-sampling cross-sectional surveys among individuals living in a 2km and 25km radius of Lake Chilwa (islands and floating homes included). Individuals aged 12months and older from Machinga and Zomba districts were sampled: 43 clusters of 14 households were surveyed. Simplified strategies were used for those living in islands and floating homes: self- delivery and community-supervised delivery of the second dose. Vaccine coverage (VC) for at-least-two-doses was estimated taking into account sampling weights and design effects. A total of 1176 households were surveyed (2.7% of non-response). Among the 2833 individuals living in the 2km radius of Lake and the 2915 in the 25km radius: 457 (16.1%) and 239 (8.2%) lived in floating homes or on islands at some point in the year, respectively. For the overall population, VC was 75.6% and 54.2%, respectively. In the 2km radius, VC was 92.2% for those living on the lake at some point of the year: 271 (64.8%) used the simplified strategies. The main reasons for non-vaccination were absence during the campaign and vaccine shortage. Few adverse events occurring in the 24h following vaccination was reported. We reached a high two-dose coverage of the most at-risk population using simplified delivery strategies. Because of the high fishermen mobility, regular catch-up campaigns or another strategy specifically targeting fishermen need to be assessed for more efficient vaccines use. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Impact of measles supplementary immunization activities on reaching children missed by routine programs.

Science.gov (United States)

Portnoy, Allison; Jit, Mark; Helleringer, Stéphane; Verguet, Stéphane

2018-01-02

Measles supplementary immunization activities (SIAs) are vaccination campaigns that supplement routine vaccination programs with a recommended second dose opportunity to children of different ages regardless of their previous history of measles vaccination. They are conducted every 2-4 years and over a few weeks in many low- and middle-income countries. While SIAs have high vaccination coverage, it is unclear whether they reach the children who miss their routine measles vaccine dose. Determining who is reached by SIAs is vital to understanding their effectiveness, as well as measure progress towards measles control. We examined SIAs in low- and middle-income countries from 2000 to 2014 using data from the Demographic and Health Surveys. Conditional on a child's routine measles vaccination status, we examined whether children participated in the most recent measles SIA. The average proportion of zero-dose children (no previous routine measles vaccination defined as no vaccination date before the SIA) reached by SIAs across 14 countries was 66%, ranging from 28% in São Tomé and Príncipe to 91% in Nigeria. However, when also including all children with routine measles vaccination data, this proportion decreased to 12% and to 58% when imputing data for children with vaccination reported by the mother and vaccination marks on the vaccination card across countries. Overall, the proportions of zero-dose children reached by SIAs declined with increasing household wealth. Some countries appeared to reach a higher proportion of zero-dose children using SIAs than others, with proportions reached varying according to the definition of measles vaccination (e.g., vaccination dates on the vaccination card, vaccination marks on the vaccination card, and/or self-reported data). This suggests that some countries could improve their targeting of SIAs to children who miss other measles vaccine opportunities. Across all countries, SIAs played an important role in reaching

A Case Study of Engaging Hard-to-Reach Participants in the Research Process: Community Advisors on Research Design and Strategies (CARDS)®.

Science.gov (United States)

Kaiser, Betty L; Thomas, Gay R; Bowers, Barbara J

2017-02-01

Lack of diversity among study participants in clinical research limits progress in eliminating health disparities. The engagement of lay stakeholders, such as patient or community advisory boards (CABs), has the potential to increase recruitment and retention of underrepresented groups by providing a structure for gathering feedback on research plans and materials from this target population. However, many CABs intentionally recruit prominent stakeholders who are connected to or comfortable with research and academia and thus may not accurately represent the perspectives of underrepresented groups who have been labeled hard-to-reach, including racial minorities and low-income or low-literacy populations. We developed a partnership between the University of Wisconsin-Madison School of Nursing and two community centers to deliberately engage hard-to-reach people in two lay advisory groups, the Community Advisors on Research Design and Strategies (CARDS)®. Community center staff recruited the CARDS from center programs, including parenting and childcare programs, women's support groups, food pantries, and senior meal programs. The CARDS model differs from other CABs in its participants, processes, and outcomes. Since 2010, the CARDS have met monthly with nurses and other researchers, helping them understand how research processes and the language, tone, appearance, and organization of research materials can discourage people from enrolling in clinical studies. We have successfully used the CARDS model to bring hard-to-reach populations into the research process and have sustained their participation. The model represents a promising strategy for increasing the diversity of participants in clinical research. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Muscle diseases with prominent joint contractures: Main entities and diagnostic strategy.

