WorldWideScience

Sample records for reported greater improvement

  1. Greater Green River Basin production improvement project, Phase 1: Site characterization report

    Energy Technology Data Exchange (ETDEWEB)

    DeJarnett, B.B.; Krystinik, L.F.; Mead, R.H.; Poe, S.C.

    1996-05-01

    Several tight, naturally-fractured, gas-productive formations in the Greater Green River Basin (GGRB) in Wyoming have been exploited using conventional vertical well technology. Typically, hydraulic fracture treatments must be performed in completing these wells to increase gas production rates to economic levels. However, with the maturation of horizontal drilling technology hydraulic fracture treatments may not be the most effective method for improving gas production from these tight reservoirs. Two of the most prolific tight gas reservoirs in the Green River Basin, the Frontier and the Mesaverde, are candidates for the application of horizontal well completion technology. The objective of the proposed project is to apply the DOE`s technical concept to the Second Frontier Formation on the western flank of the Rock Springs Uplift. Previous industry attempts to produce in commercial quantities from the Second Frontier Formation have been hampered by lack of understanding of both the in-situ natural fracture system and lack of adequate stimulation treatments. The proposed technical approach involves drilling a vertical characterization well to the Second Frontier Formation at a depth of approximately 16,000 ft. from a site located about 18 miles northwest of Rock Springs, Wyoming. Logging, coring, and well testing information from the vertical well will be used to design a hydraulic fracturing treatment and to assess the resulting production performance. Data from the vertical drilling phase will be used to design a 2,500 to 3,000-ft lateral wellbore which will be kicked off from the vertical hole and extend into the blanket marine sandstone bench of the Second Frontier Formation. The trajectory of this wellbore will be designed to intersect the maximum number of natural fractures to maximize production rates. Production testing of the resulting completion will provide an assessment of reserve potential related to horizontal lateral completions.

  2. Promoting greater Federal energy productivity [Final report

    Energy Technology Data Exchange (ETDEWEB)

    Hopkins, Mark; Dudich, Luther

    2003-03-05

    This document is a close-out report describing the work done under this DOE grant to improve Federal Energy Productivity. Over the four years covered in this document, the Alliance To Save Energy conducted liaison with the private sector through our Federal Energy Productivity Task Force. In this time, the Alliance held several successful workshops on the uses of metering in Federal facilities and other meetings. We also conducted significant research on energy efficiency, financing, facilitated studies of potential energy savings in energy intensive agencies, and undertook other tasks outlined in this report.

  3. Conservatives report, but liberals display, greater happiness.

    Science.gov (United States)

    Wojcik, Sean P; Hovasapian, Arpine; Graham, Jesse; Motyl, Matt; Ditto, Peter H

    2015-03-13

    Research suggesting that political conservatives are happier than political liberals has relied exclusively on self-report measures of subjective well-being. We show that this finding is fully mediated by conservatives' self-enhancing style of self-report (study 1; N = 1433) and then describe three studies drawing from "big data" sources to assess liberal-conservative differences in happiness-related behavior (studies 2 to 4; N = 4936). Relative to conservatives, liberals more frequently used positive emotional language in their speech and smiled more intensely and genuinely in photographs. Our results were consistent across large samples of online survey takers, U.S. politicians, Twitter users, and LinkedIn users. Our findings illustrate the nuanced relationship between political ideology, self-enhancement, and happiness and illuminate the contradictory ways that happiness differences can manifest across behavior and self-reports.

  4. F-35 Sustainment: Need for Affordable Strategy, Greater Attention to Risks, and Improved Cost Estimates

    Science.gov (United States)

    2014-09-01

    F - 35 SUSTAINMENT Need for Affordable Strategy, Greater Attention to Risks, and Improved Cost Estimates Report...2. REPORT TYPE 3. DATES COVERED 00-00-2014 to 00-00-2014 4. TITLE AND SUBTITLE F - 35 Sustainment: Need for Affordable Strategy, Greater...House of Representatives September 2014 F - 35 SUSTAINMENT Need for Affordable Strategy, Greater Attention to Risks, and Improved Cost Estimates Why

  5. Improving health and safety through greater cooperation: A labor perspective

    Energy Technology Data Exchange (ETDEWEB)

    Main, J.A.

    1996-12-31

    There has been considerable effort in the coal mining industry to improve the future of mining operations and the health and safety conditions through improved labor and management relations. The United Mine Workers of America has been a major part of that effort.

  6. Arthroscopic Tuberoplasty for a Malunited Greater Tuberosity Fracture: A Case Report.

    Science.gov (United States)

    Killen, Maire-Clare; Charalambous, Charalambos P

    2015-01-01

    Superior migration and malunion of a fractured greater tuberosity can lead to mechanical subacromial impingement with resultant ongoing pain and limitation of abduction. We describe such a case successfully treated with arthroscopic excision of the protruding portion of the greater tuberosity, with marked improvement in pain and range of movement. The greater tuberosity was exposed by elevating the supraspinatus tendon, which was reattached at the end of the procedure. This case, along with outcomes of similar techniques previously reported in literature suggest that arthroscopic excision of a superiorly malunited greater tuberosity is associated with good symptomatic outcome and preservation of rotator cuff function.

  7. Grant Monitoring: Department of Education Could Improve Its Processes with Greater Focus on Assessing Risks, Acquiring Financial Skills, and Sharing Information. Report to Congressional Requesters. GAO-10-57

    Science.gov (United States)

    Ashby, Cornelia M.

    2009-01-01

    The Department of Education (Education) awards about $45 billion in grants each year to school districts, states, and other entities. In addition, the American Recovery and Reinvestment Act of 2009 provided an additional $97 billion in grant funding. In a series of reports from 2002 to 2009, Education's Inspector General cited a number of grantees…

  8. Why do Greater one-horned rhinoceroses (Rhinoceros unicornis) die? - An evaluation of necropsy reports

    OpenAIRE

    Wyss, F; Wenker, C; Robert, N.; Clauss, Marcus; von Houwald, F

    2012-01-01

    Many case reports about different diseases in greater one-horned rhinoceroses (Rhinoceros unicornis) have been published, but an overview of the prevalence of diseases and an evaluation of causes of death is lacking. Necropsy reports of 106 greater one-horned rhinoceroses from 38 zoos worldwide were evaluated. Half of them were from adult animals, a third from perinatal deaths/stillbirths and the rest from juveniles and sub adults. Cardiac problems (cardiomyopathy, myocarditis, heart infarct)...

  9. Greater use of wood residue fuels through improved financial planning: a case study in Alabama

    Energy Technology Data Exchange (ETDEWEB)

    Billings, C.D.; Ziemke, M.C. (Alabama Univ., Huntsville, AL (United States). Coll. of Administrative Science); Stanford, R. (Alabama Dept. of Economic and Community Affairs, Montgomery, AL (United States))

    1993-01-01

    As the world reacts to environmental concerns relating to fossil energy usage, emphasis is again placed on greater use of renewable fuels such as wood residues. Realistically, however, decisions to utilize such fuels are based on economic factors, rather than desires to improve US energy independence and/or protect the environment. Because Alabama has a large forest products industry, state authorities have long sought to assist potential users of wood residue fuels to better use biomass fuels instead of the usual alternative: natural gas. State agency experience in promoting commercial and industrial use of wood residue fuels has shown that inadequate financial planning has often resulted in rejection of viable projects or acceptance of non-optimum projects. This paper discusses the reasons for this situation and suggests remedies for its improvement. (author)

  10. Improving multimodel medium range forecasts over the Greater Horn of Africa using the FSU superensemble

    Science.gov (United States)

    Kipkogei, O.; Bhardwaj, A.; Kumar, V.; Ogallo, L. A.; Opijah, F. J.; Mutemi, J. N.; Krishnamurti, T. N.

    2016-08-01

    This study makes use of the WMO's multimodel data set called THORPEX integrated grand global ensemble (TIGGE) towards the construction of multimodel superensemble forecasts covering a period of 10 days. The goal of this study is to explore the forecast skill for precipitation forecasts over the Greater Horn of Africa (this is a consortium of 11 countries). The multimodels include forecast data set from a suite of models that include: The European Centre for Medium Range Weather Forecasts (ECMWF), the National Centre for Environmental Prediction (NCEP), the Center for Weather Forecast and Climatic Studies (CPTEC) and the United Kingdom Meteorological Office (UKMO). After performing a training phase for the superensemble weights covering the previous 450 days of October, November and December months of 2008-2012, forecasts of precipitation were prepared for the multimodel superensemble. These covered day 1 to day 10 of forecasts over the region. Various skill metrics were prepared to validate the forecast rainfall against the tropical rainfall measuring mission (TRMM) observed rainfall data. This study shows that the construction of the multimodel superensemble was a worthwhile effort since it provided the best overall skills for the RMS errors, the spatial correlations and the equitable threat scores and their bias errors for precipitation forecasts from day 1 to day 10 over all of the countries covered by the Greater Horn of Africa. The best among the member model was the UKMO model. This study strongly suggests the usefulness of a product such as the multimodel superensemble for improved precipitation forecasts over East Africa.

  11. Metastasis of greater wing of sphenoid bone in bronchogenic carcinoma: a unusual case report.

    Science.gov (United States)

    Gupta, Prashant K; Mital, Mukta; Dwivedi, Amit; Gupta, Kumkum

    2011-01-01

    Orbital metastasis in systemic cancer is known to occur and occurs in up to 7% of all systemic cancers. Orbital features typically present after the diagnosis of the primary tumor. In about 20% of cases, there is no known primary cancer at the time of presentation with orbital metastatic disease. Here we report a case of a 60-year-old male smoker, in whom proptosis, due to metastasis in greater wing of left sphenoid bone secondary to bronchogenic carcinoma, was the initial symptom. We could not find in literature metastasis to greater wing of sphenoid bone due to small cell carcinoma of lung.

  12. Malignant peripheral nerve sheath tumor arising from the greater omentum: Case report

    Directory of Open Access Journals (Sweden)

    Tokunaga Masakazu

    2011-03-01

    Full Text Available Abstract Malignant peripheral nerve sheath tumors (MPNSTs are rare soft tissue tumors that arise from a peripheral nerve or exhibit nerve sheath differentiation. Most of these tumors arise on the trunk, extremities, or head and neck regions; they are very rarely located in the abdominal cavity. The patient was a 71-year-old man who was referred to our hospital for a mass and pain in the right lower abdomen. Abdominal computed tomography revealed a large (9 × 9 cm, well-circumscribed, lobulated, heterogeneously enhanced mass in the pelvis. Exploratory laparotomy revealed a large mass in the greater omentum, and the tumor was completely excised. Histopathological analysis revealed that the tumor was composed of spindle cells with high mitotic activity. On staining the tumor, positive results were obtained for S-100 but negative results were obtained for c-kit, cluster of differentiation (CD34, α-smooth muscle actin, and desmin. These findings strongly supported a diagnosis of MPNST primarily arising from the greater omentum. To the best of our knowledge, this is the first reported case of an MPNST arising from the greater omentum. In this report, we have described the case of a patient with an MPNST arising from the greater omentum and have discussed the clinical characteristics and management of MPNSTs.

  13. Variations in band reporting rate and implications for kill rate in Greater Snow Geese

    Directory of Open Access Journals (Sweden)

    Guillaume Souchay

    2014-06-01

    Full Text Available We assessed spatial and temporal variation in reporting probability of banded Greater Snow Geese (Chen caerulescens atlantica shot by hunters in eastern North America and evaluated potential residual biases in kill rate estimation. Adult Greater Snow Geese were marked with reward (value: US$10, $20, $30, $50, and $100 and standard bands ($0, control in the Canadian Arctic from 2003 to 2005. We used a spatially explicit multinomial model based on 200 direct recoveries from 4256 banded geese to estimate reporting rate and harvest rate. We found that reporting rate for standard bands varied over time whereas harvest rate was higher in Canada than in the U.S. The reporting probability increased from 0.40 ± 0.11 in the first year of the study to 0.82 ± 0.14 and 0.84 ± 0.13 the second and third years, respectively. Overall, these reporting rates are higher than two previous estimates for this population, which leads to lower estimates of kill rate. However, the large annual differences in reporting rates found in this study lead to uncertainty in the estimation of kill rate. We suggest that the increase in reporting rate in the last two year of the study may be due to the dissemination of information among hunters regarding the presence of reward bands on birds, resulting in increased reporting rate for all bands. This raises issues about the need to adequately inform the public in such large-scale studies to avoid undesirable temporal trends over the course of the study.

  14. Hepatitis from Greater celandine (Chelidonium majus L.): review of literature and report of a new case.

    Science.gov (United States)

    Moro, Paola A; Cassetti, Federica; Giugliano, Gianni; Falce, Maria T; Mazzanti, Gabriela; Menniti-Ippolito, Francesca; Raschetti, Roberto; Santuccio, Carmela

    2009-07-15

    Folk medicine is a rich source of useful therapeutic tools. Nevertheless, use of medicinal plants can have unwanted, negative effects. By means of the description of an adverse reaction to a herbal remedy, we highlight the need for better efficacy-toxicity studies on these products. To report a case of possible Chelidonium majus L. (Greater celandine)-induced hepatitis and evaluate the past published cases. We outlined the main features of hepatitis associated with use of Chelidonium majus by providing a review of cases reported and analysing in detail a new one. Several cases of acute hepatitis related to Greater celandine consumption were found in the literature. The assessment for causality using Naranjo probability scale showed a probable relationship between the liver injury and the consumption of Chelidonium majus in the case we described. Our case, along with the other ones reported in the literature, increases the concern about the safety of oral use of Chelidonium majus. Plants used in traditional medicine are not necessarily harmless. Customers and prescribers should be aware of this, especially when a herbal drug is used with therapeutic purposes in absence of reliable studies of clinical efficacy and benefit-risk assessment.

  15. Childhood osteosarcoma of greater wing of sphenoid: case report and review of literature.

    Science.gov (United States)

    Meel, Rachna; Thulkar, Sanjay; Sharma, Mehar Chand; Jagadesan, Pandjatcharan; Mohanti, Bidhu Kalyan; Sharma, Suresh Chandra; Bakhshi, Sameer

    2012-03-01

    Primary osteosarcoma of skull base is extremely rare. We present a case of primary osteosarcoma arising in greater wing of sphenoid in a child. Our patient had an incomplete excision after which he received adjuvant chemotherapy and radiotherapy. There was good response to adjuvant chemoradiotherapy and the patient is disease free at a follow-up of 18 months. Treatment of skull base osteosarcomas is difficult, as complete excision is often not possible. To the best of our knowledge, this is the first case of sphenoid wing osteosarcoma in childhood to be reported in literature.

  16. Can Crops with Greater Rooting Systems Improve Nitrogen Retention and Mitigate Emissions of Nitrous Oxide?

    Science.gov (United States)

    Decock, Charlotte; Lee, Juhwan; Barthel, Matti; Mikita, Chris; Wilde, Benjamin; Verhoeven, Elizabeth; Hund, Andreas; Abiven, Samuel; Friedli, Cordula; Conen, Franz; Mohn, Joachim; Wolf, Benjamin; Six, Johan

    2016-04-01

    It has been suggested that crops with deeper root systems could improve agricultural sustainability, because scavenging of nitrogen (N) in the subsoil would increase overall N retention and use efficiency in the system. However, the effect of plant root depth and root architecture on N-leaching and emissions of the potent greenhouse N2O remains largely unknown. We aimed to assess the effect of plant rooting depth on N-cycling and N2O production and reduction within the plant-soil system and throughout the soil profile. We hypothesized that greater root depth and root biomass will (1) increase N use efficiency and decrease N losses in the form of N leaching and N2O emissions; (2) increase N retention by shifting the fate of NH4+ from more nitrification toward more plant uptake and microbial immobilization; and (3) increase the depth of maximum N2O production and decrease the ratio of N2O:(N2O+N2) in denitrification end-products. To test these hypotheses, 4 winter wheat cultivars were grown in lysimeters (1.5 m tall, 0.5 m diameter, 3 replications per cultivar) under greenhouse conditions. Each lysimeter was equipped with an automated flux chamber for the determination of N2O surface fluxes. At 7.5, 30, 60, 90 and 120 cm depth, sampling ports were installed for the determination of soil moisture contents, as well as the collection of soil pore air and soil pore water samples. We selected two older and two newer varieties from the Swiss winter wheat breeding program, spanning a 100-year breeding history. The selection was based on previous experiments indicating that the older varieties have deeper rooting systems than the newer varieties under well watered conditions. N2O fluxes were determined twice per day on a quantum cascade laser absorption spectrometer interfaced with the automated flux chambers. Once per week, we determined concentrations of mineral N in pore water and of CO2 and N2O in the pore air. For mineral N and N2O, also natural abundance isotope deltas

  17. How report cards on physicians, physician groups, and hospitals can have greater impact on consumer choices.

    Science.gov (United States)

    Sinaiko, Anna D; Eastman, Diana; Rosenthal, Meredith B

    2012-03-01

    Public report cards with quality and cost information on physicians, physician groups, and hospital providers have proliferated in recent years. However, many of these report cards are difficult for consumers to interpret and have had little impact on the provider choices consumers are making. To gain a more focused understanding of why these reports cards have not been more successful and what improvements could be made, we interviewed experts and surveyed registrants at the March 2011 AHRQ National Summit on Public Reporting for Consumers in Health Care. We found broad agreement that public reporting has been disconnected from consumer decisions about providers because of weaknesses in report card content, design, and accessibility. Policy makers have an opportunity to change the landscape of public reporting by taking advantage of advances in measurement, data collection, and information technology to deliver a more consumer-centered report card. Overcoming the constraint of limited public funding, and achieving the acceptance of providers, is critical to realizing future success.

  18. Does Greater Autonomy Improve School Performance? Evidence from a Regression Discontinuity Analysis in Chicago

    Science.gov (United States)

    Steinberg, Matthew P.

    2014-01-01

    School districts throughout the United States are increasingly providing greater autonomy to local public (non-charter) school principals. In 2005-06, Chicago Public Schools initiated the Autonomous Management and Performance Schools program, granting academic, programmatic, and operational freedoms to select principals. This paper provides…

  19. Suspected Greater Celandine hepatotoxicity: liver-specific causality evaluation of published case reports from Europe.

    Science.gov (United States)

    Teschke, Rolf; Glass, Xaver; Schulze, Johannes; Eickhoff, Axel

    2012-03-01

    In 21 published case reports, the use of the herb Greater Celandine (GC) (Chelidonium majus L.) has been causally related to liver injury, but a variety of confounding variables were evident that might have offset causality. This study reanalyses causality levels in these cases with a liver-specific causality evaluation method. All 21 cases were submitted to the liver-specific, standardized, structured, quantitative and updated scale of the Council for International Organizations of Medical Sciences. This scale considers, among other items, latency period, course of alanine aminotransferase after treatment discontinuation, risk factors, comedication and alternative causes. Using this method for assessment, causality for GC was highly probable in two and probable in six cases, with lower causality grading in the remaining 13 cases. In these patients, causality for GC was possible in 10 cases and excluded in three cases. On the basis of the eight cases with highly probable and probable causality gradings, GC hepatotoxicity represents an idiosyncratic reaction of the metabolic type, whereas immunologic or obligatory hepatotoxic features are lacking. In some cases, alternative diagnoses and poor data quality were confounding variables that reduced causality levels. Confounding variables reduced causality levels for GC in reported cases of liver injury, but there is still striking evidence for herb-induced liver injury by GC with high causality gradings. GC hepatotoxicity is caused by an idiosyncratic reaction of the metabolic form, but there is uncertainty with respect to its culprit(s).

  20. Strategies to improve homing of mesenchymal stem cells for greater efficacy in stem cell therapy.

    Science.gov (United States)

    Naderi-Meshkin, Hojjat; Bahrami, Ahmad Reza; Bidkhori, Hamid Reza; Mirahmadi, Mahdi; Ahmadiankia, Naghmeh

    2015-01-01

    Stem/progenitor cell-based therapeutic approach in clinical practice has been an elusive dream in medical sciences, and improvement of stem cell homing is one of major challenges in cell therapy programs. Stem/progenitor cells have a homing response to injured tissues/organs, mediated by interactions of chemokine receptors expressed on the cells and chemokines secreted by the injured tissue. For improvement of directed homing of the cells, many techniques have been developed either to engineer stem/progenitor cells with higher amount of chemokine receptors (stem cell-based strategies) or to modulate the target tissues to release higher level of the corresponding chemokines (target tissue-based strategies). This review discusses both of these strategies involved in the improvement of stem cell homing focusing on mesenchymal stem cells as most frequent studied model in cellular therapies.

  1. Is Greater Improvement in Early Self-Regulation Associated with Fewer Behavioral Problems Later in Childhood?

    Science.gov (United States)

    Sawyer, Alyssa C. P.; Miller-Lewis, Lauren R.; Searle, Amelia K.; Sawyer, Michael G.; Lynch, John W.

    2015-01-01

    The aim of this study was to determine whether the extent of improvement in self-regulation achieved between ages 4 and 6 years is associated with the level of behavioral problems later in childhood. Participants were 4-year-old children (n = 510) attending preschools in South Australia. Children's level of self-regulation was assessed using the…

  2. Greater Confinement Disposal Test at the Nevada Test Site, Final Technology Report

    Energy Technology Data Exchange (ETDEWEB)

    Dickman, P. T.

    1989-01-01

    The Greater Confinement Disposal Test (GCDT) was conducted at the Nevada Test Site to demonstrate an alternative method for management of high-specific-activity (HSA) low-level waste (LLW). The GCDT was initially conceived as a method for managing small volumes of highly concentrated tritium wastes, which, due to their environmental mobiilty, are considered unsuitable for routine shallow land disposal. Later, the scope of the GCDT was increased to address a variety of other "problem" HSA wastes including isotope sources and thermal generating wastes. The basic design for the GCDT evolved from a series of studies and assessments. Operational design objectives were to (1) emplace the wastes at a depth sufficient to minimize or eliminate routine environmental transport mechanisms and instrusion scenarios and (2) provide sufficient protection for operations personnel in the handling of HSA sources. To achieve both objectives, a large diameter borehole was selected. The GCDT consisted of a borehole 3 meters (10 feet) in diameter and 36 meters (120 feet) deep, surrounded by nine monitoring holes at varying radii. The GCDT was instrumented for the measurement of temperature, moisture, and soil-gas content. Over one million curies of HSA LLW were emplaced in GCDT. This report reviews the development of the GCDT project and presents analyses of data collected.

  3. Western Juniper Management: Assessing Strategies for Improving Greater Sage-grouse Habitat and Rangeland Productivity

    Science.gov (United States)

    Farzan, Shahla; Young, Derek J. N.; Dedrick, Allison G.; Hamilton, Matthew; Porse, Erik C.; Coates, Peter S.; Sampson, Gabriel

    2015-09-01

    Western juniper ( Juniperus occidentalis subsp. occidentalis) range expansion into sagebrush steppe ecosystems has affected both native wildlife and economic livelihoods across western North America. The potential listing of the greater sage-grouse ( Centrocercus urophasianus) under the U.S. Endangered Species Act has spurred a decade of juniper removal efforts, yet limited research has evaluated program effectiveness. We used a multi-objective spatially explicit model to identify optimal juniper removal sites in Northeastern California across weighted goals for ecological (sage-grouse habitat) and economic (cattle forage production) benefits. We also extended the analysis through alternative case scenarios that tested the effects of coordination among federal agencies, budgetary constraints, and the use of fire as a juniper treatment method. We found that sage-grouse conservation and forage production goals are somewhat complementary, but the extent of complementary benefits strongly depends on spatial factors and management approaches. Certain management actions substantially increase achievable benefits, including agency coordination and the use of prescribed burns to remove juniper. Critically, our results indicate that juniper management strategies designed to increase cattle forage do not necessarily achieve measurable sage-grouse benefits, underscoring the need for program evaluation and monitoring.

  4. Western juniper management: assessing strategies for improving greater sage-grouse habitat and rangeland productivity

    Science.gov (United States)

    Farzan, Shahla; Young, Derek J.N.; Dedrick, Allison G.; Hamilton, Mattew; Porse, Erik C.; Coates, Peter S.; Sampson, Gabriel

    2015-01-01

    Western juniper (Juniperus occidentalis subsp. occidentalis) range expansion into sagebrush steppe ecosystems has affected both native wildlife and economic livelihoods across western North America. The potential listing of the greater sage-grouse (Centrocercus urophasianus) under the U.S. Endangered Species Act has spurred a decade of juniper removal efforts, yet limited research has evaluated program effectiveness. We used a multi-objective spatially explicit model to identify optimal juniper removal sites in Northeastern California across weighted goals for ecological (sage-grouse habitat) and economic (cattle forage production) benefits. We also extended the analysis through alternative case scenarios that tested the effects of coordination among federal agencies, budgetary constraints, and the use of fire as a juniper treatment method. We found that sage-grouse conservation and forage production goals are somewhat complementary, but the extent of complementary benefits strongly depends on spatial factors and management approaches. Certain management actions substantially increase achievable benefits, including agency coordination and the use of prescribed burns to remove juniper. Critically, our results indicate that juniper management strategies designed to increase cattle forage do not necessarily achieve measurable sage-grouse benefits, underscoring the need for program evaluation and monitoring.

  5. Western Juniper Management: Assessing Strategies for Improving Greater Sage-grouse Habitat and Rangeland Productivity.

    Science.gov (United States)

    Farzan, Shahla; Young, Derek J N; Dedrick, Allison G; Hamilton, Matthew; Porse, Erik C; Coates, Peter S; Sampson, Gabriel

    2015-09-01

    Western juniper (Juniperus occidentalis subsp. occidentalis) range expansion into sagebrush steppe ecosystems has affected both native wildlife and economic livelihoods across western North America. The potential listing of the greater sage-grouse (Centrocercus urophasianus) under the U.S. Endangered Species Act has spurred a decade of juniper removal efforts, yet limited research has evaluated program effectiveness. We used a multi-objective spatially explicit model to identify optimal juniper removal sites in Northeastern California across weighted goals for ecological (sage-grouse habitat) and economic (cattle forage production) benefits. We also extended the analysis through alternative case scenarios that tested the effects of coordination among federal agencies, budgetary constraints, and the use of fire as a juniper treatment method. We found that sage-grouse conservation and forage production goals are somewhat complementary, but the extent of complementary benefits strongly depends on spatial factors and management approaches. Certain management actions substantially increase achievable benefits, including agency coordination and the use of prescribed burns to remove juniper. Critically, our results indicate that juniper management strategies designed to increase cattle forage do not necessarily achieve measurable sage-grouse benefits, underscoring the need for program evaluation and monitoring.

  6. Challenge to Aviation: Hatching a Leaner Pterosauer. [Improving Commercial Aircraft Design for Greater Fuel Efficiency

    Science.gov (United States)

    Moss, F. E.

    1975-01-01

    Modifications in commercial aircraft design, particularly the development of lighter aircraft, are discussed as effective means of reducing aviation fuel consumption. The modifications outlined include: (1) use of the supercritical wing; (2) generation of the winglet; (3) production and flight testing of composite materials; and, (4) implementation of fly-by-wire control systems. Attention is also given to engineering laminar air flow control, improving cargo payloads, and adapting hydrogen fuels for aircraft use.

  7. Adrenal Rest Tumor from the Greater Omentum Mimicking Exophytic Hepatocellular Carcinoma (HCC): A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hyung Jo; Kim, Seong Hoon; Shin, Hyun Woong [Daegu Fatima Hospital, Daegu (Korea, Republic of); Park, Jae Bok [Catholic University of Daegu, Gyeongsan (Korea, Republic of); Jo, Hyun Chul; Son, Mi Young; Kim, Tae Bong [Daegu Veterans Hospital, Daegu (Korea, Republic of)

    2010-02-15

    Adrenal rest tumors are aberrant adrenocortical tissue which has been most commonly described in abdominal and pelvic sites. To our knowledge, there has been no previous description of an adrenal rest tumor of the greater omentum. We present a case of a pathologically confirmed adrenal rest tumor of the greater omentum in a 76-year- old man

  8. Herbal hepatotoxicity by Greater Celandine (Chelidonium majus): causality assessment of 22 spontaneous reports.

    Science.gov (United States)

    Teschke, Rolf; Glass, Xaver; Schulze, Johannes

    2011-12-01

    Toxic liver injury due to the herb Greater Celandine (GC) (Chelidonium majus L.) has been assumed in patients originating from various European countries and created concern. Based on regulatory and liver unspecific ad hoc causality assessments in 22 spontaneous cases of Germany, causality levels for GC were considered probable in 16 and possible in 6 cases. We now analyzed the data of these 22 cases regarding their causality levels employing the liver specific, standardized, structured and quantitative assessment method of the updated scale of CIOMS (Council for International Organizations of Medical Sciences). Causality for GC was found highly probable (n=2), probable (n=6), possible (n=10), unlikely (n=1), and excluded (n=3). Thus, causality could be upgraded in 2 cases to a highly probable causality level, but had to be down graded to excluded, unlikely, or possible causality levels in 3, 1, or 9 cases, respectively. GC hepatotoxicity shows a hepatocellular pattern of liver injury with female gender predominance. On average, age of the patients was 56.4 years, treatment 36.4 days, and latency period until first symptoms and jaundice 29.8 and 35.6 days, respectively. This analysis therefore provides further evidence for the existence of GC hepatotoxicity as a distinct form of herb induced liver injury, but due to poor data quality the causal association between GC use and liver injury is less strong than hitherto assumed. We propose replacement of the regulatory organ unspecific by a liver specific causality assessment method in cases of herb induced liver injury as well as stricter pharmacovigilance strategies towards improvements of data quality. Toxicological studies are now warranted to elucidate the mechanism(s) of human GC hepatotoxicity that represents a European issue. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Nesting ecology of greater white-fronted geese on the Nowitna National Wildlife Refuge: 1988 progress report

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report covers the nesting ecology of greater white-fronted geese on the Nowitna National Wildlife Refuge. Aerial surveys to document spring phenology and...

  10. Case report 358: Desmoid tumor of the greater wing of the right sphenoid bone

    Energy Technology Data Exchange (ETDEWEB)

    Crisi, G.; Calo, M.; Mauri, C.

    1986-03-01

    In summary, a case has been presented of a 26-year-old man who on admission showed a mild right proptosis and swelling of the right temple. Roentgenograms of the skull demonstrated loss of the right innominate line. CT studies after contrast demonstrated a sharply-demarcated, destructive area of the right greater sphenoid wing with an enhancing, spindle-shaped, soft tissue mass observed around the bony defect. Increased uptake was demonstrated on a radionuclide scan. The lesion was surgically removed and proved to be a desmoid. (orig./SHA).

  11. Greater-Than-Class C Low-Level Radioactive Waste Transportation Strategy report and institutional plan

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, R.C.; Tyacke, M.J.

    1995-01-01

    This document contains two parts. Part I, Greater-Than-Class-C Low-Level Radioactive Waste Transportation Strategy, addresses the requirements, responsibilities, and strategy to transport and receive these wastes. The strategy covers (a) transportation packaging, which includes shipping casks and waste containers; (b) transportation operations relating to the five facilities involved in transportation, i.e., waste originator, interim storage, dedicated storage, treatment, and disposal; (c) system safety and risk analysis; (d) routes; (e) emergency preparedness and response; and (o safeguards and security. A summary of strategic actions is provided at the conclusion of Part 1. Part II, Institutional Plan for Greater-Than-Class C Low-Level Radioactive Waste Packaging and Transportation, addresses the assumptions, requirements, and institutional plan elements and actions. As documented in the Strategy and Institutional Plan, the most challenging issues facing the GTCC LLW Program shipping campaign are institutional issues closely related to the strategy. How the Program addresses those issues and demonstrates to the states, local governments, and private citizens that the shipments can and will be made safely will strongly affect the success or failure of the campaign.

  12. Capillary haemangioma of the greater omentum in a 5-month-old female infant: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Chateil, J.F. [Hopital Pellegrin, 33 - Bordeaux (France). Service de Neuro-Radiologie; Unite de Radiopediatrie, Hopital Pellegrin, Bordeaux (France); Saragne-Feuga, C.; Brun, M.; Diard, F. [Hopital Pellegrin, 33 - Bordeaux (France). Service de Neuro-Radiologie; Perel, Y. [Service de Pediatrie A, Hopital Pellegrin, Bordeaux (France); Neuenschwander, S. [Service de Radiologie, Institut Curie, Paris (France); Vergnes, P. [Service de Chirurgie Pediatrique, Hopital Pellegrin, Bordeaux (France)

    2000-12-01

    Capillary haemangiomas are frequent benign tumours in infancy. The authors report a case of capillary haemangioma of the greater omentum, discovered in a child of 5 months of age and studied with US, CT and MRI. The localization of such a lesion in the greater omentum is exceptional. Abdominal US revealed a heterogeneous, multinodular intraperitoneal mass. Doppler study demonstrated hypervascularity of the lesion. CT localized the mass to the greater omentum. The mass was hypodense on the unenhanced scan and enhanced massively after injection. The infant suffered a reaction to contrast medium during the CT. MRI demonstrated a mass which was hypointense on T1-weighted images and hyperintense on T2-weighted images. Laparotomy confirmed the location of the mass within the greater omentum and allowed resection of the tumour. (orig.)

  13. College students who have an eveningness preference report lower self-control and greater procrastination.

    Science.gov (United States)

    Digdon, Nancy L; Howell, Andrew J

    2008-11-01

    Previous research suggests a possible link between eveningness and general difficulties with self-regulation (e.g., evening types are more likely than other chronotypes to have irregular sleep schedules and social rhythms and use substances). Our study investigated the relationship between eveningness and self-regulation by using two standardized measures of self-regulation: the Self-Control Scale and the Procrastination Scale. We predicted that an eveningness preference would be associated with poorer self-control and greater procrastination than would an intermediate or morningness preference. Participants were 308 psychology students (mean age=19.92 yrs) at a small Canadian college. Students completed the self-regulation questionnaires and Morningness/Eveningness Questionnaire (MEQ) online. The mean MEQ score was 46.69 (SD=8.20), which is intermediate between morningness and eveningness. MEQ scores ranged from definite morningness to definite eveningness, but the dispersion of scores was skewed toward more eveningness. Pearson and partial correlations (controlling for age) were used to assess the relationship between MEQ score and the Self-Control Scale (global score and 5 subscale scores) and Procrastination Scale (global score). All correlations were significant. The magnitude of the effects was medium for all measures except one of the Self-Control subscales, which was small. A multiple regression analysis to predict MEQ score using the Self-Control Scale (global score), Procrastination Scale, and age as predictors indicated the Self-Control Scale was a significant predictor (accounting for 20% of the variance). A multiple regression analysis to predict MEQ scores using the five subscales of the Self-Control Scale and age as predictors showed the subscales for reliability and work ethic were significant predictors (accounting for 33% of the variance). Our study showed a relationship between eveningness and low self-control, but it did not address whether the

  14. Self-reported posttraumatic growth predicts greater subsequent posttraumatic stress amidst war and terrorism.

    Science.gov (United States)

    Zalta, Alyson K; Gerhart, James; Hall, Brian J; Rajan, Kumar B; Vechiu, Catalina; Canetti, Daphna; Hobfoll, Stevan E

    2017-03-01

    This study tested three alternative explanations for research indicating a positive, but heterogeneous relationship between self-reported posttraumatic growth (PTG) and posttraumatic stress symptoms (PSS): (a) the third-variable hypothesis that the relationship between PTG and PSS is a spurious one driven by positive relationships with resource loss, (b) the growth over time hypothesis that the relationship between PTG and PSS is initially a positive one, but becomes negative over time, and (c) the moderator hypothesis that resource loss moderates the relationship between PTG and PSS such that PTG is associated with lower levels of PSS as loss increases. A nationally representative sample (N = 1622) of Israelis was assessed at three time points during a period of ongoing violence. PTG, resource loss, and the interaction between PTG and loss were examined as lagged predictors of PSS to test the proposed hypotheses. Results were inconsistent with all three hypotheses, showing that PTG positively predicted subsequent PSS when accounting for main and interactive effects of loss. Our results suggest that self-reported PTG is a meaningful but counterintuitive predictor of poorer mental health following trauma.

  15. OPSAID improvements and capabilities report.

    Energy Technology Data Exchange (ETDEWEB)

    Halbgewachs, Ronald D.; Chavez, Adrian R.

    2011-08-01

    Process Control System (PCS) and Industrial Control System (ICS) security is critical to our national security. But there are a number of technological, economic, and educational impediments to PCS owners implementing effective security on their systems. Sandia National Laboratories has performed the research and development of the OPSAID (Open PCS Security Architecture for Interoperable Design), a project sponsored by the US Department of Energy Office of Electricity Delivery and Energy Reliability (DOE/OE), to address this issue. OPSAID is an open-source architecture for PCS/ICS security that provides a design basis for vendors to build add-on security devices for legacy systems, while providing a path forward for the development of inherently-secure PCS elements in the future. Using standardized hardware, a proof-of-concept prototype system was also developed. This report describes the improvements and capabilities that have been added to OPSAID since an initial report was released. Testing and validation of this architecture has been conducted in another project, Lemnos Interoperable Security Project, sponsored by DOE/OE and managed by the National Energy Technology Laboratory (NETL).

  16. Trypanosoma evansi in dromedary camel: with a case report of zoonosis in greater Cairo, Egypt.

    Science.gov (United States)

    Haridy, Fouad M; El-Metwally, Mohamed Tolba; Khalil, Hazem H M; Morsy, Tosson A

    2011-04-01

    Trypanosoma evansi (Steel, 1885) Balbiani, is the cause of trypanosomiasis (Surra) which multiples in the blood and body fluids. The incubation period varies from 7-15 days. The mortality rate was up to 20% and fatality rate may reach up to 100% in untreated camels. Three hundred randomly selected camels were 200 males 4-6 years old and 100 females 10-15 years. They were examined clinically and diagnosed by Giemsa stained blood smear, anti- trypanosomiasis-antibodies by ELISA and urine Thymol turbidity test for natural infection with T. evani (Surra). The results showed that camels were naturally infected with T. evansi as indicated by stained blood film examination and/or ELISA. Infection in males was 6.0% (stained blood smears), 8.0% (ELISA) and 5.0% (urine thymol turbidity test). In females the infection rate was 9.0%, 24.0% and 12% respectively. By correlation with suggestive clinical manifestations, ELISA proved to be more sensitive and specific (13.3%) than stained blood films (10.0%) and urine Thymol turbidity test (7.3%). Regarding humans, one out of 30 was positive as indicated by ELISA and stained blood smear but was negative by urine thymol turbidity test. The human case was successfully treated as indicated clinically, parasitologically and serologically. This is the first reported Egyptian human case of trypanosomiasis evansi, a neglected zoonosis.

  17. Paleolithic nutrition improves plasma lipid concentrations of hypercholesterolemic adults to a greater extent than traditional heart-healthy dietary recommendations.

    Science.gov (United States)

    Pastore, Robert L; Brooks, Judith T; Carbone, John W

    2015-06-01

    Recent research suggests that traditional grain-based heart-healthy diet recommendations, which replace dietary saturated fat with carbohydrate and reduce total fat intake, may result in unfavorable plasma lipid ratios, with reduced high-density lipoprotein (HDL) and an elevation of low-density lipoprotein (LDL) and triacylglycerols (TG). The current study tested the hypothesis that a grain-free Paleolithic diet would induce weight loss and improve plasma total cholesterol, HDL, LDL, and TG concentrations in nondiabetic adults with hyperlipidemia to a greater extent than a grain-based heart-healthy diet, based on the recommendations of the American Heart Association. Twenty volunteers (10 male and 10 female) aged 40 to 62 years were selected based on diagnosis of hypercholesterolemia. Volunteers were not taking any cholesterol-lowering medications and adhered to a traditional heart-healthy diet for 4 months, followed by a Paleolithic diet for 4 months. Regression analysis was used to determine whether change in body weight contributed to observed changes in plasma lipid concentrations. Differences in dietary intakes and plasma lipid measures were assessed using repeated-measures analysis of variance. Four months of Paleolithic nutrition significantly lowered (P diet. Paleolithic nutrition offers promising potential for nutritional management of hyperlipidemia in adults whose lipid profiles have not improved after following more traditional heart-healthy dietary recommendations. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Progress Report: Experimental Saltmarsh Improvement

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — A series of recommendations for the improvement of the Parker River National Wildlife refuge salt marshes including mound constructions as well as plantings and...

  19. NDVI saturation adjustment: a new approach for improving cropland performance estimates in the Greater Platte River Basin, USA

    Science.gov (United States)

    Gu, Yingxin; Wylie, Bruce K.; Howard, Daniel M.; Phuyal, Khem P.; Ji, Lei

    2013-01-01

    In this study, we developed a new approach that adjusted normalized difference vegetation index (NDVI) pixel values that were near saturation to better characterize the cropland performance (CP) in the Greater Platte River Basin (GPRB), USA. The relationship between NDVI and the ratio vegetation index (RVI) at high NDVI values was investigated, and an empirical equation for estimating saturation-adjusted NDVI (NDVIsat_adjust) based on RVI was developed. A 10-year (2000–2009) NDVIsat_adjust data set was developed using 250-m 7-day composite historical eMODIS (expedited Moderate Resolution Imaging Spectroradiometer) NDVI data. The growing season averaged NDVI (GSN), which is a proxy for ecosystem performance, was estimated and long-term NDVI non-saturation- and saturation-adjusted cropland performance (CPnon_sat_adjust, CPsat_adjust) maps were produced over the GPRB. The final CP maps were validated using National Agricultural Statistics Service (NASS) crop yield data. The relationship between CPsat_adjust and the NASS average corn yield data (r = 0.78, 113 samples) is stronger than the relationship between CPnon_sat_adjust and the NASS average corn yield data (r = 0.67, 113 samples), indicating that the new CPsat_adjust map reduces the NDVI saturation effects and is in good agreement with the corn yield ground observations. Results demonstrate that the NDVI saturation adjustment approach improves the quality of the original GSN map and better depicts the actual vegetation conditions of the GPRB cropland systems.

  20. Olympic weightlifting and plyometric training with children provides similar or greater performance improvements than traditional resistance training.

    Science.gov (United States)

    Chaouachi, Anis; Hammami, Raouf; Kaabi, Sofiene; Chamari, Karim; Drinkwater, Eric J; Behm, David G

    2014-06-01

    A number of organizations recommend that advanced resistance training (RT) techniques can be implemented with children. The objective of this study was to evaluate the effectiveness of Olympic-style weightlifting (OWL), plyometrics, and traditional RT programs with children. Sixty-three children (10-12 years) were randomly allocated to a 12-week control OWL, plyometric, or traditional RT program. Pre- and post-training tests included body mass index (BMI), sum of skinfolds, countermovement jump (CMJ), horizontal jump, balance, 5- and 20-m sprint times, isokinetic force and power at 60 and 300° · s(-1). Magnitude-based inferences were used to analyze the likelihood of an effect having a standardized (Cohen's) effect size exceeding 0.20. All interventions were generally superior to the control group. Olympic weightlifting was >80% likely to provide substantially better improvements than plyometric training for CMJ, horizontal jump, and 5- and 20-m sprint times, whereas >75% likely to substantially exceed traditional RT for balance and isokinetic power at 300° · s(-1). Plyometric training was >78% likely to elicit substantially better training adaptations than traditional RT for balance, isokinetic force at 60 and 300° · s(-1), isokinetic power at 300° · s(-1), and 5- and 20-m sprints. Traditional RT only exceeded plyometric training for BMI and isokinetic power at 60° · s(-1). Hence, OWL and plyometrics can provide similar or greater performance adaptations for children. It is recommended that any of the 3 training modalities can be implemented under professional supervision with proper training progressions to enhance training adaptations in children.

  1. Social and institutional evaluation report for Greater-Than-Class C Low-Level Radioactive Waste Disposal

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, T.L.; Lewis, B.E.; Turner, K.H.; Rozelle, M.A. [Dames and Moore, Denver, CO (United States)

    1993-10-01

    This report identifies and characterizes social and institutional issues that would be relevant to the siting, licensing, construction, closure, and postclosure of a Greater-Than-Class-C low-level radioactive waste (GTCC LLW) disposal facility. A historical perspective of high-level radioactive waste (HLW) and LLW disposal programs is provided as an overview of radioactive waste disposal and to support the recommendations and conclusions in the report. A characterization of each issue is provided to establish the basis for further evaluations. Where applicable, the regulatory requirements of 10 CFR 60 and 61 are incorporated in the issue characterizations. The issues are used to compare surface, intermediate depth, and deep geologic disposal alternatives. The evaluation establishes that social and institutional issues do not significantly discriminate among the disposal alternatives. Recommendations are provided for methods by which the issues could be considered throughout the lifecycle of a GTCC LLW disposal program.

  2. Waste Management Facilities Cost Information report for Greater-Than-Class C and DOE equivalent special case waste

    Energy Technology Data Exchange (ETDEWEB)

    Feizollahi, F.; Shropshire, D.

    1993-07-01

    This Waste Management Facility Cost Information (WMFCI) report for Greater-Than-Class C low-level waste (GTCC LLW) and DOE equivalent special case waste contains preconceptual designs and planning level life-cycle cost (PLCC) estimates for treatment, storage, and disposal facilities needed for management of GTCC LLW and DOE equivalent waste. The report contains information on 16 facilities (referred to as cost modules). These facilities are treatment facility front-end and back-end support functions (administration support, and receiving, preparation, and shipping cost modules); seven treatment concepts (incineration, metal melting, shredding/compaction, solidification, vitrification, metal sizing and decontamination, and wet/air oxidation cost modules); two storage concepts (enclosed vault and silo); disposal facility front-end functions (disposal receiving and inspection cost module); and four disposal concepts (shallow-land, engineered shallow-land, intermediate depth, and deep geological cost modules). Data in this report allow the user to develop PLCC estimates for various waste management options. A procedure to guide the U.S. Department of Energy (DOE) and its contractor personnel in the use of estimating data is also included in this report.

  3. Adults with Greater Weight Satisfaction Report More Positive Health Behaviors and Have Better Health Status Regardless of BMI

    Directory of Open Access Journals (Sweden)

    Christine E. Blake

    2013-01-01

    Full Text Available Background. Prior studies suggest that weight satisfaction may preclude changes in behavior that lead to healthier weight among individuals who are overweight or obese. Objective. To gain a better understanding of complex relationships between weight satisfaction, weight-related health behaviors, and health outcomes. Design. Cross-sectional analysis of data from the Aerobics Center Longitudinal Study (ACLS. Participants. Large mixed-gender cohort of primarily white, middle-to-upper socioeconomic status (SES adults with baseline examination between 1987 and 2002 (n=19,003. Main Outcome Variables. Weight satisfaction, weight-related health behaviors, chronic health conditions, and clinical health indicators. Statistical Analyses Performed. Chi-square test, t-tests, and linear and multivariate logistic regression. Results. Compared to men, women were more likely to be dieting (32% women; 18% men and had higher weight dissatisfaction. Men and women with greater weight dissatisfaction reported more dieting, yo-yo dieting, and snacking and consuming fewer meals, being less active, and having to eat either more or less than desired to maintain weight regardless of weight status. Those who were overweight or obese and dissatisfied with their weight had the poorest health. Conclusion. Greater satisfaction with one’s weight was associated with positive health behaviors and health outcomes in both men and women and across weight status groups.

  4. Greater Caribbean Energy and Environment Future. Ad hoc working group report, Key Biscayne, Florida, October 26-28, 1980

    Energy Technology Data Exchange (ETDEWEB)

    Thorhaug, A. (ed.)

    1980-01-01

    This report of Workshop I (presented in outline form) by the Greater Caribbean Energy and Environment Foundation begin an intensive focus on the energy problems of the Caribbean. The process by which environmental assessments by tropical experts can be successfully integrated into energy decisions is by: (1) international loan institutions requiring or strongly recommending excellent assessments; (2) engineering awareness of total effects of energy projects; (3) governmental environmental consciousness-raising with regard to natural resource value and potential inadvertent and unnecessary resource losses during energy development; and (4) media participation. Section headings in the outline are: preamble; introduction; research tasks: today and twenty years hence; needed research, demonstration and information dissemination projects to get knowledge about Caribbean energy-environment used; summary; recommendations; generalized conclusions; and background literature. (JGB)

  5. New reports, phylogenetic analysis, and a key to Lactarius Pers. in the Greater Yellowstone Ecosystem informed by molecular data

    Directory of Open Access Journals (Sweden)

    Edward G. Barge

    2016-09-01

    Full Text Available The Greater Yellowstone Ecosystem (GYE, located in the Central Rocky Mountains of western North America, is one of the largest nearly intact temperate-zone ecosystems on Earth. Here, Lactarius is an important component of ectomycorrhizal communities in many habitat types, from low elevation riparian areas to high elevation conifer forests and alpine tundra. Molecular phylogenetic analyses of ITS and RPB2 gene sequences along with detailed morphological examination confirm at least 20 Lactarius species, as well as three varieties, and one unresolved species group in the GYE. Eight taxa are reported from the GYE for the first time, and nearly every major ectomycorrhizal host plant in the GYE appears to have at least one Lactarius species associated with it. Broad intercontinental distributions are suggested for alpine Salix and Betula associates, and for certain subalpine Picea and aspen (Populus spp. associates. Some species appear to be restricted to western North America with Pinus, Pseudotsuga or Abies. The distribution and/or host affinities of others is not clear due in part to ambiguous host assignment, taxonomic problems or the relative rarity with which they have been reported.

  6. Quantifying reporting timeliness to improve outbreak control

    NARCIS (Netherlands)

    Bonačić Marinović, Axel; Swaan, Corien; van Steenbergen, Jim; Kretzschmar, MEE

    2015-01-01

    The extent to which reporting delays should be reduced to gain substantial improvement in outbreak control is unclear. We developed a model to quantitatively assess reporting timeliness. Using reporting speed data for 6 infectious diseases in the notification system in the Netherlands, we calculated

  7. Young adult cannabis users report greater propensity for risk-taking only in non-monetary domains.

    Science.gov (United States)

    Gilman, Jodi M; Calderon, Vanessa; Curran, Max T; Evins, A Eden

    2015-02-01

    Though substance use is often associated with elevated risk-taking in real-world scenarios, many risk-taking tasks in experimental psychology using financial gambles fail to find significant differences between individuals with substance use disorders and healthy controls. We assessed whether participants using marijuana would show a greater propensity for risk-taking in distinct domains including, but not limited to, financial risk-taking. In the current study, we assessed risk-taking in young adult (age 18-25) regular marijuana users and in non-using control participants using a domain-specific risk-taking self-report scale (DOSPERT) encompassing five domains of risk-taking (social, financial, recreational, health/safety, and ethical). We also measured behavioral risk-taking using a laboratory monetary risk-taking task. Marijuana users and controls reported significant differences on the social, health/safety, and ethical risk-taking scales, but no differences in the propensity to take recreational or financial risks. Complementing the self-report finding, there were no differences between marijuana users and controls in their performance on the laboratory risk-taking task. These findings suggest that financial risk-taking may be less sensitive than other domains of risk-taking in assessing differences in risky behavior between those who use marijuana and those who do not. In order to more consistently determine whether increased risk-taking is a factor in substance use, it may be necessary to use both monetary risk-taking tasks and complementary assessments of non-monetary-based risk-taking measures. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  8. Ecology of Greater Sage-Grouse in the Bi-State Planning Area Final Report, September 2007

    Science.gov (United States)

    Casazza, Michael L.; Overton, Cory T.; Farinha, Melissa A.; Torregrosa, Alicia; Fleskes, Joseph P.; Miller, Michael R.; Sedinger, James S.; Kolada, Eric J.

    2009-01-01

    Conservation efforts for greater sage-grouse (Centrocercus urophasianus), hereafter sage-grouse, are underway across the range of this species. Over 70 local working groups have been established and are implementing on-the-ground sage-grouse oriented conservation projects. Early on in this process, the California Department of Fish and Game (CDFG) recognized the need to join in these efforts and received funding from the U.S. Fish and Wildlife Service (USFWS) under the Candidate Species Conservation Program to help develop a species conservation plan for sage-grouse in the Mono County area. This conservation plan covers portions of Alpine, Mono, and Inyo counties in California and Douglas, Esmeralda, Lyon, and Mineral counties in Nevada. A concurrent effort underway through the Nevada Governor's Sage-grouse Conservation Team established Local Area Working Groups across Nevada and eastern California. The Mono County populations of sage-grouse were encompassed by the Bi-State Local Planning Area, which was comprised of six population management units (PMUs). The state agencies from California (CDFG) and Nevada (Nevada Department of Wildlife; NDOW) responsible for the management of sage-grouse agreed to utilize the process that had begun with the Nevada Governor's Team in order to develop local plans for conservation planning and implementation. Resources from the USFWS were applied to several objectives in support of the development of the Bi-State Local Area Sage-grouse Conservation Plan through a grant to the U.S. Geological Survey (USGS). Objectives included: (1) participate in the development of the Bi-State Conservation Plan, (2) compile and synthesize existing sage-grouse data, (3) document seasonal movements of sage-grouse, (4) identify habitats critical to sage-grouse, (5) determine survival rates and identify causal factors of mortality, (6) determine nest success and brood success of sage-grouse, and (7) identify sage-grouse lek sites. Progress reports

  9. Towards a greater understanding of the illicit tobacco trade in Europe: a review of the PMI funded 'Project Star' report.

    Science.gov (United States)

    Gilmore, Anna B; Rowell, Andy; Gallus, Silvano; Lugo, Alessandra; Joossens, Luk; Sims, Michelle

    2014-05-01

    Following a legal agreement with the European Union (EU), Philip Morris International (PMI) commissions a yearly report ('Project Star', PS) on the European illicit cigarette trade from KPMG, the global accountancy firm. Review of PS 2010 report. Comparison with data from independent sources including a 2010 pan-European survey (N=18,056). Within PS, data covering all 27 EU countries are entered into a model. While the model itself seems appropriate, concerns are identified with the methodologies underlying the data inputs and thus their quality: there is little transparency over methodologies; interview data underestimate legal non-domestic product partly by failing to account for legal cross-border sales; illicit cigarette estimates rely on tobacco industry empty pack surveys which may overestimate illicit; and there is an over-reliance on data supplied by PMI with inadequate external validation. Thus, PMI sales data are validated using PMI smoking prevalence estimates, yet PMI is unable to provide sales (shipment) data for the Greek islands and its prevalence estimates differ grossly from independent data. Consequently, comparisons with independent data suggest PS will tend to overestimate illicit cigarette levels particularly where cross-border shopping is frequent (Austria, Finland, France) and in Western compared with Eastern European countries. The model also provides data on the nature of the illicit cigarette market independent of seizure data suggesting that almost a quarter of the illicit cigarette market in 2010 comprised PMI's own brands compared with just 5% counterfeited PMI brands; a finding hidden in PMI's public representation of the data. PS overestimates illicit cigarette levels in some European countries and suggests PMI's supply chain control is inadequate. Its publication serves the interests of PMI over those of the EU and its member states. PS requires greater transparency, external scrutiny and use of independent data. Published by the BMJ

  10. The Greater Phenotypic Homeostasis of the Allopolyploid Coffea arabica Improved the Transcriptional Homeostasis Over that of Both Diploid Parents.

    Science.gov (United States)

    Bertrand, Benoît; Bardil, Amélie; Baraille, Hélène; Dussert, Stéphane; Doulbeau, Sylvie; Dubois, Emeric; Severac, Dany; Dereeper, Alexis; Etienne, Hervé

    2015-10-01

    Polyploidy impacts the diversity of plant species, giving rise to novel phenotypes and leading to ecological diversification. In order to observe adaptive and evolutionary capacities of polyploids, we compared the growth, primary metabolism and transcriptomic expression level in the leaves of the newly formed allotetraploid Coffea arabica species compared with its two diploid parental species (Coffea eugenioides and Coffea canephora), exposed to four thermal regimes (TRs; 18-14, 23-19, 28-24 and 33-29°C). The growth rate of the allopolyploid C. arabica was similar to that of C. canephora under the hottest TR and that of C. eugenioides under the coldest TR. For metabolite contents measured at the hottest TR, the allopolyploid showed similar behavior to C. canephora, the parent which tolerates higher growth temperatures in the natural environment. However, at the coldest TR, the allopolyploid displayed higher sucrose, raffinose and ABA contents than those of its two parents and similar linolenic acid leaf composition and Chl content to those of C. eugenioides. At the gene expression level, few differences between the allopolyploid and its parents were observed for studied genes linked to photosynthesis, respiration and the circadian clock, whereas genes linked to redox activity showed a greater capacity of the allopolyploid for homeostasis. Finally, we found that the overall transcriptional response to TRs of the allopolyploid was more homeostatic compared with its parents. This better transcriptional homeostasis of the allopolyploid C. arabica afforded a greater phenotypic homeostasis when faced with environments that are unsuited to the diploid parental species.

  11. [Reporting of side-effects--a system in need of improvement. Reporting of a physician questionnaire].

    Science.gov (United States)

    Ekbom, Ylva; Hedenmalm, Karin; Dalin, Linda; Lönnroth, Knut; Persson, Ingemar

    2002-08-22

    The spontaneous reporting system in Sweden is based on reporting by health care professionals of adverse drug reactions (ADRs) to the Medical Products Agency. The usefulness of the spontaneous reporting system is limited by a substantial degree of underreporting. In order to study factors that make reporting of ADRs difficult as well as to obtain responses to suggestions that could increase the reporting of ADRs, an enquiry was sent to 300 randomly selected physicians. The most important factors that make reporting of ADRs more difficult are lack of time and forgetfulness. Most physicians stated that they would report ADRs to a greater extent if reporting was simpler, if resources were available or if the response to the reporting was improved. The majority of the physicians who had a computer at work stated that they would like to access the reporting form electronically.

  12. Organizational culture, continuous quality improvement, and medication administration error reporting.

    Science.gov (United States)

    Wakefield, B J; Blegen, M A; Uden-Holman, T; Vaughn, T; Chrischilles, E; Wakefield, D S

    2001-01-01

    This study explores the relationships among measures of nurses' perceptions of organizational culture, continuous quality improvement (CQI) implementation, and medication administration error (MAE) reporting. Hospital-based nurses were surveyed using measures of organizational culture and CQI implementation. These data were combined with previously collected data on perceptions of MAE reporting. A group-oriented culture had a significant positive correlation with CQI implementation, whereas hierarchical and rational culture types were negatively correlated with CQI implementation. Higher barriers to reporting MAE were associated with lower perceived reporting rates. A group-oriented culture and a greater extent of CQI implementation were positively (but not significantly) associated with the estimated overall percentage of MAEs reported. We conclude that health care organizations have implemented CQI programs, yet barriers remain relative to MAE reporting. There is a need to assess the reliability, validity, and completeness of key quality assessment and risk management data.

  13. Progress report 1988: predator control to enhance production of Greater Sandhill Cranes on Malheur National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The nesting population of greater sandhill cranes on Malheur National Wildlife Refuge, Oregon has declined from 181 pairs in 1986 when predator control began to 137...

  14. Progress report 1989: predator control to enhance the production of Greater Sandhill Cranes on Malheur National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The nesting population of greater sandhill cranes on Malheur National Wildlife Refuge, Oregon has declined from 236 pairs in 1971 to 181 pairs in 1986 when predator...

  15. Progress report 1987: predator control to enhance the production of Greater Sandhill Cranes on Malheur National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The nesting population of greater sandhill cranes on Malheur National Wildlife Refuge, Oregon has declined from 236 pairs in 1971 to 181 pairs in 1986. Nesting...

  16. Progress Report 1986 : Predator Control to Enhance the Production of Greater Sandhill Cranes on Malheur National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The nesting population of greater sandhill cranes on Malheur National Wildlife Refuge, Oregon has declined from 236 pairs in 1971 to 181 pairs in 1986. Nesting...

  17. Progress report 1991: predator control to enhance the production of greater Sandhill Cranes on Malheur National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The nesting population of greater sandhill cranes on Malheur National Wildlife Refuge, Oregon had declined from 236 pairs in 1971 to 181 pairs in 1986 when predator...

  18. Progress Report 1990: predator control to enhance the production of Greater Sandhill Cranes on Malheur National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The nesting population of greater sandhill cranes on Malheur National Wildlife Refuge, Oregon had declined from 236 pairs in 1971 to 181 pairs in 1986 when predator...

  19. Greater endurance capacity and improved dyspnoea with acute oxygen supplementation in idiopathic pulmonary fibrosis patients without resting hypoxaemia.

    Science.gov (United States)

    Dowman, Leona M; McDonald, Christine F; Bozinovski, Steven; Vlahos, Ross; Gillies, Rebecca; Pouniotis, Dodie; Hill, Catherine J; Goh, Nicole S L; Holland, Anne E

    2017-07-01

    Supplemental oxygen is commonly prescribed in patients with idiopathic pulmonary fibrosis (IPF), although its benefits have not been proven. The aims of this study were to investigate the effect of oxygen on oxidative stress, cytokine production, skeletal muscle metabolism and physiological response to exercise in IPF. Eleven participants with IPF received either oxygen, at an FiO2 of 0.50, or compressed air for 1 h at rest and during a cycle endurance test at 85% of peak work rate. Blood samples collected at rest and during exercise were analysed for markers of oxidative stress, skeletal muscle metabolism and cytokines. The protocol was repeated a week later with the alternate intervention. Compared with air, oxygen did not adversely affect biomarker concentrations at rest and significantly improved endurance time (mean difference = 99 ± 81s, P = 0.002), dyspnoea (-1 ± 1 U, P = 0.02), systolic blood pressure (BP; -11 ± 11 mm Hg, P = 0.006), nadir oxyhaemoglobin saturation (SpO2 ; 8 ± 6%, P = 0.001), SpO2 at 2-min (7 ± 6%, P = 0.003) and 5-min isotimes (5 ± 3, P < 0.001) and peak exercise xanthine concentrations (-42 ± 73 µmol/L, P = 0.03). Air significantly increased IL-10 (5 ± 5 pg/mL, P = 0.04) at 2-min isotime. Thiobarbituric acid-reactive substances (TBARs), IL-6, TNF-α, creatine kinase, lactate, heart rate and fatigue did not differ between the two interventions at any time point. In patients with IPF, breathing oxygen at FiO2 of 0.50 at rest seems safe. During exercise, oxygen improves exercise tolerance, alleviates exercise-induced hypoxaemia and reduces dyspnoea. A potential relationship between oxygen administration and improved skeletal muscle metabolism should be explored in future studies. © 2017 Asian Pacific Society of Respirology.

  20. Benchmarking for Cost Improvement. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-01

    The US Department of Energy`s (DOE) Office of Environmental Restoration and Waste Management (EM) conducted the Benchmarking for Cost Improvement initiative with three objectives: Pilot test benchmarking as an EM cost improvement tool; identify areas for cost improvement and recommend actions to address these areas; provide a framework for future cost improvement. The benchmarking initiative featured the use of four principal methods (program classification, nationwide cost improvement survey, paired cost comparison and component benchmarking). Interested parties contributed during both the design and execution phases. The benchmarking initiative was conducted on an accelerated basis. Of necessity, it considered only a limited set of data that may not be fully representative of the diverse and complex conditions found at the many DOE installations. The initiative generated preliminary data about cost differences and it found a high degree of convergence on several issues. Based on this convergence, the report recommends cost improvement strategies and actions. This report describes the steps taken as part of the benchmarking initiative and discusses the findings and recommended actions for achieving cost improvement. The results and summary recommendations, reported below, are organized by the study objectives.

  1. A collaborative project to improve identification and management of patients with chronic kidney disease in a primary care setting in Greater Manchester.

    Science.gov (United States)

    Humphreys, John; Harvey, Gill; Coleiro, Michelle; Butler, Brook; Barclay, Anna; Gwozdziewicz, Maciek; O'Donoghue, Donal; Hegarty, Janet

    2012-08-01

    Research has demonstrated a knowledge and practice gap in the identification and management of chronic kidney disease (CKD). In 2009, published data showed that general practices in Greater Manchester had a low detection rate for CKD. A 12-month improvement collaborative, supported by an evidence-informed implementation framework and financial incentives. 19 general practices from four primary care trusts within Greater Manchester. Number of recorded patients with CKD on practice registers; percentage of patients on registers achieving nationally agreed blood pressure targets. The collaborative commenced in September 2009 and involved three joint learning sessions, interspersed with practice level rapid improvement cycles, and supported by an implementation team from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for Greater Manchester. At baseline, the 19 collaborative practices had 4185 patients on their CKD registers. At final data collection in September 2010, this figure had increased by 1324 to 5509. Blood pressure improved from 34% to 74% of patients on practice registers having a recorded blood pressure within recommended guidelines. Evidence-based improvement can be implemented in practice for chronic disease management. A collaborative approach has been successful in enabling teams to test and apply changes to identify patients and improve care. The model has proved to be more successful for some practices, suggesting a need to develop more context-sensitive approaches to implementation and actively manage the factors that influence the success of the collaborative.

  2. Case Report: Anteromedial temporosphenoidal encephalocele with a clinically silent lateral bony defect in the greater wing of the sphenoid

    Directory of Open Access Journals (Sweden)

    Pandey Anoop

    2009-01-01

    Full Text Available Anteromedial temporosphenoidal encephalocele is the least common type of temporal encephalocele. It commonly presents with spontaneous cerebrospinal fluid rhinorrhea in adults. This article presents the CT cisternography and MRI findings of one such case, which also had an associated clinically silent defect in the greater wing of the sphenoid on the same side.

  3. The management for tuberculosis control in Greater London in comparison with that in Osaka City: lessons for improvement of TB control management in Osaka City urban setting.

    Science.gov (United States)

    Ohkado, Akihiro; Williams, Gini; Ishikawa, Nobukatsu; Shimouchi, Akira; Simon, Carter

    2005-07-01

    The tuberculosis (TB) notification in Osaka City has been persistently high compared with other urban areas in Japan. Although the TB notification in Greater London has kept much lower level compared with that in Osaka City, it has been also persistently high compared with other urban areas in the UK. Nonetheless, the contexts of the two cities relating TB control programme as well as the epidemiological situation greatly vary; there must be some lessons to be learnt from each other to improve each TB control programme to tackle against TB more effectively. Comparing the epidemiological situation of TB in both cities, it is obvious that Osaka City suffers TB more than Greater London in terms of the TB notification rate. Concerning the context of the TB control programme, Osaka City has centralised approach with strong local government commitment; Greater London, on the other hand, has an approach that is greatly fragmented but coordinated through voluntary TB Networks. This paper aims to draw some constructive and practical lessons from Greater London TB control management for further improvement of Osaka City TB control management through literature review and interview to health professionals. TB epidemiology in Greater London shows distinct features in the extent of TB in new entrants and TB co-infected with HIV in comparison with those in Osaka City. TB epidemiology in Osaka City is to a great extent specifically related to homeless people whereas in Greater London, this relationship occurs to a lesser extent. Both areas have relatively high TB-notification rates compared with national figures, and they have "TB hot spots" where remarkably high TB-notification rates exist. TB control in Greater London is characterised with decentralised and devolved services to local government health authorities supplemented with co-ordinating bodies across sectors as well as across Greater London. Sector-wide TB Network as well as London TB Group (LTBG) and London TB Nurses

  4. Complicated sternal dehiscence treated with the strasbourg thoracic osteosyntheses system (STRATOS and the transposition of greater omentum: a case report

    Directory of Open Access Journals (Sweden)

    Casablanca Giuseppe

    2010-06-01

    Full Text Available Abstract Sternal dehiscence is a serious complication after cardiac surgery. Sternal refixation, performed by simple rewiring or techniqual modification of rewiring as described by Robicsek, can fail, overall when the bone quality is poor or the sternum is completely destroyed. The sternal closure systems, consisting of plates, screws or rib clips and titanium bars, have been recently introduced to treat the complicated sternal dehiscence. We describe for the first time the use of the Strasbourg Thoracic Osteosyntheses System (STRATOS and the greater omentum, to treat a complicated sternal dehiscence, causing chest pain and respiratory failure.

  5. Improving communication of diagnostic radiology findings through structured reporting.

    Science.gov (United States)

    Schwartz, Lawrence H; Panicek, David M; Berk, Alexandra R; Li, Yuelin; Hricak, Hedvig

    2011-07-01

    To compare the content, clarity, and clinical usefulness of conventional (ie, free-form) and structured radiology reports of body computed tomographic (CT) scans, as evaluated by referring physicians, attending radiologists, and radiology fellows at a tertiary care cancer center. The institutional review board approved the study as a quality improvement initiative; no written consent was required. Three radiologists, three radiology fellows, three surgeons, and two medical oncologists evaluated 330 randomly selected conventional and structured radiology reports of body CT scans. For nonradiologists, reports were randomly selected from patients with diagnoses relevant to the physician's area of specialization. Each physician read 15 reports in each format and rated both the content and clarity of each report from 1 (very dissatisfied or very confusing) to 10 (very satisfied or very clear). By using a previously published radiology report grading scale, physicians graded each report's effectiveness in advancing the patient's position on the clinical spectrum. Mixed-effects models were used to test differences between report types. Mean content satisfaction ratings were 7.61 (95% confidence interval [CI]: 7.12, 8.16) for conventional reports and 8.33 (95% CI: 7.82, 8.86) for structured reports, and the difference was significant (P < .0001). Mean clarity satisfaction ratings were 7.45 (95% CI: 6.89, 8.02) for conventional reports and 8.25 (95% CI: 7.68, 8.82) for structured reports, and the difference was significant (P < .0001). Grade ratings did not differ significantly between conventional and structured reports. Referring clinicians and radiologists found that structured reports had better content and greater clarity than conventional reports.

  6. Biospecimen Reporting for Improved Study Quality (BRISQ)

    Energy Technology Data Exchange (ETDEWEB)

    National Cancer Institute; Jewell, Ph.D., Scott D.; Seijo, M.S., Edward; Kelly, Ph.D., Andrea; Somiari, Ph.D., Stella; B.Chir., M.B.; McShane, Ph.D., Lisa M.; Clark, M.D., Douglas; Greenspan, M.D., Renata; Hayes, M.D., Daniel F.; Hainaut, Ph.D., M.S., Pierre; Kim, Paula; Mansfield, Ph.D., Elizabeth; Potapova, Ph.D., Olga; Riegman, Ph.D., Peter; Rubinstein, Ph.D., Yaffa; Weier, Ph.D., Heinz-Ulrich; Zhu, Ph.D., Claire; Moore, Ph.D., Helen M.; Vaught, Ph.D., Jim; Watson, Peter

    2010-09-02

    Human biospecimens are subjected to collection, processing, and storage that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research that uses human tissues, it is crucial that information on the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications on biospecimen-related research and to help reassure patient contributors and the advocacy community that their contributions are valued and respected.

  7. Biospecimen Reporting for Improved Study Quality

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Ph.D., Helen M.; Kelly, Ph.D., Andrea B.; Jewell, Ph.D., Scott D.; McShane, Ph.D., Lisa M.; Clark, M.D., Douglas P.; Greenspan, M.D., Renata; Hayes, M.D., Daniel F.; Hainaut, Ph.D., Pierre; Kim, Paula; Mansfield, Ph.D., Elizabeth A.; Potapova, Ph.D., Olga; Riegman, Ph.D., Peter; Rubinstein, Ph.D., Yaffa; Seijo, M.S., Edward; Somiari, Ph.D., Stella; Chir., B; Weier, Ph.D., Heinz-Ulrich; Zhu, Ph.D., Claire; Vaught, Ph.D., Jim; Watson,M.B., Peter

    2010-12-27

    Human biospecimens are subjected to collection, processing, and storage that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research that uses human tissues, it is crucial that information on the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications on biospecimen-related research and to help reassure patient contributors and the advocacy community that their contributions are valued and respected.

  8. Biospecimen Reporting for Improved Study Quality (BRISQ)

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Ph.D., Helen M.; Kelly Ph.D., Andrea; Jewell Ph.D., Scott D.; McShane Ph.D., Lisa M.; Clark M.D., Douglas P.; Greenspan M.D., Renata; Hayes M.D., Daniel F.; Hainaut Ph.D.,, Pierre; Kim, Paula; Mansfield Ph.D., Elizabeth; Potapova Ph.D., Olga; Riegman Ph.D., Peter; Rubinstein Ph.D., Yaffa; Seijo M.S., Edward; Somiari Ph.D., Stella; Watson M.B., Peter; Weier Ph.D., Heinz-Ulrich; Zhu Ph.D., Claire; Vaught Ph.D., Jim

    2011-04-26

    Human biospecimens are subject to a number of different collection, processing, and storage factors that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research utilizing human tissues it is critical that information regarding the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications around biospecimen-related research and help reassure patient contributors and the advocacy community that the contributions are valued and respected.

  9. EnergyWorks Final Report: A Better Buildings Neighborhood Program in the Five-County Greater Philadelphia Region

    Energy Technology Data Exchange (ETDEWEB)

    Gajewski, Katherine [City of Philadelphia

    2014-03-05

    This report covers the grant performance period of July 1, 2010-September 30, 2013 and discusses of the program design, outcomes and best practices as they relate to the following six areas: 1. Institutional Design and Business Model; 2. Program Design and Customer Experience; 3. Driving Demand; 4. Workforce Development; 5. Financing and Incentives; 6. Data and Evaluation.

  10. Do older people with visual impairment and living alone in a rural developing country report greater difficulty in managing stairs?

    Science.gov (United States)

    Hairi, Noran N; Bulgiba, Awang; Peramalah, Devi; Mudla, Izzuna

    2013-01-01

    Managing stairs is a challenging activity of daily living (ADL) for older people. This study aims to examine the association between visual impairment and difficulty in managing stairs among older people living alone and those living with others. A population-based cross sectional study was conducted in rural Malaysia from 2007 till 2008. Seven hundred and sixty five older people aged 60 years and over underwent eye examination for visual impairment. Visual acuity criteria were used to define visual impairment. Presenting visual acuity was assessed using a standard metric Snellen Chart of E type. Difficulty in managing stairs was measured according to a question drawn from the Barthel Index which asks "do you need help in climbing stairs". Overall, the prevalence of difficulty in managing stairs among older people in our population was 135 (18.3%, 95% CI 15.7-21.2). After adjusting for important confounders the odds ratio (OR) for visual impairment and difficulty in managing stairs among older people living alone was 5.04 (95% CI 2.27, 10.62). Among older people living with others, the adjusted OR for visual impairment and difficulty in managing stairs was 3.10 (95% CI 1.52, 6.80). In a sample of older people aged 60 years and over, those living alone with visual impairment had greater difficulty in managing stairs than those living with others. Identification of these groups of older people is useful for targeting interventions. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. The SQUIRE (Standards for QUality Improvement Reporting Excellence) guidelines for quality improvement reporting: explanation and elaboration.

    Science.gov (United States)

    Ogrinc, G; Mooney, S E; Estrada, C; Foster, T; Goldmann, D; Hall, L W; Huizinga, M M; Liu, S K; Mills, P; Neily, J; Nelson, W; Pronovost, P J; Provost, L; Rubenstein, L V; Speroff, T; Splaine, M; Thomson, R; Tomolo, A M; Watts, B

    2008-10-01

    As the science of quality improvement in health care advances, the importance of sharing its accomplishments through the published literature increases. Current reporting of improvement work in health care varies widely in both content and quality. It is against this backdrop that a group of stakeholders from a variety of disciplines has created the Standards for QUality Improvement Reporting Excellence, which we refer to as the SQUIRE publication guidelines or SQUIRE statement. The SQUIRE statement consists of a checklist of 19 items that authors need to consider when writing articles that describe formal studies of quality improvement. Most of the items in the checklist are common to all scientific reporting, but virtually all of them have been modified to reflect the unique nature of medical improvement work. This "Explanation and Elaboration" document (E & E) is a companion to the SQUIRE statement. For each item in the SQUIRE guidelines the E & E document provides one or two examples from the published improvement literature, followed by an analysis of the ways in which the example expresses the intent of the guideline item. As with the E & E documents created to accompany other biomedical publication guidelines, the purpose of the SQUIRE E & E document is to assist authors along the path from completion of a quality improvement project to its publication. The SQUIRE statement itself, this E & E document, and additional information about reporting improvement work can be found at http://www.squire-statement.org.

  12. The SQUIRE (Standards for QUality Improvement Reporting Excellence) guidelines for quality improvement reporting: explanation and elaboration

    Science.gov (United States)

    Ogrinc, G; Mooney, S E; Estrada, C; Foster, T; Goldmann, D; Hall, L W; Huizinga, M M; Liu, S K; Mills, P; Neily, J; Nelson, W; Pronovost, P J; Provost, L; Rubenstein, L V; Speroff, T; Splaine, M; Thomson, R; Tomolo, A M; Watts, B

    2008-01-01

    As the science of quality improvement in health care advances, the importance of sharing its accomplishments through the published literature increases. Current reporting of improvement work in health care varies widely in both content and quality. It is against this backdrop that a group of stakeholders from a variety of disciplines has created the Standards for QUality Improvement Reporting Excellence, which we refer to as the SQUIRE publication guidelines or SQUIRE statement. The SQUIRE statement consists of a checklist of 19 items that authors need to consider when writing articles that describe formal studies of quality improvement. Most of the items in the checklist are common to all scientific reporting, but virtually all of them have been modified to reflect the unique nature of medical improvement work. This “Explanation and Elaboration” document (E & E) is a companion to the SQUIRE statement. For each item in the SQUIRE guidelines the E & E document provides one or two examples from the published improvement literature, followed by an analysis of the ways in which the example expresses the intent of the guideline item. As with the E & E documents created to accompany other biomedical publication guidelines, the purpose of the SQUIRE E & E document is to assist authors along the path from completion of a quality improvement project to its publication. The SQUIRE statement itself, this E & E document, and additional information about reporting improvement work can be found at http://www.squire-statement.org. PMID:18836062

  13. Year End Progress Report on Rattlesnake Improvements

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yaqi [Idaho National Lab. (INL), Idaho Falls, ID (United States); DeHart, Mark David [Idaho National Lab. (INL), Idaho Falls, ID (United States); Gleicher, Frederick Nathan [Idaho National Lab. (INL), Idaho Falls, ID (United States); Ortensi, Javier [Idaho National Lab. (INL), Idaho Falls, ID (United States); Schunert, Sebastian [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-09-01

    Rattlesnake is a MOOSE-based radiation transport application developed at INL to support modern multi-physics simulations. At the beginning of the last year, Rattlesnake was able to perform steady-state, transient and eigenvalue calculations for the multigroup radiation transport equations. Various discretization schemes, including continuous finite element method (FEM) with discrete ordinates method (SN) and spherical harmonics expansion method (PN) for the self-adjoint angular flux (SAAF) formulation, continuous FEM (CFEM) with SN for the least square (LS) formulation, diffusion approximation with CFEM and discontinuous FEM (DFEM), have been implemented. A separate toolkit, YAKXS, for multigroup cross section management was developed to support Rattlesnake calculations with feedback both from changes in the field variables, such as fuel temperature, coolant density, and etc., and in isotope inventory. The framework for doing nonlinear diffusion acceleration (NDA) within Rattlesnake has been set up, and both NDA calculations with SAAF-SN-CFEM scheme and Monte Carlo with OpenMC have been performed. It was also used for coupling BISON and RELAP-7 for the full-core multiphysics simulations. Within the last fiscal year, significant improvements have been made in Rattlesnake. Rattlesnake development was migrated into our internal GITLAB development environment at the end of year 2014. Since then total 369 merge requests has been accepted into Rattlesnake. It is noted that the MOOSE framework that Rattlesnake is based on is under continuous developments. Improvements made in MOOSE can improve the Rattlesnake. It is acknowledged that MOOSE developers spent efforts on patching Rattlesnake for the improvements made on the framework side. This report will not cover the code restructuring for better readability and modularity and documentation improvements, which we have spent tremendous effort on. It only details some of improvements in the following sections.

  14. Improved methods to deduct trip legs and mode from travel surveys using wearable GPS devices: A case study from the Greater Copenhagen area

    DEFF Research Database (Denmark)

    Rasmussen, Thomas Kjær; Ingvardson, Jesper Bláfoss; Halldórsdóttir, Katrín

    2015-01-01

    in the highly complex large-scale multi-modal transport network of the Greater Copenhagen area. It detects trips, trip legs and distinguishes between five modes of transport. The algorithm was validated by comparing with a control questionnaire collected among the same persons and a sensitivity analysis...... was performed. This showed that the algorithm (i) identified corresponding trip legs for 82% of the reported trip legs, (ii) avoided classifying non-trips such as scatter around activities as trip legs, (iii) identified the correct mode of transport for more than 90% of trip legs, and (iv) were robust towards...

  15. Natural Recharge to the Unconfined Aquifer System on the Hanford Site from the Greater Cold Creek Watershed: Progress Report 2004

    Energy Technology Data Exchange (ETDEWEB)

    Waichler, Scott R.; Wigmosta, Mark S.; Coleman, Andre M.

    2004-09-14

    Movement of contaminants in groundwater at the Hanford Site is heavily dependent on recharge to the unconfined aquifer. As the effects of past artificial discharges dissipate, the water table is expected to return to more natural conditions, and natural recharge will become the driving force when evaluating future groundwater flow conditions and related contaminant transport. Previous work on the relationship of natural recharge to groundwater movement at the Hanford Site has focused on direct recharge from infiltrating rainfall and snowmelt within the area represented by the Sitewide Groundwater Model (SGM) domain. However, part of the groundwater recharge at Hanford is provided by flow from Greater Cold Creek watershed (GCC), a large drainage area on the western boundary of the Hanford Site that includes Cold Creek Valley, Dry Creek Valley, and the Hanford side of Rattlesnake Mountain. This study was undertaken to estimate the recharge from GCC, which is believed to enter the unconfined aquifer as both infiltrating streamflow and shallow subsurface flow. To estimate recharge, the Distributed Hydrology-Soil-Vegetation Model (DHSVM) was used to simulate a detailed water balance of GCC from 1956 to 2001 at a spatial resolution of 200~m and a temporal resolution of one hour. For estimating natural recharge to Hanford from watersheds along its western and southwestern boundaries, the most important aspects that need to be considered are 1)~distribution and relative magnitude of precipitation and evapotranspiration over the watershed, 2)~streamflow generation at upper elevations and infiltration at lower elevations during rare runoff events, and 3)~permeability of the basalt bedrock surface underlying the soil mantle.

  16. Greater years of maternal schooling and higher scores on academic achievement tests are independently associated with improved management of child diarrhea by rural Guatemalan mothers.

    Science.gov (United States)

    Webb, Aimee L; Ramakrishnan, Usha; Stein, Aryeh D; Sellen, Daniel W; Merchant, Moeza; Martorell, Reynaldo

    2010-09-01

    Appropriate home management can alleviate many of the consequences of diarrhea including malnutrition, impaired development, growth faltering, and mortality. Maternal cognitive ability, years of schooling, and acquired academic skills are hypothesized to improve child health by improving maternal child care practices, such as illness management. Using information collected longitudinally in 1996-1999 from 466 rural Guatemalan women with children Raven's Progressive Matrices and an illness management index (IMI). Women scoring in the lowest and middle tertiles of academic skills scored lower on the IMI compared to women in the highest tertile (-0.24 [95% CI: -0.54, 0.07]; -0.30 [95% CI: -0.54, -0.06], respectively) independent of sociodemographic factors, schooling, and Raven's scores. Among mothers with less than 1 year of schooling, scoring in the lowest tertile on the Raven's Progressive Matrices compared to the highest was significantly associated with scoring one point lower on the IMI (-1.18 [95% CI: -2.20, -0.17]). Greater academic skills were independently associated with maternal care during episodes of infant diarrhea. Schooling of young girls and/or community based programs that provide women with academic skills such as literacy, numeracy and knowledge could potentially improve mothers' care giving practices.

  17. Using the Green Infrastructure as an Economic Sustainable Tool for Improving Urban Life in Emerging Countries Urban Poverty Areas Greater Cairo Case Study

    Directory of Open Access Journals (Sweden)

    Ahmed Khaled Ahmed Elewa

    2014-10-01

    Full Text Available Through the last decades rapid urbanization in the emerging countries was producing bad urban quality. This urbanization of poverty is responsible of the phenomenon of the current spreading of slums in those countries main cities, Yet the common urban solutions for improving the urban life in those areas always require a high-cost budget which usuallysurpassing the financial ability of the local governments. The study main objective is to evaluate the possibility of using the Green Infrastructure as an economic sustainable toolfor improving the urban life in urban poverty areas of emerging countries. An analytical study was done based on the case of Greater Cairo city informal areas as urban poverty areas. The study has clarified how the elements of the Green Infrastructure could be used as an effective economic and sustainable tool through its environmental, urban, and social roles, for the improvement of urban poverty areas in the emerging countries main cities, Also has shown that the Green Infrastructure depends on available local natural elements, local experts experience and the most important. Its affordable cost, which make it an effectiveeconomic tool.Key Words: Green Infrastructure, Economic Sustainability, Emerging Countries

  18. Female Rats Demonstrate Improved Locomotor Recovery and Greater Preservation of White and Gray Matter after Traumatic Spinal Cord Injury Compared to Males.

    Science.gov (United States)

    Datto, Jeffrey P; Bastidas, Johana C; Miller, Nicole L; Shah, Anna K; Arheart, Kristopher L; Marcillo, Alexander E; Dietrich, W Dalton; Pearse, Damien D

    2015-08-01

    The possibility of a gender-related difference in recovery after spinal cord injury (SCI) remains a controversial subject. Current empirical animal research lacks sizable test groups to definitively determine whether significant differences exist. Evaluating locomotor recovery variances between sexes following a precise, clinically relevant spinal cord contusion model can provide valuable insight into a possible gender-related advantage in outcome post-SCI. In the current study, we hypothesized that by employing larger sample sizes in a reproducible contusive SCI paradigm, subtle distinctions in locomotor recovery between sexes, if they exist, would be elucidated through a broad range of behavioral tests. During 13 weeks of functional assessment after a thoracic (T8) contusive SCI in rat, significant differences owing to gender existed for the Basso, Beattie, and Bresnahan score and CatWalk hindlimb swing, support four, and single stance analyses. Significant differences in locomotor performance were noticeable as early as 4 weeks post-SCI. Stereological tissue-volume analysis determined that females, more so than males, also exhibited greater volumes of preserved gray and white matter within the injured cord segment as well as more spared ventral white matter area at the center of the lesion. The stereological tissue analysis differences favoring females directly correlated with the female rats' greater functional improvement observed at endpoint.

  19. [Greater trochanteric pain syndrome].

    Science.gov (United States)

    Gollwitzer, H; Opitz, G; Gerdesmeyer, L; Hauschild, M

    2014-01-01

    Greater trochanteric pain is one of the common complaints in orthopedics. Frequent diagnoses include myofascial pain, trochanteric bursitis, tendinosis and rupture of the gluteus medius and minimus tendon, and external snapping hip. Furthermore, nerve entrapment like the piriformis syndrome must be considered in the differential diagnosis. This article summarizes essential diagnostic and therapeutic steps in greater trochanteric pain syndrome. Careful clinical evaluation, complemented with specific imaging studies and diagnostic infiltrations allows determination of the underlying pathology in most cases. Thereafter, specific nonsurgical treatment is indicated, with success rates of more than 90 %. Resistant cases and tendon ruptures may require surgical intervention, which can provide significant pain relief and functional improvement in most cases.

  20. Yoga Meditation Practitioners Exhibit Greater Gray Matter Volume and Fewer Reported Cognitive Failures: Results of a Preliminary Voxel-Based Morphometric Analysis

    Directory of Open Access Journals (Sweden)

    Brett Froeliger

    2012-01-01

    Full Text Available Hatha yoga techniques, including physical postures (asanas, breathing exercises (pranayama, and meditation, involve the practice of mindfulness. In turn, yoga meditation practices may induce the state of mindfulness, which, when evoked recurrently through repeated practice, may accrue into trait or dispositional mindfulness. Putatively, these changes may be mediated by experience-dependent neuroplastic changes. Though prior studies have identified differences in gray matter volume (GMV between long-term mindfulness practitioners and controls, no studies to date have reported on whether yoga meditation is associated with GMV differences. The present study investigated GMV differences between yoga meditation practitioners (YMP and a matched control group (CG. The YMP group exhibited greater GM volume in frontal, limbic, temporal, occipital, and cerebellar regions; whereas the CG had no greater regional greater GMV. In addition, the YMP group reported significantly fewer cognitive failures on the Cognitive Failures Questionnaire (CFQ, the magnitude of which was positively correlated with GMV in numerous regions identified in the primary analysis. Lastly, GMV was positively correlated with the duration of yoga practice. Results from this preliminary study suggest that hatha yoga practice may be associated with the promotion of neuroplastic changes in executive brain systems, which may confer therapeutic benefits that accrue with repeated practice.

  1. Greater improvement in quality of life following unilateral deep brain stimulation surgery in the globus pallidus as compared to the subthalamic nucleus

    OpenAIRE

    2009-01-01

    While deep brain stimulation (DBS) surgery is a well-accepted treatment for Parkinson disease (PD) that improves overall quality of life (QoL), its effects across different domains of QoL are unclear. The study reported here directly compared the effects of unilateral DBS in subthalamic nucleus (STN) or globus pallidus (GPi) on QoL in 42 non-demented patients with medication-refractory PD. Patients were enrolled in the COMPARE trial, a randomized clinical trial of cognitive and mood effects o...

  2. Dual-hemisphere tDCS facilitates greater improvements for healthy subjects' non-dominant hand compared to uni-hemisphere stimulation

    Directory of Open Access Journals (Sweden)

    Cerruti Carlo

    2008-10-01

    Full Text Available Abstract Background Transcranial direct current stimulation (tDCS is a non-invasive technique that has been found to modulate the excitability of neurons in the brain. The polarity of the current applied to the scalp determines the effects of tDCS on the underlying tissue: anodal tDCS increases excitability, whereas cathodal tDCS decreases excitability. Research has shown that applying anodal tDCS to the non-dominant motor cortex can improve motor performance for the non-dominant hand, presumably by means of changes in synaptic plasticity between neurons. Our previous studies also suggest that applying cathodal tDCS over the dominant motor cortex can improve performance for the non-dominant hand; this effect may result from modulating inhibitory projections (interhemispheric inhibition between the motor cortices of the two hemispheres. We hypothesized that stimultaneously applying cathodal tDCS over the dominant motor cortex and anodal tDCS over the non-dominant motor cortex would have a greater effect on finger sequence performance for the non-dominant hand, compared to stimulating only the non-dominant motor cortex. Sixteen right-handed participants underwent three stimulation conditions: 1 dual-hemisphere – with anodal tDCS over the non-dominant motor cortex, and cathodal tDCS over the dominant motor cortex, 2 uni-hemisphere – with anodal tDCS over the non-dominant motor cortex, and 3 sham tDCS. Participants performed a finger-sequencing task with the non-dominant hand before and after each stimulation. The dependent variable was the percentage of change in performance, comparing pre- and post-tDCS scores. Results A repeated measures ANOVA yielded a significant effect of tDCS condition (F(2,30 = 4.468, p = .037. Post-hoc analyses revealed that dual-hemisphere stimulation improved performance significantly more than both uni-hemisphere (p = .021 and sham stimulation (p = .041. Conclusion We propose that simultaneously applying cathodal t

  3. IVA. Improving Vocational Administration. Final Report.

    Science.gov (United States)

    EPD Consortium D, Richardson, TX.

    The Texas Improving Vocational Administration (IVA) project was conceived to improve preservice and inservice programs for vocational education administrators. Primary objectives were to (1) develop a method, including a survey, to determine existing inservice and preservice administrative training program competencies; (2) determine, using the…

  4. IVA. Improving Vocational Administration. Final Report.

    Science.gov (United States)

    EPD Consortium D, Richardson, TX.

    The Texas Improving Vocational Administration (IVA) project was conceived to improve preservice and inservice programs for vocational education administrators. Primary objectives were to (1) develop a method, including a survey, to determine existing inservice and preservice administrative training program competencies; (2) determine, using the…

  5. Benchmark Assessment for Improved Learning. AACC Report

    Science.gov (United States)

    Herman, Joan L.; Osmundson, Ellen; Dietel, Ronald

    2010-01-01

    This report describes the purposes of benchmark assessments and provides recommendations for selecting and using benchmark assessments--addressing validity, alignment, reliability, fairness and bias and accessibility, instructional sensitivity, utility, and reporting issues. We also present recommendations on building capacity to support schools'…

  6. Improving global environmental management with standard corporate reporting.

    Science.gov (United States)

    Kareiva, Peter M; McNally, Brynn W; McCormick, Steve; Miller, Tom; Ruckelshaus, Mary

    2015-06-16

    Multinational corporations play a prominent role in shaping the environmental trajectory of the planet. The integration of environmental costs and benefits into corporate decision-making has enormous, but as yet unfulfilled, potential to promote sustainable development. To help steer business decisions toward better environmental outcomes, corporate reporting frameworks need to develop scientifically informed standards that consistently consider land use and land conversion, clean air (including greenhouse gas emissions), availability and quality of freshwater, degradation of coastal and marine habitats, and sustainable use of renewable resources such as soil, timber, and fisheries. Standardization by itself will not be enough--also required are advances in ecosystem modeling and in our understanding of critical ecological thresholds. With improving ecosystem science, the opportunity for realizing a major breakthrough in reporting corporate environmental impacts and dependencies has never been greater. Now is the time for ecologists to take advantage of an explosion of sustainability commitments from business leaders and expanding pressure for sustainable practices from shareholders, financial institutions, and consumers.