Science.gov (United States)

Eymard, B; Ferreiro, A; Ben Yaou, R; Stojkovic, T

2013-01-01

Muscle diseases may have various clinical manifestations including muscle weakness, atrophy or hypertrophy and joint contractures. A spectrum of non-muscular manifestations (cardiac, respiratory, cutaneous, central and peripheral nervous system) may be associated. Few of these features are specific. Limb joint contractures or spine rigidity, when prevailing over muscle weakness in ambulant patients, are of high diagnostic value for diagnosis orientation. Within this context, among several disorders, four groups of diseases should systematically come to mind including the collagen VI-related myopathies, the Emery-Dreifuss muscular dystrophies, the SEPN1 and FHL1 related myopathies. More rarely other genetic or acquired myopathies may present with marked contractures. Diagnostic work-up should include a comprehensive assessment including family history, neurological, cardiologic and respiratory evaluations. Paraclinical investigations should minimally include muscle imaging and electromyography. Muscle and skin biopsies as well as protein and molecular analyses usually help to reach a precise diagnosis. We will first describe the main muscle and neuromuscular junction diseases where contractures are typically a prominent symptom of high diagnostic value for diagnosis orientation. In the following chapters, we will present clues for the diagnostic strategy and the main measures to be taken when, at the end of the diagnostic work-up, no definite muscular disease has been identified. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Patients' experience of care and treatment outcome at the Department of Clinical Oral Physiology, Dental Public Service in Stockholm.

Science.gov (United States)

Christidis, Nikolaos; Smedberg, Erica; Hägglund, Helene; Hedenberg-Magnusson, Britt

2010-01-01

Chronic pain conditions in the craniofacial region are common in the adult population with a prevalence of approximately 10%. They are included in the generic term temporomandibular disorders (TMD) and accompanied by restricted mouth opening capacity, chewing difficulties, headache and neck pain. These pain conditions cause psychological suffering, impaired social relations, and recurrent sick leave, subsequently leading to frequent use of health care, medication and consequently to a decreased quality of life. Approximately 25% of children have signs of TMD and girls are shown to be more affected than boys. These signs increase with age and in the adult population the prevalence is approximately 38-40%, also here with a higher frequency in women than in men. This study comprised 198 patients who answered an anonymous questionnaire after termination of their treatment. The study aimed to investigate the activity at the department of clinical oral physiology at the Folktandvården Eastman Institute in Stockholm, Sweden, regarding the patients and their cause of care-seeking, as well as the patients' subjective experiences of the specialist care and the treatment outcome. As a secondary aim the purpose was to investigate how/if the clinicians at the department of clinical oral physiology reached their intention of being "curious", "considerate" and "accessible". The results from this study show that the majority of the patients (57.1%) were referred from the dental public service in Stockholm. 71.7% of the patients were young women between the ages of 11 and 20. The main causes of care-seeking were temporomandibular joint clickings, followed by limited jaw movement, headache and orofacial pain. Further, an immense majority of the patients (89.9%) were very satisfied with their treatment as well as the treatment outcome. These results indicate that the clinicians at the department reached their intention of being "curious", "considerate"and "accessible", which also

Outcome of anti-retroviral treatment in HIV-infected orphans and non-orphans at an ART centre in North India.

Science.gov (United States)

Bhattacharya, Malobika; Saxena, Romit

2012-01-01

Few Indian studies have reported the long-term efficacy of anti-retroviral treatment (ART) in children and in orphaned, HIV-infected children in particular. To study differences in outcome of ART in HIV-infected orphans compared with non-orphans. A retrospective study of 87 HIV-infected children who commenced ART in the period January 2006 to August 2007. The main measures were orphan status, absolute CD4 count and weight-for-height (WHZ) and height-for-age (HAZ) Z-scores. Median follow-up was 33 months. Forty (45·9%) children were orphaned. Orphans and non-orphans had similar baseline median WHZ and HAZ (-2·48 vs -2·63, P = 0·65 and -2·78 vs -2·91, P = 0·77, respectively). The two groups were similar in terms of WHO clinical stage and frequency of severe immunosuppression at presentation (P = 0·88 and 0·25, respectively). After ART initiation, the median absolute CD4 count increased progressively in both groups. Median WHZ and HAZ increased throughout the study period in the orphans and reached -1 at 27 and 39 months of ART, respectively. In the non-orphans, WHZ remained below that of the orphan group, the difference becoming statistically significant from 18 months of ART. The increment in HAZ in the non-orphan group was at par with the orphan group until 12 months of follow-up, after which it fell between 18 and 30 months. Subsequently, HAZ rose but remained below that of the orphan group. Both WHZ and HAZ failed to reach -1 in the non-orphan group. In both groups, 85% reported 100% adherence to ART. The outcome of ART is not affected by orphan status with the extended family adequately supporting orphaned children. Growth of children whose parents are HIV-infected may be constrained despite ART if there is inadequate family support.

Taxation and the unequal reach of the state: mapping state capacity in Ecuador

NARCIS (Netherlands)

Harbers, I.

2015-01-01

Even though the unequal reach of the state has become an important concern in the literature on developing democracies in Latin America, empirical measures of intracountry variation in state capacity are scarce. So far, attempts to develop valid measures of the reach of the state have often been

Methodology for qualification of wood-based ash according to REACH - prestudy

Energy Technology Data Exchange (ETDEWEB)

Sjoeblom, Rolf [Tekedo AB, Nykoeping (Sweden); Tivegaard, Anna-Maria [SSAB Merox AB, Oxeloesund (Sweden)

2010-02-15

The new European Union framework directive on waste is to be implemented during the year 2010. According to this directive, much of what today is regarded as waste will instead be assessed as by-products and in many cases fall under the new European union regulation REACH (Registration, Evaluation, Authorisation and Restriction of Chemicals). REACH applies in conjunction with the new European Union regulation CLP (Classification, Labelling and Packaging of substances and mixtures). There are introductory periods for both of these regulations, and in the case of CLP this regards transition from the present and previous rules under the dangerous substances and dangerous preparations directives (DSD and DPD, respectively). Similarly, the new framework directive on waste supersedes the previous directive and some other statements. There is a connection between the directives of waste and the rules for classification and labelling in that the classification of waste (in the categories hazardous and non-hazardous) build on (but are not identical to) the rules for labelling. Similarly, the national Swedish rules for acceptance of recycled material (waste) for use in geotechnical constructions relate to the provisions in REACH on assessment of chemical safety in the both request that the risk be assessed to be small, and that the same or similar methodologies can be applied to verify this. There is a 'reference alternative' in REACH that implies substantial testing prior to registration. Registration is the key to use of a substance even though a substance may be used as such, in a mixture, or to be released from an article. However, REACH as well as CLP contain a number of provisions for using literature data, data on similar chemicals e t c in order to avoid unnecessary testing. This especially applies to testing on humans and vertebrate animals. Vaermeforsk, through its Programme on Environmentally Friendly Use of Non-Coal Ashes has developed methodologies and

Methodology for qualification of wood-based ash according to REACH - prestudy

Energy Technology Data Exchange (ETDEWEB)

Sjoeblom, Rolf (Tekedo AB, Nykoeping (Sweden)); Tivegaard, Anna-Maria (SSAB Merox AB, Oxeloesund (Sweden))

2010-02-15

The new European Union framework directive on waste is to be implemented during the year 2010. According to this directive, much of what today is regarded as waste will instead be assessed as by-products and in many cases fall under the new European union regulation REACH (Registration, Evaluation, Authorisation and Restriction of Chemicals). REACH applies in conjunction with the new European Union regulation CLP (Classification, Labelling and Packaging of substances and mixtures). There are introductory periods for both of these regulations, and in the case of CLP this regards transition from the present and previous rules under the dangerous substances and dangerous preparations directives (DSD and DPD, respectively). Similarly, the new framework directive on waste supersedes the previous directive and some other statements. There is a connection between the directives of waste and the rules for classification and labelling in that the classification of waste (in the categories hazardous and non-hazardous) build on (but are not identical to) the rules for labelling. Similarly, the national Swedish rules for acceptance of recycled material (waste) for use in geotechnical constructions relate to the provisions in REACH on assessment of chemical safety in the both request that the risk be assessed to be small, and that the same or similar methodologies can be applied to verify this. There is a 'reference alternative' in REACH that implies substantial testing prior to registration. Registration is the key to use of a substance even though a substance may be used as such, in a mixture, or to be released from an article. However, REACH as well as CLP contain a number of provisions for using literature data, data on similar chemicals e t c in order to avoid unnecessary testing. This especially applies to testing on humans and vertebrate animals. Vaermeforsk, through its Programme on Environmentally Friendly Use of Non-Coal Ashes has developed methodologies and

Evaluation of the Implementation of the Reaching Every District ...

African Journals Online (AJOL)

46987.2

ABSTRACT. Background: In 2003, the Government of Zambia in collaboration with implementing partners in immunisation introduced the Reaching Every District. (RED) strategy to improve immunization coverage. The aim of this study is to evaluate the implementation of the. RED strategy in Lusaka district. Methods: A ...

Unified communication to reach vulnerable mothers.