  7. Consultative Report on NPP Improving Loading Factor

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Compared with other advanced nuclear power plants about operation performance, we analyze the critical factor that have the negative impact in improving the loading factor of the nuclear power plants that belong to China Nuclear Union Company and summary the experience.

  8. First report of a mixed infection of Trichinella nelsoni and Trichinella T8 in a leopard (Panthera pardus from the Greater Kruger National Park, South Africa

    Directory of Open Access Journals (Sweden)

    Louis J. La Grange

    2014-02-01

    Full Text Available At least three Trichinella species, namely Trichinella nelsoni, Trichinella britovi and Trichinella zimbabwensis, and one genotype (Trichinella T8, have been isolated from sylvatic carnivores on the African continent. With the exception of T. britovi, the other species are known to circulate in wildlife of the Kruger National Park (KNP, South Africa, and KNP neighbouring game reserves (collectively known as the greater KNP area. Lions (Panthera leo and spotted hyenas (Crocuta crocuta appear to be the most important reservoirs of T. nelsoni and Trichinella T8 in the KNP and surrounding areas. Interspecies predation between lions and hyenas has been implicated as a primary mode of maintaining the life cycles of these two Trichinella species. This is the first report of a mixed natural infection of T. nelsoni and Trichinella T8 in a leopard (Panthera pardus from South Africa. Trichinella muscle larvae were identified to species level by multiplex polymerase chain reaction (PCR. Probable sources of infection, based on the known dietary preference and prey species’ range of leopards, are also discussed. The described occurrence of Trichinella species in a leopard from the greater KNP area raises the question of possible sources of infection for this predator species.

  9. First report of a mixed infection of Trichinella nelsoni and Trichinella T8 in a leopard (Panthera pardus) from the Greater Kruger National Park, South Africa.

    Science.gov (United States)

    La Grange, Louis J; Reininghaus, Björn; Mukaratirwa, Samson

    2014-11-20

    At least three Trichinella species, namely Trichinella nelsoni, Trichinella britovi and Trichinella zimbabwensis, and one genotype (Trichinella T8), have been isolated from sylvatic carnivores on the African continent. With the exception of T. britovi, the other species are known to circulate in wildlife of the Kruger National Park (KNP), South Africa, and KNP neighbouring game reserves (collectively known as the greater KNP area). Lions (Panthera leo) and spotted hyenas (Crocuta crocuta) appear to be the most important reservoirs of T. nelsoni and Trichinella T8 in the KNP and surrounding areas. Interspecies predation between lions and hyenas has been implicated as a primary mode of maintaining the life cycles of these two Trichinella species. This is the first report of a mixed natural infection of T. nelsoni and Trichinella T8 in a leopard (Panthera pardus) from South Africa. Trichinella muscle larvae were identified to species level by multiplex polymerase chain reaction (PCR). Probable sources of infection, based on the known dietary preference and prey species' range of leopards, are also discussed. The described occurrence of Trichinella species in a leopard from the greater KNP area raises the question of possible sources of infection for this predator species.

  10. Improving Education in Florida. A Report.

    Science.gov (United States)

    Governor's Citizens' Committee on Education, Tallahassee, FL.

    This document begins with clarifications of the State and the local responsibility for education. The main body of the report is given over to committee recommendations covering (1) school program and services; (2) professional development for board members, school administrators, teachers, and other noninstructional personnel; (3) educational…

  11. Improving Grading Consistency through Grade Lift Reporting

    Science.gov (United States)

    Millet, Ido

    2010-01-01

    We define Grade Lift as the difference between average class grade and average cumulative class GPA. This metric provides an assessment of how lenient the grading was for a given course. In 2006, we started providing faculty members individualized Grade Lift reports reflecting their position relative to an anonymously plotted school-wide…

  12. The Challenges to Improve Farm Animal Welfare in the United Kingdom by Reducing Disease Incidence with Greater Veterinary Involvement on Farm

    Directory of Open Access Journals (Sweden)

    Philip R. Scott

    2013-07-01

    Full Text Available The Cattle Health and Welfare Group of Great Britain report (CHAWG; 2012 lists the most important cattle diseases and disorders but fails to fully acknowledge the importance of animal mental health and; in so doing; misses the opportunity to further promote animal welfare. There are effective prevention regimens; including vaccination; husbandry and management strategies for all ten listed animal health concerns in the CHAWG report; however control measures are infrequently implemented because of perceived costs and unwillingness of many farmers to commit adequate time and resources to basic farm management tasks such as biosecurity; and biocontainment. Reducing disease prevalence rates by active veterinary herd and flock health planning; and veterinary care of many individual animal problems presently “treated” by farmers; would greatly improve animal welfare. Published studies have highlighted that treatments for lame sheep are not implemented early enough with many farmers delaying treatment for weeks; and sometimes even months; which adversely affects prognosis. Disease and welfare concerns as a consequence of sheep ectoparasites could be greatly reduced if farmers applied proven control strategies detailed in either veterinary flock health plans or advice available from expert veterinary websites. Recent studies have concluded that there is also an urgent need for veterinarians to better manage pain in livestock. Where proven treatments are available; such as blockage of pain arising from ovine obstetrical problems by combined low extradural injection of lignocaine and xylazine; these are seldom requested by farmers because the technique is a veterinary procedure and incurs a professional fee which highlights many farmers’ focus on economics rather than individual animal welfare.

  13. BISON Contact Improvements CASL FY14 Report

    Energy Technology Data Exchange (ETDEWEB)

    Spencer, B. W. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Hales, J. D. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Gaston, D. R. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Karpeev, D. A. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Williamson, R. L. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Novascone, S. R. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Perez, D. M. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Gardner, R. J. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Gamble, K. A. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-09-01

    The BISON code is the foundation for multiple fuel performance modeling efforts, and is currently under heavy development. For a variety of fuel forms, the effects of heat conduction across a gap and mechanical contact between components of a fuel system are very significant. It is thus critical that BISON have robust capabilities for enforcement of thermal and mechanical contact. BISON’s solver robustness has generally been quite good before mechanical contact between the fuel and cladding occurs, but there have been significant challenges obtaining converged solutions once that contact occurs and the solver begins to enforce mechanical contact constraints. During the current year, significant development effort has been focused on the enforcement of mechanical contact to provide improved solution robustness. In addition to this work to improve mechanical contact robustness, an investigation into questionable results attributable to thermal contact has been performed. This investigation found that the order of integration typically used on the surfaces involved in thermal contact was not sufficiently high. To address this problem, a new option was provided to permit the use of a different integration order for surfaces, and new usage recommendations were provided.

  14. Improved radiant burner material. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Milewski, J.V.; Shoultz, R.A.; Bourque, M.M.; Milewski, E.B. [and others

    1998-01-01

    Under DOE/ERIP funds were made available to Superkinetic, Inc. for the development of an improved radiant burner material. Three single crystal ceramic fibers were produced and two fiber materials were made into felt for testing as radiant burner screens. The materials were alpha alumina and alpha silicon nitride. These fibers were bonded with a high temperature ceramic and made into a structurally sound trusswork like screen composed of million psi fiber members. These screens were about 5% solid for 95 porosity as needed to permit the flow of combustable natural gas and air mixture. Combustion test proved that they performed very satisfactory and better than the current state of art screen and showed no visable degrade after testing. It is recommended that more time and money be put into expanding this technology and test these new materials for their maximum temperature and durability for production applications that require better burner material.

  15. Improved radioimmunotherapy of hematologic malignancies. [Final report

    Energy Technology Data Exchange (ETDEWEB)

    Press, O.W.

    1992-03-24

    This research project proposes to develop novel new approaches of improving the radioimmunodetection and radioimmunotherapy of malignancies by augmenting retention of radioimmunoconjugates by tumor cells. The approaches shown to be effective in these laboratory experiments will subsequently be incorporated into out ongoing clinical trials in patients. Specific project objectives include: to study the rates of endocytosis, intracellular routing, and metabolic degradation of radiolabeled monoclonal antibodies targeting tumor-associated antigens on human leukemia and lymphoma cells; To examine the effects of lysosomotropic amines (e.g. chloroquine, amantadine), carboxylic ionophores (monensin, nigericin), and thioamides (propylthiouracil), on the retention of radiolabeled MoAbs by tumor cells; to examine the impact of newer radioiodination techniques (tyramine cellobiose, paraiodobenzoyl) on the metabolic degradation of radioiodinated antibodies; to compare the endocytosis, intracellular routing, and degradation of radioimmunoconjugates prepared with different radionuclides ({sup 131}Iodine, {sup 111}Indium, {sup 90}Yttrium, {sup 99m}Technetium, {sup 186}Rhenium); and to examine the utility of radioimmunoconjugates targeting oncogene products for the radioimmunotherapy and radioimmunoscintigraphy of cancer.

  16. Improved radioimmunotherapy of hematologic malignancies. [Final report

    Energy Technology Data Exchange (ETDEWEB)

    Press, O.W.

    1992-03-24

    This research project proposes to develop novel new approaches of improving the radioimmunodetection and radioimmunotherapy of malignancies by augmenting retention of radioimmunoconjugates by tumor cells. The approaches shown to be effective in these laboratory experiments will subsequently be incorporated into out ongoing clinical trials in patients. Specific project objectives include: to study the rates of endocytosis, intracellular routing, and metabolic degradation of radiolabeled monoclonal antibodies targeting tumor-associated antigens on human leukemia and lymphoma cells; To examine the effects of lysosomotropic amines (e.g. chloroquine, amantadine), carboxylic ionophores (monensin, nigericin), and thioamides (propylthiouracil), on the retention of radiolabeled MoAbs by tumor cells; to examine the impact of newer radioiodination techniques (tyramine cellobiose, paraiodobenzoyl) on the metabolic degradation of radioiodinated antibodies; to compare the endocytosis, intracellular routing, and degradation of radioimmunoconjugates prepared with different radionuclides ({sup 131}Iodine, {sup 111}Indium, {sup 90}Yttrium, {sup 99m}Technetium, {sup 186}Rhenium); and to examine the utility of radioimmunoconjugates targeting oncogene products for the radioimmunotherapy and radioimmunoscintigraphy of cancer.

  17. Gasification Product Improvement Facility (GPIF). Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-09-01

    The gasifier selected for development under this contract is an innovative and patented hybrid technology which combines the best features of both fixed-bed and fluidized-bed types. PyGas{trademark}, meaning Pyrolysis Gasification, is well suited for integration into advanced power cycles such as IGCC. It is also well matched to hot gas clean-up technologies currently in development. Unlike other gasification technologies, PyGas can be designed into both large and small scale systems. It is expected that partial repowering with PyGas could be done at a cost of electricity of only 2.78 cents/kWh, more economical than natural gas repowering. It is extremely unfortunate that Government funding for such a noble cause is becoming reduced to the point where current contracts must be canceled. The Gasification Product Improvement Facility (GPIF) project was initiated to provide a test facility to support early commercialization of advanced fixed-bed coal gasification technology at a cost approaching $1,000 per kilowatt for electric power generation applications. The project was to include an innovative, advanced, air-blown, pressurized, fixed-bed, dry-bottom gasifier and a follow-on hot metal oxide gas desulfurization sub-system. To help defray the cost of testing materials, the facility was to be located at a nearby utility coal fired generating site. The patented PyGas{trademark} technology was selected via a competitive bidding process as the candidate which best fit overall DOE objectives. The paper describes the accomplishments to date.

  18. Towards a greater understanding of the illicit tobacco trade in Europe: a review of the PMI funded ‘Project Star’ report

    Science.gov (United States)

    Gilmore, Anna B; Rowell, Andy; Gallus, Silvano; Lugo, Alessandra; Joossens, Luk; Sims, Michelle

    2014-01-01

    Background Following a legal agreement with the European Union (EU), Philip Morris International (PMI) commissions a yearly report (‘Project Star’, PS) on the European illicit cigarette trade from KPMG, the global accountancy firm. Methods Review of PS 2010 report. Comparison with data from independent sources including a 2010 pan-European survey (N=18 056). Findings Within PS, data covering all 27 EU countries are entered into a model. While the model itself seems appropriate, concerns are identified with the methodologies underlying the data inputs and thus their quality: there is little transparency over methodologies; interview data underestimate legal non-domestic product partly by failing to account for legal cross-border sales; illicit cigarette estimates rely on tobacco industry empty pack surveys which may overestimate illicit; and there is an over-reliance on data supplied by PMI with inadequate external validation. Thus, PMI sales data are validated using PMI smoking prevalence estimates, yet PMI is unable to provide sales (shipment) data for the Greek islands and its prevalence estimates differ grossly from independent data. Consequently, comparisons with independent data suggest PS will tend to overestimate illicit cigarette levels particularly where cross-border shopping is frequent (Austria, Finland, France) and in Western compared with Eastern European countries. The model also provides data on the nature of the illicit cigarette market independent of seizure data suggesting that almost a quarter of the illicit cigarette market in 2010 comprised PMI's own brands compared with just 5% counterfeited PMI brands; a finding hidden in PMI's public representation of the data. Conclusions PS overestimates illicit cigarette levels in some European countries and suggests PMI's supply chain control is inadequate. Its publication serves the interests of PMI over those of the EU and its member states. PS requires greater transparency, external scrutiny and

  19. Age-related differences in strategy knowledge updating: blocked testing produces greater improvements in metacognitive accuracy for younger than older adults.

    Science.gov (United States)

    Price, Jodi; Hertzog, Christopher; Dunlosky, John

    2008-09-01

    Age-related differences in updating knowledge about strategy effectiveness after task experience have not been consistently found, perhaps because the magnitude of observed knowledge updating has been rather meager for both age groups. We examined whether creating homogeneous blocks of recall tests based on two strategies used at encoding (imagery and repetition) would enhance people's learning about strategy effects on recall. Younger and older adults demonstrated greater knowledge updating (as measured by questionnaire ratings of strategy effectiveness and by global judgments of performance) with blocked (versus random) testing. The benefit of blocked testing for absolute accuracy of global predictions was smaller for older than younger adults. However, individual differences in correlations of strategy effectiveness ratings and postdictions showed similar upgrades for both age groups. Older adults learn about imagery's superior effectiveness but do not accurately estimate the magnitude of its benefit, even after blocked testing.

  20. Improving reporting of adverse drug reactions: Systematic review

    Directory of Open Access Journals (Sweden)

    Mariam Molokhia

    2009-05-01

    Full Text Available Mariam Molokhia1, Shivani Tanna2, Derek Bell31Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK; 2Department of Primary Care and Social Medicine, Imperial College, London, UK; 3Division of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, UKBackground: Adverse drug reactions (ADRs are a significant cause of morbidity and mortality, with many being identified post-marketing. Improvement in current ADR reporting, including utility of underused or innovative methods, is crucial to improve patient safety and public health.Objectives: To evaluate methods to improve ADR reporting via a systematic literature review.Methods: Data sources were Medline, Embase, Cochrane Library and National Library for health searches on ADR reporting (January 1997 to August 2007 including cross-referenced articles. Twenty-four out of 260 eligible studies were identified and critically assessed. Studies were grouped as follows: i spontaneous reporting (11; ii medical chart/note review (2; iii patient interviews/questionnaires (3; and iv combination methods including computer-assisted methods (8.Results: Using computerized monitoring systems (CMS to generate signals associated with changes in laboratory results with other methods can improve ADR reporting. Educational interventions combined with reminders and/or prescription card reports can improve hospitalbased ADR reporting, and showed short to medium term improvement.Conclusions: The use of electronic health data combined with other methods for ADR reporting can improve efficiency and accuracy for detecting ADRs and can be extended to other health care settings. Although methods with educational intervention appear to be effective, few studies have reviewed long-term effects to assess if the improvements can be sustained. Keywords: adverse drug reaction, reporting, ADR

  1. Improving reporting of critical incidents through education and involvement.

    Science.gov (United States)

    Donnelly, Peter

    2015-01-01

    Critical incident reporting involves highlighting events and near-misses which have a potential impact on patient care and patient safety. Reporting of critical incidents is a recognised tool in improving patient safety. Within the community paediatric setting in the Belfast Health & Social Care Trust (BHSCT) there is a paucity of incident report forms. The purpose of this quality improvement project was to establish the barriers to reporting critical incidents and to implement plan-do-study-act (PDSA) cycles to create a climate for change. The methodology for this project was to firstly perform a baseline audit to review all submitted critical incident reports for the Community Paediatric team in the BHSCT for a six month period. A questionnaire was distributed to staff within the multidisciplinary team to establish examples of barriers to reporting. Interventions performed included introducing an agreed definition of a critical incident, distributing/presenting questionnaire findings to senior members of the various management teams and providing feedback to healthcare workers after presentation of a critical incident presentation. A review of incident reports was performed over the subsequent six month period to assess how the interventions impacted on incident reporting. Over 12 questionnaires 28 barriers to reporting critical incidents were reported which fell into five separate categories. Staff members were twice as likely to report negativity after reporting a critical incident. Overall critical incident reporting within the BHSCT Community Paediatric team improved from 11 incident reports (1.8 per month) to 22 incident reports (3.7 per month) after completion of the quality improvement project. This represents an increase of 100%.

  2. Improved Space Bounds for Cache-Oblivious Range Reporting

    DEFF Research Database (Denmark)

    Afshani, Peyman; Zeh, Norbert

    2011-01-01

    We provide improved bounds on the size of cacheoblivious range reporting data structures that achieve the optimal query bound of O(logB N + K/B) block transfers. Our first main result is an O(N √ logN log logN)-space data structure that achieves this query bound for 3-d dominance reporting and 2-...

  3. High Intensity Interval Training Leads to Greater Improvements in Acute Heart Rate Recovery and Anaerobic Power as High Volume Low Intensity Training

    Directory of Open Access Journals (Sweden)

    Thomas L. Stöggl

    2017-08-01

    Full Text Available The purpose of the current study was to explore if training regimes utilizing diverse training intensity distributions result in different responses on neuromuscular status, anaerobic capacity/power and acute heart rate recovery (HRR in well-trained endurance athletes.Methods: Thirty-six male (n = 33 and female (n = 3 runners, cyclists, triathletes and cross-country skiers [peak oxygen uptake: (VO2peak: 61.9 ± 8.0 mL·kg−1·min−1] were randomly assigned to one of three groups (blocked high intensity interval training HIIT; polarized training POL; high volume low intensity oriented control group CG/HVLIT applying no HIIT. A maximal anaerobic running/cycling test (MART/MACT was performed prior to and following a 9-week training period.Results: Only the HIIT group achieved improvements in peak power/velocity (+6.4%, P < 0.001 and peak lactate (P = 0.001 during the MART/MACT, while, unexpectedly, in none of the groups the performance at the established lactate concentrations (4, 6, 10 mmol·L−1 was changed (P > 0.05. Acute HRR was improved in HIIT (11.2%, P = 0.002 and POL (7.9%, P = 0.023 with no change in the HVLIT oriented control group.Conclusion: Only a training regime that includes a significant amount of HIIT improves the neuromuscular status, anaerobic power and the acute HRR in well-trained endurance athletes. A training regime that followed more a low and moderate intensity oriented model (CG/HVLIT had no effect on any performance or HRR outcomes.

  4. Improving report writing by peer assessment using Coursera

    DEFF Research Database (Denmark)

    Christiansen, Henrik Lehrmann

    2015-01-01

    report writing. In the case of report writing active learning could include peer evaluation which is what is investigated in this paper. This paper presents a case study from the Technical University of Denmark. A course on mobile communication was redesigned to include peer evaluation as a tool...... for improving report writing skills. The peer evaluation process was automated using the elearning tool Coursera. What was investigated was the improvement in report writing as well as the consistency and quality of the peer assessed grades.......Report writing is a general engineering competence and it should therefore be part of any university engineering education to learn how to write a good report. Active leaning methods are well-known to be effective in supporting student learning; hence it should preferably also be used for teaching...

  5. Improving the safety of LWR power plants. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1980-04-01

    This report documents the results of the Study to identify current, potential research issues and efforts for improving the safety of Light Water Reactor (LWR) power plants. This final report describes the work accomplished, the results obtained, the problem areas, and the recommended solutions. Specifically, for each of the issues identified in this report for improving the safety of LWR power plants, a description is provided in detail of the safety significance, the current status (including information sources, status of technical knowledge, problem solution and current activities), and the suggestions for further research and development. Further, the issues are ranked for action into high, medium, and low priority with respect to primarily (a) improved safety (e.g. potential reduction in public risk and occupational exposure), and secondly (b) reduction in safety-related costs (improving or maintaining level of safety with simpler systems or in a more cost-effective manner).

  6. Lodging Update: Greater Boston

    Directory of Open Access Journals (Sweden)

    Rachel Roginsky

    2012-09-01

    Full Text Available Pinnacle Advisory Group provides an update of lodging industry performance in New England and Boston for the first half of 2012. While the New England region outpaced the nation, the specific story varies from state to state. Only Massachusetts and Vermont achieved REVPAR performance better than the national average. A review of the Greater Boston lodging market reveals that a healthy local economy and strong convention calendar, combined with a number of one-time events and limited new supply, boosted the local market in 2012. The outlook for 2013 in Greater Boston remains positive, with expectations of a 4.7% growth in REVPAR.

  7. A call to improve sampling methodology and reporting in young novice driver research.

    Science.gov (United States)

    Scott-Parker, B; Senserrick, T

    2017-02-01

    Young drivers continue to be over-represented in road crash fatalities despite a multitude of research, communication and intervention. Evidence-based improvement depends to a great extent upon research methodology quality and its reporting, with known limitations in the peer-review process. The aim of the current research was to review the scope of research methodologies applied in 'young driver' and 'teen driver' research and their reporting in four peer-review journals in the field between January 2006 and December 2013. In total, 806 articles were identified and assessed. Reporting omissions included participant gender (11% of papers), response rates (49%), retention rates (39%) and information regarding incentives (44%). Greater breadth and specific improvements in study designs and reporting are thereby identified as a means to further advance the field.

  8. Improving Autopsy Report Turnaround Times by Implementing Lean Management Principles.

    Science.gov (United States)

    Cromwell, Susan; Chiasson, David A; Cassidy, Debra; Somers, Gino R

    2017-01-01

    The autopsy is an integral part of the service of a large academic pathology department. Timely reporting is central to providing good service and is beneficial for many stakeholders, including the families, the clinical team, the hospital, and the wider community. The current study aimed to improve hospital-consented autopsy reporting times (turnaround time, TAT) by using lean principles modified for a healthcare setting, with an aim of signing out 90% of autopsies in 90 days. An audit of current and historical TATs was performed, and a working group incorporating administrative, technical, and professional staff constructed a value stream map documenting the steps involved in constructing an autopsy report. Two areas of delay were noted: examination of the microscopy and time taken to sign-out the report after the weekly autopsy conference. Several measures were implemented to address these delays, including visual tracking using a whiteboard and individualized tracking sheets, weekly whiteboard huddles, and timelier scheduling of clinicopathologic conference rounds. All measures resulted in an improvement of TATs. In the 30 months prior to the institution of lean, 37% of autopsies (53/144) were signed out in 90 days, with a wide variation in reporting times. In the 30 months following the institution of lean, this improved to 74% (136/185) ( P lean; 63 days post-lean). The application of lean principles to autopsy sign-out workflow can significantly improve TATs and reduce variability, without changing staffing levels or significantly altering scheduling structure.

  9. Improving report writing by peer assessment using Coursera

    DEFF Research Database (Denmark)

    Christiansen, Henrik Lehrmann

    2015-01-01

    Report writing is a general engineering competence and it should therefore be part of any university engineering education to learn how to write a good report. Active leaning methods are well-known to be effective in supporting student learning; hence it should preferably also be used for teachin...... for improving report writing skills. The peer evaluation process was automated using the elearning tool Coursera. What was investigated was the improvement in report writing as well as the consistency and quality of the peer assessed grades.......Report writing is a general engineering competence and it should therefore be part of any university engineering education to learn how to write a good report. Active leaning methods are well-known to be effective in supporting student learning; hence it should preferably also be used for teaching...... report writing. In the case of report writing active learning could include peer evaluation which is what is investigated in this paper. This paper presents a case study from the Technical University of Denmark. A course on mobile communication was redesigned to include peer evaluation as a tool...

  10. Improved Space Bounds for Cache-Oblivious Range Reporting

    DEFF Research Database (Denmark)

    Afshani, Peyman; Zeh, Norbert

    2011-01-01

    second main result shows that any cache-oblivious 2-d three-sided range reporting data structure with the optimal query bound has to use Ω(N logε N) space, thereby improving on a recent lower bound for the same problem. Using known transformations, the lower bound extends to 3-d dominance reporting and 3......We provide improved bounds on the size of cacheoblivious range reporting data structures that achieve the optimal query bound of O(logB N + K/B) block transfers. Our first main result is an O(N √ logN log logN)-space data structure that achieves this query bound for 3-d dominance reporting and 2-d...... three-sided range reporting. No cache-oblivious o(N log N/ log logN)-space data structure for these problems was known before, even when allowing a query bound of O(logO(1) 2 N + K/B) block transfers.1 Our result also implies improved space bounds for general 2-d and 3-d orthogonal range reporting. Our...

  11. Improving Indicators in a Brazilian Hospital Through Quality-Improvement Programs Based on STS Database Reports

    Directory of Open Access Journals (Sweden)

    Pedro Gabriel Melo de Barros e Silva

    2015-12-01

    Full Text Available ABSTRACT OBJECTIVE: To report the initial changes after quality-improvement programs based on STS-database in a Brazilian hospital. METHODS: Since 2011 a Brazilian hospital has joined STS-Database and in 2012 multifaceted actions based on STS reports were implemented aiming reductions in the time of mechanical ventilation and in the intensive care stay and also improvements in evidence-based perioperative therapies among patients who underwent coronary artery bypass graft surgeries. RESULTS: All the 947 patients submitted to coronary artery bypass graft surgeries from July 2011 to June 2014 were analyzed and there was an improvement in all the three target endpoints after the implementation of the quality-improvement program but the reduction in time on mechanical ventilation was not statistically significant after adjusting for prognostic characteristics. CONCLUSION: The initial experience with STS registry in a Brazilian hospital was associated with improvement in most of targeted quality-indicators.

  12. Umatilla River Subbasin Fish Habitat Improvement Program, 2005 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    St. Hilaire, Danny R. (Oregon Department of Fish and Wildlife, Pendleton, OR)

    2006-05-01

    This annual report is in fulfillment of contractual obligations with Bonneville Power Administration (BPA), which is the funding source for the Oregon Department of Fish and Wildlife's (ODFW), Umatilla River Subbasin Fish Habitat Improvement Program (Program). The Program works cooperatively with private landowners to develop long-term restoration agreements, under which, passive and active Habitat Improvement Projects are conducted. Historically, projects have included livestock exclusion fencing (passive restoration) to protect riparian habitats, along with the installation of instream structures (active restoration) to address erosion and improve fish habitat conditions. In recent years, the focus of active restoration has shifted to bioengineering treatments and, more recently, to channel re-design and re-construction aimed at improving fish habitat, through the restoration of stable channel function. This report provides a summary of Program activities for the 2005 calendar year (January 1 through December 31, 2005), within each of the four main project phases, including: (1) Implementation--Pre-Work, (2) Implementation--On Site Development, (3) Operation and Maintenance (O&M), and (4) Monitoring and Evaluation (M&E). This report also summarizes activities associated with Program Administration, Interagency Coordination, and Public Education.

  13. The trauma report nurse: a trauma triage process improvement project.

    Science.gov (United States)

    Jelinek, Lisa; Fahje, Carol; Immermann, Carol; Elsbernd, Terri

    2014-09-01

    Accurate trauma triage is imperative to facilitate appropriate resource mobilization for severely injured trauma patients. A critical window of opportunity exists to prevent secondary injury or death. Timely assessment with a multidisciplinary trauma team is essential to facilitate rapid diagnosis and treatment. However, consistent and accurate trauma triage proved daunting at our institution, resulting in instances of undertriage. A process improvement strategy aimed at improving trauma triage accuracy was implemented. An innovative role, the trauma report nurse (TRN), was created and became the trauma nurse expert. The TRN was responsible for assigning a trauma triage level to all incoming adult and pediatric trauma patients. In parallel, improvements were made to the prehospital report format, increasing standardization and clarifying hand-off verbiage. Undertriage rates dropped from 14% to 4.8%. Qualitative data demonstrated acceptance and support of the TRN role among physicians, nurses and nursing and ancillary staff. Designating trauma triage to an ED registered nurse proved to reduce undertriage rates. By providing staff education, infrastructure improvements, and leadership support, the role continues to thrive, resulting in improved care for severely injured trauma patients. Copyright © 2014 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  14. Structured reporting platform improves CAD-RADS assessment.

    Science.gov (United States)

    Szilveszter, Bálint; Kolossváry, Márton; Karády, Júlia; Jermendy, Ádám L; Károlyi, Mihály; Panajotu, Alexisz; Bagyura, Zsolt; Vecsey-Nagy, Milán; Cury, Ricardo C; Leipsic, Jonathon A; Merkely, Béla; Maurovich-Horvat, Pál

    2017-09-18

    Structured reporting in cardiac imaging is strongly encouraged to improve quality through consistency. The Coronary Artery Disease - Reporting and Data System (CAD-RADS) was recently introduced to facilitate interdisciplinary communication of coronary CT angiography (CTA) results. We aimed to assess the agreement between manual and automated CAD-RADS classification using a structured reporting platform. Five readers prospectively interpreted 500 coronary CT angiographies using a structured reporting platform that automatically calculates the CAD-RADS score based on stenosis and plaque parameters manually entered by the reader. In addition, all readers manually assessed CAD-RADS blinded to the automatically derived results, which was used as the reference standard. We evaluated factors influencing reader performance including CAD-RADS training, clinical load, time of the day and level of expertise. Total agreement between manual and automated classification was 80.2%. Agreement in stenosis categories was 86.7%, whereas the agreement in modifiers was 95.8% for "N", 96.8% for "S", 95.6% for "V" and 99.4% for "G". Agreement for V improved after CAD-RADS training (p = 0.047). Time of the day and clinical load did not influence reader performance (p > 0.05 both). Less experienced readers had a higher total agreement as compared to more experienced readers (87.0% vs 78.0%, respectively; p = 0.011). Even though automated CAD-RADS classification uses data filled in by the readers, it outperforms manual classification by preventing human errors. Structured reporting platforms with automated calculation of the CAD-RADS score might improve data quality and support standardization of clinical decision making. Copyright © 2017. Published by Elsevier Inc.

  15. Public acceptance of management actions and judgments of responsibility for the wolves of the southern Greater Yellowstone Area: Report to Grand Teton National Park

    Science.gov (United States)

    Taylor, Jonathan G.; Johnson, S. Shea; Shelby, Lori B.

    2005-01-01

    Introduction Wolves of Grand Teton National Park and the Greater Yellowstone Area Gray wolves (Canis lupus) appeared in Grand Teton National Park (GRTE) in October of 1998, two years after being reintroduced to Yellowstone National Park (YNP). Since that time, five packs have been within the GRTE borders - Gros Ventre Pack, Nez Perce Pack, Yellowstone Delta Pack, Teton Pack, and Green River Pack (Table 1). Wolves in the Greater Yellowstone Area are increasing and spreading out geographically (USFWS and others, 2004). This dispersion was demonstrated recently by the death of a 2-year-old female wolf from the Swan Lake pack on I-70 in Colorado (June 7, 2004; http://mountain-prairie.USFWS.gov/pressrel /04-43.htm). The organization of wolf packs in the GYA is dynamic and highly structured. In 2003, for example, a wolf from the Teton Pack joined with the Green River Pack, and several young wolves left the Teton Pack and moved south (USFWS and others, 2004). Pack size (averaging five to ten members) is dependent on hunting efficiency, which depends on prey size, type, and density. Each pack defends home ranges of several hundred square miles. The social structure of the pack is based on a breeding pair (an alpha male and female). Other wolves in the pack can be categorized as betas (males and/or females second in rank to the alphas), subordinates, pups, and occasional omegas (outcasts). Because generally only the alpha pair breeds, subordinate wolves of reproductive age must disperse from their packs and form new associations in order to breed. (http://www.nps.gov/grte/wolf/biolo.htm). The reintroduced wolves are classified by the U.S. Fish and Wildlife Service (USFWS) as "nonessential experimental" under section 10(j) of the Endangered Species Act. The recovery criteria for the GYA wolves were met in 2002 for removing the wolves from the Endangered Species List (30 or more breeding pairs). Currently, the USFWS manages wolf populations in the GYA until delisting occurs

  16. Figures in clinical trial reports: current practice & scope for improvement

    Directory of Open Access Journals (Sweden)

    Travison Thomas G

    2007-11-01

    Full Text Available Abstract Background Most clinical trial publications include figures, but there is little guidance on what results should be displayed as figures and how. Purpose To evaluate the current use of figures in Trial reports, and to make constructive suggestions for future practice. Methods We surveyed all 77 reports of randomised controlled trials in five general medical journals during November 2006 to January 2007. The numbers and types of figures were determined, and then each Figure was assessed for its style, content, clarity and suitability. As a consequence, guidelines are developed for presenting figures, both in general and for each specific common type of Figure. Results Most trial reports contained one to three figures, mean 2.3 per article. The four main types were flow diagram, Kaplan Meier plot, Forest plot (for subgroup analyses and repeated measures over time: these accounted for 92% of all figures published. For each type of figure there is a considerable diversity of practice in both style and content which we illustrate with selected examples of both good and bad practice. Some pointers on what to do, and what to avoid, are derived from our critical evaluation of these articles' use of figures. Conclusion There is considerable scope for authors to improve their use of figures in clinical trial reports, as regards which figures to choose, their style of presentation and labelling, and their specific content. Particular improvements are needed for the four main types of figures commonly used.

  17. Voluntary Medical Incident Reporting Tool to Improve Physician Reporting of Medical Errors in an Emergency Department

    Directory of Open Access Journals (Sweden)

    Nnaemeka G. Okafor

    2015-12-01

    Full Text Available Introduction: Medical errors are frequently under-reported, yet their appropriate analysis, coupled with remediation, is essential for continuous quality improvement. The emergency department (ED is recognized as a complex and chaotic environment prone to errors. In this paper, we describe the design and implementation of a web-based ED-specific incident reporting system using an iterative process. Methods: A web-based, password-protected tool was developed by members of a quality assurance committee for ED providers to report incidents that they believe could impact patient safety. Results: The utilization of this system in one residency program with two academic sites resulted in an increase from 81 reported incidents in 2009, the first year of use, to 561 reported incidents in 2012. This is an increase in rate of reported events from 0.07% of all ED visits to 0.44% of all ED visits. In 2012, faculty reported 60% of all incidents, while residents and midlevel providers reported 24% and 16% respectively. The most commonly reported incidents were delays in care and management concerns. Conclusion: Error reporting frequency can be dramatically improved by using a web-based, userfriendly, voluntary, and non-punitive reporting system.

  18. Emotional scenes elicit more pronounced self-reported emotional experience and greater EPN and LPP modulation when compared to emotional faces.

    Science.gov (United States)

    Thom, Nathaniel; Knight, Justin; Dishman, Rod; Sabatinelli, Dean; Johnson, Douglas C; Clementz, Brett

    2014-06-01

    Emotional faces and scenes carry a wealth of overlapping and distinct perceptual information. Despite widespread use in the investigation of emotional perception, expressive face and evocative scene stimuli are rarely assessed in the same experiment. Here, we evaluated self-reports of arousal and pleasantness, as well as early and late event-related potentials (e.g., N170, early posterior negativity [EPN], late positive potential [LPP]) as subjects viewed neutral and emotional faces and scenes, including contents representing anger, fear, and joy. Results demonstrate that emotional scenes were rated as more evocative than emotional faces, as only scenes produced elevated self-reports of arousal. In addition, viewing scenes resulted in more extreme ratings of pleasantness (and unpleasantness) than did faces. EEG results indicate that both expressive faces and emotional scenes evoke enhanced negativity in the N170 component, while the EPN and LPP components show significantly enhanced modulation only by scene, relative to face stimuli. These data suggest that viewing emotional scenes results in a more pronounced emotional experience that is associated with reliable modulation of visual event-related potentials that are implicated in emotional circuits in the brain.

  19. Lightning Reporting at 45th Weather Squadron: Recent Improvements

    Science.gov (United States)

    Finn, Frank C.; Roeder, William P.; Buchanan, Michael D.; McNamara, Todd M.; McAllenan, Michael; Winters, Katherine A.; Fitzpatrick, Michael E.; Huddleston, Lisa L.

    2010-01-01

    The 45th Weather Squadron (45 WS) provides daily lightning reports to space launch customers at CCAFS/KSC. These reports are provided to assess the need to inspect the electronics of satellite payloads, space launch vehicles, and ground support equipment for induced current damage from nearby lightning strokes. The 45 WS has made several improvements to the lightning reports during 2008-2009. The 4DLSS, implemented in April 2008, provides all lightning strokes as opposed to just one stroke per flash as done by the previous system. The 45 WS discovered that the peak current was being truncated to the nearest kilo amp in the database used to generate the daily lightning reports, which led to an up to 4% underestimate in the peak current for average lightning. This error was corrected and led to elimination of this underestimate. The 45 WS and their mission partners developed lightning location error ellipses for 99% and 95% location accuracies tailored to each individual stroke and began providing them in the spring of 2009. The new procedure provides the distance from the point of interest to the best location of the stroke (the center of the error ellipse) and the distance to the closest edge of the ellipse. This information is now included in the lightning reports, along with the peak current of the stroke. The initial method of calculating the error ellipses could only be used during normal duty hours, i.e. not during nights, weekends, or holidays. This method was improved later to provide lightning reports in near real-time, 24/7. The calculation of the distance to the closest point on the ellipse was also significantly improved later. Other improvements were also implemented. A new method to calculate the probability of any nearby lightning stroke. being within any radius of any point of interest was developed and is being implemented. This may supersede the use of location error ellipses. The 45 WS is pursuing adding data from nine NLDN sensors into 4DLSS in

  20. Improving plant bioaccumulation science through consistent reporting of experimental data.

    Science.gov (United States)

    Fantke, Peter; Arnot, Jon A; Doucette, William J

    2016-10-01

    Experimental data and models for plant bioaccumulation of organic contaminants play a crucial role for assessing the potential human and ecological risks associated with chemical use. Plants are receptor organisms and direct or indirect vectors for chemical exposures to all other organisms. As new experimental data are generated they are used to improve our understanding of plant-chemical interactions that in turn allows for the development of better scientific knowledge and conceptual and predictive models. The interrelationship between experimental data and model development is an ongoing, never-ending process needed to advance our ability to provide reliable quality information that can be used in various contexts including regulatory risk assessment. However, relatively few standard experimental protocols for generating plant bioaccumulation data are currently available and because of inconsistent data collection and reporting requirements, the information generated is often less useful than it could be for direct applications in chemical assessments and for model development and refinement. We review existing testing guidelines, common data reporting practices, and provide recommendations for revising testing guidelines and reporting requirements to improve bioaccumulation knowledge and models. This analysis provides a list of experimental parameters that will help to develop high quality datasets and support modeling tools for assessing bioaccumulation of organic chemicals in plants and ultimately addressing uncertainty in ecological and human health risk assessments.

  1. Dose intensification in acute myeloid leukaemia: greater effectiveness at lower cost. Principal report of the Medical Research Council's AML9 study. MRC Leukaemia in Adults Working Party.

    Science.gov (United States)

    Rees, J K; Gray, R G; Wheatley, K

    1996-07-01

    Between 1984 and 1990, 972 patients aged 1-79 years with acute myeloid leukaemia (AML), from 85 British hospitals, were entered into the MRC's 9th AML trial. Patients were randomized between DAT 1 + 5 (daunorubicin for 1 d, with cytarabine and 6-thioguanine for 5 d) and DAT 3 + 10 (same dose drugs for 3 and 10 d respectively) as induction therapy. The 63% who achieved complete remission (CR) were randomized to receive two courses of DAT 2 + 7 alternating with two courses of either MAZE (m-AMSA, 5-azacytidine, etoposide) or COAP (cyclophosphamide, vincristine, cytarabine, prednisone). Finally, those still in CR were randomized to receive either 1 year of maintenance treatment with eight courses of cytarabine and thioguanine followed by four courses of COAP, or no further cytotoxic therapy. Resistance to induction therapy was less common with the DAT 3 + 10 regimen than with DAT 1 + 5 (13% v 23%; P = 0.0001) and hence, despite a 5% increase in the risk of induction death, the CR rate was higher (66% v 61%; P = 0.15). Moreover, CR was achieved more rapidly with DAT 3 + 10 (median 34 v 46 d; P COAP. 5-year survival was not significantly higher with MAZE (37% v 31%). Finally, although 1 year of outpatient maintenance treatment appeared to delay, but not prevent, recurrence it did not improve 5-year survival which was non-significantly worse for those allocated maintenance treatment (41% v 44%). We conclude that the more intensive induction regimen, DAT 3 + 10, is not only more effective than DAT 1 + 5, even for older patients, but is also less expensive; intensive post-remission therapy with MAZE achieves better leukaemic control but at the cost of substantial toxicity; whereas low-level maintenance therapy confers no apparent advantage in survival as well as being inconvenient and costly.

  2. Efficiency improvements in pipeline transportation systems. Technical report, Task 3

    Energy Technology Data Exchange (ETDEWEB)

    Banks, W. F.; Horton, J. H.

    1977-01-01

    This report identifies those potential energy-conservative pipeline innovations that are most energy- and cost-effective, and formulates recommendations for the R, D, and D programs needed to exploit those opportunities. From a candidate field of over twenty classes of efficiency improvements, eight systems are recommended for pursuit. Most of these possess two highly important attributes: large potential energy savings and broad applicability outside the pipeline industry. The R, D, and D program for each improvement and the recommended immediate next step are described. The eight programs recommended for pursuit are: gas-fired combined-cycle compressor station; internally cooled internal combustion engine; methanol-coal slurry pipeline; methanol-coal slurry-fired and coal-fired engines; indirect-fired coal-burning combined-cycle pump station; fuel-cycle pump station; internal coatings in pipelines; and drag-reducing additives in liquid pipelines.

  3. Improving cancer treatment with cyclotron produced radionuclides. Progress report

    Energy Technology Data Exchange (ETDEWEB)

    Larson, S.M.; Finn, R.D.

    1993-11-01

    This report describes our continuing long term goal of promoting nuclear medicine applications by improving the scientific basis for tumor diagnosis, treatment and treatment follow-up based on the use of cyclotron produced radiotracers in oncology. The program includes 3 interactive components: Radiochemistry/Cyclotron; Pharmacology; and Immunology. An essential strategy is as follows: novel radionuclides and radiotracers developed in the Radiochemistry/Cyclotron section will be employed in the Pharmacology and Immunology sections during the next year. The development of novel radionuclides and tracers is of course useful in and of itself, but their utility is greatly enhanced by the interaction with the immunology and pharmacology components of the program.

  4. Mirtazapine improves visual hallucinations in Parkinson's disease: a case report.

    Science.gov (United States)

    Tagai, Kenji; Nagata, Tomoyuki; Shinagawa, Shunichiro; Tsuno, Norifumi; Ozone, Motohiro; Nakayama, Kazuhiko

    2013-06-01

    Psychotic symptoms often occur as a complication in Parkinson's disease patients, and a set of criteria for Parkinson's disease with psychosis (PDPsy) has been established. Among these criteria, hallucinations are one of the specific symptoms, with visual hallucinations being the most common. While atypical antipsychotic agents are often used for the treatment of PDPsy, adverse effects, including extrapyramidal symptoms, often hinder its continuation or tolerance. There have been some reports and reviews indicating that antidepressants may be effective for PDPsy and other forms of dementia with psychosis. In this report, we present a patient with PDPsy who was treated with one of the new-generation antidepressants, mirtazapine. Mirtazapine improved the patient's refractory psychotic symptoms, especially her visual hallucinations, without worsening her motor symptoms.

  5. Structured reports of videofluoroscopic swallowing studies have the potential to improve overall report quality compared to free text reports.

    Science.gov (United States)

    Schoeppe, Franziska; Sommer, Wieland H; Haack, Mareike; Havel, Miriam; Rheinwald, Marika; Wechtenbruch, Juliane; Fischer, Martin R; Meinel, Felix G; Sabel, Bastian O; Sommer, Nora N

    2017-07-28

    To compare free text (FTR) and structured reports (SR) of videofluoroscopic swallowing studies (VFSS) and evaluate satisfaction of referring otolaryngologists and speech therapists. Both standard FTR and SR of 26 patients with VFSS were acquired. A dedicated template focusing on oropharyngeal phases was created for SR using online software with clickable decision-trees and concomitant generation of semantically structured reports. All reports were evaluated regarding overall quality and content, information extraction and clinical decision support (10-point Likert scale (0 = I completely disagree, 10 = I completely agree)). Two otorhinolaryngologists and two speech therapists evaluated FTR and SR. SR received better ratings than FTR in all items. SR were perceived to contain more details on the swallowing phases (median rating: 10 vs. 5; P quality was rated significantly higher in SR than FTR (P quality of the report and, thus, are recommended for the evaluation of VFSS. • Structured reports on videofluoroscopic exams of deglutition lead to improved report quality. • Information extraction is facilitated when using structured reports based on decision trees. • Template-based reports add more value to clinical decision-making than free text reports. • Structured reports receive better ratings by speech therapists and otolaryngologists. • Structured reports on videofluoroscopic exams may improve the comparability between exams.