Science.gov (United States)

Tezcan, B; Von Rege, I; Henkson, H; Oteng-Ntim, E

2011-01-01

The feasibility of using a mobile text to reach vulnerable patient groups was assessed in this study. A total of 121 pregnant or postnatal women were randomly asked to complete a questionnaire. The questionnaire was given to them in the antenatal clinic, postnatal ward, antenatal ward or in the day assessment unit at St Thomas' Hospital, London. The forms were collected and analysed using an Excel database. The results of this survey show that mobile technology is readily available for 97% of the obstetric population. In mothers from vulnerable groups and in mothers from deprived areas, 61% possessed 3rd generation mobile technology. The majority of mothers surveyed wanted their care supplemented by the use of their mobile phones.

Adaptation to delayed force perturbations in reaching movements.

Directory of Open Access Journals (Sweden)

Noa Levy

Full Text Available Adaptation to deterministic force perturbations during reaching movements was extensively studied in the last few decades. Here, we use this methodology to explore the ability of the brain to adapt to a delayed velocity-dependent force field. Two groups of subjects preformed a standard reaching experiment under a velocity dependent force field. The force was either immediately proportional to the current velocity (Control or lagged it by 50 ms (Test. The results demonstrate clear adaptation to the delayed force perturbations. Deviations from a straight line during catch trials were shifted in time compared to post-adaptation to a non-delayed velocity dependent field (Control, indicating expectation to the delayed force field. Adaptation to force fields is considered to be a process in which the motor system predicts the forces to be expected based on the state that a limb will assume in response to motor commands. This study demonstrates for the first time that the temporal window of this prediction needs not to be fixed. This is relevant to the ability of the adaptive mechanisms to compensate for variability in the transmission of information across the sensory-motor system.

Flow Instabilities and Main Steam Line Vibrations in a Pressurized Water Reactor

International Nuclear Information System (INIS)

Henriksson, Mats; Westin, Johan; Granhall, Tord; Andersson, Lars; Bjerke, Lars-Erik

2002-01-01

Severe vibrational problems occurred in the main steam system of a PWR nuclear power plant, about 18 months after a steam generator replacement had been carried out. The magnitude of the vibrations reached levels at which the operators had to reduce power in order to stay within the operating limits imposed by the nuclear inspectorate. To solve the problem the following analyses methods were employed: - Testing the influence on vibration level from different modes of plant operation; - Analyses of plant measurement data; - Calculations of: hydraulic behaviour of the system, structural dynamic behaviour of the system, flow at the steam generator outlet. Scale model testing of the steam generator outlet region. Hydraulic flow disturbances in the main steam system were measured using pressure and strain gauges, which made it possible to track individual pressure pulses propagating through the main steam system. Analyses showed that the pressure pulses causing the vibration originated from the vicinity of the steam generator outlet. By using computer codes for network fluid flow analyses the pressure pulses found in the measurement traces could be generated in calculations. Careful studies of the flow at the steam generator outlet region, using model testing in a 1:3 scale model as well as transient 3D CFD calculations, gave clear indications that flow separation occurred at the steam generator outlet nozzle and at the first bend. Finally, by substituting the outlet nozzle for a different design with a multi-port nozzle, the steam line vibration problem has been solved. (authors)

Does freeze-all policy affect IVF outcomes in poor responders?

Science.gov (United States)

Roque, Matheus; Valle, Marcello; Sampaio, Marcos; Geber, Selmo

2017-12-27

To evaluate whether the freeze-all strategy affects in vitro fertilization (IVF) outcomes in poor ovarian responders following the Bologna criteria. We performed a retrospective cohort study conducted between January 2012 and December 2016. A total of 433 poor responders (per the Bologna criteria) fulfilled the inclusion/exclusion criteria and were included in the study, with 277 patients included in the fresh group and 156 in the freeze-all group. All patients were submitted to controlled ovarian stimulation (COS) with a gonadotropin-releasing hormone antagonist protocol and cleavage-stage embryo transfer (ET). The main outcome measure was ongoing pregnancy rate. Secondary outcomes included implantation and clinical pregnancy rates. The freeze-all strategy was implemented when the progesterone serum level was >1.5 ng/mL on the trigger day, when the endometrium was <7 mm on the trigger day, or as a patient preference. Patients with previous failed fresh embryo transfer were also submitted to fresh or freeze-all strategy considering the indications mentioned above. The patients' mean age in the freeze-all group was 39.5±3.6 years, while that of patients in the fresh group was 39.7±3.8 years (P=0.54). The mean number of embryos transferred (nET) was 1.53±0.6 and 1.60±0.6 (P=0.12) in the freeze-all and fresh groups, respectively. Ongoing pregnancy rates did not significantly differ between the freeze-all and fresh groups (9.6% versus 10.1%, respectively; Relative Risk [RR]: 0.95; 95% CI: 0.52-1.73), nor did the clinical pregnancy rates (14.1% versus 13.7%, respectively; RR: 1.03; 95% CI: 0.63-1.76). Implantation rates were 9.6% and 9.8% (P=0.82) in the freeze-all and fresh groups, respectively. The logistic regression analysis (including age, antral follicle count [AFC], the number of retrieved oocytes, the number of mature oocytes, nET, and fresh versus freeze-all strategy) indicated that age (P<0.001) and the nET (P=0.039) were the only independent variables