  6. Molten carbonate fuel cell technology improvement. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1991-06-01

    This report summarizes the work performed under Department of Energy Contract DEAC21-87MC23270, ``Molten Carbonate Fuel Cell Technology Improvement.`` This work was conducted over a three year period and consisted of three major efforts. The first major effort was the power plant system study which reviewed the competitive requirements for a coal gasifier/molten carbonate fuel cell power plant, produced a conceptual design of a CG/MCFC, and defined the technology development requirements. This effort is discussed in Section 1 of the report. The second major effort involved the design and development of a new MCFC cell configuration which reduced the material content of the cell to a level competitive with competing power plants, simplified the cell configuration to make the components more manufacturable and adaptable to continuous low cost processing techniques, and introduced new-low-pressure drop flow fields for both reactant gases. The new flow fields permitted the incorporation of recirculation systems in both reactant gas systems, permitting simplified cooling techniques and the ability to operate on both natural gas and a wide variety of gasifier fuels. This cell technology improvement is discussed in Section 2. The third major effort involved the scaleup of the new cell configuration to the full-area, 8-sq-ft size and resulted in components used for a 25-kW, 20-cell stack verification test. The verification test was completed with a run of 2200 hours, exceeding the goal of 2000 hours and verifying the new cell design. TWs test, in turn, provided the confidence to proceed to a 100-kW demonstration which is the goal of the subsequent DOE program. The scaleup and stack verification tests are discussed in Sections 3, 4, 5, and 6 of this report.

  7. Better living through transparency: improving the reproducibility of fMRI results through comprehensive methods reporting.

    Science.gov (United States)

    Carp, Joshua

    2013-09-01

    Recent studies suggest that a greater proportion of published scientific findings than expected cannot be replicated. The field of functional neuroimaging research is no exception to this trend, with estimates of false positive results ranging from 10 % to 40 %. While false positive results in neuroimaging studies stem from a variety of causes, incomplete methodological reporting is perhaps the most obvious: Most published reports of neuroimaging studies provide ambiguous or incomplete descriptions of their methods and results. If neuroimaging researchers do not report methods and results in adequate detail, independent scientists can neither check their work for errors nor accurately replicate their efforts. Thus, I argue that comprehensive methods reporting is essential for reproducible research. I recommend three strategies for improving transparency and reproducibility in neuroimaging research: improving natural language descriptions of research protocols; sharing source code for data collection and analysis; and sharing formal, machine-readable representations of methods and results. Last, I discuss the technological and cultural barriers to implementing these recommendations and suggest steps toward overcoming those barriers.

  8. Statistical reviewers improve reporting in biomedical articles: a randomized trial.

    Directory of Open Access Journals (Sweden)

    Erik Cobo

    Full Text Available BACKGROUND: Although peer review is widely considered to be the most credible way of selecting manuscripts and improving the quality of accepted papers in scientific journals, there is little evidence to support its use. Our aim was to estimate the effects on manuscript quality of either adding a statistical peer reviewer or suggesting the use of checklists such as CONSORT or STARD to clinical reviewers or both. METHODOLOGY AND PRINCIPAL FINDINGS: Interventions were defined as 1 the addition of a statistical reviewer to the clinical peer review process, and 2 suggesting reporting guidelines to reviewers; with "no statistical expert" and "no checklist" as controls. The two interventions were crossed in a 2x2 balanced factorial design including original research articles consecutively selected, between May 2004 and March 2005, by the Medicina Clinica (Barc editorial committee. We randomized manuscripts to minimize differences in terms of baseline quality and type of study (intervention, longitudinal, cross-sectional, others. Sample-size calculations indicated that 100 papers provide an 80% power to test a 55% standardized difference. We specified the main outcome as the increment in quality of papers as measured on the Goodman Scale. Two blinded evaluators rated the quality of manuscripts at initial submission and final post peer review version. Of the 327 manuscripts submitted to the journal, 131 were accepted for further review, and 129 were randomized. Of those, 14 that were lost to follow-up showed no differences in initial quality to the followed-up papers. Hence, 115 were included in the main analysis, with 16 rejected for publication after peer review. 21 (18.3% of the 115 included papers were interventions, 46 (40.0% were longitudinal designs, 28 (24.3% cross-sectional and 20 (17.4% others. The 16 (13.9% rejected papers had a significantly lower initial score on the overall Goodman scale than accepted papers (difference 15.0, 95% CI: 4

  9. Does physiotherapy based on the Bobath concept, in conjunction with a task practice, achieve greater improvement in walking ability in people with stroke compared to physiotherapy focused on structured task practice alone?: a pilot randomized controlled trial.

    Science.gov (United States)

    Brock, Kim; Haase, Gerlinde; Rothacher, Gerhard; Cotton, Susan

    2011-10-01

    To compare the short-term effects of two physiotherapy approaches for improving ability to walk in different environments following stroke: (i) interventions based on the Bobath concept, in conjunction with task practice, compared to (ii) structured task practice alone. Randomized controlled trial. Two rehabilitation centres Participants: Twenty-six participants between four and 20 weeks post-stroke, able to walk with supervision indoors. Both groups received six one-hour physiotherapy sessions over a two-week period. One group received physiotherapy based on the Bobath concept, including one hour of structured task practice. The other group received six hours of structured task practice. The primary outcome was an adapted six-minute walk test, incorporating a step, ramp and uneven surface. Secondary measures were gait velocity and the Berg Balance Scale. Measures were assessed before and after the intervention period. Following the intervention, there was no significant difference in improvement between the two groups for the adapted six-minute walk test (89.9 (standard deviation (SD) 73.1) m Bobath versus 41 (40.7) m task practice, P = 0.07). However, walking velocity showed significantly greater increases in the Bobath group (26.2 (SD 17.2) m/min versus 9.9 (SD = 12.9) m/min, P = 0.01). No significant differences between groups were recorded for the Berg Balance Scale (P = 0.2). This pilot study indicates short-term benefit for using interventions based on the Bobath concept for improving walking velocity in people with stroke. A sample size of 32 participants per group is required for a definitive study.

  10. Improving energy audit process and report outcomes through planning initiatives

    Science.gov (United States)

    Sprau Coulter, Tabitha L.

    Energy audits and energy models are an important aspect of the retrofit design process, as they provide project teams with an opportunity to evaluate a facilities current building systems' and energy performance. The information collected during an energy audit is typically used to develop an energy model and an energy audit report that are both used to assist in making decisions about the design and implementation of energy conservation measures in a facility. The current lack of energy auditing standards results in a high degree of variability in energy audit outcomes depending on the individual performing the audit. The research presented is based on the conviction that performing an energy audit and producing a value adding energy model for retrofit buildings can benefit from a revised approach. The research was divided into four phases, with the initial three phases consisting of: 1.) process mapping activity - aimed at reducing variability in the energy auditing and energy modeling process. 2.) survey analysis -- To examine the misalignment between how industry members use the top energy modeling tools compared to their intended use as defined by software representatives. 3.) sensitivity analysis -- analysis of the affect key energy modeling inputs are having on energy modeling analysis results. The initial three phases helped define the need for an improved energy audit approach that better aligns data collection with facility owners' needs and priorities. The initial three phases also assisted in the development of a multi-criteria decision support tool that incorporates a House of Quality approach to guide a pre-audit planning activity. For the fourth and final research phase explored the impacts and evaluation methods of a pre-audit planning activity using two comparative energy audits as case studies. In each case, an energy audit professionals was asked to complete an audit using their traditional methods along with an audit which involved them first

  11. Insulin glargine provides greater improvements in glycaemic control vs. intensifying lifestyle management for people with type 2 diabetes treated with OADs and 7-8% A1c levels. The TULIP study.

    Science.gov (United States)

    Blicklé, J-F; Hancu, N; Piletic, M; Profozic, V; Shestakova, M; Dain, M-P; Jacqueminet, S; Grimaldi, A

    2009-04-01

    To determine whether earlier administration of insulin glargine (glargine) vs. the intensification of lifestyle management (LM) improves glycaemic control in type 2 diabetes patients with A1c 7-8% treated with oral therapy. TULIP [Testing the Usefulness of gLargine when Initiated Promptly in type 2 diabetes mellitus (T2DM)] was a 9-month, 12-visit, open-label, multinational, multicentre, randomized study to evaluate starting glargine or intensifying LM in T2DM patients aged 40-75 years, body mass index (BMI) 24-35 kg/m2 and A1c 7-8%, treated with maximum doses of metformin and sulphonylurea for > or = 2 years. Glargine was injected once daily (evening) and titrated to fasting blood glucose 0.7-1.0 g/l. In the LM arm, dietary and physical activity counselling recommended stable weight for people with BMI or = 27 kg/m2. A total of 215 patients were randomized to glargine (n = 106) or LM (n = 109). The primary objective was patients achieving A1c < 7% at endpoint. Secondary endpoints included changes in A1c, in fasting plasma glucose (FPG), body weight and hypoglycaemia incidence. Two hundred and eleven (52.6% male) patients were randomized and treated; mean (+/- s.d.) age 60.7 +/- 7.9 years, weight 84.5 +/- 13.1 kg, BMI 29.9 +/- 3.5 kg/m2 and A1c 7.6 +/- 0.4%. More patients reached A1c < 7% (66 vs. 38%; p < 0.0001) or < 6.5% (34 vs. 11%; p = 0.0001) with glargine vs. LM. The change in FPG from baseline to study endpoint was significantly greater in the glargine vs. the LM arm (-0.50 +/- 0.47 vs. -0.05 +/- 0.39 g/l respectively; p < 0.0001). Compared with the glargine group, the LM group showed a decrease in weight (+0.9 +/- 2.9 vs. -2.5 +/- 3.2 kg; p < 0.0001), as well as the expected lower symptomatic hypoglycaemia (55.3 vs. 25.0%; p < 0.0001) and nocturnal hypoglycaemia (20.4 vs. 5.6%; p = 0.0016). No significant changes were observed from baseline to study endpoint in any of the lipid parameters tested. In patients with T2DM with A1c 7-8%, who were previously

  12. Improved techniques for fluid diversion in oil recovery. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Seright, R.

    1996-01-01

    This three-year project had two technical objectives. The first objective was to compare the effectiveness of gels in fluid diversion (water shutoff) with those of other types of processes. Several different types of fluid-diversion processes were compared, including those using gels, foams, emulsions, particulates, and microorganisms. The ultimate goals of these comparisons were to (1) establish which of these processes are most effective in a given application and (2) determine whether aspects of one process can be combined with those of other processes to improve performance. Analyses and experiments were performed to verify which materials are the most effective in entering and blocking high-permeability zones. The second objective of the project was to identify the mechanisms by which materials (particularly gels) selectively reduce permeability to water more than to oil. A capacity to reduce water permeability much more than oil or gas permeability is critical to the success of gel treatments in production wells if zones cannot be isolated during gel placement. Topics covered in this report include (1) determination of gel properties in fractures, (2) investigation of schemes to optimize gel placement in fractured systems, (3) an investigation of why some polymers and gels can reduce water permeability more than oil permeability, (4) consideration of whether microorganisms and particulates can exhibit placement properties that are superior to those of gels, and (5) examination of when foams may show placement properties that are superior to those of gels.

  13. ADDITIVE TESTING FOR IMPROVED SULFUR RETENTION: PRELIMINARY REPORT

    Energy Technology Data Exchange (ETDEWEB)

    Amoroso, J.; Fox, K.

    2011-09-07

    The Savannah River National Laboratory is collaborating with Alfred University to evaluate the potential for additives in borosilicate glass to improve sulfur retention. This preliminary report provides further background on the incorporation of sulfur in glass and outlines the experiments that are being performed by the collaborators. A simulated waste glass composition has been selected for the experimental studies. The first phase of experimental work will evaluate the impacts of BaO, PbO, and V{sub 2}O{sub 5} at concentrations of 1.0, 2.0, and 5.0 wt % on sulfate retention in simulated high level waste borosilicate glass. The second phase of experimental work will evaluate the effects of time at the melt temperature on sulfur retention. The resulting samples will be characterized to determine the amount of sulfur remaining as well as to identify the formation of any crystalline phases. The results will be used to guide the future selection of frits and glass forming chemicals in vitrifying Department of Energy wastes containing high sulfur concentrations.

  14. Conceptual design report -- Gasification Product Improvement Facility (GPIF)

    Energy Technology Data Exchange (ETDEWEB)

    Sadowski, R.S.; Skinner, W.H.; House, L.S.; Duck, R.R. [CRS Sirrine Engineers, Inc., Greenville, SC (United States); Lisauskas, R.A.; Dixit, V.J. [Riley Stoker Corp., Worcester, MA (United States); Morgan, M.E.; Johnson, S.A. [PSI Technology Co., Andover, MA (United States). PowerServe Div.; Boni, A.A. [PSI-Environmental Instruments Corp., Andover, MA (United States)

    1994-09-01

    The problems heretofore with coal gasification and IGCC concepts have been their high cost and historical poor performance of fixed-bed gasifiers, particularly on caking coals. The Gasification Product Improvement Facility (GPIF) project is being developed to solve these problems through the development of a novel coal gasification invention which incorporates pyrolysis (carbonization) with gasification (fixed-bed). It employs a pyrolyzer (carbonizer) to avoid sticky coal agglomeration caused in the conventional process of gradually heating coal through the 400 F to 900 F range. In so doing, the coal is rapidly heated sufficiently such that the coal tar exists in gaseous form rather than as a liquid. Gaseous tars are then thermally cracked prior to the completion of the gasification process. During the subsequent endothermic gasification reactions, volatilized alkali can become chemically bound to aluminosilicates in (or added to) the ash. To reduce NH{sub 3} and HCN from fuel born nitrogen, steam injection is minimized, and residual nitrogen compounds are partially chemically reduced in the cracking stage in the upper gasifier region. Assuming testing confirms successful deployment of all these integrated processes, future IGCC applications will be much simplified, require significantly less mechanical components, and will likely achieve the $1,000/kWe commercialized system cost goal of the GPIF project. This report describes the process and its operation, design of the plant and equipment, site requirements, and the cost and schedule. 23 refs., 45 figs., 23 tabs.

  15. Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome

    DEFF Research Database (Denmark)

    Storgaard, Filip Holst; Pedersen, Christina Gravgaard; Jensen, Majbritt Lykke

    Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome.......Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome....

  16. Lemhi River Habitat Improvement Study, 1985 Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    Dorratcaque, Dennis E.

    1986-02-01

    The objective was to develop methods for improving anadromous fish passage in the Lemhi River in east central Idaho. Alternatives assessed include flow concentration, fish screen improvement, groundwater augmentation, groundwater irrigation, water withdrawal reduction, return flow improvement, sprinkler irrigation, storage, and trap and haul. (ACR)

  17. Conscientiousness predicts greater recovery from negative emotion

    OpenAIRE

    Kristin N Javaras; Schaefer, Stacey M.; van Reekum, Carien M.; Lapate, Regina C.; Greischar, Lawrence L.; Bachuber, David R.; Love, Gale; Ryff, Carol D.; Richard J Davidson

    2012-01-01

    Greater levels of conscientiousness have been associated with lower levels of negative affect. We focus on one mechanism through which conscientiousness may decrease\\ud negative affect: effective emotion regulation, as reflected by greater recovery from negative stimuli. In 273 adults who were 35 - 85 years old, we collected self-report measures of personality including conscientiousness and its self-control facet, followed\\ud on average 2 years later by psychophysiological measures of emotio...

  18. Integrated approach towards the application of horizontal wells to improve waterflooding performance. 1995 annual report

    Energy Technology Data Exchange (ETDEWEB)

    Kelkar, M.; Liner, C.; Kerr, D.

    1996-06-01

    This annual report describes the progress during the third year of the project on Integrated Approach Towards the Application of Horizontal Wells to Improve Waterflooding Performance. This project is funded under the Department of Energy`s Class I program which is targeted towards improving the reservoir performance of mature oil fields located in fluvially dominated deltaic geological environments. The project involves using an integrated approach to characterize the reservoir followed by proposing an appropriate reservoir management strategy to improve the field performance. In the first stage of the project, the type of data we integrated include cross borehole seismic surveys, geological interpretation based on the logs and the cores, and the engineering information. In contrast, during the second stage of the project, we intend to use only conventional data to construct the reservoir description. This report covers the results of the implementation from the first stage of the project. It also discusses the work accomplished so far for the second stage of the project. The preliminary results look promising from the field implementation. The production from the Self Unit (location of Stage I) has increased by 35 bbls/day with additional increase anticipated with further implementation. Based on our understanding of the first stage, we hope to examine a greater area of the Glenn Pool field for additional increase in production. We have collected available core and log data and have finished the initial geological description. Although not a direct part of this project, we also have initiated a 3-D seismic survey of the area which should help us in improving the reservoir description.

  19. Programme Reporting Standards (PRS) for improving the reporting of sexual, reproductive, maternal, newborn, child and adolescent health programmes.

    Science.gov (United States)

    Kågesten, Anna E; Tunçalp, Özge; Portela, Anayda; Ali, Moazzam; Tran, Nhan; Gülmezoglu, A Metin

    2017-08-03

    stakeholders. The World Health Organization will develop a document that explains the items in greater detail, and will also apply the PRS to on-going initiatives. We welcome continuous input from the field, while it is being used, to improve its relevance and usefulness.

  20. Anaerobic fermentation of agricultural residue: potential for improvement and implementation. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Jewell, W. J.; Capener, H. R.; Dell& #x27; orto, S.

    1978-02-01

    The results of studies designed to evaluate the potential of rapidly improving the technology of anaerobic fermentation of agricultural residues and methods of implementing it in existing agricultural operations are reported. The main objectives of this study were to: identify simple and low cost anaerobic fermentor design criteria that would be appropriate in small agricultural operations, develop high rate fermentor concepts that would enable multiple product recovery from the reactor, expand the information base particularly in the area of temperature influence on the process, and to review sociological and economic issues relating to implementation of fermentation technology. This study has identified several major anaerobic fermentation concepts which illustrate that the technology may be rapidly improved. A simple reactor design utilizing an unmixed plug flow concept was shown to be comparable to the more complex completely mixed reactor when using dairy cow residue. A high rate thermophilic reactor designed to encourage flotation of particulate solids illustrated that liquid, solid, and gaseous products can be generated within the anaerobic fermentor thus eliminating an additional dewatering unit process. A third reactor concept involved extension of the anaerobic attached microbial film expanded bed to the treatment of cow manure slurries. A high rate of methane generation was recorded. Comprehensive thermophilic fermentation studies (60/sup 0/C) indicated that the increased temperature resulted in little improvement in total quantity or the rate of yield of gas over that obtained with mesophilic fermentation with reactor retention periods greater than 10 days. Finally, other areas where preliminary date were obtained are noted.

  1. Embedded Sensors and Controls to Improve Component Performance and Reliability Conceptual Design Report

    Energy Technology Data Exchange (ETDEWEB)

    Kisner, R.; Melin, A.; Burress, T.; Fugate, D.; Holcomb, D.; Wilgen, J.; Miller, J.; Wilson, D.; Silva, P.; Whitlow, L.; Peretz, F.

    2012-09-15

    The objective of this project is to demonstrate improved reliability and increased performance made possible by deeply embedding instrumentation and controls (I&C) in nuclear power plant (NPP) components and systems. The project is employing a highly instrumented canned rotor, magnetic bearing, fluoride salt pump as its I&C technology demonstration platform. I&C is intimately part of the basic millisecond-by-millisecond functioning of the system; treating I&C as an integral part of the system design is innovative and will allow significant improvement in capabilities and performance. As systems become more complex and greater performance is required, traditional I&C design techniques become inadequate and more advanced I&C needs to be applied. New I&C techniques enable optimal and reliable performance and tolerance of noise and uncertainties in the system rather than merely monitoring quasistable performance. Traditionally, I&C has been incorporated in NPP components after the design is nearly complete; adequate performance was obtained through over-design. By incorporating I&C at the beginning of the design phase, the control system can provide superior performance and reliability and enable designs that are otherwise impossible. This report describes the progress and status of the project and provides a conceptual design overview for the platform to demonstrate the performance and reliability improvements enabled by advanced embedded I&C.

  2. Environmental report for the Gasification Product Improvement Facility (GPIF)

    Energy Technology Data Exchange (ETDEWEB)

    Sadowski, R.S.; Skinner, W.H.; Norris, E.S.; Duck, R.R.; Hass, R.B.; Morgan, M.E.; Helble, J.J.; Johnson, S.A.

    1993-01-01

    The Fossil Energy Program has a mission to develop energy systems that utilize national coal resources in power systems with increased efficiency and environmental compatibility. Coal gasification technology is a versatile candidate that meets this goal. This two phased project consists primarily of the design, construction and operation of a 5-foot inside diameter (minimum) fixed-bed gasifier called PyGas{trademark} and supporting infrastructure (Phase I), and an additional follow on phase consisting of the design, construction and operation of a hot fuel gas cleanup unit (Phase II). Issues expected to be successfully overcome by PyGas{trademark} through its application in this test facility include the processing of high-swelling coals, which causes agglomeration in conventional fixed-bed gasifiers. Such coals comprise 87% of all eastern coals. Other issues expected to be eliminated or significantly reduced include: production of ash clinkers, production of ammonia, the presence of significant tars and fines, and the volatilization of alkalinity in the product fuel gas. A second portion of the NEPA report is concerned with the emission of toxic metal compounds by the gasification process improvement facility (GPIF). The GPIF facility will be located on site at the Fort Martin facility of Allegheny Power Company, and the energy produced (steam) will be directly used by Fort Martin to produce electricity. The coal used at the GPIF facility will be the same coal used by the utility. Therefore, the emissions of the GPIF will be put in context of the entire facility. The GPIF assessment will be divided into four sections: Estimation of the toxic metals content of the raw coal; calculation of the emissions from Fort Martin normally; an estimate of the emission from the GPIF; and a comparison of the two flows.

  3. Electricity Supply Infrastructure Improvements: Final Technical Status Report, December 2010

    Energy Technology Data Exchange (ETDEWEB)

    Piekarski, D.; Brad, D.

    2011-02-01

    This report is about a work effort where the overall objectives were to establish a methodology and approach for selected transmission and distribution (T&D) grid modernization; monitor the results; and report on the findings, recommendations, and lessons learned. The work reported addressed T&D problems and solutions, related reliability issues, equipment and operation upgrades, and respective field testing.

  4. Brazil - Improving Fiscal Circumstances for Growth : Volume 2. Main Report

    OpenAIRE

    World Bank

    2007-01-01

    This document is part of a series of reports by the World Bank on Brazil's potential to foment more robust economic growth and reduce poverty and inequality. The main focus of this report is on the interrelated fiscal circumstances facing Brazil, with an emphasis on public sector spending. The report is divided into two volumes. This first volume distills the essential stylized facts (that...

  5. AEL Continuous School Improvement Questionnaire. User Manual and Technical Report.

    Science.gov (United States)

    Meehan, Merrill L.; Cowley, Kimberly S.; Craig, James R.; Balow, Nancy; Childers, Robert D.

    The Continuous School Improvement Questionnaire (CSIQ) developed by the AEL helps a school staff gauge its performance on six dimensions related to continuous school improvement. Each member of the staff responds to the CSIQ individually. Although results might be used at the district or regional level, the most widely intended unit for applying…

  6. Improving Mental Health Reporting Practices in Between Personnel Security Investigations

    Science.gov (United States)

    2017-06-01

    review and SME discussions underscore the need to further clarify mental health -related reporting requirements (generally) and to provide guidance to SMs... health issues of potential risk to national security. Training should stress reporting requirements and should address how to FINDINGS...influenced DoD requirements , specifically for self, co-worker, and supervisor reporting of security-relevant mental health issues. Early personnel

  7. Invited review: Recommendations for reporting intervention studies on reproductive performance in dairy cattle: Improving design, analysis, and interpretation of research on reproduction.

    Science.gov (United States)

    Lean, Ian J; Lucy, Matthew C; McNamara, John P; Bradford, Barry J; Block, Elliot; Thomson, Jennifer M; Morton, John M; Celi, Pietro; Rabiee, Ahmad R; Santos, José E P; Thatcher, William W; LeBlanc, Stephen J

    2016-01-01

    Abundant evidence from the medical, veterinary, and animal science literature demonstrates that there is substantial room for improvement of the clarity, completeness, and accuracy of reporting of intervention studies. More rigorous reporting guidelines are needed to improve the quality of data available for use in comparisons of outcomes (or meta-analyses) of multiple studies. Because of the diversity of factors that affect reproduction and the complexity of interactions between these, a systematic approach is required to design, conduct, and analyze basic and applied studies of dairy cattle reproduction. Greater consistency, clarity, completeness, and correctness of design and reporting will improve the value of each report and allow for greater depth of evaluation in meta-analyses. Each of these benefits will improve understanding and application of current knowledge and better identify questions that require additional modeling or primary research. The proposed guidelines and checklist will aid in the design, conduct, analysis, and reporting of intervention studies. We propose an adaptation of the REFLECT (Reporting Guidelines for Randomized Controlled Trials for Livestock and Food Safety) statement to provide guidelines and a checklist specific to reporting intervention studies in dairy cattle reproduction. Furthermore, we provide recommendations that will assist investigators to produce studies with greater internal and external validity that can more often be included in systematic reviews and global meta-analyses. Such studies will also assist the development of models to describe the physiology of reproduction.

  8. Conscientiousness predicts greater recovery from negative emotion.

    Science.gov (United States)

    Javaras, Kristin N; Schaefer, Stacey M; van Reekum, Carien M; Lapate, Regina C; Greischar, Lawrence L; Bachhuber, David R; Love, Gayle Dienberg; Ryff, Carol D; Davidson, Richard J

    2012-10-01

    Greater levels of conscientiousness have been associated with lower levels of negative affect. We focus on one mechanism through which conscientiousness may decrease negative affect: effective emotion regulation, as reflected by greater recovery from negative stimuli. In 273 adults who were 35-85 years old, we collected self-report measures of personality including conscientiousness and its self-control facet, followed on average 2 years later by psychophysiological measures of emotional reactivity and recovery. Among middle-aged adults (35-65 years old), the measures of conscientiousness and self-control predicted greater recovery from, but not reactivity to, negative emotional stimuli. The effect of conscientiousness and self-control on recovery was not driven by other personality variables or by greater task adherence on the part of high conscientiousness individuals. In addition, the effect was specific to negative emotional stimuli and did not hold for neutral or positive emotional stimuli.

  9. Matrix Summaries Improve Research Reports: Secondary Analyses Using Published Literature

    Science.gov (United States)

    Zientek, Linda Reichwein; Thompson, Bruce

    2009-01-01

    Correlation matrices and standard deviations are the building blocks of many of the commonly conducted analyses in published research, and AERA and APA reporting standards recommend their inclusion when reporting research results. The authors argue that the inclusion of correlation/covariance matrices, standard deviations, and means can enhance…

  10. Improving Accuracy of Sleep Self-Reports through Correspondence Training

    Science.gov (United States)

    St. Peter, Claire C.; Montgomery-Downs, Hawley E.; Massullo, Joel P.

    2012-01-01

    Sleep insufficiency is a major public health concern, yet the accuracy of self-reported sleep measures is often poor. Self-report may be useful when direct measurement of nonverbal behavior is impossible, infeasible, or undesirable, as it may be with sleep measurement. We used feedback and positive reinforcement within a small-n multiple-baseline…

  11. BWR Servicing and Refueling Improvement Program: Phase I summary report

    Energy Technology Data Exchange (ETDEWEB)

    Perry, D.R.

    1978-09-01

    Under the U.S. Department of Energy sponsorship, General Electric Co. (GE) undertook a study of boiling water reactor (BWR) refueling outages for the purpose of recommending the development and demonstration of critical path time savings improvements. The Tennessee Valley Authority (TVA) joined the study as a subcontractor, providing monitoring assistance and making the Browns Ferry Site available for improvement demonstrations. Agreement was also reached with Georgia Power Co., Power Authority of the State of New York, and Commonwealth Edison Co. for monitoring and data collection at Hatch 1, FitzPatrick, and Quad Cities 1 nuclear plants, respectively. The objective was to identify, develop, and demonstrate improved refueling, maintenance, and inspection procedures and equipment. The improvements recommended in this study are applicable to BWR nuclear plants currently in operation as well as those in the design and construction phases. The recommendations and outage information can be used as a basis to plan and conduct the first outages of new plants and to improve the planning and facilities of currently operating plants. Many of the recommendations can readily be incorporated in plants currently in the design and construction phases as well as in the design of future plants. Many of these recommended improvements can be implemented immediately by utilities without further technical development.

  12. A Novel Reporting System to Improve Accuracy in Appendicitis Imaging

    Science.gov (United States)

    Godwin, Benjamin D.; Drake, Frederick T.; Simianu, Vlad V.; Shriki, Jabi E.; Hippe, Daniel S.; Dighe, Manjiri; Bastawrous, Sarah; Cuevas, Carlos; Flum, David; Bhargava, Puneet

    2015-01-01

    OBJECTIVE The purpose of this study was to ascertain if standardized radiologic reporting for appendicitis imaging increases diagnostic accuracy. MATERIALS AND METHODS We developed a standardized appendicitis reporting system that includes objective imaging findings common in appendicitis and a certainty score ranging from 1 (definitely not appendicitis) through 5 (definitely appendicitis). Four radiologists retrospectively reviewed the preoperative CT scans of 96 appendectomy patients using our reporting system. The presence of appendicitis-specific imaging findings and certainty scores were compared with final pathology. These comparisons were summarized using odds ratios (ORs) and the AUC. RESULTS The appendix was visualized on CT in 89 patients, of whom 71 (80%) had pathologically proven appendicitis. Imaging findings associated with appendicitis included appendiceal diameter (odds ratio [OR] = 14 [> 10 vs appendicitis. In this initially indeterminate group, using the standardized reporting system, radiologists assigned higher certainty scores (4 or 5) in 21 of the 28 patients with appendicitis (75%) and lower scores (1 or 2) in five of the seven patients without appendicitis (71%) (AUC = 0.90; p = 0.001). CONCLUSION Standardized reporting and grading of objective imaging findings correlated well with postoperative pathology and may decrease the number of CT findings reported as indeterminate for appendicitis. Prospective evaluation of this reporting system on a cohort of patients with clinically suspected appendicitis is currently under way. PMID:26001230

  13. Silicon Carbide Temperature Monitor Processing Improvements. Status Report

    Energy Technology Data Exchange (ETDEWEB)

    Unruh, Troy Casey [Idaho National Lab. (INL), Idaho Falls, ID (United States); Daw, Joshua Earl [Idaho National Lab. (INL), Idaho Falls, ID (United States); Al Rashdan, Ahamad [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-01-29

    could be performed in an MFC hot cell, further reducing the time and expense of lengthy decontaminations prior to processing. Sections of this report provide a general description of resistivity techniques currently used to infer peak irradiation temperature from silicon carbide temperature monitors along with some representative data, the proposed concepts to improve the process of analyzing irradiated SiC temperature monitors, the completed efforts to prove the proposed concepts, and future activities. The efforts detailed here succeeded in designing and developing a real-time automated SiC resistivity measurement system, and performed two initial test runs. Activities carried out include the assembly and integration of the system hardware; the design and development of a preliminary monitor fixture; the design of a technique to automate the data analysis and processing; the development of the communication, coordination, and user software; and the execution and troubleshooting of test run experiments using the box furnace. Although the automation system performed as required, the designed fixture did not succeed in establishing the needed electrical contacts with the SiC monitor.

  14. Improving Project Outcomes and Growing the Anaerobic Digestion Industy Report

    Science.gov (United States)

    Anaerobic digestion ombudsmen assist with project development, ensure the long-term sustainability of projects, and help advance the industry. This report explores the benefits of anaerobic digestion ombudsmen and provides guidance for implementing them.

  15. Improving Patients\\\\\\' Care through Electronic Medical Error Reporting System

    Directory of Open Access Journals (Sweden)

    Fatemeh Rangraz Jeddi

    2015-06-01

    Full Text Available Medical errors are unintentional acts that take place due to the negligence or lead to undesirable consequences in medical practice. The purpose of this study was to design a conceptual model for medical error reporting system. This applied descriptive cross-sectional research employed Delphi method carried out from 2012 to 2013. The study population was medical and paramedical personnel of health workers and paramedical personnel of hospitals, deputy of treatment, faculty members of Kashan University of Medical Sciences in addition to the internet and library resources. Sample size included 30 expert individuals in the field of medical errors. The one-stage stratified sampling procedure was used. The items with opposition ranging 0 to 25 were confirmed and those exceeding 50 were rejected whereas the items with the opposition 25 to 50 were reevaluated in the second session. This process continued for three times and the items that failed to be approved were eliminated in the model. Based on the results of this research, repeated informing about and reporting operation at on-line bases that have access to the incidence of error detected on time, identifying cause and damage due to the incidence reported confidential and anonymously immediately after the occurrence is necessary. Analysis of data quantitatively and qualitatively by using computer software is needed. Classifying the errors reports based on feedback provision according to the cause of error is needed. In addition, confidential report and possible manual retrieval were suggested It is essential to determine the means of reporting and items in the reporting form including time, cause and damage of medical error, media of reporting and method of recording and analysis.

  16. DTU International Energy Report 2012: Energy efficiency improvements

    DEFF Research Database (Denmark)

    Increased energy efficiency can reduce global CO2 emissions over the period to 2050 with up to 25%. On the top of that large profits can be gained for very little investment. Energy efficiency improvements can save investment in new energy infrastructure, cut fuel costs, increase competitiveness...

  17. Improving plant bioaccumulation science through consistent reporting of experimental data

    DEFF Research Database (Denmark)

    Fantke, Peter; Arnot, Jon A.; Doucette, William J.

    2016-01-01

    experimental data are generated they are used to improve our understanding of plant-chemical interactions that in turn allows for the development of better scientific knowledge and conceptual and predictive models. The interrelationship between experimental data and model development is an ongoing, never...

  18. CERN Summer Student Report 2016 Monte Carlo Data Base Improvement

    CERN Document Server

    Caciulescu, Alexandru Razvan

    2016-01-01

    During my Summer Student project I worked on improving the Monte Carlo Data Base and MonALISA services for the ALICE Collaboration. The project included learning the infrastructure for tracking and monitoring of the Monte Carlo productions as well as developing a new RESTful API for seamless integration with the JIRA issue tracking framework.

  19. IMPROVING TACONITE PROCESSING PLANT EFFICIENCY BY COMPUTER SIMULATION, Final Report

    Energy Technology Data Exchange (ETDEWEB)

    William M. Bond; Salih Ersayin

    2007-03-30

    This project involved industrial scale testing of a mineral processing simulator to improve the efficiency of a taconite processing plant, namely the Minorca mine. The Concentrator Modeling Center at the Coleraine Minerals Research Laboratory, University of Minnesota Duluth, enhanced the capabilities of available software, Usim Pac, by developing mathematical models needed for accurate simulation of taconite plants. This project provided funding for this technology to prove itself in the industrial environment. As the first step, data representing existing plant conditions were collected by sampling and sample analysis. Data were then balanced and provided a basis for assessing the efficiency of individual devices and the plant, and also for performing simulations aimed at improving plant efficiency. Performance evaluation served as a guide in developing alternative process strategies for more efficient production. A large number of computer simulations were then performed to quantify the benefits and effects of implementing these alternative schemes. Modification of makeup ball size was selected as the most feasible option for the target performance improvement. This was combined with replacement of existing hydrocyclones with more efficient ones. After plant implementation of these modifications, plant sampling surveys were carried out to validate findings of the simulation-based study. Plant data showed very good agreement with the simulated data, confirming results of simulation. After the implementation of modifications in the plant, several upstream bottlenecks became visible. Despite these bottlenecks limiting full capacity, concentrator energy improvement of 7% was obtained. Further improvements in energy efficiency are expected in the near future. The success of this project demonstrated the feasibility of a simulation-based approach. Currently, the Center provides simulation-based service to all the iron ore mining companies operating in northern

  20. Report of Accomplishments Under the Airport Improvement Program.

    Science.gov (United States)

    1986-01-01

    RESOLUTION TESI VCH.ART w ’"%fAll ’l 󈧭NDARD% 1% A - - ’V "mrv-anio OflC FILE coed -% FIFTH ANNUAL REPORT US Department OF ACCOMPLISHMENTS Federal...OVERLAY RUNWAY AND TAXIWAY DUMAS MUNICIPAL (GENERAL AVIATION) ELPASO 06 $380,959 REHABILITATE RUNWAY AND TAXIWAY, GROOVE EL PASO INTERNATIONAL RUNWAY

  1. Improving Employability Skills, Enriching Our Economy. Case Study Report

    Science.gov (United States)

    National Foundation for Educational Research, 2015

    2015-01-01

    This report has been produced by four organisations--the National Foundation for Educational Research, South East Strategic Leaders, London Councils and the London Enterprise Panel. It is based on research into how secondary schools, colleges, SMEs (small and medium-sized enterprises) and micro-businesses in London and the South East work together…

  2. Performance Report and Improvements in CV Machine Areas

    CERN Document Server

    Monsted, A

    2000-01-01

    The performance of cooling and ventilation (CV) equipment is defined as its availability to the PS, SPS and LEP accelerators. Three teams for the accelerators plus a Utilities team, which receives performance information from the physics and technical control room, carry out the operation of this equipment. Collected performance statistics as well as data from the Computer Aided Maintenance Management system (CAMM) and supervision system provide information on the exact state of the CV equipment. This is used to more effectively schedule preventive maintenance which, by reducing system failures, results in improved equipment performance. This paper will present performance data and discuss the prospects for improving it through the use of an updated version of CAMM and a new supervision system.

  3. [Financial incentives in improving healthcare quality. SESPAS Report 2012].

    Science.gov (United States)

    Eirea Eiras, Carlos; Ortún Rubio, Vicente

    2012-03-01

    We address the contribution of financial incentives linked to pay for performance (P4P) to improving the quality of care. The situation of P4P is analyzed internationally and in the distinct health services in Spain. The participation of P4P in wage compensation and the effects of the current economic crisis on these incentives is discussed. We review the results of recent studies to clarify the role of these incentive models and assess possible orientations and new proposals.

  4. Program to develop improved downhole drilling motors. Semiannual report

    Energy Technology Data Exchange (ETDEWEB)

    Maurer, W.C.

    1976-11-01

    The following are described: the history of turbodrill development, positive displacement motor development, the theory of turbodrills, the theory of positive displacement motors, basic motor components, forces on thrust bearings, thrust bearing design, radial bearing design, rotary seal design, sealed lubrication system, lubricants, and project status. Included in appendices are materials on high-temperature lubricants and a progress report on the design of downhole motor seal, bearing, and lubrication test systems. (MHR)

  5. Improved radioimmunotherapy of hematologic malignancies. Progress report, 1988--1991

    Energy Technology Data Exchange (ETDEWEB)

    Press, O.W.; Barofsky, D.F.

    1991-12-31

    This progress report describes accomplishments under four headings, namely: The study of the relative rates of metabolic degradation of radiolabeled monoclonal antibodies (MAb) targeting tumor associated antigens; Effects of lysosomotropic amines, carboxylic ionophores, and thioamides on the retention of radiolabeled MAbs by tumor cells; Subcellular site of radioimmunoconjugate degradation and the sizes of fragments generated by intracellular metabolism of radiolabeled antibodies; and Patterns of metabolic degradation of radioimmunoconjugates made with different techniques and with different radionuclides.

  6. Natural Propagation and Habitat Improvement, Volume 1, Oregon, 1986 Final and Annual Reports.

    Energy Technology Data Exchange (ETDEWEB)

    Stuart, Amy

    1987-01-01

    This report describes activities implemented for fisheries habitat improvement work on priority drainages in the Clackamas and Hood River sub-basins. Separate abstracts have been prepared for the reports on individual projects. (ACR)

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

    Science.gov (United States)

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

    2015-06-01

    The SQUIRE (Standards of QUality Improvement Reporting Excellence) guidelines were developed to improve the reporting of quality improvement (QI) projects. The effect of the guidelines on the completeness of reporting in the QI literature is unknown. Our primary objective was to determine if the completeness of reporting in the QI literature has been improved[OUP_CE13] since the introduction of the SQUIRE guidelines. We performed a before-and-after evaluation of QI articles selected from four prominent journals of healthcare quality. Twenty-five articles published in each of two time periods (2006-2008 and 2010-2011) were confirmed to be QI projects using a standardised definition and were independently evaluated by two investigators as an interim evaluation of a planned larger sample. Articles were assessed using 50 statements of the SQUIRE guidelines, and the overall change in the completeness of reporting between the two groups was determined. The value of pSQUIRE statements completed by authors before and after publication of the SQUIRE guidelines, 20.2 (5.0) versus 20.4 (7.0), p=0.9. The study was stopped early due to the absence of any significant trend in the completeness of reporting. There was no overall improvement observed in the completeness of reporting of QI projects after the publication of the SQUIRE guidelines, and the study was stopped early. There is potential for improvement in reporting standards, particularly for those guideline items or statements specific to QI projects. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Improved lux reporters for use in Staphylococcus aureus.

    Science.gov (United States)

    Mesak, Lili Rosana; Yim, Grace; Davies, Julian

    2009-05-01

    The use of luxABCDE (lux) offers certain advantages over other reporters, such as: lacZ and xylE. It is real time and its signal generation is produced without the requirement for any additional substrates. In some bacteria such as Staphylococcus spp, light production by luciferase is restricted because of a limited availability of endogenous substrates such as fatty acid aldehyde. We describe the construction of promoterless-lux cloning vectors, pGYlux and pAmilux. S. aureus carrying B. subtilis xyl/tetO promoter fused to the lux genes of pGYlux gave up to a 2.5-fold enhancement of luminescence over S. aureus carrying the xyl/tetO promoter fused to lux genes of the previously published parent vector pAL2. Furthermore, pAmilux showed a 6-fold enhancement of lux expression when compared to pGYlux in S. aureus. This was achieved by cloning the constitutive ami promoter upstream of the luxCDE genes to increase endogenous fatty acid aldehyde production while maintaining its reporter functionality by fusing promoters to the luxAB genes.

  9. Melatonin treatment improves primary progressive multiple sclerosis: a case report.

    Science.gov (United States)

    López-González, Antonio; Álvarez-Sánchez, Nuria; Lardone, Patricia J; Cruz-Chamorro, Ivan; Martínez-López, Alicia; Guerrero, Juan M; Reiter, Russel J; Carrillo-Vico, Antonio

    2015-03-01

    We describe the case of a female patient who, at the age of 28, was diagnosed with symptoms of primary progressive multiple sclerosis (PPMS). Glucocorticoid treatment was immediately initiated. The disease and the demyelinating lesions progressed during the following 9 years reaching Expanded Disability Status Scale (EDSS) 8.0 (patient essentially restricted to bed, a chair or perambulated in a wheelchair). At this point, the patient began taking melatonin at doses ranging from 50 to 300 mg per day. Melatonin was her only treatment for the next 4 years; during this interval, her EDSS progressively recovered to 6.0 (the person needs intermittent or unilateral constant assistance such as cane, crutch, or brace to walk 100 meters with or without resting). This long-lasting improvement is likely due to melatonin usage since it is related in time and because of its exceptionally long duration.

  10. A field laboratory for improved oil recovery. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Hildebrandt, A.F.; McDonald, J.; Claridge, E.; Killough, J.

    1992-09-01

    The purpose of Annex III of the Memorandum of Understanding, undertaken by the Houston Petroleum Research Center at the University of Houston, was to develop a field laboratory for research in improved oil recovery using a Gulf Coast reservoir in Texas. The participants: (1) make a field site selection and conducted a high resolution seismic survey in the demonstration field, (2) obtained characteristics of the reservoir (3) developed an evaluation of local flood efficiency in different parts of the demonstration reservoir, (4) used diverse methodology to evaluate the potential recovery of the remaining oil in the test reservoir, (5) developed cross-well seismic tomography, and (6) will transfer the learned technologies to oil operators through publication and workshops. This abstract is an overview of these tasks.

  11. Improved Controls for Fusion RF Systems. Final technical report

    Energy Technology Data Exchange (ETDEWEB)

    Casey, Jeffrey A. [Rockfield Research Inc., Las Vegas, NV (United States)

    2011-11-08

    We have addressed the specific requirements for the integrated systems controlling an array of klystrons used for Lower Hybrid Current Drive (LHCD). The immediate goal for our design was to modernize the transmitter protection system (TPS) for LHCD on the Alcator C-Mod tokamak at the MIT Plasma Science and Fusion Center (MIT-PSFC). Working with the Alcator C-Mod team, we have upgraded the design of these controls to retrofit for improvements in performance and safety, as well as to facilitate the upcoming expansion from 12 to 16 klystrons. The longer range goals to generalize the designs in such a way that they will be of benefit to other programs within the international fusion effort was met by designing a system which was flexible enough to address all the MIT system requirements, and modular enough to adapt to a large variety of other requirements with minimal reconfiguration.

  12. Widely Assumed but Thinly Tested: Do Employee Volunteers' Self-Reported Skill Improvements Reflect the Nature of Their Volunteering Experiences?

    Science.gov (United States)

    Jones, David A

    2016-01-01

    An increasing number of companies use corporate volunteering programs (CVPs) to support and coordinate their employees' efforts to serve their communities. Among the most frequently touted benefits of such programs to sponsoring companies and employee volunteers alike is the opportunities for employees to develop tangible work-related skills through their volunteering activities. Evidence for skill development through volunteering, however, is mostly limited to the expressed beliefs of corporate leaders and employee volunteers. This study was designed to contribute to this largely anecdotal literature by testing hypotheses about the extent to which employee volunteers' self-reported skill development reflects the characteristics of the volunteers and their volunteering experiences. Study participants were 74 employee volunteers who completed a service apprenticeship managed by a U.S.-based nonprofit called Citizen Schools that partners with middle schools to extend the learning day with a combination of academic support, enrichment, and youth development activities. Data were obtained via the nonprofit's records, and surveys completed by employee volunteers before and after their service experience, including measures used to assess self-reported improvements in each of 10 work-related skills: communicating performance expectations, leadership, mentorship, motivating others, project management, providing performance feedback, public speaking and presenting, speaking clearly, teamwork, and time management. Support was found for several hypothesized effects suggesting that employees who practiced specific skills more often during their volunteering experience reported greater improvements in those skills. Improvements in some skills were higher among employee volunteers who completed a greater number of pre-volunteering preparation courses, and the effects of preparation courses were moderated by the employee volunteers' self-efficacy about improving their work

  13. Widely Assumed but Thinly Tested: Do Employee Volunteers' Self-Reported Skill Improvements Reflect the Nature of Their Volunteering Experiences?

    Science.gov (United States)

    Jones, David A.