Evaluating Regime Change of Sediment Transport in the Jingjiang River Reach, Yangtze River, China

Directory of Open Access Journals (Sweden)

Li He

2018-03-01

Full Text Available The sediment regime in the Jingjiang river reach of the middle Yangtze River has been significantly changed from quasi-equilibrium to unsaturated since the impoundment of the Three Gorges Dam (TGD. Vertical profiles of suspended sediment concentration (SSC and sediment flux can be adopted to evaluate the sediment regime at the local and reach scale, respectively. However, the connection between the vertical concentration profiles and the hydrologic conditions of the sub-saturated channel has rarely been examined based on field data. Thus, vertical concentration data at three hydrological stations in the reach (Zhicheng, Shashi, and Jianli are collected. Analyses show that the near-bed concentration (within 10% of water depth from the riverbed may reach up to 15 times that of the vertical average concentration. By comparing the fractions of the suspended sediment and bed material before and after TGD operation, the geomorphic condition under which the distinct large near-bed concentrations occur have been examined. Based on daily discharge-sediment hydrographs, the reach scale sediment regime and availability of sediment sources are analyzed. In total, remarkable large near-bed concentrations may respond to the combination of wide grading suspended particles and bed material. Finally, several future challenges caused by the anomalous vertical concentration profiles in the unsaturated reach are discussed. This indicates that more detailed measurements or new measuring technologies may help us to provide accurate measurements, while a fractional dispersion equation may help us in describing. The present study aims to gain new insights into regime change of sediment suspension in the river reaches downstream of a very large reservoir.

Spatial and temporal variability of soil moisture in a restored reach of an Alpine river

Science.gov (United States)

Luster, Jörg

2010-05-01

In order to assess the effects of river restoration on water quality, the biogeochemical functions of restored river reaches have to be quantified, and soil moisture is a key environmental variable controlling this functionality. Restored sections of rivers often are characterized by a dynamic mosaic of riparian zones with varying exposure to flooding. In this presentation, the spatial and temporal variability of soil moisture in riparian soils of a restored reach of the Alpine river Thur in northeastern Switzerland is shown. The study was part of the interdisciplinary project cluster RECORD, which was initiated to advance the mechanistic understanding of coupled hydrological and ecological processes in river corridors. The studied river reach comprised the following three functional processing zones (FPZ) representing a lateral successional gradient with decreasing hydrological connectivity (i.e. decreasing flooding frequency and duration). (i) The grass zone developed naturally on a gravel bar after restoration of the channelized river section (mainly colonized by canary reed grass Phalaris arundinacae). The soil is loamy sand to sandy loam composed of up to 80 cm thick fresh sediments trapped and stabilized by the grass roots. (ii) The bush zone is composed of young willow trees (Salix viminalis) planted during restoration to stabilize older overbank deposits with a loamy fine earth. (iii) The mixed forest is a mature riparian hardwood forest with ash and maple as dominant trees developed on older overbank sediments with a silty loamy fine earth. The study period was between spring 2009 and winter 2009/2010 including three flood events in June, July and December 2009. The first and third flood inundated the grass zone and lower part of the bush zone while the second flood was bigger and swept through all the FPZs. Water contents in several soil depths were measured continuously in 30 minute intervals using Decagon EC-5 and EC-TM sensors. There were six spatial

Association of the Duration of Active Pushing With Obstetric Outcomes.

Science.gov (United States)

Grobman, William A; Bailit, Jennifer; Lai, Yinglei; Reddy, Uma M; Wapner, Ronald J; Varner, Michael W; Caritis, Steve N; Prasad, Mona; Tita, Alan T N; Saade, George; Sorokin, Yoram; Rouse, Dwight J; Blackwell, Sean C; Tolosa, Jorge E