    2016-01-01

    An increasing number of companies use corporate volunteering programs (CVPs) to support and coordinate their employees' efforts to serve their communities. Among the most frequently touted benefits of such programs to sponsoring companies and employee volunteers alike is the opportunities for employees to develop tangible work-related skills through their volunteering activities. Evidence for skill development through volunteering, however, is mostly limited to the expressed beliefs of corporate leaders and employee volunteers. This study was designed to contribute to this largely anecdotal literature by testing hypotheses about the extent to which employee volunteers' self-reported skill development reflects the characteristics of the volunteers and their volunteering experiences. Study participants were 74 employee volunteers who completed a service apprenticeship managed by a U.S.-based nonprofit called Citizen Schools that partners with middle schools to extend the learning day with a combination of academic support, enrichment, and youth development activities. Data were obtained via the nonprofit's records, and surveys completed by employee volunteers before and after their service experience, including measures used to assess self-reported improvements in each of 10 work-related skills: communicating performance expectations, leadership, mentorship, motivating others, project management, providing performance feedback, public speaking and presenting, speaking clearly, teamwork, and time management. Support was found for several hypothesized effects suggesting that employees who practiced specific skills more often during their volunteering experience reported greater improvements in those skills. Improvements in some skills were higher among employee volunteers who completed a greater number of pre-volunteering preparation courses, and the effects of preparation courses were moderated by the employee volunteers' self-efficacy about improving their work

  14. Foundations for Improvements to Passive Detection Systems - Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Labov, S E; Pleasance, L; Sokkappa, P; Craig, W; Chapline, G; Frank, M; Gronberg, J; Jernigan, J G; Johnson, S; Kammeraad, J; Lange, D; Meyer, A; Nelson, K; Pohl, B; Wright, D; Wurtz, R

    2004-10-07

    This project explores the scientific foundation and approach for improving passive detection systems for plutonium and highly enriched uranium in real applications. Sources of gamma-ray radiation of interest were chosen to represent a range of national security threats, naturally occurring radioactive materials, industrial and medical radiation sources, and natural background radiation. The gamma-ray flux emerging from these sources, which include unclassified criticality experiment configurations as surrogates for nuclear weapons, were modeled in detail. The performance of several types of gamma-ray imaging systems using Compton scattering were modeled and compared. A mechanism was created to model the combine sources and background emissions and have the simulated radiation ''scene'' impinge on a model of a detector. These modeling tools are now being used in various projects to optimize detector performance and model detector sensitivity in complex measuring environments. This study also developed several automated algorithms for isotope identification from gamma-ray spectra and compared these to each other and to algorithms already in use. Verification testing indicates that these alternative isotope identification algorithms produced less false positive and false negative results than the ''GADRAS'' algorithms currently in use. In addition to these algorithms that used binned spectra, a new approach to isotope identification using ''event mode'' analysis was developed. Finally, a technique using muons to detect nuclear material was explored.

  15. Final Scientific Report - "Improved Fuel Efficiency from Nanocomposite Tire Tread"

    Energy Technology Data Exchange (ETDEWEB)

    Dr. Andrew Myers

    2005-12-30

    Rolling resistance, a measure of the energy lost as a tire rotates while moving, is a significant source of power and fuel loss. Recently, low rolling resistant tires have been formulated by adding silica to tire tread. These "Green Tires" (so named from the environmental advantages of lower emissions and improved fuel economy) have seen some commercial success in Europe, where high fuel prices and performance drive tire selection. Unfortunately, the higher costs of the silica and a more complicated manufacturing process have prevented significant commercialization - and the resulting fuel savings - in the U.S. In this project, TDA Research, Inc. (TDA) prepared an inexpensive alternative to silica that leads to tire components with lower rolling resistance. These new tire composite materials were processed with traditional rubber processing equipment. We prepared specially designed nanoparticle additives, based on a high purity, inorganic mineral whose surface can be easily modified for compatibility with tire tread formulations. Our nanocomposites decreased energy losses to hysteresis, the loss of energy from the compression and relaxation of an elastic material, by nearly 20% compared to a blank SBR sample. We also demonstrated better performance than a leading silica product, with easier production of our final rubber nanocomposite.

  16. Yakima Habitat Improvement Project Master Plan, Technical Report 2003.

    Energy Technology Data Exchange (ETDEWEB)

    Golder Associates, Inc.

    2003-04-22

    The Yakima Urban Growth Area (UGA) is a developing and growing urban area in south-central Washington. Despite increased development, the Yakima River and its tributaries within the UGA continue to support threatened populations of summer steelhead and bull trout as well as a variety of non-listed salmonid species. In order to provide for the maintenance and recovery of these species, while successfully planning for the continued growth and development within the UGA, the City of Yakima has undertaken the Yakima Habitat Improvement Project. The overall goal of the project is to maintain, preserve, and restore functioning fish and wildlife habitat within and immediately surrounding the Yakima UGA over the long term. Acquisition and protection of the fish and wildlife habitat associated with key properties in the UGA will prevent future subdivision along riparian corridors, reduce further degradation or removal of riparian habitat, and maintain or enhance the long term condition of aquatic habitat. By placing these properties in long-term protection, the threat of development from continued growth in the urban area will be removed. To most effectively implement the multi-year habitat acquisition and protection effort, the City has developed this Master Plan. The Master Plan provides the structure and guidance for future habitat acquisition and restoration activities to be performed within the Yakima Urban Area. The development of this Master Plan also supports several Reasonable and Prudent Alternatives (RPAs) of the NOAA Fisheries 2000 Biological Opinion (BiOp), as well as the Water Investment Action Agenda for the Yakima Basin, local planning efforts, and the Columbia Basin Fish and Wildlife Authority's 2000 Fish and Wildlife Program. This Master Plan also provides the framework for coordination of the Yakima Habitat Improvement Project with other fish and wildlife habitat acquisition and protection activities currently being implemented in the area. As a

  17. Improved, inexpensive solar-energy-heating heat reservoir. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1979-02-07

    The use of a salt hydrate, sodium sulfate decahydrate (glauber salt) to increase the heat storage capacity of a solar space heating system was studied. The rheological properties of the solids slurry was altered by modifying the crystal habit of glauber salt so as to form small chunky crystals and by using a viscosity modifier. Various additives to modify the crystal form habit were found; and though none were completely successful under pilot plant conditions, dodecylamine HCl and Monsanto dequest were quite effective in the laboratory. Additional screening studies are required. An alginate viscosity modifier altered the surface tension of the slurry so as to prevent plugging and maintain a pumpable slurry. The slurry was contacted with air in a direct contact heat transfer column. The efficiency of the heat transfer decreased as the viscosity of the slurry increased. However, this is not a limiting factor and air temperatures of 80 to 82/sup 0/F can be achieved. The slurry was found to be suitable for a radiant heating system and could be quite economically effective immediately. The storage capacity with a glauber salt slurry is about twice that of water with a potential of three times with improvement. A more important aspect of using the slurry is the increase in collector efficiency due to the decreased storage temperature. This could have the effect of halving the required collector area.

  18. Quantify and improve PEM fuel cell durability. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Grahl-Madsen, L.; Odgaard, M.; Munksgaard Nielsen, R. (IRD Fuel Cell A/S, Svendborg (Denmark)); Li, Q.; Jensen, Jens Oluf (Technical Univ. of Denmark, Dept. of Chemistry, Kgs. Lyngby (Denmark)); Andersen, Shuang Ma; Speder, J.; Skou, E. (Syddansk Univ. (SDU), Odense (Denmark))

    2010-07-01

    The aim of the present project is to systematically quantify and improve the durability of the PEM FC including the following three PEM FC variants: LT PEM FC, DMFC, and HT PEM FC. Different factors influencing dissolution properties of noble metal catalyst platinum and platinum-ruthenium alloy has been studied. The dissolution was found to increase by increasing the CV cycle upper potential limit, number of potential cycles, solution acidity, oxygen partial pressure, involvement of chloride, and temperature. Ruthenium was found to deteriorate ten (10) times faster than platinum catalyst; and carbon supported catalyst (Pt: 20%, Ru: up to 100%) deteriorate ten (10) times faster than non-supported catalyst (Pt: 2%, Ru: 30%) at the same condition. Loss of sulphonic acid groups and fluoride from perfluorinated sulfonic acid membrane was confirmed by different techniques, which locally leads to loss of acidity, and consequently enhances dissolution of noble metal catalyst. Degradation of Nafion ionomer in the electrode was enhanced by noble metal catalyst and the thermal decomposition properties has synergetic effect with carbon degradation. Hydrophobicity of GDL and electrode on GDL were found to degrade e.g. radical attack, oxidation, and physical wear out. The very top micro surface structure turned out to be responsible for wetting property after chemical ageing. Optimal catalyst and ionomer ratio is also reflected in contact angle value, which can be understood in terms of catalyst/carbon - ionomer affinity and layered structure. Long-term tested and 'virgin' LT PEM MEAs have been characterised with respect to SEM, TEM, EDS, and XRD. Both failed and well-functioning MEAs have been characterised. The Post Mortem analysis has shown and quantified degradation mechanisms like catalyst growth and carbon corrosion. Furthermore, the effect of fuel starvation was shown by pronounced Ru-catalyst band within the membrane. The catalyst coarsening observed after

  19. [Autoerotic fatalities in Greater Dusseldorf].

    Science.gov (United States)

    Hartung, Benno; Hellen, Florence; Borchard, Nora; Huckenbeck, Wolfgang

    2011-01-01

    Autoerotic fatalities in the Greater Dusseldorf area correspond to the relevant medicolegal literature. Our results included exclusively young to middle-aged, usually single men who were found dead in their city apartments. Clothing and devices used showed a great variety. Women's or fetish clothing and complex shackling or hanging devices were disproportionately frequent. In most cases, death occurred due to hanging or ligature strangulation. There was no increased incidence of underlying psychiatric disorders. In most of the deceased no or at least no remarkable alcohol intoxication was found. Occasionally, it may be difficult to reliably differentiate autoerotic accidents, accidents occurring in connection with practices of bondage & discipline, dominance & submission (BDSM) from natural death, suicide or homicide.

  20. Sarilumab improves patient-reported outcomes in rheumatoid arthritis patients with inadequate response/intolerance to tumour necrosis factor inhibitors

    Science.gov (United States)

    Strand, Vibeke; Reaney, Matthew; Chen, Chieh-I; Proudfoot, Clare W J; Guillonneau, Sophie; Bauer, Deborah; Mangan, Erin; Graham, Neil M H; van Hoogstraten, Hubert; Lin, Yong; Pacheco-Tena, César; Fleischmann, Roy

    2017-01-01

    Objective To evaluate effects of the anti-interleukin-6 receptor monoclonal antibody sarilumab administered with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) on patient-reported outcomes (PROs) in the TARGET trial in patients with rheumatoid arthritis (RA) with inadequate response or intolerance to tumour necrosis factor inhibitors (TNF-IR). Methods 546 patients (81.9% female, mean age 52.9 years) were randomised to placebo, sarilumab 150 or 200 mg subcutaneously every 2 weeks + csDMARDs. PROs included patient global assessment (PtGA); pain and morning stiffness visual analogue scales; Health Assessment Questionnaire Disability Index (HAQ-DI); Short Form-36 Health Survey (SF-36); FACIT-Fatigue (FACIT-F); Work Productivity Survey-Rheumatoid Arthritis (WPS-RA) and Rheumatoid Arthritis Impact of Disease (RAID). Changes from baseline at weeks 12 and 24 were analysed using a mixed model for repeated measures; post hoc analyses included percentages of patients reporting improvements ≥ minimum clinically important differences (MCID) and scores ≥ normative values. Results Sarilumab + csDMARDs doses resulted in improvements from baseline at week 12 vs placebo + csDMARDs in PtGA, pain, HAQ-DI, SF-36 and FACIT-F that were maintained at week 24. Sarilumab improved morning stiffness and reduced the impact of RA on work, family, social/leisure activities participation (WPS-RA) and on patients' lives (RAID). Percentages of patients reporting improvements ≥MCID and ≥ normative scores were greater with sarilumab than placebo. Conclusions In patients with TNF-IR RA, 150 and 200 mg sarilumab + csDMARDs resulted in clinically meaningful patient-reported benefits on pain, fatigue, function, participation and health status at 12 and 24 weeks that exceeded placebo + csDMARDs, and were consistent with the clinical profile previously reported. Trial registration number NCT01709578; Results. PMID:28326189

  1. Burn-injured adolescents report gaining multiple developmental benefits and improved life skills as a result of burn camp attendance.

    Science.gov (United States)

    Rimmer, Ruth Brubaker; Pressman, Melissa S; Takach, Oliver P; Bay, R Curtis; Croteau, Renee; Hansen, Linda D; Foster, Kevin N; Caruso, Daniel M

    2012-01-01

    Anecdotally, burn camp has been reported to be a positive developmental and rehabilitative experience for attendees; there is little empirical data to support this belief. This study sought to explore whether burn camp either directly or indirectly elicits positive development outcomes in pediatric burn survivors or increases their psychosocial well-being and achievement. The Youth Experience Survey 2.0, a 66-item self-report inventory designed to measure developmental experiences in an organized youth activity, was administered to children aged 11 to 18 years attending summer burn camp. One hundred and ten burn-injured youth, 58 male and 52 female, reported that burn camp had positively impacted their lives through improved identity exploration, goal-setting and problem-solving abilities, increased physical activity, communication, emotional regulation, and time management skills (P camp for more than 5 years resulted in greater improvement. Study results support the burn camp experience as a far-reaching and positive developmental activity. Participants credited the camp experience with helping them with identity formation and reflection, improved social interactions, and increased initiative; all positive developmental outcomes for youth. Results suggest that burn camp participation not only helps burn-injured youth to deal with their burns but also assists them in the development of social and basic life skills, which will allow them to navigate the transition from youth to adulthood, more effectively and successfully.

  2. Greater trochanter apophysitis in the adolescent athlete.

    Science.gov (United States)

    Young, Simon W; Safran, Marc R

    2015-05-01

    Lower limb traction apophysitis is common in young athletes, occurring at sites such as the tibial tubercle (Osgood-Schlatter disease) and distal patella (Sinding-Larsen-Johansson disease). Around the hip, iliac apophysitis is well recognized, but no cases of greater trochanter apophysitis have previously been reported. We describe the case of a 15-year-old male basketball player with a 2-month history of the right hip pain and significant functional limitation. X-rays revealed widening of the greater trochanter apophysis with subchondral sclerosis, consistent with a diagnosis of traction apophysitis. The patient was treated with a period of relative rest and anti-inflammatory medication. He gradually returned to full athletic activity, including basketball, without recurrence of pain or limitation. We describe the first reported case of traction apophysitis of the greater trochanter. The unique muscular anatomy of this apophysis with balanced forces explains the rarity of this condition. If encountered, rest and activity modification is the recommended treatment.

  3. Greater clinical benefit of more intensive oral antiplatelet therapy with prasugrel in patients with diabetes mellitus in the trial to assess improvement in therapeutic outcomes by optimizing platelet inhibition with prasugrel-Thrombolysis in Myocardial Infarction 38.

    NARCIS (Netherlands)

    Wiviott, S.D.; Braunwald, E.; Angiolillo, D.J.; Meisel, S.; Dalby, A.J.; Verheugt, F.W.A.; Goodman, S.G.; Corbalan, R.; Purdy, D.A.; Murphy, S.A.; McCabe, C.H.; Antman, E.M.

    2008-01-01

    BACKGROUND: Patients with diabetes mellitus (DM) are at high risk for recurrent cardiovascular events after acute coronary syndromes, in part because of increased platelet reactivity. The Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel-Thrombolysi

  4. Mindfulness-Based Stress Reduction Therapy Improves Patient and Caregiver-Reported Outcomes in Cirrhosis.

    Science.gov (United States)

    Bajaj, Jasmohan S; Ellwood, Michael; Ainger, Timothy; Burroughs, Thomas; Fagan, Andrew; Gavis, Edith A; Heuman, Douglas M; Fuchs, Michael; John, Binu; Wade, James B

    2017-07-27

    Patient-reported outcomes such as health-related quality of life (HRQOL) are impaired in cirrhosis due to under-treated mood and sleep disorders, which can adversely impact their caregivers. Mindfulness-based stress reduction (MBSR) can improve patient-reported outcomes (PRO) in non-cirrhotic patients but their impact in cirrhosis is unclear. To evaluate the effect of MBSR and supportive group therapy on mood, sleep and HRQOL in cirrhotic patients and their caregivers. Cirrhotic outpatients with mild depression (Beck Depression Inventory (BDI)>14) on screening with an adult caregiver were enrolled. At baseline, BDI, sleep (Pittsburgh sleep quality index PSQI, Epworth Sleepiness Scale, ESS), anxiety (Beck Anxiety inventory) and HRQOL (Sickness Impact Profile, SIP) for both patients/caregivers and caregiver burden (Zarit Burden Interview Short-form, ZBI-SF and perceived caregiver burden, PCB) and patient covert HE(CHE) status were measured. Patients who had BDI>14 at baseline, along with their caregivers then underwent a structured MBSR program with four weekly hour-long group sessions interspersed with home practice using CDs. After the last group, all questionnaires were repeated. 20 patient/caregiver dyads were included. All patients were men (60±8 years MELD 12.9±5.7, 14 prior hepatic encephalopathy (HE)) while most caregivers (n=15) were women (55±12 years, 23±14 years of relationship, 65% spouses). There was no change in patient BDI between screening and baseline (20.1±11.2 vs. 19.0±10.6, P=0.81). All dyads were able to complete the four MBSR+supportive group therapy sessions. There was a significant improvement in BDI (19.0±10.6 vs.15.6±8.2 P=0.01), PSQI (7.2±3.7 vs. 5.5±3.7, P<0.001) and overall HRQOL (25.0±13.2 vs. 17.7±14.0,P=0.01) but not in anxiety or CHE rates in patients. Similarly caregiver burden (ZBI-SF13.0±9.0 vs. 9.8±6.9,P=0.04, Perceived burden 72.1±29.9 vs. 63.0±14.5,P=0.05) and depression reduced (BDI 9.1±7.8 vs. 5.9±6.0,P=0

  5. Greater Trochanter Tuberculosis : MRI Findings

    Directory of Open Access Journals (Sweden)

    My Youssef Alaoui Lamrani

    2016-12-01

    Full Text Available Tuberculosis has been reported in almost all bones of body. The great trochanter tuberculosis (GTT installation is insidious and clinical symptoms are often vague with moderate painful swelling and stiffness. GTT is about 0,2 to 2% of all osteo-articular tuberculosis, occurring most commonly by hematogenous seeding secondary to primary focus elsewhere, more commonly in the lungs. Isolated GTT is unusual and thus its awareness is slow and diagnosis is often delayed.

  6. Greater patient confidence yields greater functional outcomes after primary total shoulder arthroplasty.

    Science.gov (United States)

    Styron, Joseph F; Higuera, Carlos A; Strnad, Greg; Iannotti, Joseph P

    2015-08-01

    Patient satisfaction is increasingly being tied to reimbursement rates, and patient satisfaction is often associated with improving functionality and decreasing disability postoperatively. This study sought to determine if a total shoulder arthroplasty patient's preoperative confidence in his or her ability to attain the level of activity desired would influence postoperative functional scores. Patients undergoing a primary total shoulder arthroplasty at a single institution were asked to complete a preoperative questionnaire with multiple items including baseline symptom severity measures and their confidence in reaching their level of desired functionality postoperatively (scored 0-10). Patients then completed an identical postoperative questionnaire at their follow-up visits. Associations between the patient's confidence in attaining treatment goals and functional outcomes was established by multiple linear regression models that were adjusted for gender, age, body mass index, baseline 12-Item Short Form Health Survey mental component scores, college education, smoking status, baseline functional scores, and length of follow-up. Patients had a high level of confidence that their outcome would match their expectations, with an average score of 7.8 (range, 0-10; 28.4% reported a full 10/10 confidence). For every 1-point increase in confidence, patients experienced an average increase in their function score of 2.7 points (P = .039) and improvement in their pain score of 2.0 (P = .033) according to the Penn Shoulder Score. There was no significant association with the patient's 12-Item Short Form Health Survey score postoperatively. Patients with greater preoperative confidence actually have significantly better postoperative functional outcomes than their less confident peers even with adjustment for other known risk factors. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  7. Natural Propagation and Habitat Improvement, Volume I, Oregon, 1984 Final and Annual Reports.

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Rod

    1986-02-01

    This volume contains reports on habitat improvement and fisheries enhancement projects conducted in the following subbasins: (1) Clackamas River; (2) Hood River; :(3) Deschutes River; (4) John Day River; (5) Umatilla River; and (6) Grande Ronde River. (ACR)

  8. Motivators and barriers to using patient experience reports for performance improvement

    NARCIS (Netherlands)

    Geissler, K.H.; Friedberg, M.W.; SteelFisher, G.K.; Schneider, E.C.

    2013-01-01

    Increasingly, patient experience surveys are available to provide performance feedback to physician groups. However, limited published literature addresses factors influencing use of these reports for performance improvement. To address this gap, we conducted semistructured interviews with leaders o

  9. Environmental planning and management in Greater Johannesburg.

    Science.gov (United States)

    Von Schirnding, Y E

    1996-03-01

    This article describes the actions among urban environmental, management, and development planners in Greater Johannesburg, South Africa. Initiatives, such as the Healthy Cities Project and Model Communities, are being integrated into an environmental management and development approach that attains the goals of Agenda 21. Greater Johannesburg has housing shortages and homelessness. Priority needs include the areas of housing, water, electricity, public transportation, and sanitation. Clean water and air are inequitably distributed. Other key environmental problems include illegal dumping, inadequate waste disposal, poor environmental hygiene in overcrowded inner city areas, lack of open spaces, flooding, and water scarcities. The newly formed metropolitan authority offers opportunities to improve coordination and integration of environmental problems. Stakeholders from government at all levels, politicians, nongovernmental organizations, and the business sector formed an intersectoral, interdepartmental environment management committee in 1995. Stakeholders will integrate Agenda 21 within broader urban development plans and processes. The executive committee and the full council approved a set of guiding principles on environmental policy and an administrative framework for management. Four workshops were held to ensure a participatory consultation process in 1995. The WHO Collaborating Center for Urban Health will be used to facilitate the work of the Greater Johannesburg Metropolitan Council. Changes are being made in the way local governments work.

  10. Asset Management Process (AMP) Improvement Project: Final Report of Findings and Recommendations

    Science.gov (United States)

    2009-10-01

    cannibalized components could no longer be sighted due to their re-use in other systems or equipment. Solution — A Rapid Improvement Event, or Kaizen , was...Property Loss Reporting domain’s lifecycle, the Green Belt recognized the opportunity for a Rapid Improvement Event (RIE), or Kaizen . A five-day RIE was

  11. Improving Test Score Reporting: Perspectives from the ETS Score Reporting Conference. Research Report. ETS RR-11-45

    Science.gov (United States)

    Zapata-Rivera, Diego, Ed.; Zwick, Rebecca, Ed.

    2011-01-01

    This volume includes 3 papers based on presentations at a workshop on communicating assessment information to particular audiences, held at Educational Testing Service (ETS) on November 4th, 2010, to explore some issues that influence score reports and new advances that contribute to the effectiveness of these reports. Jessica Hullman, Rebecca…

  12. Helping States, Helping Students: Improving Education in Tough Times. 2011 Annual Report

    Science.gov (United States)

    Southern Regional Education Board (SREB), 2011

    2011-01-01

    The 2011 Southern Regional Education Board annual report describes SREB's recent achievements and how the organization has helped its 16 member states improve education in tough economic times. The report highlights program activities and also includes remarks from the Board Chair and President, acknowledgment of financial contributors, and lists…

  13. Accuracy of reporting endocervical component adequacy--a continuous quality improvement project.

    Science.gov (United States)

    Roberson, Janie; Connolly, Kathy; St John, Kay; Eltoum, Isam; Chhieng, David C

    2002-09-01

    Inaccurate reporting of the absence of an endocervical (EC) component on Pap smears often results in slide rescreens, amended reports, clinician dissatisfaction, and sometimes unnecessary repeat smears. Therefore, the accuracy of reporting EC component adequacy was selected as a quality indicator for the laboratory continuous quality improvement program (CQI). The process consisted of problem identification, analysis of the situation, collection of data, implementation of solutions, and evaluation of results. The objective of the study was to determine if the accuracy of reporting EC component adequacy on Pap smears improved after application of such a program. During the first phase, 150 Pap smears originally reported with the absence of an adequate EC component and 150 smears reported with the presence of an adequate EC component were rescreened to measure the baseline accuracy of EC component adequacy reporting. The improvement process was then implemented. A cause-and-effect diagram was developed and root cause was determined. A presentation was then made to the cytology staff. Criteria for EC component adequacy were reviewed, examples were shown, and standardized marking of EC component was implemented. Following improvement actions, a second audit of 150 Pap smears reported with the absence of an adequate EC component as well as 150 smears reported with the presence of an adequate EC component was undertaken to measure change in performance in assessing EC component adequacy. For the baseline rescreening, before initiation of the CQI program, 98% accuracy was achieved with smears that were reported as adequate for EC component present. However, the accuracy with smears reported as absence of an adequate EC component was only 71%, i.e., an adequate EC component was identified in almost 1/3 of these cases on rescreen. After the implementation of improvement actions, the accuracy with smears reported with the presence of EC component remained high (98%) and the

  14. Report from SG 1.1: improving the performance of existing gas storages

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    This report aims to identify underlying trends for improvements in the underground gas storage (UGS) industry. It highlights best practices and state-of-the-art technology used in operating gas storages. The core conclusions of this report are based on a survey, which was sent out to the member countries. A reply was received from 15 countries, represented by 22 companies/institutions, including more than 100 gas storage sites. This response represents some 30% of the total estimated world storage working volume. In the survey operators were asked to report on the following issues: - measures implemented to improve the performance, - current priorities for improvements, - most important drivers for improvement, - techniques used to analyze performance, - techniques used to optimize storage performance, - software packages used, - technology used for reservoir management, wells and surface facilities, - safety and environment. (author)

  15. An evaluation of a training placement in general practice for paramedic practitioner students: improving patient-centred care through greater interprofessional understanding and supporting the development of autonomous practitioners.

    Science.gov (United States)

    Ruston, Annmarie; Tavabie, Abdol

    2011-01-01

    To report the extent to which the placement of paramedic practitioner students (PPSs) in accredited general practice (GP) training practices supported their development as autonomous, patient-centred practitioners and fostered interprofessional learning. A case study method was used. Sources of data included semi-structured telephone interviews (eight PPSs, eight GP trainers), an online end of placement survey and placement and assessment documentation. Interview data were transcribed and analysed using the constant comparative method. Accredited training practices in South East England. All respondents were positive that the placement provided a high-quality interprofessional learning environment which provided PPSs with learning opportunities based on assessed need, the support of experienced trainers and access to a wide range of patients and learning situations. The placement enabled PPSs to acquire the appropriate skills, knowledge and understanding to act as autonomous, patient-centred practitioners. The placement provides a sound model for expanding the skills of paramedic practitioners in order to meet the increasing demands for patient-centred, community based health care. It provided them with the skills to treat patients closer to home rather than automatically transporting them to hospital.

  16. Incorporating Reporting Efforts to Manage and Improve Health and Wellness Programs.

    Science.gov (United States)

    Wells, Timothy S; Ozminkowski, Ronald J; McGinn, Michael P; Hawkins, Kevin; Bhattarai, Gandhi R; Serxner, Seth A; Greame, Chris

    2016-08-30

    Wellness programs are designed to help individuals maintain or improve their health. This article describes how a reporting process can be used to help manage and improve a wellness program. Beginning in 2014, a wellness pilot program became available in New Jersey for individuals with an AARP Medicare Supplement Insurance plan insured by UnitedHealthcare Insurance Company. The program has since expanded to include Missouri, Texas, Alabama, and Washington. This wellness program includes an online health portal, one-on-one telephonic coaching, gym membership discounts, and local health events. To assure smooth program operations and alignment with program objectives, weekly and monthly reports are produced. The weekly report includes metrics on member engagement and utilization for the aforementioned 4 program offerings and reports on the last 4 weeks, as well as for the current month and the current year to date. The monthly report includes separate worksheets for each state and a summary worksheet that includes all states combined, and provides metrics on overall engagement as well as utilization of the 4 program components. Although the monthly reports were used to better manage the 4 program offerings, the weekly reports help management to gauge response to program marketing. Reporting can be a data-driven management tool to help manage wellness programs. Reports provide rapid feedback regarding program performance. In contrast, in-depth program evaluations serve a different purpose, such as to report program-related savings, return on investment, or to report other longer term program-related outcomes.

  17. Widely Assumed but Thinly Tested: Do Employee Volunteers’ Self-Reported Skill Improvements Reflect the Nature of their Volunteering Experience?

    Directory of Open Access Journals (Sweden)

    David Allen Jones

    2016-04-01

    Full Text Available An increasing number of companies use corporate volunteering programs (CVPs to support and coordinate their employees’ efforts to serve their communities. Among the most frequently touted benefits of such programs to sponsoring companies and employee volunteers alike is the opportunities they provide for employees to develop tangible work-related skills through their volunteering activities. Evidence for skill development through volunteering, however, is mostly limited to the expressed beliefs of corporate leaders and employee volunteers. This study was designed to contribute to this largely anecdotal literature by testing hypotheses about the extent to which employee volunteers’ self-reported skill development reflects the characteristics of the volunteers and their volunteering experience. Study participants were 74 employees who volunteered a few hours of their time once a week for ten weeks in a service apprenticeship managed by a U.S.-based nonprofit called Citizen Schools that partners with middle schools to extend the learning day with a combination of academic support, enrichment, and youth development activities. Data were obtained via the nonprofit’s records, and surveys completed by employee volunteers before and after their service experience, including measures used to assess self-reported improvements in each of ten work-related skills: communicating performance expectations, leadership, mentorship, motivating others, project management, providing performance feedback, public speaking and presenting, speaking clearly, teamwork, and time management. Support was found for several hypothesized effects suggesting that employees who practiced specific skills more often during their volunteering experience reported greater improvements in those skills. Improvements in some skills were higher among employee volunteers who completed a greater number of pre-volunteering preparation courses, and the effects of preparation courses were

  18. Does updating improve the methodological and reporting quality of systematic reviews?

    Directory of Open Access Journals (Sweden)

    Hamel Candyce

    2006-06-01

    Full Text Available Abstract Background Systematic reviews (SRs must be of high quality. The purpose of our research was to compare the methodological and reporting quality of original versus updated Cochrane SRs to determine whether updating had improved these two quality dimensions. Methods We identifed updated Cochrane SRs published in issue 4, 2002 of the Cochrane Library. We assessed the updated and original versions of the SRs using two instruments: the 10 item enhanced Overview Quality Assessment Questionnaire (OQAQ, and an 18-item reporting quality checklist and flow chart based upon the Quality of Reporting of Meta-analyses (QUOROM statement. At least two reviewers extracted data and assessed quality. We calculated the percentage (with a 95% confidence interval of 'yes' answers to each question. We calculated mean differences in percentage, 95% confidence intervals and p-values for each of the individual items and the overall methodological quality score of the updated and pre-updated versions using OQAQ. Results We assessed 53 SRs. There was no significant improvement in the global quality score of the OQAQ (mean difference 0.11 (-0.28; 0.70 p = 0.52. Updated reviews showed a significant improvement of 18.9 (7.2; 30.6 p Conclusion The overall quality of Cochrane SRs is fair-to-good. Although reporting quality improved on certain individual items there was no overall improvement seen with updating and methodological quality remained unchanged. Further improvement of quality of reporting is possible. There is room for improvement of methodological quality as well. Authors updating reviews should address identified methodological or reporting weaknesses. We recommend to give full attention to both quality domains when updating SRs.

  19. Greater Sage-Grouse National Research Strategy

    Science.gov (United States)

    Hanser, Steven E.; Manier, Daniel J.

    2013-01-01

    The condition of the sagebrush ecosystem has been declining in the Western United States, and greater sage-grouse (Centrocercus urophasianus), a sagebrush-obligate species, has experienced concurrent decreases in distribution and population numbers. This has prompted substantial research and management over the past two decades to improve the understanding of sage-grouse and its habitats and to address the observed decreases in distribution and population numbers. The amount of research and management has increased as the year 2015 approaches, which is when the U.S. Fish and Wildlife Service (FWS) is expected to make a final decision about whether or not to protect the species under the Endangered Species Act. In 2012, the Sage-Grouse Executive Oversight Committee (EOC) of the Western Association of Fish and Wildlife Agencies (WAFWA) requested that the U.S. Geological Survey (USGS) lead the development of a Greater Sage-Grouse National Research Strategy (hereafter Research Strategy). This request was motivated by a practical need to systematically connect existing research and conservation plans with persisting or emerging information needs. Managers and researchers also wanted to reduce redundancy and help focus limited funds on the highest priority research and management issues. The USGS undertook the development of this Research Strategy, which addresses information and science relating to the greater sage-grouse and its habitat across portions of 11 Western States. This Research Strategy provides an outline of important research topics to ensure that science information gaps are identified and documented in a comprehensive manner. Further, by identifying priority topics and critical information needed for planning, research, and resource management, it provides a structure to help coordinate members of an expansive research and management community in their efforts to conduct priority research.

  20. Commercial Integrated Heat Pump with Thermal Storage --Demonstrate Greater than 50% Average Annual Energy Savings, Compared with Baseline Heat Pump and Water Heater (Go/No-Go) FY16 4th Quarter Milestone Report

    Energy Technology Data Exchange (ETDEWEB)

    Shen, Bo [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Baxter, Van D. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Rice, C. Keith [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Abu-Heiba, Ahmad [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2017-03-01

    For this study, we authored a new air source integrated heat pump (AS-IHP) model in EnergyPlus, and conducted building energy simulations to demonstrate greater than 50% average energy savings, in comparison to a baseline heat pump with electric water heater, over 10 US cities, based on the EnergyPlus quick-service restaurant template building. We also assessed water heating energy saving potentials using ASIHP versus gas heating, and pointed out climate zones where AS-IHPs are promising.

  1. Peer pressure and public reporting within healthcare setting: improving accountability and health care quality in hospitals.

    Science.gov (United States)

    Specchia, Maria Lucia; Veneziano, Maria Assunta; Cadeddu, Chiara; Ferriero, Anna Maria; Capizzi, Silvio; Ricciardi, Walter

    2012-01-01

    In the last few years, the need of public reporting of health outcomes has acquired a great importance. The public release of performance results could be a tool for improving health care quality and many attempts have been made in order to introduce public reporting programs within the health care context at different levels. It would be necessary to promote the introduction of a standardized set of outcome and performance measures in order to improve quality of health care services and to make health care providers aware of the importance of transparency and accountability.

  2. DOD Joint Bases: Management Improvements Needed to Achieve Greater Efficiencies

    Science.gov (United States)

    2012-11-01

    bases should maintain a clean and healthy environment by cleaning certain restrooms three times a week, and should sweep and mop floors, vacuum carpets ...remove trash, and clean walk-off mats once a week; buff floors monthly; and maintain/strip floors and shampoo carpets annually. Officials at Joint...Fraud, Waste, and Abuse in Federal Programs Congressional Relations Public Affairs Please Print on Recycled Paper.

  3. Reporting quality of survival analyses in medical journals still needs improvement. A minimal requirements proposal.

    Science.gov (United States)

    Abraira, Víctor; Muriel, Alfonso; Emparanza, José I; Pijoan, José I; Royuela, Ana; Plana, María Nieves; Cano, Alejandra; Urreta, Iratxe; Zamora, Javier

    2013-12-01

    We reviewed publications with two main objectives: to describe how survival analyses are reported across medical journal specialties and to evaluate changes in reporting across periods and journal specialties. Systematic review of clinical research articles published in 1991 and 2007, in 13 high-impact medical journals. The number of articles performing survival analysis published in 1991 (104) and 2007 (240) doubled (17% vs. 33.5%; P = 0.000), although not uniformly across specialties. The percentage of studies using regression models and the number of patients included also increased. The presentation of results improved, although only the reporting of precision of effect estimates reached satisfactory levels (53.1% in 1991 vs. 94.2% in 2007; P = 0.000). Quality of reporting also varied across specialties; for example, cardiology articles were less likely than oncology ones to discuss sample size estimation (odds ratio = 0.12; 95% confidence interval: 0.05, 0.30). We also detected an interaction effect between period and specialty regarding the likelihood of reporting precision of curves and precision of effect estimates. The application of survival analysis to medical research data is increasing, whereas improvement in reporting quality is slow. We propose a list of minimum requirements for improved application and description of survival analysis. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Pain improvement in rheumatoid arthritis with hyperbaric oxygen: report of three cases.

    Science.gov (United States)

    Slade, John B; Potts, Mary V; Fowler, Alan M; Sit, Michelle T; Schmidt, Thomas W

    2016-01-01

    Rheumatoid arthritis (RA) is a chronic, erosive, symmetrical inflammatory disease that can progress to synovial destruction, severe disability and premature mortality. Immunotherapies, while beneficial, can cause significant adverse events. Three patients with RA treated in our facility with hyperbaric oxygen (HBO₂) for unrelated diagnoses all reported significant but unanticipated improvement in RA-related pain, increased activity and improved sleeping patterns. Two improved while continuing traditional RA medications; the other patient had all RA meds held due to cancer and postoperative wound healing problems. The significant symptomatic improvement in these three patients led us to hypothesize that HBO₂ for patients with RA may result in decreased joint pain, increased activity level, improvement in sleeping patterns and possibly a decreased need for standard rheumatologic medications, effectively reducing or avoiding the effects of immunosuppression. A clinical trial is planned to objectively assess these findings. Copyright© Undersea and Hyperbaric Medical Society.

  5. Umatilla River Subbasin Fish Habitat Improvement Program, 1996-2003 Summary Report.

    Energy Technology Data Exchange (ETDEWEB)

    St. Hilaire, Danny R.; Montgomery, Michael; Bailey, Timothy D. (Oregon Department of Fish and Wildlife, John Day, OR)

    2005-01-01

    This annual report is in fulfillment of contractual obligations with Bonneville Power Administration (BPA), which is the funding source for the Oregon Department of Fish and Wildlife's (ODFW), Umatilla River Subbasin Fish Habitat Improvement Program (Program). The last Annual Program Report was submitted in 1997, and described projects undertaken in 1995. This report describes Program activities carried out in 2003, along with a summary of projects undertaken during the years 1996 through 2002. The Program works cooperatively with private landowners to develop long-term restoration agreements, under which, passive and active Habitat Improvement Projects are conducted. Historically, projects have included livestock exclusion fencing (passive restoration) to protect riparian habitats, along with the installation of instream structures (active restoration) to address erosion and improve fish habitat. In recent years, the focus of active restoration has shifted to bioengineering treatments and, more recently, to channel re-design and re-construction aimed at improving fish habitat, by restoring stable channel function. This report provides a summary table of past projects (1996-2002), along with a text description of more extensive habitat improvement projects, including: (1) Implementation of a four-phased project on the Lobato property (Birch Creek) beginning in 1996 and involving a demonstration bioengineering site and riparian improvements (fencing, planting), (2) Implementation of stable channel design/instream structure placement on the Houser property, East Birch Creek, beginning in 1998, an (3) Implementation of a joint, US Army Corps of Engineers/ODFW (cost share) project beginning in 2001 on the Brogoitti property, East Birch Creek, which involved implementation of stable channel design/construction and riparian improvement treatments.

  6. Using informatics-enabled quality improvement techniques to meet health record documentation requirements in radiology reports.

    Science.gov (United States)

    Prevedello, Luciano M; Farkas, Cameron; Dufault, Allen; Damiano, Maria; Doubilet, Peter; Khorasani, Ramin

    2013-08-01

    Medicare requires documented teaching physician involvement (attestation) in trainee-generated radiology reports. Automated attestation statement insertion in reports expedites the process but does not comply with requirements for active attestation. We evaluated an informatics-enabled quality improvement (QI) intervention to improve health record documentation requirements for active attestation. Institutional review board approval was not needed for this QI project performed in a 776-bed tertiary/quaternary teaching hospital. The intervention consisted of (1) policy requiring staff radiologists to actively attest to trainee-generated reports by personally activating a "macro" in the reporting system and (2) a semiautomated process to detect reports missing attestation; radiologists received daily e-mail reminders until the attestation statement was inserted. A random sample of 600 of 123,561 trainee-generated radiology reports created 17 months after the intervention (May 2011) was manually reviewed to determine attestation policy adherence. The number of attestation statements added in response to reminders throughout the entire study period was also evaluated. Trend analysis of the number of report addenda containing solely the attestation statement (proxy for missing initial attestation) was performed. Of 600 reports, 594 (99%) contained the attestation statement. Monthly attestations in response to email notifications decreased from 585 to 227 by the sixth month, a 2.6-fold reduction (P < .01). No significant trend was observed the following year, indicating a sustained effect. Informatics-enabled QI techniques resulted in 99% adherence to our teaching physician attestation policy with sustained results. Similar approaches may help improve adherence to other mandated performance measures in radiology reports. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

  7. Post-irradiation angiosarcoma of the greater omentum

    Energy Technology Data Exchange (ETDEWEB)

    Westenberg, A.H.; Wiggers, T.; Henzen-Logmans, S.C.; Verweij, J.; Meerwaldt, J.A.; Geel, A.N. van (Dr Daniel den Hoed Cancer Center, Rotterdam (Netherlands))

    1989-04-01

    A case of angiosarcoma of the greater omentum is reported. This angiosarcoma developed 8 years after irradiation for cervical carcinoma and presented with an intra-abdominal hemorrhage. The authors describe her clinical course, treatment and follow-up. Although several other locations of irradiation-induced sarcomas have been published, this is the first report in literature of a postirradiation angiosarcoma in the greater omentum. (author).

  8. Post-irradiation angiosarcoma of the greater omentum.

    Science.gov (United States)

    Westenberg, A H; Wiggers, T; Henzen-Logmans, S C; Verweij, J; Meerwaldt, J A; van Geel, A N

    1989-04-01

    A case of angiosarcoma of the greater omentum is reported. This angiosarcoma developed 8 years after irradiation for cervical carcinoma and presented with an intra-abdominal hemorrhage. We describe her clinical course, treatment and follow-up. Although several other locations of irradiation-induced sarcomas have been published, this is the first report in literature of a postirradiation angiosarcoma in the greater omentum.

  9. Improved compliance with reporting standards: A retrospective analysis of Intersocietal Accreditation Commission Nuclear Cardiology Laboratories.

    Science.gov (United States)

    Maddux, P Tim; Farrell, Mary Beth; Ewing, Joseph A; Tilkemeier, Peter L

    2016-11-09

    In 2011, Tilkemeier et al reported significant nuclear cardiology laboratory noncompliance with reporting standards. The aim of this study was to identify and examine noncompliant reporting elements with the Intersocietal Accreditation Commission Nuclear/PET (IAC) Reporting Standards and to compare compliance between 2008 and 2014. This was a retrospective study of compliance with 18 reporting elements utilizing accreditation findings from all laboratories applying for accreditation in 2008 and 2014. 1816 labs applying for initial or subsequent accreditation were analyzed for compliance. The mean reporting noncompliance per lab decreased from 2008 to 2014 (2.48 ± 2.67 to 1.24 ± 1.79, P types, labs with Certification Board of Nuclear Cardiology physicians on staff, and by geographic region (P < .001). Overall severity of reporting issues decreased. Facilities with compliant reports increased from 35.0% in 2008 to 57.1% in 2014 (P < .001). Continuing medical education, accreditation, and other instructional activities aimed at improving nuclear cardiology reporting appear to have made a positive impact over time with the number and severity of noncompliance decreased. More labs are now compliant with the IAC Standards and, thus, reporting guidelines. However, the need for continued educational efforts remains.

  10. Monitoring and research on the Bi-State Distinct Population Segment of greater sage-grouse (Centrocercus urophasianus) in the Pine Nut Mountains, California and Nevada—Study progress report, 2011–15

    Science.gov (United States)

    Coates, Peter S.; Andrle, Katie M.; Ziegler, Pilar T.; Casazza, Michael L.

    2016-09-29

    The Bi-State distinct population segment (DPS) of greater sage-grouse (Centrocercus urophasianus) that occurs along the Nevada–California border was proposed for listing as threatened under the Endangered Species Act (ESA) by the U.S. Fish and Wildlife Service (FWS) in October 2013. However, in April 2015, the FWS determined that the Bi-State DPS no longer required protection under the ESA and withdrew the proposed rule to list the Bi-State DPS (U.S. Fish and Wildlife Service, 2015). The Bi-State DPS occupies portions of Alpine, Mono, and Inyo Counties in California, and Douglas, Esmeralda, Lyon, Carson City, and Mineral Counties in Nevada. Unique threats facing this population include geographic isolation, expansion of single-leaf pinyon (Pinus monophylla) and Utah juniper (Juniperus osteosperma), anthropogenic activities, and recent changes in predator communities. Estimating population vital rates, identifying seasonal habitat, quantifying threats, and identifying movement patterns are important first steps in developing effective sage-grouse management and conservation plans. During 2011–15, we radio- and Global Positioning System (GPS)-marked (2012–14 only) 44, 47, 17, 9, and 3 sage-grouse, respectively, for a total of 120, in the Pine Nut Mountains Population Management Unit (PMU). No change in lek attendance was detected at Mill Canyon (maximum=18 males) between 2011 and 2012; however, 1 male was observed in 2014 and no males were observed in 2013 and 2015. Males were observed near Bald Mountain in 2013, making it the first year this lek was observed to be active during the study period. Males were observed at a new site in the Buckskin Range in 2014 during trapping efforts and again observed during surveys in 2015. Findings indicate that pinyon-juniper is avoided by sage-grouse during every life stage. Nesting females selected increased sagebrush cover, sagebrush height, and understory horizontal cover, and brood-rearing females selected similar areas

  11. [Role of reporting and learning systems in the improvement of patient safety].

    Science.gov (United States)

    Lám, Judit; Sümegi, Viktória; Surján, Cecília; Kullmann, Lajos; Belicza, Éva

    2016-06-26

    The principles and requirements of a patient safety related reporting and learning system were defined by the World Health Organization Draft Guidelines for Adverse Event Reporting and Learning Systems published in 2005. Since then more and more Hungarian health care organizations aim to improve their patient safety culture. In order to support this goal the NEVES reporting and learning system and the series of Patient Safety Forums for training and consultation were launched in 2006 and significantly renewed recently. Current operative modifications to the Health Law emphasize patient safety, making the introduction of these programs once again necessary.