2016-04-01

To estimate the associations between the duration of active pushing during the second stage of labor and maternal and neonatal outcomes. We performed an observational study in which data were obtained by trained abstractors from maternal and neonatal charts of deliveries at 25 hospitals over a 3-year period. In this secondary analysis, women with no prior cesarean delivery who had a term, singleton, cephalic gestation and reached complete dilation were analyzed. The duration of pushing, defined as the time from initiation of pushing to either vaginal delivery or the decision to proceed with a cesarean delivery, was determined. The primary maternal outcome was cesarean delivery and the primary neonatal outcome was a composite that included: mechanical ventilation, proven sepsis, brachial plexus palsy, clavicular fracture, skull fracture, other fracture, seizures, hypoxic-ischemic encephalopathy, or death. Nulliparous and parous women were analyzed separately in univariable and then multivariable analyses. A total of 53,285 women were analyzed. In both nulliparous and parous women, longer duration of pushing was associated with increased odds of both cesarean delivery and the neonatal adverse outcome composite. Nevertheless, even after 4 hours of pushing, approximately 78% of nulliparous women who continued with active pushing had a vaginal delivery and more than 97% did not have the composite adverse neonatal outcome. Similarly, after more than 2 hours of pushing, approximately 82% of parous women who continued active pushing delivered vaginally and more than 97% did not have the adverse neonatal outcome. A longer duration of pushing is associated with an increased relative risk, but small absolute difference in risk, of neonatal complications. Approximately 78% of nulliparous women delivered vaginally even after 4 hours of pushing.

Characteristics of magnetic switch used as main switch of solid-state accelerator

International Nuclear Information System (INIS)

Li Song; Qian Baoliang; Yang Hanwu; Meng Zhipeng; Yang Shi

2012-01-01

In order to improve the performance of solid-state accelerator, the characteristics of magnetic switch used as the main switch of the accelerator have been investigated. The volume of magnetic core, the loss, and saturated inductance of the magnetic switch have been derived. The results show that the spacing factor of the magnetic switch reaches the peak when the height of the magnetic materials is 0.05 m for selected magnetic cores. The saturated inductance of the windings changes slowly when the average magnetic path length of the core is greater than 1 m. The physical process of saturation in the cores was analyzed by using saturation-wave theory. The rise-time factor of the output pulse was derived. The thickness, resistivity and magnetic path length difference of the magnetic core are shown to be key parameters affecting the rise-time factor. (authors)

Global Broadcast Service Reach Back via Ultra High Frequency Demand Assigned Multiple Satellite Communications

National Research Council Canada - National Science Library

Arthur, Joseph

1998-01-01

.... An integral part of the user pull is the reach back channel. The reach back channel allows users to specify' the information they need broadcast and tailor the information to meet their mission needs...

Reach Out Churches: A Community-Based Participatory Research Pilot Trial to Assess the Feasibility of a Mobile Health Technology Intervention to Reduce Blood Pressure Among African Americans.

Science.gov (United States)

Skolarus, Lesli E; Cowdery, Joan; Dome, Mackenzie; Bailey, Sarah; Baek, Jonggyu; Byrd, James Brian; Hartley, Sarah E; Valley, Staci C; Saberi, Sima; Wheeler, Natalie C; McDermott, Mollie; Hughes, Rebecca; Shanmugasundaram, Krithika; Morgenstern, Lewis B; Brown, Devin L

2017-06-01

Innovative strategies are needed to reduce the hypertension epidemic among African Americans. Reach Out was a faith-collaborative, mobile health, randomized, pilot intervention trial of four mobile health components to reduce high blood pressure (BP) compared to usual care. It was designed and tested within a community-based participatory research framework among African Americans recruited and randomized from churches in Flint, Michigan. The purpose of this pilot study was to assess the feasibility of the Reach Out processes. Feasibility was assessed by willingness to consent (acceptance of randomization), proportion of weeks participants texted their BP readings (intervention use), number lost to follow-up (retention), and responses to postintervention surveys and focus groups (acceptance of intervention). Of the 425 church members who underwent BP screening, 94 enrolled in the study and 73 (78%) completed the 6-month outcome assessment. Median age was 58 years, and 79% were women. Participants responded with their BPs on an average of 13.7 (SD = 10.7) weeks out of 26 weeks that the BP prompts were sent. All participants reported satisfaction with the intervention. Reach Out, a faith-collaborative, mobile health intervention was feasible. Further study of the efficacy of the intervention and additional mobile health strategies should be considered.

A solution to the online guidance problem for targeted reaches: proportional rate control using relative disparity tau.

Science.gov (United States)

Anderson, Joe; Bingham, Geoffrey P

2010-09-01

We provide a solution to a major problem in visually guided reaching. Research has shown that binocular vision plays an important role in the online visual guidance of reaching, but the visual information and strategy used to guide a reach remains unknown. We propose a new theory of visual guidance of reaching including a new information variable, tau(alpha) (relative disparity tau), and a novel control strategy that allows actors to guide their reach trajectories visually by maintaining a constant proportion between tau(alpha) and its rate of change. The dynamical model couples the information to the reaching movement to generate trajectories characteristic of human reaching. We tested the theory in two experiments in which participants reached under conditions of darkness to guide a visible point either on a sliding apparatus or on their finger to a point-light target in depth. Slider apparatus controlled for a simple mapping from visual to proprioceptive space. When reaching with their finger, participants were forced, by perturbation of visual information used for feedforward control, to use online control with only binocular disparity-based information for guidance. Statistical analyses of trajectories strongly supported the theory. Simulations of the model were compared statistically to actual reaching trajectories. The results supported the theory, showing that tau(alpha) provides a source of information for the control of visually guided reaching and that participants use this information in a proportional rate control strategy.