  12. Chart-stimulated Recall as a Learning Tool for Improving Radiology Residents' Reports.

    Science.gov (United States)

    Nadeem, Naila; Zafar, Abdul Mueed; Haider, Sonia; Zuberi, Rukhsana W; Ahmad, Muhammad Nadeem; Ojili, Vijayanadh

    2017-08-01

    Workplace-based assessments gauge the highest tier of clinical competence. Chart-stimulated recall (CSR) is a workplace-based assessment method that complements chart audit with an interview based on the residents' notes. It allows evaluation of the residents' knowledge and heuristics while providing opportunities for feedback and self-reflection. We evaluated the utility of CSR for improving the radiology residents' reporting skills. Residents in each year of training were randomly assigned to an intervention group (n = 12) or a control group (n = 13). Five pre-intervention and five post-intervention reports of each resident were independently evaluated by three blinded reviewers using a modified Bristol Radiology Report Assessment Tool. The study intervention comprised a CSR interview tailored to each individual resident's learning needs based on the pre-intervention assessment. The CSR process focused on the clinical relevance of the radiology reports. Student's t test (P < .05) was used to compare pre- and post-intervention scores of each group. A total of 125 pre-intervention and 125 post-intervention reports were evaluated (total 750 assessments). The Cronbach's alpha for the study tool was 0.865. A significant improvement was seen in the cumulative 19-item score (66% versus 73%, P < .001) and the global rating score (59% versus 72%, P < .001) of the intervention group after the CSR. The reports of the control group did not demonstrate any significant improvement. CSR is a feasible workplace-based assessment method for improving reporting skills of the radiology residents. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  13. An educational intervention to improve nurses' knowledge, attitude, and practice toward reporting of adverse drug reactions.

    Science.gov (United States)

    Hanafi, Somayeh; Torkamandi, Hassan; Hayatshahi, Alireza; Gholami, Kheirollah; Shahmirzadi, Nikinaz Ashrafi; Javadi, Mohammad Reza

    2014-01-01

    The reporting of adverse drug reactions (ADRs) by nurses in hospitals is very important. This study was aimed at investigating the impact of an educational intervention to improve ADR reporting and whether trained nurses had better knowledge, attitude, and practice toward ADR reporting. A total of 300 nurses in a tertiary care teaching hospital in Tehran, Iran were evaluated with a knowledge, attitude, and practice (KAP) questionnaire regarding ADR reporting in March 2010. After this, an educational program about ADR was provided to nurses. Then the nurses were re-evaluated by the same questionnaire. Comparisons were made of the attitude and knowledge within nurses, before and after education. Data were analyzed using SPSS software. P < 0.05 was considered as significant level. Independent-sample t-test was used to measure the intervention effect. The response rate was 61.3% (N = 184). Knowledge of nurses before the intervention was significantly less than the knowledge after the intervention (P = 0.001). Also, there was a significant effect on attitude (P = 0.002). During the follow-up period of 4 months after the intervention, 26 spontaneous reports were received. Continuous ADR educational program, training, and integration of ADRs' reporting into the activities of the nurses would likely improve ADR reporting.

  14. Partnership for Rural Improvement: PRI in Transition. Annual Report 1979-80.

    Science.gov (United States)

    Hagood, Richard A.; And Others

    Covering 1979-80, which was the final year of the initial four year grant period for the Partnership for Rural Improvement (PRI), this report details the major assessments and program adjustments made during that year. Several program developments of critical importance to understanding the transition occurring in PRI are highlighted in the…

  15. Toward Improved Statistical Reporting in the Journal of Consulting and Clinical Psychology

    Science.gov (United States)

    Fidler, Fiona; Cumming, Geoff; Thomason, Neil; Pannuzzo, Dominique; Smith, Julian; Fyffe, Penny; Edmonds, Holly; Harrington, Claire; Schmitt, Rachel

    2005-01-01

    Philip Kendall's (1997) editorial encouraged authors in the Journal of Consulting and Clinical Psychology (JCCP) to report effect sizes and clinical significance. The present authors assessed the influence of that editorial--and other American Psychological Association initiatives to improve statistical practices--by examining 239 JCCP articles…

  16. Toward Improved Statistical Reporting in the Journal of Consulting and Clinical Psychology

    Science.gov (United States)

    Fidler, Fiona; Cumming, Geoff; Thomason, Neil; Pannuzzo, Dominique; Smith, Julian; Fyffe, Penny; Edmonds, Holly; Harrington, Claire; Schmitt, Rachel

    2005-01-01

    Philip Kendall's (1997) editorial encouraged authors in the Journal of Consulting and Clinical Psychology (JCCP) to report effect sizes and clinical significance. The present authors assessed the influence of that editorial--and other American Psychological Association initiatives to improve statistical practices--by examining 239 JCCP articles…

  17. Molten carbonate fuel cell product design and improvement. Quarterly report, December 1994--March 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-08-01

    Primary objective is to establish the commercial readiness of MW- class IMHEX {reg_sign} MCFC power plants for distributed generation, cogeneration, and compressor station applications. The following tasks are reported: product definition/planning, system design/analysis, manufacturing process development, packaging/assembly, test facilities, and technology development/improvement/verification.

  18. The Multi-Purpose Center for Curriculum Improvement. End of Project Report.

    Science.gov (United States)

    Puzzuoli, David A.; Wholley, Peter J.

    The report for the 8-county West Virginia Multi-Purpose Center for Curriculum Improvement, funded under Title III of the Elementary and Secondary Education Act, represents a comprehensive evaluation of the numerous activities with which the center was involved. The first section of the document presents general characteristics of the project area,…

  19. Improved forage strategies for high-yielding dairy cows in Vietnam : report of a workshop

    NARCIS (Netherlands)

    Wouters, A.P.; Lee, van der J.

    2013-01-01

    This report presents results of the workshop "Improved forage strategies for high-yielding dairy cows in Vietnam" which was held with Vietnamese stakeholders on January 17-18, 2013 in Ho Chi Minh City as part of the project "Forage and Grass Production for Dairy Development in Vietnam" funded by the

  20. Reporting Data with "Over-the-Counter" Data Analysis Supports Improves Educators' Data Analyses

    Science.gov (United States)

    Rankin, Jenny Grant

    2014-01-01

    The benefits of making data-informed decisions to improve learning rely on educators correctly interpreting given data. Many educators routinely misinterpret data, even at districts with proactive support for data use. The tool most educators use for data analyses, which is an information technology data system or its reports, typically reports…

  1. Dementia post-radiotherapy: improvement with acetylcholinesterase inhibitor A case report

    Directory of Open Access Journals (Sweden)

    Antonio Eduardo Damin

    Full Text Available Abstract Cognitive decline associated with radiotherapy is a progressive complication that affects many patients submitted to this form of treatment. The lack of an effective treatment drives research for new treatment options to improve the quality of life of patients with this disorder. We report the case of a 64 year-old man who developed a severe dementia of the frontal subcortical type, which was associated with subcortical frontal lesions and appeared as a late complication of radiotherapy used to treat a pituitary tumor. After many pharmacological attempts to improve his cognitive and behavioral problems, the patient showed a significant improvement in the cognitive, functional and behavioral impairments after treatment with an acetylcholinesterase inhibitor. This report discusses hypotheses for the positive effect of this treatment.

  2. Improvement in the incident reporting and investigation procedures using process excellence (DMAI2C) methodology.

    Science.gov (United States)

    Miles, Elizabeth N

    2006-03-17

    In 1996, Health & Safety introduced an incident investigation process called Learning to Look to Johnson & Johnson. This process provides a systematic way of analyzing work-related injuries and illness, uncovers root cause that leads to system defects, and points to viable solutions. The process analyzed involves three steps: investigation and reporting of the incident, determination of root cause, and development and implementation of a corrective action plan. The process requires the investigators to provide an initial communication for work-related serious injuries and illness as well as lost workday cases to Corporate Headquarters within 72 h of the incident with a full investigative report to follow within 10 days. A full investigation requires a written report, a cause-result logic diagram (CRLD), a corrective action plan (CAP) and a report of incident costs (SafeCost) all due to be filed electronically. It is incumbent on the principal investigator and his or her investigative teams to assemble the various parts of the investigation and to follow up with the relevant parties to ensure corrective actions are implemented, and a full report submitted to Corporate executives. Initial review of the system revealed that the process was not working as designed. A number of reports were late, not signed by the business leaders, and in some instances, all cause were not identified. Process excellence was the process used to study the issue. The team used six sigma DMAI2C methodologies to identify and implement system improvements. The project examined the breakdown of the critical aspects of the reporting and investigation process that lead to system errors. This report will discuss the study findings, recommended improvements, and methods used to monitor the new improved process.

  3. Improving knowledge management through the support of image examination and data annotation using DICOM structured reporting.

    Science.gov (United States)

    Torres, José Salavert; Damian Segrelles Quilis, J; Espert, Ignacio Blanquer; García, Vicente Hernandez

    2012-12-01

    An important effort has been invested on improving the image diagnosis process in different medical areas using information technologies. The field of medical imaging involves two main data types: medical imaging and reports. Developments based on the DICOM standard have demonstrated to be a convenient and widespread solution among the medical community. The main objective of this work is to design a Web application prototype that will be able to improve diagnosis and follow-on of breast cancer patients. It is based on TRENCADIS middleware, which provides a knowledge-oriented storage model composed by federated repositories of DICOM image studies and DICOM-SR medical reports. The full structure and contents of the diagnosis reports are used as metadata for indexing images. The TRENCADIS infrastructure takes full advantage of Grid technologies by deploying multi-resource grid services that enable multiple views (reports schemes) of the knowledge database. The paper presents a real deployment of such Web application prototype in the Dr. Peset Hospital providing radiologists with a tool to create, store and search diagnostic reports based on breast cancer explorations (mammography, magnetic resonance, ultrasound, pre-surgery biopsy and post-surgery biopsy), improving support for diagnostics decisions. A technical details for use cases (outlining enhanced multi-resource grid services communication and processing steps) and interactions between actors and the deployed prototype are described. As a result, information is more structured, the logic is clearer, network messages have been reduced and, in general, the system is more resistant to failures.

  4. Improving GHG inventories by regional information exchange: a report from Asia

    Directory of Open Access Journals (Sweden)

    Umemiya Chisa

    2006-08-01

    Full Text Available Abstract Background The Parties to the United Nations Framework Convention on Climate Change (UNFCCC are required to develop and report a national inventory of greenhouse gases not controlled by the Montreal Protocol. In the Asia region, "Workshops on Greenhouse Gas Inventories in Asia (WGIA" have been organised annually since 2003 under the support of the government of Japan. WGIAs promote information exchange in the region to support countries' efforts to improve the quality of greenhouse gas inventories. This paper reports the major outcomes of the WGIAs and discusses the key aspects of information exchange in the region for the improvement of inventories. Results The major outcomes of WGIAs intended to help countries improve GHG inventories, can be summarised as follows: (1 identification of common issues and possible solutions by sector, (2 reporting country inventory practices, and (3 verification of the UNFCCC reporting requirements. Conclusion The workshops provided the opportunity for countries to share common issues and constraints pertinent to GHG inventories and to exchange information regarding possible solutions for those issues based on their own experience. The relevance of information exchange is determined due to emission sources, emitting mechanisms from sources, and technologies used. Information exchange about emission sources that are unique to Asia, like those of the agriculture sector, contributes significantly to the accumulation of knowledge at the regional and global levels. Enabling countries to verify their national circumstances with the reporting requirements under UNFCCC is also an essential part of the WGIA information exchange activities.

  5. Patients report improvement in quality of life and satisfaction after hip resurfacing arthroplasty.

    Science.gov (United States)

    Rahman, Wael A; Greidanus, Nelson V; Siegmeth, Alexander; Masri, Bassam A; Duncan, Clive P; Garbuz, Donald S

    2013-02-01

    A number of reconstructive procedures are available for the management of hip osteoarthritis. Hip resurfacing arthroplasty is now an accepted procedure, with implant survivorship comparable to THA at up to 10 years' followup in certain series. Most reports focus on implant survivorship, surgeon-derived results, or complications. Fewer data pertain to patient-reported results, including validated measures of quality of life (QoL) and satisfaction and baseline measures from which to determine magnitude of improvement. Validated patient-reported results are essential to guide patients and surgeons in the current era of informed and shared decision making. We determined whether patients reported improvement in disease-specific, joint-specific, and generic QoL after hip resurfacing arthroplasty; whether patients were satisfied with the results of the procedure; and latest activity level and return to sport. We retrospectively reviewed 127 patients (100 men, 27 women) who underwent 143 hip resurfacing procedures between 2002 and 2006. Mean patient age was 52 years. Patients completed the WOMAC, Oxford Hip Score, and SF-12 at baseline and again at minimum 2-year followup (mean, 2.5 years; range, 2-6 years). At latest followup, patients completed a validated satisfaction questionnaire and UCLA activity score. All QoL scores improved (normalized to a 0-100 scale, where 100 = best health state). WOMAC improved from 46 to 95, Oxford Hip Score from 42 to 95, SF-12 (physical) from 34 to 54, and SF-12 (mental) from 46 to 56. Patient satisfaction score was 96. UCLA activity score was 8. The majority of patients reported improvement in QoL, were very satisfied with their outcome, and returned to a high level of activity after hip resurfacing arthroplasty. Level IV, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.

  6. Improvement in Hemodynamics After Methylene Blue Administration in Drug-Induced Vasodilatory Shock: A Case Report.

    Science.gov (United States)

    Laes, JoAn R; Williams, David M; Cole, Jon B

    2015-12-01

    The purpose of this study is to describe a case where methylene blue improved hemodynamics in a poisoned patient. This is a single case report where a poisoned patient developed vasodilatory shock following ingestion of atenolol, amlodipine, and valsartan. Shock persisted after multiple therapies including vasopressors, high-dose insulin, hemodialysis, and 20% intravenous fat emulsion. Methylene blue (2 mg/kg IV over 30 min) was administered in the ICU with temporal improvement as measured by pulmonary artery catheter hemodynamic data pre- and post-methylene blue administration. Within 1 h of methylene blue administration, systemic vascular resistance improved (240 dyn s/cm5 increased to 1204 dyn s/cm5), and vasopressor requirements decreased with maintenance of mean arterial pressure 60 mmHg. Methylene blue may improve hemodynamics in drug-induced vasodilatory shock and should be considered in critically ill patients poisoned with vasodilatory medications refractory to standard therapies.

  7. Umatilla River Subbasin Fish Habitat Improvement Program, 2004-2005 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    St. Hilaire, Danny R. (Oregon Department of Fish and Wildlife, Pendleton, OR)

    2006-02-01

    This annual report is in fulfillment of contractual obligations with Bonneville Power Administration (BPA), which is the funding source for the Oregon Department of Fish and Wildlife's (ODFW), Umatilla River Subbasin Fish Habitat Improvement Program (Program). The Program works cooperatively with private landowners to develop long-term restoration, under which, passive and active Habitat Improvement Projects are conducted. Historically, projects have included livestock exclusion fencing (passive restoration) to protect riparian habitats, along with the installation of instream structures (active restoration) to address erosion and improve fish habitat. In recent years, the focus of active restoration has shifted to bioengineering treatments and, more recently, to channel re-design and reconstruction aimed at improving fish habitat, by restoring stable channel function. This report provides a summary of Program activities for the 2004 calendar year (January 1 through December 31, 2004), within each of the four main project phases, including: (1) Implementation--Pre-Work, (2) Implementation--On Site Development, (3) Operation and Maintenance, and (4) Monitoring and Evaluation. This report also summarizes Program Administrative, Interagency Coordination, and Public Education activities.

  8. DOD Major Automated Information Systems: Improvements Can Be Made in Reporting Critical Changes and Clarifying Leadership Responsibility

    Science.gov (United States)

    2016-03-01

    DOD MAJOR AUTOMATED INFORMATION SYSTEMS Improvements Can Be Made in Reporting Critical Changes and Clarifying... INFORMATION SYSTEMS Improvements Can Be Made in Reporting Critical Changes and Clarifying Leadership Responsibility Why GAO Did This Study The National... information system (MAIS) programs that experienced a critical change to program cost, schedule, or system performance targets submitted complete reports to

  9. NIH working group report: Innovative research to improve maintenance of weight loss.

    Science.gov (United States)

    MacLean, Paul S; Wing, Rena R; Davidson, Terry; Epstein, Leonard; Goodpaster, Bret; Hall, Kevin D; Levin, Barry E; Perri, Michael G; Rolls, Barbara J; Rosenbaum, Michael; Rothman, Alexander J; Ryan, Donna

    2015-01-01

    The National Institutes of Health, led by the National Heart, Lung, and Blood Institute, organized a working group of experts to discuss the problem of weight regain after weight loss. A number of experts in integrative physiology and behavioral psychology were convened with the goal of merging their perspectives regarding the barriers to scientific progress and the development of novel ways to improve long-term outcomes in obesity therapeutics. The specific objectives of this working group were to: (1) identify the challenges that make maintaining a reduced weight so difficult; (2) review strategies that have been used to improve success in previous studies; and (3) recommend novel solutions that could be examined in future studies of long-term weight control. Specific barriers to successful weight loss maintenance include poor adherence to behavioral regimens and physiological adaptations that promote weight regain. A better understanding of how these behavioral and physiological barriers are related, how they vary between individuals, and how they can be overcome will lead to the development of novel strategies with improved outcomes. Greater collaboration and cross-talk between physiological and behavioral researchers is needed to advance the science and develop better strategies for weight loss maintenance. © 2014 The Obesity Society.

  10. Improvement of gross motor and cognitive abilities by an exercise training program: three case reports

    Directory of Open Access Journals (Sweden)

    Alesi M

    2014-03-01

    Full Text Available Marianna Alesi,1 Giuseppe Battaglia,2 Michele Roccella,1 Davide Testa,1 Antonio Palma,2 Annamaria Pepi1 1Department of Psychology, 2Department of Law, Social and Sport Science, University of Palermo, Palermo, Italy Background: This work examined the efficacy of an integrated exercise training program (coach and family in three children with Down syndrome to improve their motor and cognitive abilities, in particular reaction time and working memory. Methods: The integrated exercise training program was used in three children with Down syndrome, comprising two boys (M1, with a chronological age of 10.3 years and a mental age of 4.7 years; M2, with a chronological age of 14.6 years and a mental age of less than 4 years and one girl (F1, chronological age 14.0 years and a mental age of less than 4 years. Results: Improvements in gross motor ability scores were seen after the training period. Greater improvements in task reaction time were noted for both evaluation parameters, ie, time and omissions. Conclusion: There is a close interrelationship between motor and cognitive domains in individuals with atypical development. There is a need to plan intervention programs based on the simultaneous involvement of child and parents and aimed at promoting an active lifestyle in individuals with Down syndrome. Keywords: disability, Down syndrome, gross motor abilities, cognitive abilities, physical activity

  11. Fuel utilization improvements in a once-through PWR fuel cycle. Final report on Task 6

    Energy Technology Data Exchange (ETDEWEB)

    Dabby, D.

    1979-06-01

    In studying the position of the United States Department of Energy, Non-proliferation Alternative Systems Assessment Program, this report determines the uranium saving associated with various improvement concepts applicable to a once-through fuel cycle of a standard four-loop Westinghouse Pressurized Water Reactor. Increased discharged fuel burnup from 33,000 to 45,000 MWD/MTM could achieve a 12% U/sub 3/O/sub 8/ saving by 1990. Improved fuel management schemes combined with coastdown to 60% power, could result in U/sub 3/O/sub 8/ savings of 6%.

  12. Fuel performance improvement program. Quarterly/annual progress report, October 1977--September 1978. [BWR; PWR

    Energy Technology Data Exchange (ETDEWEB)

    Crouthamel, C.E. (comp.)

    1978-10-01

    This quarterly/annual report reviews and summarizes the activities performed in support of the Fuel Performance Improvement Program (FPIP) during Fiscal Year 1978 with emphasis on those activities that transpired during the quarter ending September 30, 1978. Significant progress has been made in achieving the primary objectives of the program, i.e., to demonstrate commercially viable fuel concepts with improved fuel - cladding interaction (FCI) behavior. This includes out-of-reactor experiments to support the fuel concepts being evaluated, initiation of instrumented test rod experiments in the Halden Boiling Water Reactor (HBWR), and fabrication of the first series of demonstration rods for irradiation in the Big Rock Point Reactor (BRPR).

  13. Improving gross motor function and postural control with hippotherapy in children with Down syndrome: case reports.

    Science.gov (United States)

    Champagne, Danielle; Dugas, Claude

    2010-11-01

    The purpose of this case report is to describe the impact of an 11-week hippotherapy program on the gross motor functions of two children (respectively 28 and 37 months old) diagnosed with Down syndrome. Hippotherapy is a strategy that uses the horse's motion to stimulate and enhance muscle contraction and postural control. The children were assessed by the Gross Motor Function Measure (GMFM) and accelerometry. The results indicate that both children improved on many dimensions of the GMFM. Power spectral analysis of the acceleration signals showed improvement in postural control of either the head or trunk, because the children adopted two different adaptative strategies to perturbation induced by the moving horse.

  14. Improved reporting of statistical design and analysis: guidelines, education, and editorial policies.

    Science.gov (United States)

    Mazumdar, Madhu; Banerjee, Samprit; Van Epps, Heather L

    2010-01-01

    A majority of original articles published in biomedical journals include some form of statistical analysis. Unfortunately, many of the articles contain errors in statistical design and/or analysis. These errors are worrisome, as the misuse of statistics jeopardizes the process of scientific discovery and the accumulation of scientific knowledge. To help avoid these errors and improve statistical reporting, four approaches are suggested: (1) development of guidelines for statistical reporting that could be adopted by all journals, (2) improvement in statistics curricula in biomedical research programs with an emphasis on hands-on teaching by biostatisticians, (3) expansion and enhancement of biomedical science curricula in statistics programs, and (4) increased participation of biostatisticians in the peer review process along with the adoption of more rigorous journal editorial policies regarding statistics. In this chapter, we provide an overview of these issues with emphasis to the field of molecular biology and highlight the need for continuing efforts on all fronts.

  15. Industrial Energy-Efficiency Improvement Program. Annual report to the Congress and the President 1979

    Energy Technology Data Exchange (ETDEWEB)

    1980-12-01

    The industrial energy efficiency improvement program to accelerate market penetration of new and emerging industrial technologies and practices which will improve energy efficiency; encourage substitution of more plentiful domestic fuels; and enhance recovery of energy and materials from industrial waste streams is described. The role of research, development, and demonstration; technology implementation; the reporting program; and progress are covered. Specific reports from the chemicals and allied products; primary metals; petroleum and coal products; stone, clay, and glass, paper and allied products; food and kindred products; fabricated metals; transportation equipment; machinery (except electrical); textile mill products; rubber and miscellaneous plastics; electrical and electronic equipment; lumber and wood; and tobacco products are discussed. Additional data from voluntary submissions, a summary on progress in the utilization of recovered materials, and an analysis of industrial fuel mix are briefly presented. (MCW)

  16. Prosthetic improvement of pronounced buccally positioned zygomatic implants: a clinical report.

    Science.gov (United States)

    Bacchi, Ataís; Santos, Mateus Bertolini Fernandes dos; Pimentel, Marcele Jardim; Nóbilo, Mauro Antonio de Arruda; Consani, Rafael Leonardo Xediek

    2014-08-01

    This report presents a prosthetic technique for the improvement of surgically positioned, buccally placed zygomatic implants with the use of custom abutments for improved retention screw position and an esthetic implant reconstruction. The patient presented four zygomatic implants with pronounced buccal inclination. The anterior implants were inclined toward the location where the anterior artificial teeth should be placed during rehabilitation. As the manufacturer does not provide angulated abutments, we attempted the waxing and overcasting of a prosthetic abutment, repositioning the access holes of the prosthetic screws to a more palatal position. This clinical report demonstrates that abutment customization could be an interesting way to relocate the access holes of the prosthetic screws in cases of zygomatic implants with pronounced buccal inclination.

  17. Greater Celandine hepatotoxicity: a clinical review.

    Science.gov (United States)

    Teschke, Rolf; Frenzel, Christian; Glass, Xaver; Schulze, Johannes; Eickhoff, Axel

    2012-01-01

    Herbal hepatotoxicity is a rare and poorly described disease because reported cases are mostly scattered and lack an appropriate causality assessment. We now describe in detail the clinical picture of herbal hepatotoxicity by extracts of Greater Celandine (GC), syn. Chelidonium majus L. from the Papaveraceae family, which contain more than 20 ingredients including various biologically active isoquinoline alkaloids. For this purpose, we analyzed and reviewed published cases of 16 patients from various European countries. In all patients, herbal hepatotoxicity was of probable and highly probable causality for GC, using the original and updated scale of CIOMS (Council for International Organizations of Medical Sciences). GC associated hepatotoxicity usually has an acute clinical course exhibiting a hepatocellular pattern of injury and is correlated to an idiosyncratic reaction with its metabolic subtype. Jaundice combined with high values of serum aminotransferases was present in virtually all cases with favourable outcome despite severe clinical course. In conclusion, GC hepatotoxicity is a typical herbal hepatotoxicity with a sound causality track for GC, but there is uncertainty regarding the respective causative compound(s). The present detailed review of GC hepatotoxicity may serve as an example for clinical causality assessments of future cases of liver injury due to other herbs.

  18. Improving GHG inventories by regional information exchange: a report from Asia

    OpenAIRE

    Umemiya Chisa

    2006-01-01

    Abstract Background The Parties to the United Nations Framework Convention on Climate Change (UNFCCC) are required to develop and report a national inventory of greenhouse gases not controlled by the Montreal Protocol. In the Asia region, "Workshops on Greenhouse Gas Inventories in Asia (WGIA)" have been organised annually since 2003 under the support of the government of Japan. WGIAs promote information exchange in the region to support countries' efforts to improve the quality of greenhouse...

  19. A Nephrology Fellows' Communication Skills Course: An Educational Quality Improvement Report.

    Science.gov (United States)

    Cohen, Robert A; Jackson, Vicki A; Norwich, Diana; Schell, Jane O; Schaefer, Kristen; Ship, Amy N; Sullivan, Amy M

    2016-08-01

    Nephrology fellows need expertise navigating challenging conversations with patients throughout the course of advanced kidney disease. However, evidence shows that nephrologists receive inadequate training in this area. This study assessed the effectiveness of an educational quality improvement intervention designed to enhance fellows' communication with patients who have advanced kidney disease. Quality improvement project. Full-day annual workshops (2013-2014) using didactics, discussion, and practice with simulated patients. Content focused on delivering bad news, acknowledging emotion, discussing care goals in dialysis decision making when prognosis is uncertain, and addressing dialysis therapy withdrawal and end of life. Participants were first-year nephrology fellows from 2 Harvard-affiliated training programs (N=26). Study assessed the effectiveness of an intervention designed to enhance fellows' communication skills. Primary outcomes were changes in self-reported patient communication skills, attitudes, and behaviors related to discussing disease progression, prognostic uncertainty, dialysis therapy withdrawal, treatments not indicated, and end of life; responding to emotion; eliciting patient goals and values; and incorporating patient goals into recommendations. Surveys measured prior training, pre- and postcourse perceived changes in skills and values, and reported longer term (3-month) changes in communication behaviors, using both closed- and open-ended items. Response rates were 100% (pre- and postsurveys) and 68% (follow-up). Participants reported improvement in all domains, with an overall mean increase of 1.1 (summed average scores: precourse, 2.8; postcourse, 3.9 [1-5 scale; 5 = "extremely well prepared"]; Pskills taught, such as "Ask-Tell-Ask" and using open-ended questions. Self-reported data may overestimate actual changes; small sample size and the programs' affiliation with a single medical school may limit generalizability. A day

  20. Quality Improvement-Focused Departmental Grand Rounds Reports: A Strategy to Engage General Surgery Residents.

    Science.gov (United States)

    Abelson, Jonathan S; Mitchell, Katrina B; Afaneh, Cheguevera; Rich, Barrie S; Frey, Theresa J; Gellman, Carol; Pomp, Alfons; Michelassi, Fabrizio

    2016-05-01

    Background Many institutions are seeking ways to enhance their surgical trainees' quality improvement (QI) skills. Objective To educate trainees about the importance of lifelong performance improvement, chief residents at New York Presbyterian Hospital-Weill Cornell Medicine are members of a multidisciplinary QI team tasked with improving surgical outcomes. We describe the process and the results of this effort. Methods Our analysis used 2 data sources to assess complication rates: the National Surgical Quality Improvement Program (NSQIP) and ECOMP, our own internal complication database. Chief residents met with a multidisciplinary QI team to review complication rates from both data sources. Chief residents performed a case-by-case analysis of complications and a literature search in areas requiring improvement. Based on this information, chief residents met with the multidisciplinary team to select interventions for implementation, and delivered QI-focused grand rounds summarizing the QI process and new interventions. Results Since 2009, chief residents have presented 16 QI-focused grand rounds. Urinary tract infections (UTIs) and surgical site infections (SSIs) were the most frequently discussed. Interventions to improve UTIs and SSIs were introduced to the department of surgery through these reports in 2011 and 2012. During this time we saw improvement in outcomes as measured by NSQIP odds ratio. Conclusions Departmental grand rounds are a suitable forum to review NSQIP data and our internal, resident-collected data as a means to engage chief residents in QI improvement, and can serve as a model for other institutions to engage surgery residents in QI projects.

  1. Assessment of the Fishery Improvement Opportunities on the Pend Oreille River, Appendices, 1990 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Ashe, Becky L.; Lillengreen, Kelly L.; Vella, John J.

    1991-03-01

    This report is a compilation of the seven appendices to DOE/BP/39339--4 the annual report for FY 1990. These appendices contain the supporting numerical data for the study. The purpose of this study was to assess the fishery improvement opportunities on the Box Canyon portion of the Pend Oreilla River. This three year study was initiated as part of the Northwest Power Planning Council's 1987 Columbia River Basin Fish and Wildlife Program. This report contains the findings of the third and final year of the study. The objectives of the third year of the study were to determine the relative abundance of each species in the river and sloughs; the population levels in five selected tributaries and, if possible, for fish in the river and sloughs; each species growth rate, feeding habits, abundance of preferred prey, and migration patterns; and the seasonal movement patterns and habitat utilization of largemouth bass.

  2. Improving a newly developed patient-reported outcome for thyroid patients, using cognitive interviewing

    DEFF Research Database (Denmark)

    Watt, Torquil; Rasmussen, Ase Krogh; Groenvold, Mogens;

    2008-01-01

    was within the set of problems involving attribution. Conclusion The cognitive interview methodology was effective in identifying and reducing problems within the questionnaire responding process. Patients tended to selectively report problems they considered to be caused by their thyroid disease even when......Objective To improve a newly developed patient-reported outcome measure for thyroid patients using cognitive interviewing. Methods Thirty-one interviews using immediate retrospective and expansive probing were conducted among patients with non-toxic goiter (n = 4), nodular toxic goiter (n = 5.......e. whether or not to report only issues considered of thyroid causality. Within each round of interviews, the number of problems declined from an initial average of six per interview to two, mainly due to a reduction in the number of problems associated with comprehension. The least amount of reduction...

  3. Greater Trochanteric Pain Syndrome in general Practice

    NARCIS (Netherlands)

    A. Brinks (Tineke)

    2011-01-01

    textabstractThis thesis focuses on patients with greater trochanteric pain syndrome. These patients suffer from local pain at the lateral side of the hip. The syndrome is characterized by chronic intermittent or continuous pain at and around the greater trochanter, sometimes radiating to the lateral

  4. Improving human reliability through better nuclear power plant system design. Progress report

    Energy Technology Data Exchange (ETDEWEB)

    Golay, M.W.

    1995-01-10

    The project on {open_quotes}Development of a Theory of the Dependence of Human Reliability upon System Designs as a Means of Improving Nuclear Power Plant Performance{close_quotes} has been undertaken in order to address the important problem of human error in advanced nuclear power plant designs. Most of the creativity in formulating such concepts has focused upon improving the mechanical reliability of safety related plant systems. However, the lack of a mature theory has retarded similar progress in reducing the likely frequencies of human errors. The main design mechanism used to address this class of concerns has been to reduce or eliminate the human role in plant operations and accident response. The plan of work being pursued in this project is to perform a set of experiments involving human subject who are required to operate, diagnose and respond to changes in computer-simulated systems, relevant to those encountered in nuclear power plants. In the tests the systems are made to differ in complexity in a systematic manner. The computer program used to present the problems to be solved also records the response of the operator as it unfolds. Ultimately this computer is also to be used in compiling the results of the project. The work of this project is focused upon nuclear power plant applications. However, the persuasiveness of human errors in using all sorts of electromechanical machines gives it a much greater potential importance. Because of this we are attempting to pursue our work in a fashion permitting broad generalizations.

  5. Use of a portable biofeedback device to improve insomnia in a combat zone, a case report.

    Science.gov (United States)

    McLay, Robert N; Spira, James L

    2009-12-01

    Insomnia is a common problem in situations of stress. Some forms of stress, however, may contraindicate the use of traditional, pharmacological interventions. Working in a combat zone is such a situation. Alternative means of improving sleep are clearly needed for Service Members. We report a case involving a medical provider who was serving in a military, emergency-services facility in Iraq, and who presented with anxiety, depressed mood, and insomnia. Symptoms were sub-threshold for major depressive disorder or acute stress disorder. Mood and anxiety symptoms responded to traditional therapy techniques, but problems with insomnia remained. The patient was given a portable biofeedback device that employs an infrared sensor photoplethysmograph to measure heart rate variability (HRV) from peripheral finger pulse. One week later, sleep was significantly improved. Symptom improvement lasted to at least 6 weeks while in theater. One year later, a check-in with the patient revealed that after returning home, he had been diagnosed with post traumatic stress disorder (PTSD). PTSD symptoms had resolved after 6 months of psychopharmacology and cognitive behavioral therapy. These results indicate that biofeedback may be a useful means of improving sleep in a combat zone, but that such improvements may not necessarily prevent the development of more serious symptoms later. No clear causality can be inferred from a single case, and further study is needed to determine if this finding have wider applicability.

  6. Mandatory Reporting? Issues to consider when developing legislation and policy to improve discovery of child abuse

    Directory of Open Access Journals (Sweden)

    Emma Davies

    2014-10-01

    Full Text Available Article by Dr Emma Davies (School of Law, Liverpool John Moores University, Associate Professor Ben Mathews (School of Law, Queensland University of Technology and Professor John Read (Institute of Psychology, Health and Society, University of Liverpool. In the United Kingdom, recent investigations into child sexual abuse occurring within schools, the Catholic Church and the British Broadcasting Corporation, have intensified debate on ways to improve the discovery of child sexual abuse, and child maltreatment generally. One approach adopted in other jurisdictions to better identify cases of severe child maltreatment is the introduction of some form of legislative mandatory reporting to require designated persons to report known and suspected cases. The debate in England has raised the prospect of whether adopting a strategy of some kind of mandatory reporting law is advisable. The purpose of this article is to add to this debate by identifying fundamental principles, issues and complexities underpinning policy and even legislative developments in the interests of children and society. The article will first highlight the data on the hidden nature of child maltreatment and the background to the debate. Secondly, it will identify some significant gaps in knowledge that need to be filled. Thirdly, the article will summarise the barriers to reporting abuse and neglect. Fourthly, we will identify a range of options for, and clarify the dilemmas in developing, legislative mandatory reporting, addressing two key issues: who should be mandated to report, and what types of child maltreatment should they be required to report? Finally, we draw attention to some inherently different goals and competing interests, both between and within the various institutions involved in the safeguarding of children and the criminal prosecution of some offenders. Based on this analysis we offer some concluding observations that we hope contribute to informed and careful

  7. Media reporting of health interventions: signs of improvement, but major problems persist.

    Directory of Open Access Journals (Sweden)

    Amanda Wilson

    Full Text Available BACKGROUND: Studies have persistently shown deficiencies in medical reporting by the mainstream media. We have been monitoring the accuracy and comprehensiveness of medical news reporting in Australia since mid 2004. This analysis of more than 1200 stories in the Australian media compares different types of media outlets and examines reporting trends over time. METHODS AND FINDINGS: Between March 2004 and June 2008 1230 news stories were rated on a national medical news monitoring web site, Media Doctor Australia. These covered a variety of health interventions ranging from drugs, diagnostic tests and surgery to dietary and complementary therapies. Each story was independently assessed by two reviewers using ten criteria. Scores were expressed as percentages of total assessable items deemed satisfactory according to a coding guide. Analysis of variance was used to compare mean scores and Fishers exact test to compare proportions. Trends over time were analysed using un-weighted linear regression analysis. Broadsheet newspapers had the highest average satisfactory scores: 58% (95% CI 56-60%, compared with tabloid newspapers and online news outlets, 48% (95% CI 44-52 and 48% (95% CI 46-50 respectively. The lowest scores were assigned to stories broadcast by human interest/current affairs television programmes (average score 33% (95% CI 28-38. While there was a non- significant increase in average scores for all outlets, a significant improvement was seen in the online news media: a rise of 5.1% (95%CI 1.32, 8.97; P 0.009. Statistically significant improvements were seen in coverage of the potential harms of interventions, the availability of treatment or diagnostic options, and accurate quantification of benefits. CONCLUSION: Although the overall quality of medical reporting in the general media remains poor, this study showed modest improvements in some areas. However, the most striking finding was the continuing very poor coverage of health news

  8. Greater happiness for a greater number: is that possible and desirable?

    NARCIS (Netherlands)

    R. Veenhoven (Ruut)

    2010-01-01

    textabstractGREATER HAPPINESS FOR A GREATER NUMBER: IS THAT POSSIBLE AND DESIRABLE? Utilitarian philosophy holds that public policy should aim at greater happiness for a greater number of people. This moral tenet meets many objections, on pragmatic grounds it is denounced as unfeasible and on ideolo

  9. Greater happiness for a greater number: is that possible and desirable?

    NARCIS (Netherlands)

    R. Veenhoven (Ruut)

    2010-01-01

    textabstractGREATER HAPPINESS FOR A GREATER NUMBER: IS THAT POSSIBLE AND DESIRABLE? Utilitarian philosophy holds that public policy should aim at greater happiness for a greater number of people. This moral tenet meets many objections, on pragmatic grounds it is denounced as unfeasible and on

  10. An experimental predeployment training program improves self-reported patient treatment confidence and preparedness of Army combat medics.

    Science.gov (United States)

    Gerhardt, Robert T; Hermstad, Erik L; Oakes, Michael; Wiegert, Richard S; Oliver, Jeffrey

    2008-01-01

    To develop and assess impact of a focused review of International Trauma Life Support (ITLS) and combat casualty care with hands-on procedure training for U.S. Army medics deploying to Iraq. The setting was a U.S. Army Medical Department Center and School and Camp Eagle, Iraq. Investigators developed and implemented a command-approved prospective educational intervention with a post hoc survey. Subjects completed a three-day course with simulator and live-tissue procedure laboratories. At deployment's end, medics were surveyed for experience, confidence, and preparedness in treating various casualty severity levels. Investigators used two-tailed t-test with unequal variance for continuous data and chi-square for categorical data. Twenty-nine medics deployed. Eight completed the experimental program. Twenty-one of 25 (84%) available medics completed the survey including six of the eight (75%) experimental medics. The experimental group reported significantly greater levels of preparedness and confidence treating "minimal," "delayed," and "immediate" casualties at arrival in Iraq. These differences dissipated progressively over the time course of the deployment. This experimental program increased combat medic confidence and perceived level of preparedness in treating several patient severity levels. Further research is warranted to determine if the experimental intervention objectively improves patient care quality and translates into lives saved early in deployment.

  11. Improving Transparency in the Reporting of Safeguards Implementation: FY11 Update

    Energy Technology Data Exchange (ETDEWEB)

    Toomey, Christopher; Odlaug, Christopher S.; Wyse, Evan T.

    2011-09-30

    In 2008, the Standing Advisory Group on Safeguards Implementation (SAGSI) indicated that the International Atomic Energy Agency's (IAEA) Safeguards Implementation Report (SIR) has not kept pace with the evolution of safeguards and provided the IAEA with a set of recommendations for improvement. The SIR is the primary mechanism for providing an overview of safeguards implementation in a given year and reporting on the annual safeguards findings and conclusions drawn by the Secretariat. As the IAEA transitions to State-level safeguards approaches, SIR reporting must adapt to reflect these evolutionary changes. This evolved report will better reflect the IAEA's transition to a more qualitative and information-driven approach, based upon State-as-a-whole considerations. This paper applies SAGSI's recommendations to the development of multiple models for an evolved SIR and finds that an SIR repurposed as a 'safeguards portal' could significantly enhance information delivery, clarity, and transparency. In addition, this paper finds that the 'portal concept' also appears to have value as a standardized information presentation and analysis platform for use by Country Officers, for continuity of knowledge purposes, and the IAEA Secretariat in the safeguards conclusion process. Accompanying this paper is a fully functional prototype of the 'portal' concept, built using commercial software and IAEA Annual Report data and available for viewing at http://safeguardsportal.pnnl.gov.

  12. Final Report on the Operation and Maintenance Improvement Program for Concentrating Solar Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Cohen Gilbert E.; Kearney, David W.; Kolb, Gregory J.

    1999-06-01

    This report describes the results of a six-year, $6.3 million project to reduce operation and maintenance (O&M) costs at power plants employing concentrating solar power (CSP) technology. Sandia National Laboratories teamed with KJC Operating Company to implement the O&M Improvement Program. O&M technologies developed during the course of the program were demonstrated at the 150-MW Kramer Junction solar power park located in Boron, California. Improvements were made in the following areas: (a) efficiency of solar energy collection, (b) O&M information management, (c) reliability of solar field flow loop hardware, (d) plant operating strategy, and (e) cost reduction associated with environmental issues. A 37% reduction in annual O&M costs was achieved. Based on the lessons learned, an optimum solar- field O&M plan for future CSP plants is presented. Parabolic trough solar technology is employed at Kramer Junction. However, many of the O&M improvements described in the report are also applicable to CSP plants based on solar power tower or dish/engine concepts.

  13. Greater Happiness for a Greater Number: Did the Promise of Enlightenment Come True?

    Science.gov (United States)

    Veenhoven, Ruut

    2017-01-01

    In the eighteenth century 'Enlightened' thinkers challenged the belief that happiness exists only in Heaven. They claimed that happiness is possible in earthly life and foresaw that greater happiness would be achieved using reason. Did this promise of greater happiness come true? Several scholars doubt that we have become any happier and some claim that happiness has declined. These critical claims are tested using the time trend data available in the World Database of Happiness, which cover the period 1950-2010 and involve 1531 data points in 67 nations yielding 199 time-series ranging for 10 to more than 40 years. The analysis reveals that happiness has risen in most nations. The average yearly rise in the 67 nations was +0.012 on scale 0-10, which equals a rise of one full point every 83 years. At this rate happiness must have improved by more than two points over the past two centuries and, together with increasing longevity, this denotes an unprecedented rise in happy life years.

  14. Final priority; technical assistance to improve state data capacity--National Technical Assistance Center to improve state capacity to accurately collect and report IDEA data. Final priority.

    Science.gov (United States)

    2013-05-20

    The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Technical Assistance to Improve State Data Capacity program. The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2013 and later years. We take this action to focus attention on an identified national need to provide technical assistance (TA) to States to improve their capacity to meet the data collection and reporting requirements of the Individuals with Disabilities Education Act (IDEA). We intend this priority to establish a TA center to improve State capacity to accurately collect and report IDEA data (Data Center).

  15. Country Report on China's Participation in Greater Mekong Subregion Cooperation

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    1.Executive SummaryThe Mekong River,which originates from the Danggula Mountain Range on the Qinghai-Tibet Plateau in China and runs 4,880 km southward through six countries,namely,China,Myartmar,Laos,Thailand,Cambodia and Viet Nam,is an important transnational river in Asia and even the world.The section in China is called the Lancang River.Since the 1990s,the international cooperation in the Lancang-Mekong subregiun has received wide attention from the international community.Related countries and intemational organizations have carried out extensive cooperation,which has produced good results and forcefully facilitated economic and social development of the subregion.

  16. Improved vacuum sealing drainage in the treatment of gas gangrene: a case report.

    Science.gov (United States)

    Liu, Zhaofa; Zhao, Dewei; Wang, Benjie

    2015-01-01

    In this case, improved vacuum sealing drainage was used for gas gangrene treatment, which is different from traditional therapies of gas gangrene and this is the first report of using improved vacuum sealing drainage to treat gas gangrene. The patient was a 12-year-old Asian Male who was presented to the Emergency Department with a one-day history of left femoral progressing swelling, paining and fevering. Four days ago, rusty iron bars were plugged into the muscle of the left femoral when he played. Then he was taken to the local clinic and injected with tetanus antitoxin. A diagnosis of gas gangrene was made and modified vacuum sealing drainage device was used after thorough debridement. After two weeks' treatment, left femoral was kept and gas gangrene was cured successfully.

  17. Interim Report: Air-Cooled Condensers for Next Generation Geothermal Power Plants Improved Binary Cycle Performance

    Energy Technology Data Exchange (ETDEWEB)

    Daniel S. Wendt; Greg L. Mines

    2010-09-01

    As geothermal resources that are more expensive to develop are utilized for power generation, there will be increased incentive to use more efficient power plants. This is expected to be the case with Enhanced Geothermal System (EGS) resources. These resources will likely require wells drilled to depths greater than encountered with hydrothermal resources, and will have the added costs for stimulation to create the subsurface reservoir. It is postulated that plants generating power from these resources will likely utilize the binary cycle technology where heat is rejected sensibly to the ambient. The consumptive use of a portion of the produced geothermal fluid for evaporative heat rejection in the conventional flash-steam conversion cycle is likely to preclude its use with EGS resources. This will be especially true in those areas where there is a high demand for finite supplies of water. Though they have no consumptive use of water, using air-cooling systems for heat rejection has disadvantages. These systems have higher capital costs, reduced power output (heat is rejected at the higher dry-bulb temperature), increased parasitics (fan power), and greater variability in power generation on both a diurnal and annual basis (larger variation in the dry-bulb temperature). This is an interim report for the task ‘Air-Cooled Condensers in Next- Generation Conversion Systems’. The work performed was specifically aimed at a plant that uses commercially available binary cycle technologies with an EGS resource. Concepts were evaluated that have the potential to increase performance, lower cost, or mitigate the adverse effects of off-design operation. The impact on both cost and performance were determined for the concepts considered, and the scenarios identified where a particular concept is best suited. Most, but not all, of the concepts evaluated are associated with the rejection of heat. This report specifically addresses three of the concepts evaluated: the use of

  18. The Space Situational Assessment Report to Improve Public Awareness in China

    Science.gov (United States)

    Li, Hongbo; Zhang, Qi; Xie, Zebing; Wei, Xiangwang; Wang, Tao

    For improvement of public awareness of the impact of space activities in China, a Space Situational Assessment Report 2013 will be issued in March 2014. More than ten Chinese main medium are invited for a special press conference. The Space Situational Assessment Report aims to introduce international space activities to Chinese public, and provide a common, comprehensive knowledge base to support the development of national policies and international security cooperation of outer space. The full report organizes international space activities until 2013 according to three parts those are Foundations, Strategies and Environment, including nine chapters, such as Space laws and policies; Space facility and equipment; Institutions and Human Resource; Military space, Civil space and Commercial space; Natural space environment; Space situational awareness, etc. A kind of Space Situational Assessment Index System is presented as a globally-focused analytic framework that defines, measures, and ranks national space activity. To use for a variety of public themes, different assessment indexes are constituted by scores of individual qualitative and quantitative metrics based on the Index System. Three research organizaitons of space sciences and technologies collaborated on the Space Situational Assessment Report. It is a scholarly and ungovernmental work.