Can donated media placements reach intended audiences?

Science.gov (United States)

Cooper, Crystale Purvis; Gelb, Cynthia A; Chu, Jennifer; Polonec, Lindsey

2013-09-01

Donated media placements for public service announcements (PSAs) can be difficult to secure, and may not always reach intended audiences. Strategies used by the Centers for Disease Control and Prevention's (CDC) Screen for Life: National Colorectal Cancer Action Campaign (SFL) to obtain donated media placements include producing a diverse mix of high-quality PSAs, co-branding with state and tribal health agencies, securing celebrity involvement, monitoring media trends to identify new distribution opportunities, and strategically timing the release of PSAs. To investigate open-ended recall of PSAs promoting colorectal cancer screening, CDC conducted 12 focus groups in three U.S. cities with men and women either nearing age 50 years, when screening is recommended to begin, or aged 50-75 years who were not in compliance with screening guidelines. In most focus groups, multiple participants recalled exposure to PSAs promoting colorectal cancer screening, and most of these individuals reported having seen SFL PSAs on television, in transit stations, or on the sides of public buses. Some participants reported exposure to SFL PSAs without prompting from the moderator, as they explained how they learned about the disease. Several participants reported learning key campaign messages from PSAs, including that colorectal cancer screening should begin at age 50 years and screening can find polyps so they can be removed before becoming cancerous. Donated media placements can reach and educate mass audiences, including millions of U.S. adults who have not been screened appropriately for colorectal cancer.

Association between imagined and actual functional reach (FR): a comparison of young and older adults.

Science.gov (United States)

Gabbard, Carl; Cordova, Alberto

2013-01-01

Recent studies indicate that the ability to mentally represent action using motor imagery declines with advanced age (>64 years). As the ability to represent action declines, the elderly may experience increasing difficulty with movement planning and execution. Here, we determined the association between estimation of reach via use of motor imagery and actual FR. Young adults (M=22 years) and older adults (M=66 years) estimated reach while standing with targets randomly presented in peripersonal (within actual reach) and extrapersonal (beyond reach) space. Imagined responses were compared to the individual's scaled maximum reach. FR, also while standing, was assessed using the standardized Functional Reach Test (FRT). Results for total score estimation accuracy showed that there was no difference for age; however, results for mean bias and distribution of error revealed that the older group underestimated while the younger group overestimated. In reference to FR, younger adults outperformed older adults (30 versus 14in.) and most prominent, only the younger group showed a significant relationship between estimation and FR. In addition to gaining insight to the effects of advanced age on the ability to mentally represent action and its association with movement execution, these results although preliminary, may have clinical implications based on the question of whether motor imagery training could improve movement estimations and how that might affect actual reach. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Transparency of chemical risk assessment data under REACH.

Science.gov (United States)

Ingre-Khans, Ellen; Ågerstrand, Marlene; Beronius, Anna; Rudén, Christina

2016-12-08

The REACH regulation requires EU manufacturers and importers of substances to register information on the hazard and risk of their substances with the European Chemicals Agency (ECHA). Risk management of the substances is based on the provided information. It is known that conclusions on hazard and risk are influenced by expert judgements as well as potential conflict of interests. Thus, it is important that hazard and risk assessments are transparent and can be evaluated by a third party. The aim of this study is to scrutinize the transparency, i.e. the accessibility and comprehensibility, of information on substances registered under REACH. Data on repeated dose toxicity and hazard assessment conclusions were extracted for 60 substances from the REACH registration database available on the ECHA website. The data were compiled in a database for systematically evaluating the transparency of information related to the conclusions on hazard or risk. In addition, chemical safety reports (CSR) were requested from ECHA for five substances. The transparency of information on the hazard and risk of substances was found to be limited for several reasons. First, certain information was removed due to confidentiality and certain fields were not published because they could contain confidential information although the information had not been claimed confidential. Also, the extent to which registrants reported information varied, and the presentation of some data and certain terminology required further clarification. In addition, the data source for the majority of the key and supporting studies could not be identified due to confidentiality. Since registrants are only required to summarise studies, it cannot be verified whether all relevant information from non-public industry reports have been reported. Lastly, certain information related to the hazard and risk assessment were only reported in the CSR which is only available upon request; a time-consuming and work

Trends in radionuclide concentrations in Hanford Reach fish, 1982 through 1992

International Nuclear Information System (INIS)

Poston, T.M.

1994-06-01

Environmental monitoring has been conducted at the US Department of Energy's Hanford Site in southeast Washington State since 1945. Fish from the Hanford Reach of the Columbia River, which borders the Site, are monitored annually. The two objectives of this report were (1) to evaluate trends in the concentrations of radionuclides [e.g., 90 Sr and 137 Cs] in two species of Columbia River fish [smallmouth bass and mountain whitefish] sampled from the Hanford Reach from 1982 through 1992; and (2) to determine the impact of Hanford Site releases on these two species and carp and fall chinook salmon collected during this time frame. The evaluation found gradual reductions of 137 Cs in bass muscle and 90 Sr in bass and whitefish carcass from 1982 through 1992. Concentrations of 90 Sr in bass and whitefish followed the pattern established by reported Hanford Site releases from 1982 through 1992 and was supported by significant regression analyses comparing annual releases to sample concentration. Because data for carp have been collected only since 1990, the data base was inadequate for determining trends. Moreover, fall chinook salmon were only sampled once in this 11-year period. Concentrations of 90 Sr and 137 Cs in fish samples collected from distant background locations exceeded concentrations in Hanford Reach fish. Estimates of the dose from consumption of Hanford Reach fish were less than 0.001 times the National Council on Radiation Protection and Measurements and the US Department of Energy guideline of 100 mrem/yr

Pregnancy outcome in the elderly gravida in Addis Ababa | Marai ...

African Journals Online (AJOL)

1998-08-30

... to August 30, 1998 in the above setting fulfilling inclusion criteria were cases and controls respectively. Main outcome measures: Included current obstetric problems, labour induction, operative delivery, low birthweight, apgar scores, prenatal death, neonatal intensive care admission rates and mean foetal birthweight.

Implementation of a clinical pathway may improve alcohol treatment outcome

DEFF Research Database (Denmark)

Nielsen, Anette Søgaard; Nielsen, Bent

2015-01-01

This article describes the design, implementation, and evaluation of a clinical pathway system in a two-cohort quasi-experimental study before and after implementation, controlling for confounders. The main outcome measures were retention in care and sensible alcohol use (defined as abstinent...

Reaching out for patients: public relations and events with real results.

Science.gov (United States)

Kuechel, Marie Czenko

2010-02-01

In today's market, the aesthetic physician needs to connect with patients using methods that are personal, educational, and that will glean the interest of prospective patients whose attention and dollars are sought by countless facial plastic surgery competitors near and far. Public relations, or reaching your prospective patient without a direct solicitation (advertising) for services, are traditional means that include media relations and charitable and social events. With the added component of social media, today the opportunities to reach out for new patients and garner real results are more varied and more affordable than ever before. Thieme Medical Publishers.

Traditional open-bay versus single-family room neonatal intensive care unit: a comparison of selected nutrition outcomes

Directory of Open Access Journals (Sweden)

Christina Erickson

2011-03-01

Full Text Available Christina Erickson1, Kendra Kattelmann1, Jessica Remington1, Cuirong Ren2, Carol C Helseth3, Dennis C Stevens31Department of Health and Nutritional Sciences, 2Department of Plant Science, South Dakota State University, Brookings, SD, USA; 3Sanford Children's Hospital, Sioux Falls, SD, USABackground: In contrast to the traditional open-bay–type design of the neonatal intensive care unit (tNICU, infants in developmentally appropriate NICU (dNICU are housed in individual rooms with greater control of light and noise. Previous reports have documented positive influence of the dNICU in cardiorespiratory status, physiologic stability, and weight gain of the infants. The objective of this study was to explore selected nutrition outcomes of infants in the dNICU versus tNICU.Method: A prospective cohort study was conducted on infants with birth weight of 1500 g or less cared for in dNICU (n = 42 or tNICU (n = 31. Differences between days to reach full parenteral nutrition, full enteral nutrition, or full bottling were determined using analysis of covariance controlling for gestational age, birth weight, and clinical risk index for babies (CRIB acuity score.Results: There were no differences between the two groups in days to reach full parenteral and bottle feeding. The infants in the dNICU took fewer days to reach full enteral nutrition (20.8 days, 95% confidence intervals [CI]: 17, 24.6 (dNICU vs 23.3 days, 95% CI: 17.1, 29.6 (tNICU, P = 0.04 than those in the tNICU.Conclusions: Although the two groups of infants only differed in the days to reach full enteral feeding, it is important to remember that the lack of difference may be clinically significant. Clinically, the infants in the dNICU were younger (gestational age and sicker (CRIB acuity score than the infants in the tNICU. Consequently, the results of this study support the change to dNICU, as the private room model provides a supportive environment for growth as evidenced by similar