  19. Evaluation and management of greater trochanter pain syndrome.

    Science.gov (United States)

    Mulligan, Edward P; Middleton, Emily F; Brunette, Meredith

    2015-08-01

    Greater trochanteric pain syndrome is an enigmatic but common cause of lateral hip symptoms in middle-aged active women. The most common manifestation of this syndrome is a degenerative tendinopathy of the hip abductors similar to the intrinsic changes seen with rotator cuff pathology in the shoulder. There are no definitive tests to isolate the underlying pathology and palpation is a non-specific means by which to differentiate the source of the pain generator. The physical examination must comprehensively evaluate for a cluster of potential impairments and contributing factors that will need to be addressed to effectively manage the likely functional limitations and activity challenges the syndrome presents to the patient. Compressive forces through increased tension in the iliotibial band should be avoided. Intervention strategies should include education regarding postural avoidance, activity modifications, improvement of lumbopelvic control, and a patient approach to resolving hip joint restrictions and restoring the tensile capabilities of the deep rotators and abductors of the hip. A number of reliable and validated hip-specific self-report outcome tools are available to baseline a patient's status and monitor their progress. Further investigations to identify the epidemiological risk factors, establish effective treatment strategies, and predict prognosis are warranted.

  20. Correlation between pain response and improvements in patient-reported outcomes and health-related quality of life in duloxetine-treated patients with diabetic peripheral neuropathic pain

    Directory of Open Access Journals (Sweden)

    Ogawa K

    2015-08-01

    Full Text Available Kei Ogawa,1 Shinji Fujikoshi,2 William Montgomery,3 Levent Alev1 1Medical Science, 2Statistical Science, Eli Lilly Japan K.K., Kobe, Japan; 3Global Patient Outcomes and Real World Evidence, Eli Lilly Australia Pty Ltd, West Ryde, NSW, Australia Objective: We assessed whether quality of life (QoL improvement in duloxetine-treated patients with diabetic peripheral neuropathic pain (DPNP correlates with the extent of pain relief.Methods: Pooled data from three multicountry, double-blind, 12-week, placebo-controlled trials of duloxetine-treated (duloxetine 60 mg once daily; total number =335 patients with DPNP were analyzed. Based on improvement in 24-hour average pain scores, patients were stratified into four groups. Improvement in QoL, which was measured as the change from baseline in two patient-reported health outcome measures (Short Form [SF]-36 and five-dimension version of the EuroQol Questionnaire [EQ-5D], was evaluated and compared among the four groups. Pearson’s correlation coefficient was calculated to assess the correlation between improvement in pain scores and improvement in QoL.Results: The group with more pain improvement generally showed greater mean change from baseline in all of the SF-36 scale scores and on the EQ-5D index. Pearson’s correlation coefficients ranged from 0.114 to 0.401 for the SF-36 scale scores (P<0.05, and it was 0.271 for the EQ-5D (P<0.001.Conclusion: Improvement in pain scores was positively correlated with improvement in QoL and patient-reported outcomes in duloxetine-treated patients. Keywords: diabetic peripheral neuropathic pain, duloxetine, efficacy, function, quality of life

  1. The A3 Problem Solving Report: A 10-Step Scientific Method to Execute Performance Improvements in an Academic Research Vivarium

    OpenAIRE

    Bassuk, James A.; Washington, Ida M.

    2013-01-01

    The purpose of this study was to illustrate the application of A3 Problem Solving Reports of the Toyota Production System to our research vivarium through the methodology of Continuous Performance Improvement, a lean approach to healthcare management at Seattle Children's (Hospital, Research Institute, Foundation). The Report format is described within the perspective of a 10-step scientific method designed to realize measurable improvements of Issues identified by the Report's Author, Sponso...

  2. Improved performance of linear coal cutting compared with rotary cutting. Report of investigations/1995

    Energy Technology Data Exchange (ETDEWEB)

    Roepke, W.W.; Hanson, B.D.; Olson, R.C.; Wingquist, C.F.; Myren, T.A.

    1995-07-01

    The linear cutting system, developed by the U.S. Bureau of Mines, uses geometric principles developed by Cardan to produce a nearly constant cut depth. The new system has been extensively tested in a synthetic material under laboratory conditions to verify mechanical capability and to identify operational characteristics. Comparisons between 15-rpm linear cutting and 50-rpm rotary cutting systems show significant improvement in respirable dust entrainment, product size distribution, and energy usage. Respirable dust is reduced by as much as 90 pct. Recovered product showed a 67-pct reduction in -0.32-cm (-1/8-in) material and a 200-pct increase in +5.08 cm (+2 in) material. Average power was reduced by 66 pct for the linear cutting. Because the bit cutting paths differ between linear and rotary cutting, it was necessary to compare the two at the same cut depths and bit types. These comparisons show that low revolution per minute rotary cutting entrains about the same amount of respirable dust as the linear cutting system, but the average shaft torque may be 55 to 130 pct greater for the rotary system.

  3. Development of a Natural Rearing System to Improve Supplemental Fish Quality, 1991-1995 Progress Report.

    Energy Technology Data Exchange (ETDEWEB)

    Maynard, Desmond J.; Flagg, Thomas A.; Mahnken, Conrad V.W.

    1996-08-01

    In this report, the National Marine Fisheries Service (NMFS), in collaboration with the Bonneville Power Administration (BPA), the Washington State Department of Fish and Wildlife (WDFW), and the US Fish and Wildlife Service (USFWS), presents research findings and guidelines for development and evaluation of innovative culture techniques to increase postrelease survival of hatchery fish. The Natural Rearing Enhancement System (NATURES) described in this report is a collection of experimental approaches designed to produce hatchery-reared chinook salmon (Oncorhynchus tshawytscha) that exhibit wild-like behavior, physiology, and morphology. The NATURES culture research for salmonids included multiple tests to develop techniques such as: raceways equipped with cover, structure, and natural substrates to promote development of proper body camouflage coloration; feed-delivery systems that condition fish to orient to the bottom rather than the surface of the rearing vessel; predator conditioning of fish to train them to avoid predators; and supplementing diets with natural live foods to improve foraging ability. The underlying assumptions are that NATURES will: (1) promote the development of natural cryptic coloration and antipredator behavior; (2) increase postrelease foraging efficiency; (3) improve fish health and condition by alleviating chronic, artificial rearing habitat-induced stress; and (4) reduce potential genetic selection pressures induced by the conventional salmon culture environment. A goal in using NATURES is to provide quality fish for rebuilding depleted natural runs.

  4. Anterior capsulotomy improves persistent developmental stuttering with a psychiatric disorder: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Zhang SZ

    2014-04-01

    Full Text Available Shizhen Zhang,* Peng Li,* Zhujun Zhang, Wei WangDepartment of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China *These authors contributed equally to this workAbstract: Stuttering is characterized by disrupted fluency of verbal expression, and occurs mostly in children. Persistent developmental stuttering (PDS may occur in adults. Reports of the surgical management of PDS are limited. Here we present the case of a 28-year-old man who had had PDS since the age of 7 years, was diagnosed with depression and anxiety disorder at the age of 24 years, and had physical concomitants. He underwent a bilateral anterior capsulotomy 4 years after the diagnosis. Over one year of follow-up, his physical concomitants resolved, and significant improvements in his psychiatric disorders and PDS were observed. To the best of our knowledge, this is the first report of simultaneous improvement in a patient's PDS and psychiatric disorder after a bilateral anterior capsulotomy.Keywords: persistent developmental stuttering, psychiatric disorders, anterior capsulotomy

  5. Development of a Natural Rearing System to Improve Supplemental Fish Quality, 1996-1998 Progress Report.

    Energy Technology Data Exchange (ETDEWEB)

    Maynard, Desmond J.

    2001-09-13

    This report covers the 1996-1998 Natural Rearing Enhancement System (NATURES) research for increasing hatchery salmon postrelease survival and producing fish with more wild-like behavior, physiology, and morphology prior to release. Experiments were conducted evaluating automatic subsurface feeders; natural diets; exercise systems; seminatural raceway habitat enriched with cover, structure, and substrate; and predator avoidance conditioning for hatchery salmonids. Automatic subsurface feed delivery systems did not affect chinook salmon depth distribution or vulnerability to avian predators. Live-food diets only marginally improved the ability of chinook salmon to capture prey in stream enclosures. A prototype exercise system that can be retrofitted to raceways was developed, however, initial testing indicated that severe amounts of exercise may increase in culture mortality. Rearing chinook salmon in seminatural raceway habitat with gravel substrate, woody debris structure, and overhead cover improved coloration and postrelease survival without impacting in-culture health or survival. Steelhead fry reared in enriched environments with structure, cover, and point source feeders dominated and outcompeted conventionally reared fish. Exposing chinook salmon to caged predators increased their postrelease survival. Chinook salmon showed an antipredator response to chemical stimuli from injured conspecifics and exhibited acquired predator recognition following exposure to paired predator-prey stimuli. The report also includes the 1997 Natural Rearing System Workshop proceedings.

  6. Hailstones across the Greater Sydney Metropolitan Area

    Directory of Open Access Journals (Sweden)

    A. A. Rasuly

    2014-11-01

    Full Text Available This study addresses the recent climatology of hail occurrence in the Greater Metropolitan Severe Thunderstorm Warning Area (GMSTWA of New South Wales, Australia, which is a sprawling suburban area, with a population of nearly 4.7 million and one of Australia's largest metropolis. The main objective is to highlight the recent temporal-spatial fluctuations of hailstone frequencies and magnitudes for each of recognized and vastly inhabited Local Government Areas (LGAs. The relevant hail event data from 1989 to 2013 were initially derived from the severe storm archive of Australian Bureau of Meteorology. A climatologically oriented GIS technique was applied in the examining and mapping procedure of all hail events and hail days reported throughout the study area. By applying a specific criterion, all severe hails (defined as 2 cm or more in diameter were cautiously selected and then imported into the ArcGIS software for relevant analysis. Appropriate data layers were stored in a unique database to allow logical integration of the data directly into some geoprocessing functions, mainly for querying, analyzing and mapping purposes in a model-builder setting. The database includes 357 hailstones with sizes 2–11 cm and occurred in 169 hail days across the region during the past 25 years. The models have established that hailstones are neither temporally nor spatially uniform in magnitude throughout the study area. Temporal analysis indicated that most of hail events occurred predominately in the afternoons with peak time of 1–5 p.m. EST. They were particularly common in spring and summer, and reached maximum frequency in November and December. There was an average of 14.3 events each year, but a significant decreasing trend in terms of hail frequency and associated magnitude in the recent years has been identified. In turn, spatial models also established three main distribution patterns over the study area, which include the Sydney Metropolitan

  7. Stereotactic Radiosurgery for Trigeminal Neuralgia Improves Patient-Reported Quality of Life and Reduces Depression.

    Science.gov (United States)

    Kotecha, Rupesh; Miller, Jacob A; Modugula, Sujith; Barnett, Gene H; Murphy, Erin S; Reddy, Chandana A; Suh, John H; Neyman, Gennady; Machado, Andre; Nagel, Sean; Chao, Samuel T

    2017-08-01

    To characterize quality-of-life (QOL) outcomes after stereotactic radiosurgery (SRS) for trigeminal neuralgia (TN). The EuroQOL 5 Dimensions (EQ-5D) and Patient Health Questionnaire 9 (PHQ-9) were prospectively collected before and after SRS for 50 patients with TN. Pain response and treatment-related facial numbness were classified by Barrow Neurological Institute (BNI) scales. Differences in pooled QOL outcomes were tested with paired t tests and sign tests. The Kaplan-Meier method was used to estimate time-dependent improvements in the EQ-5D index, EQ-5D perceived health status (PHS), PHQ-9 score, and freedom from pain failure (BNI class IV-V) or facial numbness (BNI class III-IV). Following SRS, the 12-month rate of freedom from pain failure was 92% (95% confidence interval [CI], 77%-97%) while the 12-month rate of freedom from facial numbness was 89% (95% CI, 66%-97%). Significant improvements in the EQ-5D index (P<.01), PHS (P=.01), and PHQ-9 (P=.03) were observed, driven by the EQ-5D subscores for self-care and for pain and/or discomfort (P=.02 and P<.01, respectively). At 12 months after SRS, the actuarial rates of improvement in the EQ-5D, PHS, and PHQ-9 were 55% (95% CI, 40%-70%), 59% (95% CI, 40%-76%), and 59% (95% CI, 39%-76%), respectively. The median time to improvement in each of the QOL measures was 9 months (95% CI, 3-36 months) for the EQ-5D index, 5 months (95% CI, 3-36 months) for PHS, and 9 months (95% CI, 3-18 months) for the PHQ-9. On multivariate analysis, only higher prescription dose (86 Gy vs ≤82 Gy) was associated with improvement in the EQ-5D index (hazard ratio, 5.73; 95% CI, 1.85-22.33; P<.01). Patients with TN treated with SRS reported significant improvements in multiple QOL measures, with the therapeutic benefit strongly driven by improvements in pain and/or discomfort and in self-care, along with lower rates of depression. In this analysis, there appears to be a correlation between prescription dose and treatment

  8. Development and process evaluation of improved Fischer-Tropsch slurry catalysts. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Bukur, D.B.; Mukesh, D.; Patel, S.A.; Zimmerman, W.H.; Rosynek, M.P. [Texas A& M Univ., College Station, TX (United States); Kellogg, L.J. [Air Products and Chemicals, Inc., Allentown, PA (United States)

    1990-04-01

    This report describes results of a study aimed at developing and evaluating improved catalysts for a slurry Fischer-Tropsch (FT) process for converting synthesis gas to high quality transportation fuels (gasoline and distillate). The improvements in catalyst performance were sought by studying effects of pretreatment conditions, promoters and binders/supports. A total of 20 different, iron based, catalysts were evaluated in 58 fixed bed reactor tests and 10 slurry reactor tests. The major accomplishments and conclusions are summarized below. The pretreatment conditions (temperature, duration and the nature of reducing gas) have significant effect on catalyst performance (activity, selectivity and stability) during Fischer-Tropsch synthesis. One of precipitated unsupported catalysts had hydrocarbon selectivity similar to Mobil`s I-B catalyst in high wax mode operation, and had not experienced any loss in activity during 460 hours of testing under variable process conditions in a slurry reactor. The effect of promoters (copper and potassium) on catalyst performance during FT synthesis has been studied in a systematic way. It was found that potassium promotion increases activities of the FT and water-gas-shift (WGS) reactions, the average molecular weight of hydrocarbon products, and suppresses the olefin hydrogenation and isomerization reactions. The addition of binders/supports (silica or alumina) to precipitated Fe/Cu/K catalysts, decreased their activity but improved their stability and hydrocarbon selectivity. The performance of catalysts of this type was very promising and additional studies are recommended to evaluate their potential for use in commercial slurry reactors.

  9. Improving the quality of adverse drug reaction reporting by 4th-year medical students.

    Science.gov (United States)

    Rosebraugh, Curtis J; Tsong, Yi; Zhou, Feng; Chen, Min; Mackey, Ann Corken; Flowers, Charlene; Toyer, Denise; Flockhart, David A; Honig, Peter K

    2003-03-01

    Evaluate whether a 15-minute lecture intervention will improve adverse drug reaction reporting quality on standard MedWatch forms. Seventy-eight 4th-year medical students were randomized to intervention 'Group-A' or non-intervention 'Group-B' on the first day of a required five-day clinical pharmacology rotation. Group-A participants attended a 15-minute lecture on completing a MedWatch form with quality information considered by the Food and Drug Administration as critical to adequate adverse drug reaction reporting. Group-B participants did not attend this lecture. Both groups then watched a standardized patient interview of a recognizable adverse drug reaction and completed MedWatch forms. Four Safety Evaluators from the Food and Drug Administration (FDA) rated student responses in a blinded fashion for the primary efficacy variable of Overall Impression and six informational domins using a standardized data quality analysis form that was developed within the Office of Postmarketing Drug Risk Assessment of the FDA. Seventy-eight MedWatch forms were evaluated (Group-A = 40, Group B = 38). Overall MedWatch information quality scores for the intervention group were significantly higher than the non-intervention group (p students. Academic medical centers should consider incorporating adverse drug reaction reporting curriculum into the clinical training of medical students.

  10. Orthogonal Range Reporting: Query Lower Bounds, Optimal Structures in 3-d, and Higher Dimensional Improvements

    DEFF Research Database (Denmark)

    Afshani, Peyman; Arge, Lars Allan; Larsen, Kasper Dalgaard

    2010-01-01

    Orthogonal range reporting is the problem of storing a set of n points in d-dimensional space, such that the k points in an axis-orthogonal query box can be reported efficiently. While the 2-d version of the problem was completely characterized in the pointer machine model more than two decades ago...... data structure for the d-dimensional orthogonal range reporting problem in the pointer machine model of computation that uses S(n) space must spend Ω((log n/ log(S(n)/n))⌊d/2⌋--1) time to answer queries. Thus, if S(n)/n is poly-logarithmic, then the query time is at least Ω((log n/ log log n)⌊d/2......) to Ω((log n/ log log n)2 + k) somewhere between three and six dimensions. Finally, we show that our techniques also lead to improved structures for point location in rectilinear subdivisions, that is, the problem of storing a set of n disjoint d-dimensional axis-orthogonal rectangles...

  11. American College of Surgeons National Surgical Quality Improvement Program Pediatric: a phase 1 report.

    Science.gov (United States)

    Raval, Mehul V; Dillon, Peter W; Bruny, Jennifer L; Ko, Clifford Y; Hall, Bruce L; Moss, R Lawrence; Oldham, Keith T; Richards, Karen E; Vinocur, Charles D; Ziegler, Moritz M

    2011-01-01

    There has been a long-standing desire to implement a multi-institutional, multispecialty program to address surgical quality improvement for children. This report documents results of the initial phase of the American College of Surgeons National Surgical Quality Improvement Program Pediatric. From October 2008 to December 2009, patients from 4 pediatric referral centers were sampled using American College of Surgeons National Surgical Quality Improvement Program methodology tailored to children. A total of 7,287 patients were sampled, representing general/thoracic surgery (n = 2,237; 30.7%), otolaryngology (n = 1,687; 23.2%), orthopaedic surgery (n = 1,367; 18.8%), urology (n = 893; 12.3%), neurosurgery (n = 697; 9.6%), and plastic surgery (n = 406; 5.6%). Overall mortality rate detected was 0.3% and 287 (3.9%) patients had postoperative occurrences. After accounting for demographic, preoperative, and operative factors, occurrences were 4 times more likely in those undergoing inpatient versus outpatient procedures (odds ratio [OR] = 4.71; 95% CI, 3.01-7.35). Other factors associated with higher likelihood of postoperative occurrences included nutritional/immune history, such as preoperative weight loss/chronic steroid use (OR = 1.49; 95% CI, 1.03-2.15), as well as physiologic compromise, such as sepsis/inotrope use before surgery (OR = 1.68; 95% CI, 1.10-1.95). Operative factors associated with occurrences included multiple procedures under the same anesthetic (OR = 1.58; 95% CI, 1.21-2.06) and American Society of Anesthesiologists classification category 4/5 versus 1 (OR = 5.74; 95% CI, 2.94-11.24). Specialty complication rates varied from 1.5% for otolaryngology to 9.0% for neurosurgery (p Pediatric has the potential to identify outcomes of children's surgical care that can be targeted for quality improvement efforts. Copyright © 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  12. A report on developing a checklist to assess company plans focused on improving safety awareness, safe behaviour and safety culture : final report

    NARCIS (Netherlands)

    Steijger, N.; Starren, H.; Keus, M.; Gort, J.; Vervoort, M.

    2003-01-01

    This report describes the process of developing a checklist to asses company plans focused on improving safety awareness, safe behaviour and safety culture. These plans are part of a programme initiated by the Ministry of Social Affairs and Employment aiming at improving the safety performance of co

  13. Greater Somalia, the never-ending dream?

    DEFF Research Database (Denmark)

    Zoppi, Marco

    2015-01-01

    This paper provides an historical analysis of the concept of Greater Somalia, the nationalist project that advocates the political union of all Somali-speaking people, including those inhabiting areas in current Djibouti, Ethiopia and Kenya. The Somali territorial unification project of “lost ter...

  14. Greater trochanteric fracture with occult intertrochanteric extension.

    Science.gov (United States)

    Reiter, Michael; O'Brien, Seth D; Bui-Mansfield, Liem T; Alderete, Joseph

    2013-10-01

    Proximal femoral fractures are frequently encountered in the emergency department (ED). Prompt diagnosis is paramount as delay will exacerbate the already poor outcomes associated with these injuries. In cases where radiography is negative but clinical suspicion remains high, magnetic resonance imaging (MRI) is the study of choice as it has the capability to depict fractures which are occult on other imaging modalities. Awareness of a particular subset of proximal femoral fractures, namely greater trochanteric fractures, is vital for both radiologists and clinicians since it has been well documented that they invariably have an intertrochanteric component which may require surgical management. The detection of intertrochanteric or cervical extension of greater trochanteric fractures has been described utilizing MRI but is underestimated with both computed tomography (CT) and bone scan. Therefore, if MRI is unavailable or contraindicated, the diagnosis of an isolated greater trochanteric fracture should be met with caution. The importance of avoiding this potential pitfall is demonstrated in the following case of an elderly woman with hip pain and CT demonstrating an isolated greater trochanteric fracture who subsequently returned to the ED with a displaced intertrochanteric fracture.

  15. Annual Report: Support Research for Development of Improved Geothermal Drill Bits

    Energy Technology Data Exchange (ETDEWEB)

    Hendrickson, R.R.; Winzenried, R.W.; Jones, A.H.; Green, S.J.

    1978-07-01

    The work reported herein is a continuation of the program initiated under DOE contract E(10-1)-1546* entitled "Program to Design and Experimentally Test an Improved Geothermal Bit"; the program is now DOE Contract EG-76-C-1546*. The objective of the program has been to accelerate the commercial availability of a tolling cutter drill bit for geothermal applications. Data and experimental tests needed to develop a bit suited to the harsh thermal, abrasive, and chemical environment of the more problematic geothermal wells, including those drilled with air, have been obtained. Efforts were directed at the improvement of both the sealed (lubricated) and unsealed types of bits. The unsealed bit effort included determination of the rationale for materials selection, the selection of steels for the bit body, cutters, and bearings, the selection of tungsten carbide alloys for the friction bearing, and preliminary investigation of optimized tungsten carbide drilling inserts. Bits build** with the new materials were tested under stimulated wellbore conditions. The sealed bit effort provided for the evaluation of candidate high temperature seals and lubricants, utilizing two specially developed test apparatus which simulate the conditions found in a sealed bit operating in a geothermal wellbore. Phase I of the program was devoted largely to (1) the study of the geothermal environment and the failure mechanisms of existing geothermal drill bits, (2) the design and construction of separate facilities for testing both drill-bit seals and full-scale drill bits under simulated geothermal drilling conditions, and (3) fabrication of the MK-I research drill bits from high-temperature steels, and testing in the geothermal drill-bit test facility. The work accomplished in Phase I is reported in References 1 through 9. In Phase II, the first generation experimental bits were tested in the geothermal drill-bit test facility. Test results indicated that hardness retention at temperature

  16. Improving carbon monitoring and reporting in forests using spatially-explicit information.

    Science.gov (United States)

    Boisvenue, Céline; Smiley, Byron P; White, Joanne C; Kurz, Werner A; Wulder, Michael A

    2016-12-01

    Understanding and quantifying carbon (C) exchanges between the biosphere and the atmosphere-specifically the process of C removal from the atmosphere, and how this process is changing-is the basis for developing appropriate adaptation and mitigation strategies for climate change. Monitoring forest systems and reporting on greenhouse gas (GHG) emissions and removals are now required components of international efforts aimed at mitigating rising atmospheric GHG. Spatially-explicit information about forests can improve the estimates of GHG emissions and removals. However, at present, remotely-sensed information on forest change is not commonly integrated into GHG reporting systems. New, detailed (30-m spatial resolution) forest change products derived from satellite time series informing on location, magnitude, and type of change, at an annual time step, have recently become available. Here we estimate the forest GHG balance using these new Landsat-based change data, a spatial forest inventory, and develop yield curves as inputs to the Carbon Budget Model of the Canadian Forest Sector (CBM-CFS3) to estimate GHG emissions and removals at a 30 m resolution for a 13 Mha pilot area in Saskatchewan, Canada. Our results depict the forests as cumulative C sink (17.98 Tg C or 0.64 Tg C year(-1)) between 1984 and 2012 with an average C density of 206.5 (±0.6) Mg C ha(-1). Comparisons between our estimates and estimates from Canada's National Forest Carbon Monitoring, Accounting and Reporting System (NFCMARS) were possible only on a subset of our study area. In our simulations the area was a C sink, while the official reporting simulations, it was a C source. Forest area and overall C stock estimates also differ between the two simulated estimates. Both estimates have similar uncertainties, but the spatially-explicit results we present here better quantify the potential improvement brought on by spatially-explicit modelling. We discuss the source of the differences

  17. Assessment of the Fshery Improvement Opportunities on the Pend Oreille River, 1990 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Ashe, Becky L.; Lillengreen, Kelly L.; Vella, John J.

    1991-03-01

    The purpose of this study was to assess the fishery improvement opportunities on the Box Canyon portion of the Pend Oreilla River. This three year study was initiated as part of the Northwest Power Planning Council's 1987 Columbia River Basin Fish and Wildlife Program. This report contains the findings of the third and final year of the study. The objectives of the third year of the study were to determine the relative abundance of each species in the river and sloughs; the population levels in five selected tributaries and, if possible, for fish in the river and sloughs; each species growth rate, feeding habits abundance preferred prey, and migration patterns; and the seasonal movement patterns and habitat utilization of largemouth bass. 64 refs., 8 figs., 263., tabs.

  18. Improving cancer treatment with cyclotron produced radionuclides. Comprehensive progress report, February 1, 1990--January 31, 1993

    Energy Technology Data Exchange (ETDEWEB)

    Larson, S.M. Finn, R.D.

    1992-08-04

    This report describes the author`s continuing long term goal of promoting nuclear medicine applications by improving the scientific basis for tumor diagnosis treatment and treatment follow-up based on the use of cyclotron produced radiotracers in oncology. The program has 3 interactive components: Radiochemistry /Cyclotron; Pharmacology; and Immunology. An essential strategy is as follows: novel radionuclides and radiotracers developed in the Radiochemistry/Cyclotron section under the DOE grant during the 1989--1992 grant period, will be employed in the Pharmacology and Immunology sections of the DOE grant during the 1992--1995 grant period. The development of novel radionuclides and tracers is of course useful in and of itself, but their utility is greatly enhanced by the interaction with the immunology and pharmacology components of the program.

  19. Phonetics and tongue position to improve mandibular denture retention: a clinical report.

    Science.gov (United States)

    Bohnenkamp, David M; Garcia, Lily T

    2007-11-01

    The fabrication, use, and wear instructions for complete dentures are often the factors determining success. The dentist must help guide the mental attitude of the skeptical patient to foster acceptance and success of complete dentures. A "feeling of looseness" may be a condition experienced while patients learn to wear a new mandibular complete denture. Some patients may not understand the reasons given by dentists for the lack of retention of a new mandibular denture. This type of patient requires more explanation, more advice, and more instruction. A phonetic training technique, to demonstrate to the patient how to retain and stabilize the mandibular denture, may be needed for some denture patients. This article reports the clinical use of phonetics and its effect on tongue position to improve the retention and stability of a mandibular complete denture.

  20. Improved Accuracy and Safety of Intracorporeal Transpedicular Bone Grafting - using Contrast Impregnated Bone: A Case Report

    Directory of Open Access Journals (Sweden)

    CK Chiu

    2014-11-01

    Full Text Available A method of transpedicular bone grafting using contrast impregnated bone to improve the visualization of bone graft on the image intensifier is reported. A - 36-year old man who had sustained traumatic burst fracture of T12 vertebra, with Load-Sharing Classification (LSC score of 8, was treated with posterior short segment fusion from T11 to L1 with transpedicular bone graft of T12 vertebra. We were able to correct the kyphotic end plate angle (EPA from 19º to 1.4º. Anterior bone graft augmentation was achieved with contrast enhaced transpedicular bone grafts. At six months follow up, CT scan showed good bony integration of the anterior column with EPA of 4.5º and two years later, radiographs showed EPA of 7.6 º.

  1. Benchmark Report on Key Outage Attributes: An Analysis of Outage Improvement Opportunities and Priorities

    Energy Technology Data Exchange (ETDEWEB)

    Germain, Shawn St. [Idaho National Laboratory (INL), Idaho Falls, ID (United States); Farris, Ronald [Idaho National Laboratory (INL), Idaho Falls, ID (United States)

    2014-09-01

    Advanced Outage Control Center (AOCC), is a multi-year pilot project targeted at Nuclear Power Plant (NPP) outage improvement. The purpose of this pilot project is to improve management of NPP outages through the development of an AOCC that is specifically designed to maximize the usefulness of communication and collaboration technologies for outage coordination and problem resolution activities. This report documents the results of a benchmarking effort to evaluate the transferability of technologies demonstrated at Idaho National Laboratory and the primary pilot project partner, Palo Verde Nuclear Generating Station. The initial assumption for this pilot project was that NPPs generally do not take advantage of advanced technology to support outage management activities. Several researchers involved in this pilot project have commercial NPP experience and believed that very little technology has been applied towards outage communication and collaboration. To verify that the technology options researched and demonstrated through this pilot project would in fact have broad application for the US commercial nuclear fleet, and to look for additional outage management best practices, LWRS program researchers visited several additional nuclear facilities.

  2. The GDAHA hospital performance reports project: a successful community-based quality improvement initiative.

    Science.gov (United States)

    Snow, Richard J; Engler, David; Krella, Joseph M

    2003-01-01

    During the past decade there has been increasing distribution of hospital performance information but few examples of how this information is affecting the quality of health care delivery. This article describes the methods of implementation and factors influencing a successful community-based quality improvement initiative in Dayton, Ohio, involving a collaborative of five competing hospitals in partnership with the business community and local and state hospital associations. The initiative contributed to a 36% reduction in acute myocardial infarction mortality over a 3-year period by changing reperfusion patterns in patients with ST segment elevated myocardial infarction. Identification of an opportunity gap, root cause analysis, and development of process measures used to facilitate health care provider change are summarized. The driving and restraining forces that have shaped this initiative from a report card to a quality improvement program are outlined and a list of five contributors to success are presented. These factors can serve as a basis for how other communities can benefit from this collaborative model.

  3. Natural Propagation and Habitat Improvement, Volume 2, Idaho, 1984 Final and Annual Reports.

    Energy Technology Data Exchange (ETDEWEB)

    Hair, Don

    1986-01-01

    In 1984, and under the auspices of the Northwest Power Planning Council, the Clear-water National Forest and the Bonneville Power Administration entered into a contractual agreement to improve anadromous fish habitat in Lolo Creek. This was to be the second and final year of instream enhancement work in Lolo Creek, a major tributary to the Clearwater River. The project was again entitled Lolo Creek Habitat Improvement (No.84-6) which was scheduled from April 1, 1984, through March 31, 1985. Project costs were not to exceed $39,109. The following report is a description of the project objectives, methodology, results, and conclusions of this year's work, based on the knowledge and experience gained through 2 years of enhancement work. The primary objective was to partially mitigate the juvenile and adult anadromous fish losses accrued through hydroelectric development in the Columbia and Snake River systems by enhancing the spawning and rearing habitats of selected Clearwater River tributaries for spring chinook salmon and summer steelhead trout. The enhancement was designed to ameliorate the ''limiting production factors'' by the in-stream placement of habitat structures that would positively alter the pool-riffle structure and increase the quality of over-winter habitat.

  4. Powerplant productivity improvement study: demonstration of the DOE/MRI methodology. Final report

    Energy Technology Data Exchange (ETDEWEB)

    None

    1978-11-17

    A methodology, distributed by DOE, may be used as a potential tool for the utility industry to assess and evaluate productivity and reliability problems of existing and future units. The model can be used to assess the impact of an improvement project or corrective action on unit productivity parameters such as heat rate, capacity factor, availability, or equivalent availability. The methodology analyzes: the effect of component redundancy on unit equivalent availability; the effect of component reliability on unit equivalent availability; and a component's outage trend to project the component's future outage rate. The first purpose of this study is to illustrate for the utilities how to apply the methodology. Thus, this report contains the analysis performed by applying the methodology at three units of Illinois power plants. The units evaluated were Wood River 5, Quad Cities 1, and Quad Cities 2. A total of 8 improvement projects were evaluated and all outage data and equations used are included in order to facilitate utility reproduction of the given results. The second purpose is to evaluate the methodology as a useful tool for individual utilities; a number of modifications are suggested.

  5. Selegiline remarkably improved stage 5 treatment-resistant major depressive disorder: a case report

    Directory of Open Access Journals (Sweden)

    Kitaichi Y

    2013-10-01

    Full Text Available Yuji Kitaichi,1 Takeshi Inoue,1 Nobuyuki Mitsui,1 Shin Nakagawa,1 Rie Kameyama,1 Yoshiyuki Hayashishita,1 Tohru Shiga,2 Ichiro Kusumi,1 Tsukasa Koyama1 1Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Sapporo, Japan; 2Department of Nuclear Medicine, Graduate School of Medicine, Hokkaido University, Sapporo, Japan Abstract: We report a case in which selegiline, an irreversible monoamine oxidase B (MAO-B inhibitor, greatly improved depressive symptoms in an adult with stage 5 treatment-resistant major depressive disorder. Four antidepressants and four augmentation therapies had previously been ineffective or intolerable, and electroconvulsive therapy had only a temporary effect. After 20 weeks of treatment with selegiline (10 mg/day, the patient's score on the 17-item Hamilton Depression Rating Scale (HDRS had decreased from 19 to 4 points. [18F]-Fluorodeoxyglucose positron emission tomography (FDG-PET showed increased glucose metabolism in the bilateral basal ganglia after initiating selegiline treatment; blood dopamine levels were also increased after selegiline treatment. These results raise the possibility that selegiline enhances dopaminergic neural transmission in treatment-resistant depression, thus leading to an improvement in depressive symptoms. Keywords: treatment-resistant depression, FDG-PET, glucose metabolism, basal ganglia

  6. Improving reservoir conformance using gelled polymer systems. Annual report, September 15, 1993--September 24, 1994

    Energy Technology Data Exchange (ETDEWEB)

    Green, D.W.; Willhite, G.P.

    1995-07-01

    The objectives of the research program are to (1) identify and develop polymer systems which have potential to improve reservoir conformance of fluid displacement processes, (2) determine the performance of these systems in bulk and in porous media, and (3) develop methods to predict their performance in field applications. The research focuses on three types of aqueous gel systems - a polysaccharide (KUSP1) that gels as a function of pH, a polyacrylamide-chromium(III) system and a polyacrylamide-aluminum citrate system. This report describes work conducted during the second year of a three-year program. Progress was made in the utilization of KUSP1 as a gelling agent. It was shown that gels can be formed in situ in porous media using CO{sub 2} or ester hydrolysis to lower pH. An ester was identified that could be used in field-scale operations. It was determined that KUSP1 will form strong gels when ortho boric acid is added to the system. It was also determined, in cooperation with Abbott Laboratories, that KUSP1 can be produced on a commercial scale. Rheological studies showed that shear rate significantly affects gelation time and gel strength. The effect of rock-fluid interactions at alkaline conditions was examined experimentally and through mathematical modeling. A model was developed that treats non-equilibrium conditions and this is an improvement over previously published models.

  7. Improved Clinical Outcomes of Patients With Type 2 Diabetes Mellitus Utilizing Integrative Medicine: A Case Report

    Science.gov (United States)

    Grise, Diane E.; McAllister, Heath M.

    2015-01-01

    This case report demonstrates a successful approach to managing patients with type 2 diabetes mellitus (DM2). Botanical herbs (including Gymnema sylvestre) and nutrients (including alpha lipoic acid and chromium) were used alongside metformin to help improve insulin sensitization; however, the greatest emphasis of treatment for this patient centered on a low-carbohydrate, whole-foods diet and regular exercise that shifted the focus to the patient's role in controlling their disease. Research on DM2 often focuses on improving drug efficacy while diet and lifestyle are generally overlooked as both a preventive and curative tool. During the 7 months of treatment, the patient's hemoglobin A1c and fasting glucose significantly decreased to within normal ranges and both cholesterol and liver enzyme markers normalized. A significant body of evidence already exists advocating for disease management using various diets, including Mediterranean, low-carb, and low-fat vegan diets; however, no clear dietary standards have been established. This study supports the use of naturopathic medicine as well as dietary and lifestyle changes to develop the most efficacious approach for the treatment of DM2. PMID:25984419

  8. Feed-pump hydraulic performance and design improvement, Phase I: research program design. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Brown, W.H.; Gopalakrishnan, S.; Fehlau, R.; Thompson, W.E.; Wilson, D.G.

    1982-03-01

    As a result of prior EPRI-sponsored studies, it was concluded that a research program should be designed and implemented to provide an improved basis for the design, procurement, testing, and operation of large feed pumps with increased reliability and stability over the full range of operating conditions. This two-volume report contains a research plan which is based on a review of the present state of the art and which defines the necessary R and D program and estimates the benefits and costs of the program. The recommended research program consists of 30 interrelated tasks. It is designed to perform the needed research; to verify the results; to develop improved components; and to publish computer-aided design methods, pump specification guidelines, and a troubleshooting manual. Most of the technology proposed in the research plan is applicable to nuclear power plants as well as to fossil-fired plants. This volume contains appendixes on pump design, cavitation damage, performance testing, hydraulics, two-phase flow in pumps, flow stability, and rotor dynamics.

  9. Housing improvement and self-reported mental distress among council estate residents.

    Science.gov (United States)

    Thomas, Richard; Evans, Sherrill; Huxley, Peter; Gately, Claire; Rogers, Anne

    2005-06-01

    This paper is concerned with how housing improvements instigated either publicly or privately influence the degree of psychological stress reported by council estate residents in South Manchester. Stress is measured on the GHQ12 scale containing standard symptomatic items. Potential sources of variation in this indicator are analysed within a geographical setting where repeated samples of residents were drawn from two adjacent suburban council housing estates before and after the implementation of a single regeneration budget (SRB) housing initiative in late 1999. The residents of one of these estates (Wythenshawe) were targeted by this funding while those in the other (Mersey Bank) were not. The latter, therefore, serve as a control for the effects of the enhanced incidence of housing improvement activity promoted by this SRB. Regression analyses revealed that stress was raised significantly among the SRB residents perhaps on account of the additional environmental nuisance they encountered. The experience of stress among all residents, however, was dominated by measures of personal psychosocial risk and it is argued that future regeneration initiatives should address the manifestation of these risks in the effort to achieve better mental health.

  10. Brace Treatment Can Improve Thoracic Kyphosis During Growth: A Case Report

    Directory of Open Access Journals (Sweden)

    Hans-Rudolf Weiss

    2013-03-01

    Full Text Available Abstract. While in scoliosis bracing today there is evidence that during growth curvatures can be corrected significantly, there is no evidence that the standard of kyphosis bracing we use today may lead to final corrections after weaning off the brace. Case report: A 12-year-old kyphosis patient presented at the office of the author with a curve of 58° in summer 2009. Brace treatment with a modern kyphosis brace was started immediately with an in-brace correction of more than 30 degrees. After one year of treatment the patient had outgrown his first brace, but was still immature. Therefore a new brace was constructed. The curvature was 37° without and 25° in the new brace. This brace was worn for another two years for 16 h/day and weaned off in summer 2012. 6 months later—the patient meanwhile was nearly mature (Risser 4/voice change 2.6 years the final X-ray showed an angle of 38° (normal range of kyphosis angles with full flexibility of the spine. Conclusion: Bracing with small size orthosis in kyphosis patients during growth can lead to an improvement of the curvature angle after the end of growth. The functional limitations there are in severe kyphosis angles can be improved and normalized in some cases.

  11. Improvement of depression after treatment of dural arteriovenous fistula: a case report and a review.

    Science.gov (United States)

    Nakagawa, Minoru; Sugiu, Kenji; Tokunaga, Koji; Sakamoto, Chihoko; Fujiwara, Kenjiro

    2012-01-01

    Patients with dural arteriovenous fistulas (DAVFs) in the transverse-sigmoid sinus suffer from several symptoms: bruit, headache, visual impairment, and so on. But depression is rare in patients with DAVF. The authors reported a rare case presenting the improvement of depression after the treatment of a dural arteriovenous fistula in the left transverse-sigmoid sinus. A 46-year-old male had suffered from depression and was treated with antidepressants at a local hospital for four years. The patient was temporarily laid off due to his depression. Afterwards, he had Gerstmann's syndrome and came to our hospital. A DAVF in the left transverse-sigmoid sinus was demonstrated on the angiogram. The DAVF was successfully treated with endovascular surgery, coil embolization of the isolated diseased sinus through the mastoid emissary vein which was a draining vein from the fistula. After this treatment, his depression as well as Gerstmann's syndrome was improved and the quantity of the antidepressants decreased. The patient returned to work without any antidepressant two years after the treatment. DAVFs might be one of the causes of depression. It may be necessary to evaluate cerebral vessels in patients suffering from depression by using MRA or 3D-CTA even if there are not any abnormal findings on plain CT scans.

  12. Using phrases and document metadata to improve topic modeling of clinical reports.

    Science.gov (United States)

    Speier, William; Ong, Michael K; Arnold, Corey W

    2016-06-01

    Probabilistic topic models provide an unsupervised method for analyzing unstructured text, which have the potential to be integrated into clinical automatic summarization systems. Clinical documents are accompanied by metadata in a patient's medical history and frequently contains multiword concepts that can be valuable for accurately interpreting the included text. While existing methods have attempted to address these problems individually, we present a unified model for free-text clinical documents that integrates contextual patient- and document-level data, and discovers multi-word concepts. In the proposed model, phrases are represented by chained n-grams and a Dirichlet hyper-parameter is weighted by both document-level and patient-level context. This method and three other Latent Dirichlet allocation models were fit to a large collection of clinical reports. Examples of resulting topics demonstrate the results of the new model and the quality of the representations are evaluated using empirical log likelihood. The proposed model was able to create informative prior probabilities based on patient and document information, and captured phrases that represented various clinical concepts. The representation using the proposed model had a significantly higher empirical log likelihood than the compared methods. Integrating document metadata and capturing phrases in clinical text greatly improves the topic representation of clinical documents. The resulting clinically informative topics may effectively serve as the basis for an automatic summarization system for clinical reports. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Embedded Sensors and Controls to Improve Component Performance and Reliability -- Bench-scale Testbed Design Report

    Energy Technology Data Exchange (ETDEWEB)

    Melin, Alexander M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Kisner, Roger A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Drira, Anis [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Reed, Frederick K. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2015-09-01

    Embedded instrumentation and control systems that can operate in extreme environments are challenging due to restrictions on sensors and materials. As a part of the Department of Energy's Nuclear Energy Enabling Technology cross-cutting technology development programs Advanced Sensors and Instrumentation topic, this report details the design of a bench-scale embedded instrumentation and control testbed. The design goal of the bench-scale testbed is to build a re-configurable system that can rapidly deploy and test advanced control algorithms in a hardware in the loop setup. The bench-scale testbed will be designed as a fluid pump analog that uses active magnetic bearings to support the shaft. The testbed represents an application that would improve the efficiency and performance of high temperature (700 C) pumps for liquid salt reactors that operate in an extreme environment and provide many engineering challenges that can be overcome with embedded instrumentation and control. This report will give details of the mechanical design, electromagnetic design, geometry optimization, power electronics design, and initial control system design.

  14. Dragline bucket improvement survey. Final report, September 30, 1977-September 29, 1979

    Energy Technology Data Exchange (ETDEWEB)

    Stilwell, T.; Kelly, H.; Rumbarger, J.; Dowling, M.

    1979-01-01

    An operating dragline bucket receives a lot of abuse. It logs about a million dig cycles every two or three years, all the while operating through abrasive overburden on a round-the-clock basis. It is to the credit of designers, operators and maintenance men alike that these buckets perform so well under such adverse conditions. Comments made in this report are for the purpose of focusing on areas in which further improvements can be made, and in no way are intended to reflect adversely on the generally high quality of bucket design, use and repair. From December 1977 to September 1978, investigators visited nine surface coal mines to review first-hand the techniques and problems associated with dragline equipment. The contractor also conducted some basic analyses regarding bucket geometry and force patterns. The report concludes that: dragline bucket and rigging designs, while traditionally satisfactory, could be bettered in some areas; the major maintenance problem associated with buckets and associated rigging is abrasive wear; the repair costs for associated rigging (primarily chains) can run in excess of 50% of the repair costs for buckets; there is no established engineering information available regarding stresses, forces, soil flow and soil resistance in relation to dragline buckets; present computer monitoring and analysis equipment could, with appropriate modifications, be utilized to yield useful engineering information.

  15. Explanation and elaboration of the SQUIRE (Standards for Quality Improvement Reporting Excellence) Guidelines, V.2.0: examples of SQUIRE elements in the healthcare improvement literature.

    Science.gov (United States)

    Goodman, Daisy; Ogrinc, Greg; Davies, Louise; Baker, G Ross; Barnsteiner, Jane; Foster, Tina C; Gali, Kari; Hilden, Joanne; Horwitz, Leora; Kaplan, Heather C; Leis, Jerome; Matulis, John C; Michie, Susan; Miltner, Rebecca; Neily, Julia; Nelson, William A; Niedner, Matthew; Oliver, Brant; Rutman, Lori; Thomson, Richard; Thor, Johan

    2016-12-01

    Since its publication in 2008, SQUIRE (Standards for Quality Improvement Reporting Excellence) has contributed to the completeness and transparency of reporting of quality improvement work, providing guidance to authors and reviewers of reports on healthcare improvement work. In the interim, enormous growth has occurred in understanding factors that influence the success, and failure, of healthcare improvement efforts. Progress has been particularly strong in three areas: the understanding of the theoretical basis for improvement work; the impact of contextual factors on outcomes; and the development of methodologies for studying improvement work. Consequently, there is now a need to revise the original publication guidelines. To reflect the breadth of knowledge and experience in the field, we solicited input from a wide variety of authors, editors and improvement professionals during the guideline revision process. This Explanation and Elaboration document (E&E) is a companion to the revised SQUIRE guidelines, SQUIRE 2.0. The product of collaboration by an international and interprofessional group of authors, this document provides examples from the published literature, and an explanation of how each reflects the intent of a specific item in SQUIRE. The purpose of the guidelines is to assist authors in writing clearly, precisely and completely about systematic efforts to improve the quality, safety and value of healthcare services. Authors can explore the SQUIRE statement, this E&E and related documents in detail at http://www.squire-statement.org. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  16. Annual Progress Report Fish Research Project Oregon : Project title, Evaluation of Habitat Improvements -- John Day River.

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, Erik A.

    1984-01-01

    This report summarizes data collected in 1983 to evaluate habitat improvements in Deer, Camp, and Clear creeks, tributaries of the John Day River. The studies are designed to evaluate changes in abundance of spring chinook and summer steelhead due to habitat improvement projects and to contrast fishery benefits with costs of construction and maintenance of each project. Structure types being evaluated are: (1) log weirs, rock weirs, log deflectors, and in stream boulders in Deer Creek; (2) log weirs in Camp Creek; and (3) log weir-boulder combinations and introduced spawning gravel in Clear Creek. Abundance of juvenile steelhead ranged from 16% to 119% higher in the improved (treatment) area than in the unimproved (control) area of Deer Creek. However, abundance of steelhead in Camp Creek was not significantly different between treatment and control areas. Chinook and steelhead abundance in Clear Creek was 50% and 25% lower, respectively in 1983, than the mean abundance estimated in three previous years. The age structure of steelhead was similar between treatment and control areas in Deer and Clear creeks. The treatment area in Camp Creek, however, had a higher percentage of age 2 and older steelhead than the control. Steelhead redd counts in Camp Creek were 36% lower in 1983 than the previous five year average. Steelhead redd counts in Deer Creek were not made in 1983 because of high streamflows. Chinook redds counted in Clear Creek were 64% lower than the five year average. Surface area, volume, cover, and spawning gravel were the same or higher than the corresponding control in each stream except in Deer Creek where there was less available cover and spawning gravel in sections with rock weirs and in those with log deflectors, respectively. Pool:riffle ratios ranged from 57:43 in sections in upper Clear Creek with log weirs to 9:91 in sections in Deer Creek with rock weirs. Smolt production following habitat improvements is estimated for each stream

  17. Requirements and standards facilitating quality improvement for reporting systems in gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement.

    Science.gov (United States)

    Bretthauer, Michael; Aabakken, Lars; Dekker, Evelien; Kaminski, Michal F; Rösch, Thomas; Hultcrantz, Rolf; Suchanek, Stepan; Jover, Rodrigo; Kuipers, Ernst J; Bisschops, Raf; Spada, Cristiano; Valori, Roland; Domagk, Dirk; Rees, Colin; Rutter, Matthew D

    2016-03-01

    To develop standards for high quality in gastrointestinal (GI) endoscopy, the European Society of Gastrointestinal Endoscopy (ESGE) has established the ESGE Quality Improvement Committee. A prerequisite for quality assurance and improvement for all GI endoscopy procedures is state-of-the-art integrated digital reporting systems for standardized documentation of the procedures. The current paper describes the ESGE's viewpoints on the requirements for high-quality endoscopy reporting systems in GI endoscopy. Recommendations 1 Endoscopy reporting systems must be electronic. 2 Endoscopy reporting systems should be integrated into hospitals' patient record systems. 3 Endoscopy reporting systems should include patient identifiers to facilitate data linkage to other data sources. 4 Endoscopy reporting systems shall restrict the use of free-text entry to a minimum, and be based mainly on structured data entry. 5 Separate entry of data for quality or research purposes is discouraged. Automatic data transfer for quality and research purposes must be facilitated. 6 Double entry of data by the endoscopist or associate personnel is discouraged. Available data from outside sources (administrative or medical) must be made available automatically. 7 Endoscopy reporting systems shall facilitate the inclusion of information on histopathology of detected lesions, patient satisfaction, adverse events, and surveillance recommendations. 8 Endoscopy reporting systems must facilitate easy data retrieval at any time in a universally compatible format. 9 Endoscopy reporting systems must include data fields for key performance indicators as defined by quality improvement committees. 10 Endoscopy reporting systems must facilitate changes in indicators and data entry fields as required by professional organizations.

  18. Reporting systems in gastrointestinal endoscopy: Requirements and standards facilitating quality improvement: European Society of Gastrointestinal Endoscopy position statement.

    Science.gov (United States)

    Bretthauer, Michael; Aabakken, Lars; Dekker, Evelien; Kaminski, Michal F; Rösch, Thomas; Hultcrantz, Rolf; Suchanek, Stepan; Jover, Rodrigo; Kuipers, Ernst J; Bisschops, Raf; Spada, Cristiano; Valori, Roland; Domagk, Dirk; Rees, Colin; Rutter, Matthew D

    2016-04-01

    To develop standards for high quality of gastrointestinal endoscopy, the European Society of Gastrointestinal Endoscopy (ESGE) has established the ESGE Quality Improvement Committee. A prerequisite for quality assurance and improvement for all gastrointestinal endoscopy procedures is state-of-the-art integrated digital reporting systems for standardized documentation of the procedures. The current paper describes the ESGE's viewpoints on requirements for high-quality endoscopy reporting systems. The following recommendations are issued: Endoscopy reporting systems must be electronic.Endoscopy reporting systems should be integrated into hospital patient record systems.Endoscopy reporting systems should include patient identifiers to facilitate data linkage to other data sources.Endoscopy reporting systems shall restrict the use of free text entry to a minimum, and be based mainly on structured data entry.Separate entry of data for quality or research purposes is discouraged. Automatic data transfer for quality and research purposes must be facilitated.Double entry of data by the endoscopist or associate personnel is discouraged. Available data from outside sources (administrative or medical) must be made available automatically.Endoscopy reporting systems shall enable the inclusion of information on histopathology of detected lesions; patient's satisfaction; adverse events; surveillance recommendations.Endoscopy reporting systems must facilitate easy data retrieval at any time in a universally compatible format.Endoscopy reporting systems must include data fields for key performance indicators as defined by quality improvement committees.Endoscopy reporting systems must facilitate changes in indicators and data entry fields as required by professional organizations.

  19. Lake Roosevelt Rainbow Trout Habitat/Passage Improvement Project, Annual Report 2001-2002.

    Energy Technology Data Exchange (ETDEWEB)

    Sears, Sheryl

    2003-01-01

    The construction of Chief Joseph and Grand Coulee Dams completely and irrevocably blocked anadromous fish migrations to the Upper Columbia River. Historically this area hosted vast numbers of salmon returning to their natal waters to reproduce and die. For the native peoples of the region, salmon and steelhead were a principle food source, providing physical nourishment and spiritual sustenance, and contributing to the religious practices and the cultural basis of tribal communities. The decaying remains of spawned-out salmon carcasses contributed untold amounts of nutrients into the aquatic, aerial, and terrestrial ecosystems of tributary habitats in the upper basin. Near the present site of Kettle Falls, Washington, the second largest Indian fishery in the state existed for thousands of years. Returning salmon were caught in nets and baskets or speared on their migration to the headwater of the Columbia River in British Columbia. Catch estimates at Kettle Falls range from 600,000 in 1940 to two (2) million around the turn of the century (UCUT, Report No.2). The loss of anadromous fish limited the opportunities for fisheries management and enhancement exclusively to those actions addressed to resident fish. The Lake Roosevelt Rainbow Trout Habitat/Passage Improvement Project is a mitigation project intended to enhance resident fish populations and to partially mitigate for anadromous fish losses caused by hydropower system impacts. This substitution of resident fish for anadromous fish losses is considered in-place and out-of-kind mitigation. Upstream migration and passage barriers limit the amount of spawning and rearing habitat that might otherwise be utilized by rainbow trout. The results of even limited stream surveys and habitat inventories indicated that a potential for increased natural production exists. However, the lack of any comprehensive enhancement measures prompted the Upper Columbia United Tribes Fisheries Center (UCUT), Colville Confederated

  20. Lake Roosevelt Rainbow Trout Habitat/Passage Improvement Project, Annual Report 2002-2003.

    Energy Technology Data Exchange (ETDEWEB)

    Sears, Sheryl

    2004-01-01

    The construction of Chief Joseph and Grand Coulee Dams completely and irrevocably blocked anadromous fish migrations to the Upper Columbia River. Historically this area hosted vast numbers of salmon returning to their natal waters to reproduce and die. For the native peoples of the region, salmon and steelhead were a principle food source, providing physical nourishment and spiritual sustenance, and contributing to the religious practices and the cultural basis of tribal communities. The decaying remains of spawned-out salmon carcasses contributed untold amounts of nutrients into the aquatic, aerial, and terrestrial ecosystems of tributary habitats in the upper basin. Near the present site of Kettle Falls, Washington, the second largest Indian fishery in the state existed for thousands of years. Returning salmon were caught in nets and baskets or speared on their migration to the headwater of the Columbia River in British Columbia. Catch estimates at Kettle Falls range from 600,000 in 1940 to two (2) million around the turn of the century (UCUT, Report No.2). The loss of anadromous fish limited the opportunities for fisheries management and enhancement exclusively to those actions addressed to resident fish. The Lake Roosevelt Rainbow Trout Habitat/Passage Improvement Project is a mitigation project intended to enhance resident fish populations and to partially mitigate for anadromous fish losses caused by hydropower system impacts. This substitution of resident fish for anadromous fish losses is considered in-place and out-of-kind mitigation. Upstream migration and passage barriers limit the amount of spawning and rearing habitat that might otherwise be utilized by rainbow trout. The results of even limited stream surveys and habitat inventories indicated that a potential for increased natural production exists. However, the lack of any comprehensive enhancement measures prompted the Upper Columbia United Tribes Fisheries Center (UCUT), Colville Confederated

  1. Federally Sponsored Research at Educational Institutions: A Need for Improved Accountability. Report by the U.S. General Accounting Office.

    Science.gov (United States)

    General Accounting Office, Washington, DC.

    This report discusses federally sponsored research at educational institutions and suggests ways to improve accountability for these funds. The following suggestions are made for minimizing problems presented in this report: (1) development of more definitive cost principles for both the institutions and the Federal auditors to follow; (2) more…

  2. CSRA CESA Project for Incremental Improvement in Career Education. Final Report, October 1, 1978, to September 30, 1979.

    Science.gov (United States)

    Harper, Margaret T.

    This document contains the final and evaluation reports of a Central Savannah River Area Cooperative Educational Services Agency (CSRA CESA) career education project to effect incremental improvements in elementary, junior high, and senior high schools in the Columbia County School System. The final report describes these major activities:…

  3. Improvements in tongue strength and pressure-generation precision following a tongue-pressure training protocol in older individuals with dysphagia: Three case reports

    Directory of Open Access Journals (Sweden)

    Erin M Yeates

    2008-12-01

    Full Text Available Erin M Yeates1, Sonja M Molfenter1, Catriona M Steele1,2,3,41Toronto Rehabilitation Institute, Toronto, Canada; 2Department of Speech-Language Pathology, University of Toronto, Toronto, Canada; 3Canadian Institutes of Health Research New Investigator in Aging; 4Bloorview Kids Rehab, Toronto, CanadaAbstract: Dysphagia, or difficulty swallowing, often occurs secondary to conditions such as stroke, head injury or progressive disease, many of which increase in frequency with advancing age. Sarcopenia, the gradual loss of muscle bulk and strength, can place older individuals at greater risk for dysphagia. Data are reported for three older participants in a pilot trial of a tongue-pressure training therapy. During the experimental therapy protocol, participants performed isometric strength exercises for the tongue as well as tongue pressure accuracy tasks. Biofeedback was provided using the Iowa Oral Performance Instrument (IOPI, an instrument that measures tongue pressure. Treatment outcome measures show increased isometric tongue strength, improved tongue pressure generation accuracy, improved bolus control on videofluoroscopy, and improved functional dietary intake by mouth. These preliminary results indicate that, for these three adults with dysphagia, tongue-pressure training was beneficial for improving both instrumental and functional aspects of swallowing. The experimental treatment protocol holds promise as a rehabilitative tool for various dysphagia populations.Keywords: speech-language pathology, dysphagia, rehabilitation, aging, strength, accuracy

  4. The a3 problem solving report: a 10-step scientific method to execute performance improvements in an academic research vivarium.

    Directory of Open Access Journals (Sweden)

    James A Bassuk

    Full Text Available The purpose of this study was to illustrate the application of A3 Problem Solving Reports of the Toyota Production System to our research vivarium through the methodology of Continuous Performance Improvement, a lean approach to healthcare management at Seattle Children's (Hospital, Research Institute, Foundation. The Report format is described within the perspective of a 10-step scientific method designed to realize measurable improvements of Issues identified by the Report's Author, Sponsor and Coach. The 10-step method (Issue, Background, Current Condition, Goal, Root Cause, Target Condition, Countermeasures, Implementation Plan, Test, and Follow-up was shown to align with Shewhart's Plan-Do-Check-Act process improvement cycle in a manner that allowed for quantitative analysis of the Countermeasure's outcomes and of Testing results. During fiscal year 2012, 9 A3 Problem Solving Reports were completed in the vivarium under the teaching and coaching system implemented by the Research Institute. Two of the 9 reports are described herein. Report #1 addressed the issue of the vivarium's veterinarian not being able to provide input into sick animal cases during the work day, while report #7 tackled the lack of a standard in keeping track of weekend/holiday animal health inspections. In each Report, a measurable Goal that established the basis for improvement recognition was present. A Five Whys analysis identified the Root Cause for Report #1 as historical work patterns that existed before the veterinarian was hired on and that modern electronic communication tools had not been implemented. The same analysis identified the Root Cause for Report #7 as the vivarium had never standardized the process for weekend/holiday checks. Successful outcomes for both Reports were obtained and validated by robust audit plans. The collective data indicate that vivarium staff acquired a disciplined way of reporting on, as well as solving, problems in a manner

  5. Surgeon-Reported Needs for Improved Training in Identifying and Managing Free Flap Compromise.

    Science.gov (United States)

    McMillan, Catherine; D'Hondt, Veerle; Marshall, Alexandra H; Binhammer, Paul; Lipa, Joan; Snell, Laura

    2017-07-01

    Background This study examined the need for improved training in the identification and management of free flap (FF) compromise and assessed a potential role for simulated scenario training. Methods Online needs assessment surveys were completed by plastic surgeons and a subsample with expertise in microsurgery education participated in focus groups. Data were analyzed using descriptive statistics and mixed qualitative methods. Results In this study, 77 surgeons completed surveys and 11 experts participated in one of two focus groups. Forty-nine (64%) participants were educators, 65 and 45% of which reported having an insufficient volume of FF cases to adequately teach the management and identification of compromise, respectively. Forty-three percent of educators felt that graduating residents are not adequately prepared to manage FF compromise independently. Exposure to normal and abnormal FF cases was felt to be critical for effective training by focus group participants. Experts identified low failure rates, communication issues, and challenging teaching conditions as current barriers to training. Most educators (74%) felt that simulated scenario training would be "very useful" or "extremely useful" to current residents. Focus groups highlighted the need for a widely accepted algorithm for re-exploration and salvage on which to base the development of a training adjunct consisting of simulated scenarios. Conclusion Trainee exposure to FF compromise is inadequate in existing plastic surgery programs. Early exposure, high case volume, and a standardized algorithmic approach to management with a focus on decision making may improve training. Simulated scenario training may be valuable in addressing current barriers. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  6. Active music therapy improves cognition and behaviour in chronic vascular encephalopathy: a case report.

    Science.gov (United States)

    Giovagnoli, Anna Rita; Oliveri, Serena; Schifano, Letizia; Raglio, Alfredo

    2014-02-01

    This study describes the effects of active music therapy (AMT) on cognition and behaviour in chronic vascular encephalopathy. A single case study investigated different cognitive and psycho-behavioural changes after AMT. An adult patient with memory, attention, and verbal fluency deficits associated with Vascular Cognitive Impairment-No Dementia (VCI-ND) was treated. A four-months AMT course was based on creative and interactive music playing. Sixteen sessions were conducted simultaneously to the pharmacological therapy. Cognitive performances, mood, interpersonal interactions, and perceived abilities were assessed using standardized neuropsychological and psycho-behavioural measurements. At baseline, the patient reported a tendency to feel tense, nervous, and angry and difficulties in memory and visuospatial performances, frequently accompanied by attention drops. The social network was a habitual component of the patient's life, but not a source of sharing of personal experiences, safety or comfort. Neuropsychological tests showed deficits in object and figure naming, verbal fluency, short and long-term verbal memory, short-term spatial memory, selective attention, and visuomotor coordination. After AMT, the cognitive profile significantly improved in attention, visuomotor coordination, and verbal and spatial memory. Such positive changes were confirmed at the three-months follow-up. An increase of the interpersonal interactions and consistent reduction of anxiety were also observed. In selected patients with VCI-ND, a well-structured AMT intervention added to standard therapy may contribute in determining a stable improvement of cognitive and psycho-behavioural aspects. Controlled studies are needed to confirm these promising results. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Comprehensive approach to improving maternal health and achieving MDG 5: report from the mountains of Lesotho.

    Directory of Open Access Journals (Sweden)

    Hind Satti

    Full Text Available BACKGROUND: Although it is now widely recognized that reductions in maternal mortality and improvements in women's health cannot be achieved through simple, vertical strategies, few programs have provided successful models for how to integrate services into a comprehensive program for maternal health. We report our experience in rural Lesotho, where Partners In Health (PIH in partnership with the Ministry of Health and Social Welfare implemented a program that provides comprehensive care of pregnant women from the community to the clinic level. METHODS: Between May and July 2009, PIH trained 100 women, many of whom were former traditional birth attendants, to serve as clinic-affiliated maternal health workers. They received performance-based incentives for accompanying pregnant women during antenatal care (ANC visits and facility-based delivery. A nurse-midwife provided ANC and delivery care and supervised the maternal health workers. To overcome geographic barriers to delivering at the clinic, women who lived far from the clinic stayed at a maternal lying-in house prior to their expected delivery dates. We analyzed data routinely collected from delivery and ANC registers to compare service utilization before and after implementation of the program. RESULTS: After the establishment of the program, the average number first ANC visits increased from 20 to 31 per month. The clinic recorded 178 deliveries in the first year of the program and 216 in the second year, compared to 46 in the year preceding the program. During the first two years of the program, 49 women with complications were successfully transported to the district hospital, and no maternal deaths occurred among the women served by the program. CONCLUSIONS: Our results demonstrate that it is possible to achieve dramatic improvements in the utilization of maternal health services and facility-based delivery by strengthening human resource capacity, implementing active follow-up in the

  8. Endorsement for improving the quality of reports on randomized controlled trials of traditional medicine journals in Korea: a systematic review.

    Science.gov (United States)

    Choi, Jiae; Jun, Ji Hee; Kang, Byoung Kab; Kim, Kun Hyung; Lee, Myeong Soo

    2014-11-05

    The aim of this study was to assess the endorsement of reporting guidelines in Korean traditional medicine (TM) journals by reviewing their instructions to authors. We examined the instructions to authors in all of the TM journals published in Korea to assess the appropriate use of reporting guidelines for research studies. The randomized controlled trials (RCTs) published after 2010 in journals that endorsed reporting guidelines were obtained. The reporting quality was assessed using the following guidelines: the 38-item Consolidated Standards of Reporting Trials (CONSORT) statement for non-pharmacological trials (NPT); the 17-item Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) statement, instead of the 5-item CONSORT for acupuncture trials; and the 22-item CONSORT extensions for herbal medicine trials. The overall item score was calculated and expressed as a proportion.One journal that endorsed reporting guidelines was identified. Twenty-nine RCTs published in this journal after 2010 met the selection criteria. General editorial policies such as those of the International Committee of Medical Journal Editors (ICMJE) were endorsed by 15 journals. In each of the CONSORT-NPT articles, 21.6 to 56.8% of the items were reported, with an average of 11.3 items (29.7%) being reported. In the 24 RCTs (24/29, 82.8%) appraised using the STRICTA items, an average of 10.6 items (62.5%) were addressed, with a range of 41.2 to 100%. For the herbal intervention reporting, 17 items (77.27%) were reported. In the RCT studies before and after the endorsement of CONSORT and STRICTA guidelines by each journal, all of the STRICTA items had significant improvement, whereas the CONSORT-NPT items improved without statistical significance.The endorsement of reporting guidelines is limited in the TM journals in Korea. Authors should adhere to the reporting guidelines, and editorial departments should refer authors to the various reporting guidelines to

  9. Greater omentum in reconstruction of refractory wounds

    Institute of Scientific and Technical Information of China (English)

    沈余明; 沈祖尧

    2003-01-01

    Objective: To evaluate the clinical efficacy of greater omentum in reconstruction of refractory wounds. Methods: From August 1988 to May 2001, 20 patients with refractory wound underwent pedicle or microvascular free transfer of the greater omentum. Indications of surgery were electrical injury of the wrist and hand in 9 patients, electrical injury of the scalp and cranial bones in 3, avulsion injury of the scalp in 2, radiation-related ulcer of the chest wall in 2, ulcer and osteomyelitis following resection of the sternum sarcoma in 1, electrical injury of the abdomen in 1, bone and soft tissue defects following compound fracture of the leg in 1, and extensive scar and ulcer of the leg and footdrop following trauma in 1. Severe infection and extensive tissue necrosis were present prior to surgical operation in 12 patients. Eleven patients were treated with pedicled omental flaps, and 9 patients with free omental flaps. The size of the omental flaps ranged from 20 cm×12 cm to 38 cm×23 cm. Results: All the omental flaps survived. Healing at the first intention of the wounds was achieved in 17 cases. The on-top skin grafts resulted in partial necrosis of lipid liquefaction developed in the omentum and healed with dressing change in 2 cases. A sinus tract of osteomyelitis occurred in one case and healed after delayed excision of the necrosed bone. Follow-up study of all cases from 3 to 24 months showed no recurrent wounds and post-operative abdominal complication. Recovery with acceptable appearance and restoration of function was satisfactory. Conclusions: Greater omentum provides a well-vascularized tissue with lymphatic ducts for wound coverage. It has strong resistance against infection. It is very malleable and can be molded easily. Therefore it is an ideal tissue in filling cavities and repairing defects, especially in covering large and irregular defects that can not be treated with skin or muscle flaps.

  10. Interspecific hybridization between greater kudu and nyala.

    Science.gov (United States)

    Dalton, Desiré L; Tordiffe, Adrian; Luther, Ilse; Duran, Assumpta; van Wyk, Anna M; Brettschneider, Helene; Oosthuizen, Almero; Modiba, Catherine; Kotzé, Antoinette

    2014-06-01

    Hybridization of wildlife species, even in the absence of introgression, is of concern due to wasted reproductive effort and a reduction in productivity. In this study we detail an accidental mating between a female nyala (Tragelaphus angasii) and a male greater kudu (T. strepsiceros). The hybrid was phenotypically nyala and was identified as such based on mitochondrial DNA. Further genetic analysis based on nine microsatellite markers, chromosome number and chromosome morphology however, confirmed its status as an F1 hybrid. Results obtained from a reproductive potential assessment indicated that this animal does not have the potential to breed successfully and can be considered as sterile.

  11. 老年腹膜透析患者改良腹透置管术在预防大网膜包裹中的应用%Clinical efficiency of application of improved drain tube insertion in the prevention of greater omentum package in elderly patients with peritoneal dialysis

    Institute of Scientific and Technical Information of China (English)

    雷红英; 周盛起; 徐妙娟; 蒋苗芳; 郑雪俭

    2016-01-01

    Objective To investigate the effects of improved dialysis catheter in the prevention of omental wrap in patients with postoperative dialysis catheter.Methods A total of 72 patients were divided into experimental group(37 cases)and control group(35 cases).The experimental group was treated by an improved dialysis catheter combined with traditional dialysis catheter.22 patients with a great quantity of greater omentum in experimental group were treated with improved dialysis catheter,namely,tying 3 to 5 knots with 7th line on the large greater omentum to draw the omentum.The control group was treated with traditional dialysis catheter.The routine dialysate measurement,blood routine,serum creatinine,urea nitrogen,C-reactive protein were compared between two groups,and complications such as omental wrapping,perioperative peritonitis,ileus,and peritoneal fluid leakage were observed.Results Compared with the control group,the incidence of greater omental wrap in the experimental group was significantly reduced(P<0.05).No significant differences in other parameters were found,including WBC,hemoglobin,Scr,BUN,hs-CRP,karyocyte count of peritoneal dialysate,over flow discharge of peritoneal dialysis.Conclusions For elderly peritoneal dialysis patients with a great quantity of greater omentum,the improved dialysis catheter can effectively prevent the occurrence of postoperative complication of omental wrapping.And it is simple to operate,which is of great clinical application value.%目的 通过改良腹透置管术观察术后大网膜包裹情况,探讨老年腹膜透析患者改良腹透置管术在预防大网膜包裹中的作用. 方法 72例患者分成试验组(37例)和对照组(35例),试验组在传统腹透置管术基础上,对于术中可见到大量大网膜的22例患者,进行改良腹透置管术,即在其大网膜上予7号线打结3~5个以吸引大网膜;对照组进行传统腹透置管术;比较两组腹透液常规、血常规、血肌酐、尿

  12. Improved solid oxide fuel cell stacks: Power density, durability and modularity. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Lund Frandsen, H.; Kiebach, W.R.; Hoeegh, J. (Technical Univ. of Denmark. Risoe National Lab. for Sustainable Energy, Roskilde (Denmark)) (and others)

    2010-10-15

    This report presents the work performed within the project PSO2009-1-10207 during the period from 01-04-2009 - 31-06-2010. The report is divided into three parts covering the three work packages: Stack components; Stacks and durability; and Large SOFC systems: modularity and scalability. The project contains 38 milestones and all milestones in the project have been either fully or partly fulfilled. Two major achievements within this project concern the robustness towards dynamic operations and implementation of cells with more active cathodes: Within this project tools to evaluate and test SOFC stacks with respect to robustness during dynamic operations has been developed. From stack tests performed under dynamic conditions it was observed that the effect on degradation and failure seemed to be very little. The thermo-mechanical models developed in this project in combination with the dynamic stack model was used in combination to understand why. The results clearly showed that the hardest stress field applied to the cells arises from the steady state operating point rather than from the dynamic conditions. This is a very promising result concerning the fact that especially small CHP units in a commercial system will experience dynamic conditions from load cycling and thermal cycling. A new type of cell with a more active cathode has been formulated and introduced into the TOFC stacks in this project. The aim was to improve the effect of the stack by 25 %. However, compared to a standard stack with the ''old'' cells, the stack effect was increased by 44% - from a cross flow stack with standard 2G cells to a cross flow stack with 2.5G cells. The new type of cells also show an excellent stability towards moisture in the cathode feed, and a stack with 2.5G cells has been tested for 12.000 hrs with a degradation rate of 30 mOMEGAcm2/1000 hr. (Author)

  13. Nuclear medicine incident reporting in Australia: control charts and notification rates inform quality improvement.

    Science.gov (United States)

    Larcos, G; Collins, L T; Georgiou, A; Westbrook, J I

    2015-06-01

    Australia has a statutory incident reporting system for radiopharmaceutical maladministrations, but additional research into registry data is required for the purpose of quality improvement in nuclear medicine. We (i) used control charts to identify factors contributing to special cause variation (indicating higher than expected rates) in maladministrations and (ii) evaluated the impact of heterogeneous notification criteria and extent of underreporting among jurisdictions and individual facilities, respectively. Anonymised summaries of Australian Radiation Incident Register reports permitted calculation of national monthly maladministration notification rates for 2007-2012 and preparation of control charts. Multivariate logistic regression assessed the association of population, insurance and regulatory characteristics with maladministration notifications in each Australian State and Territory. Maladministration notification rates from two facilities with familiarity of notification processes and commitment to radiation protection were compared with those elsewhere. Special cause variation occurred in only 3 months, but contributed to 21% of all incidents (42 of 197 patients), mainly because of 'clusters' of maladministrations (n = 24) arising from errors in bulk radiopharmaceutical dispensing. Maladministration notification rates varied significantly between jurisdictions (0 to 12.2 maladministrations per 100 000 procedures (P < 0.05)) and individual facilities (31.7 vs 5.8 per 100 000; χ(2) = 40; 1 degree of freedom, P < 0.001). Unexpected increases in maladministration notifications predominantly relate to incident 'clusters' affecting multiple patients. The bulk preparation of radiopharmaceuticals is a vulnerable process and merits additional safeguards. Maladministration notification rates in Australia are heterogeneous. Adopting uniform maladministration notification criteria among States and Territories and methods to overcome underreporting are

  14. Greater trochanteric stippling in trisomy 7p

    Energy Technology Data Exchange (ETDEWEB)

    Wilde, Justin R. [Starship Children' s Hospital, Department of Paediatrics, Auckland (New Zealand); Teele, Rita L. [Starship Children' s Hospital, Department of Radiology, Auckland (New Zealand); Aftimos, Salim [Auckland City Hospital, Northern Regional Genetic Services, Auckland, Private Bag 92024 (New Zealand)

    2006-08-15

    Trisomy 7p is a rare condition involving partial or complete duplication of the short arm of chromosome 7. Radiological features include large fontanelles, widened sutures, dolicocephaly and asymmetrical skull. We report a new radiological finding of punctate calcifications in the region of femoral trochanters. This finding has not previously been reported with chromosome 7p duplication. (orig.)

  15. Improvements of the cash-flow statement control function in financial reporting

    Directory of Open Access Journals (Sweden)

    Metka Duhovnik

    2008-06-01

    Full Text Available On the basis of deductive considerations applying professional judgement, the article focuses on the additional value of accounting information that can be given to the users of fi nancial statements by a properly prepared statement of cash fl ows. It is based on the fi nding that the professional literature is inconsistent in distinguishing liquidity and profi tability information, and consequently also in distinguishing between the ratios calculated on that basis. It therefore stimulates an improvement in the quality of accounting information with a direct statement of cash fl ows, based on tracing instead of calculating the actual cash fl ow. On the basis of fi nancial statements, including a direct statement of cash fl ows, the ratio analysis of fi nancial statements should be approached from both aspects of profi tability and cash return. The cash fl ow ratios would serve as a control mechanism over the assumptions used when preparing the balance sheet and income statement within the chosen financial reporting framework.

  16. Assessment of the Fishery Improvement Opportunities on the Pend Oreille River, 1988 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Barber, Michael R.; Willms, Roger A.; Scholz, Allan T.

    1989-10-01

    The purpose of this study is to assess the fishery improvement opportunities on the Box Canyon portion of the Pend Oreille River. This report contains the findings of the first year of the study. Chinook salmon (Oncorhynchus tshawytscha (Walbaum)) and steelhead (Oncorhynchus mykiss (Richardson)) were present in the Pend Oreille River prior to the construction of Grand Coulee Dam. The river also contained native cutthroat trout (Oncorhynchus clarki (Richardson)), bull trout (Salvelinus confluentus (Walbaum)) and mountain whitefish (Prosopium williamsoni (Girard)). Rainbow trout were planted in the river and some grew to lengths in excess of 30 inches. With the construction of Box Canyon Dam, in 1955, the most productive section of the river was inundated. Following the construction of the dam the trout fishery declined and the populations of spiny ray fish and rough fish increased. The objectives of the first year of the study were to determine the relative abundance of each species in the river and sloughs; the population levels in fish in the river and four selected tributaries; fish growth rates; the feeding habits and abundance of preferred prey; the migration patterns; and the total fishing pressure, catch per unit effort, and total harvest by conducting a year-round creel survey. 132 refs.

  17. Assessment of the Fishery Improvement Opportunities on the Pend Oreille River, 1989 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Barber, Michael R.; Renberg, Becky L.; Vella, John J.

    1990-09-01

    The purpose of this study was to assess the fishery improvement opportunities on the Box Canyon portion of the Pend Oreille River. This three year study was initiated as part of the Northwest Power Planning Council's 1987 Columbia River Basin Fish and Wildlife Program. This report contains the findings of the second year of the study. Currently, yellow perch (Perca flavescens (Mitchill)) are the predominant fish species in the river and largemouth bass (Micropterus salmoides (Lacepede)) are the predominant sport fish. The objectives of the second year of the study were to determine: the relative abundance of each species in the river and sloughs; the population levels in five selected tributaries and, if possible, for fish in the river and sloughs; fish growth rates; the feeding habits and abundance of preferred prey; migration patterns; and the total fishing pressure, catch-per-unit-effort, and total harvest by conducting a year-round creel survey. 55 refs., 7 figs., 154 tabs.

  18. National Trauma Database (NTrD)--improving trauma care: first year report.

    Science.gov (United States)

    Sabariah, F J; Ramesh, N; Mahathar, A W

    2008-09-01

    The first Malaysian National Trauma Database was launched in May 2006 with five tertiary referral centres to determine the fundamental data on major trauma, subsequently to evaluate the major trauma management and to come up with guidelines for improved trauma care. A prospective study, using standardized and validated questionnaires, was carried out from May 2006 till April 2007 for all cases admitted and referred to the participating hospitals. During the one year period, 123,916 trauma patients were registered, of which 933 (0.75%) were classified as major trauma. Patients with blunt injury made up for 83.9% of cases and RTA accounted for 72.6% of injuries with 64.9% involving motorcyclist and pillion rider. 42.8% had severe head injury with an admission Glasgow Coma Scale (GCS) of 3-8 and the Revised Trauma Score (RTS) of 5-6 were recorded in 28.8% of patients. The distribution of Injury Severity Score (ISS) showed that 42.9% of cases were in the range of 16-24. Only 1.9% and 6.3% of the patients were reviewed by the Emergency Physician and Surgeon respectively. Patients with admission systolic blood pressure of less than 90 mmHg had a death rate of 54.6%. Patients with severe head injury (GCS report has successfully demonstrated its significance in giving essential data on major trauma in Malaysia, however further expansion of the study may reflect more comprehensive trauma database in this country.

  19. Wire rope improvement program. Fiscal years 1979 to 1980. Interim report

    Energy Technology Data Exchange (ETDEWEB)

    Morgenstern, M.H.; Alzheimer, J.M.; Anderson, W.E.; Beeman, G.H.; Rice, R.C.; Strope, L.A.; Werry, E.V.

    1980-08-01

    This report describes the work performed by the Pacific Northwest Laboratory and its subcontractor Battelle Columbus Laboratories on the Wire Rope Improvement Program during FY-1979 and the first half of FY80. The program, begun in 1975 by the US Bureau of Mines, was transferred to the US Department of Energy (DOE) on October 1, 1978. Since that time, the DOE's Division of Solid Fuels Mining and Preparation has sponsored the program. To address identified problems and provide information from which behavior of large-diameter wire rope could be better understood, efforts in the following areas were undertaken: large-diameter rope testing, small-diameter rope testing, data analysis and evaluation, wear and failure analysis, load sensor development, and technology transfer. Wire ropes 3/4 in., 1-1/2 in., and 3 in. in diameter were tested in bend-over sheave fatigue. Attempts were made to correlate fatigue life of these ropes. Limited field rope data were available to compare with test results. The modes of failure and wear in laboratory ropes were compared with those seen previously in field ropes. A load sensor was designed and ordered in FY79. It will be connected to the drag rope and jewelry of working draglines during the summer of FY80. Technology transfer was achieved through disseminating written materials, conducting seminars, holding a national symposium, and filming of selected field operations.

  20. Embedded Sensors and Controls to Improve Component Performance and Reliability: Conceptual Design Report

    Energy Technology Data Exchange (ETDEWEB)

    Kisner, Roger A [ORNL; Melin, Alexander M [ORNL; Burress, Timothy A [ORNL; Fugate, David L [ORNL; Holcomb, David Eugene [ORNL; Wilgen, John B [ORNL; Miller, John M [ORNL; Wilson, Dane F [ORNL; Silva, Pamela C [ORNL; Whitlow, Lynsie J [ORNL; Peretz, Fred J [ORNL

    2012-10-01

    The overall project objective is to demonstrate improved reliability and increased performance made possible by deeply embedding instrumentation and controls (I&C) in nuclear power plant components. The project is employing a highly instrumented canned rotor, magnetic bearing, fluoride salt pump as its I&C technology demonstration vehicle. The project s focus is not primarily on pump design, but instead is on methods to deeply embed I&C within a pump system. However, because the I&C is intimately part of the basic millisecond-by-millisecond functioning of the pump, the I&C design cannot proceed in isolation from the other aspects of the pump. The pump will not function if the characteristics of the I&C are not embedded within the design because the I&C enables performance of the basic function rather than merely monitoring quasi-stable performance. Traditionally, I&C has been incorporated in nuclear power plant (NPP) components after their design is nearly complete; adequate performance was obtained through over-design. This report describes the progress and status of the project and provides a conceptual design overview for the embedded I&C pump.

  1. Octreotide improves early dumping syndrome potentially through incretins: a case report.

    Science.gov (United States)

    Sato, Daisuke; Morino, Katsutaro; Ohashi, Natsuko; Ueda, Emi; Ikeda, Kazuhiro; Yamamoto, Hideka; Ugi, Satoshi; Yamamoto, Hiroshi; Araki, Shinichi; Maegawa, Hiroshi

    2013-01-01

    Dumping syndrome, or rapid gastric emptying, is a frequent complication after gastric surgery. In this case, the patient was a 47-year-old woman who 10 years previously had undergone distal gastrectomy with Billroth I reconstruction for early-stage gastric cancer. She presented with symptoms of weakness, headache, palpitation, sweating, dizziness and significant fatigue between one and two hours after a meal. Because a 75 g oral glucose tolerance test (75 g-OGTT) induced both acute postprandial tachycardia (within 1 hour) and postprandial hypoglycemia, we diagnosed this patient with early and late dumping syndrome. Dietary measures and acarbose improved symptoms of late dumping syndrome but did not prevent the symptoms of early dumping syndrome such as postprandial tachycardia, weakness, headache, palpitation, and dizziness. We therefore used the somatostatin analogue octreotide, which has been reported as an effective therapy for early dumping syndrome. Octreotide prevented the symptoms of early dumping syndrome, especially postprandial tachycardia, but caused postprandial hyperglycemia. Glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) were completely suppressed during the 75 g-OGTT following subcutaneous injection of octreotide. No change was observed in vasoactive intestinal polypeptide (VIP), which is the gastrointestinal peptide hormone generally responsible for early dumping syndrome, suggesting possible contribution of incretins in early dumping syndrome of this patient.

  2. Combined diversity and improved energy detection in cooperative spectrum sensing with faded reporting channels

    Directory of Open Access Journals (Sweden)

    Srinivas Nallagonda

    2016-04-01

    Full Text Available In this paper we evaluate the performance of cooperative spectrum sensing (CSS where each cognitive radio (CR employs an improved energy detector (IED with multiple antennas and uses selection combining (SC for detecting the primary user (PU in noisy and faded sensing (S channels. We derive an expression for the probability of false alarm and expressions for probability of missed detection in non-faded (AWGN and Rayleigh faded sensing environments in terms of cumulative distribution function (CDF. Each CR transmits its decision about PU via noisy and faded reporting (R channel to fusion center (FC. In this paper we assume that S-channels are noisy and Rayleigh faded while several cases of fading are considered for R-channels such as: (i Hoyt (or Nakagami-q, (ii Rayleigh, (iii Rician (or Nakagami-n, and (iv Weibull. A Binary Symmetric channel (BSC with a fixed error probability (r in the R-channel is also considered. The impact of fading in R-channel, S-channel and several network parameters such as IED parameter, normalized detection threshold, number of CRs, and number of antennas on missed detection and total error probability is assessed. The effects of Hoyt, Rician, and Weibull fading parameters on overall performance of IED-CSS are also highlighted.

  3. Severe bronchopulmonary dysplasia improved by noninvasive positive pressure ventilation: a case report

    Directory of Open Access Journals (Sweden)

    Mann Christian

    2011-09-01

    Full Text Available Abstract Introduction This is the first report to describe the feasibility and effectiveness of noninvasive positive pressure ventilation in the secondary treatment of bronchopulmonary dysplasia. Case presentation A former male preterm of Caucasian ethnicity delivered at 29 weeks gestation developed severe bronchopulmonary dysplasia. At the age of six months he was in permanent tachypnea and dyspnea and in need of 100% oxygen with a flow of 2.0 L/minute via a nasal cannula. Intermittent nocturnal noninvasive positive pressure ventilation was then administered for seven hours daily. The ventilator was set at a positive end-expiratory pressure of 6 cmH2O, with pressure support of 4 cmH2O, trigger at 1.4 mL/second, and a maximum inspiratory time of 0.7 seconds. Over the course of seven weeks, the patient's maximum daytime fraction of inspired oxygen via nasal cannula decreased from 1.0 to 0.75, his respiratory rate from 64 breaths/minute to 50 breaths/minute and carbon dioxide from 58 mmHg to 44 mmHg. Conclusion Noninvasive positive pressure ventilation may be a novel therapeutic option for established severe bronchopulmonary dysplasia. In the case presented, noninvasive positive pressure ventilation achieved sustained improvement in ventilation and thus prepared our patient for safe home oxygen therapy.

  4. The post-orgasmic prolactin increase following intercourse is greater than following masturbation and suggests greater satiety.

    Science.gov (United States)

    Brody, Stuart; Krüger, Tillmann H C

    2006-03-01

    Research indicates that prolactin increases following orgasm are involved in a feedback loop that serves to decrease arousal through inhibitory central dopaminergic and probably peripheral processes. The magnitude of post-orgasmic prolactin increase is thus a neurohormonal index of sexual satiety. Using data from three studies of men and women engaging in masturbation or penile-vaginal intercourse to orgasm in the laboratory, we report that for both sexes (adjusted for prolactin changes in a non-sexual control condition), the magnitude of prolactin increase following intercourse is 400% greater than that following masturbation. The results are interpreted as an indication of intercourse being more physiologically satisfying than masturbation, and discussed in light of prior research reporting greater physiological and psychological benefits associated with coitus than with any other sexual activities.

  5. The Wind Forecast Improvement Project (WFIP): A Public/Private Partnership for Improving Short Term Wind Energy Forecasts and Quantifying the Benefits of Utility Operations. The Southern Study Area, Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Freedman, Jeffrey M. [AWS Truepower, LLC, Albany, NY (United States); Manobianco, John [MESO, Inc., Troy, NY (United States); Schroeder, John [Texas Tech Univ., Lubbock, TX (United States). National Wind Inst.; Ancell, Brian [Texas Tech Univ., Lubbock, TX (United States). Atmospheric Science Group; Brewster, Keith [Univ. of Oklahoma, Norman, OK (United States). Center for Analysis and Prediction of Storms; Basu, Sukanta [North Carolina State Univ., Raleigh, NC (United States). Dept. of Marine, Earth, and Atmospheric Sciences; Banunarayanan, Venkat [ICF International (United States); Hodge, Bri-Mathias [National Renewable Energy Lab. (NREL), Golden, CO (United States); Flores, Isabel [Electricity Reliability Council of Texas (United States)

    2014-04-30

    This Final Report presents a comprehensive description, findings, and conclusions for the Wind Forecast Improvement Project (WFIP) -- Southern Study Area (SSA) work led by AWS Truepower (AWST). This multi-year effort, sponsored by the Department of Energy (DOE) and National Oceanographic and Atmospheric Administration (NOAA), focused on improving short-term (15-minute - 6 hour) wind power production forecasts through the deployment of an enhanced observation network of surface and remote sensing instrumentation and the use of a state-of-the-art forecast modeling system. Key findings from the SSA modeling and forecast effort include: 1. The AWST WFIP modeling system produced an overall 10 - 20% improvement in wind power production forecasts over the existing Baseline system, especially during the first three forecast hours; 2. Improvements in ramp forecast skill, particularly for larger up and down ramps; 3. The AWST WFIP data denial experiments showed mixed results in the forecasts incorporating the experimental network instrumentation; however, ramp forecasts showed significant benefit from the additional observations, indicating that the enhanced observations were key to the model systems’ ability to capture phenomena responsible for producing large short-term excursions in power production; 4. The OU CAPS ARPS simulations showed that the additional WFIP instrument data had a small impact on their 3-km forecasts that lasted for the first 5-6 hours, and increasing the vertical model resolution in the boundary layer had a greater impact, also in the first 5 hours; and 5. The TTU simulations were inconclusive as to which assimilation scheme (3DVAR versus EnKF) provided better forecasts, and the additional observations resulted in some improvement to the forecasts in the first 1 - 3 hours.

  6. Surgical treatment of high-standing greater trochanter.

    Science.gov (United States)

    Takata, K; Maniwa, S; Ochi, M

    1999-01-01

    Eleven patients with high-standing greater trochanter (13 joints) aged 13-36 years underwent surgery. Distal transfer of the greater trochanter (group T) was performed in 4 patients (5 joints) and lateral displacement osteotomy (group L) in 7 (8 joints). The average follow-up duration was 13.4 years in group T and 5.9 years in group L. Clinical results were evaluated by the hip score according to Merle d'Aubigne. The mean hip score in group T was 13.4 points before operation and 15.4 points after operation, and in group L, 12.8 and 17.4 points, respectively. The postoperative clinical results of group L were significantly better than those of group T (P = 0.0494). In radiological evaluation, although the articulo-trochanteric distance (ATD) increased in both groups in group L it improved remarkably from 9.8 to 24.3, indicating a large descending distance of the greater trochanter. The lever arm ratio (LAR) did not change significantly in group T, but it decreased from 1.97 to 1.60 in group L (P = 0.004). This means that the lever arm of the abductors can certainly be extended by lateral displacement osteotomy. Lateral displacement osteotomy is the most effective procedure for high-standing greater trochanter.

  7. Facilitating improvements in laboratory report writing skills with less grading: a laboratory report peer-review process.

    Science.gov (United States)

    Brigati, Jennifer R; Swann, Jerilyn M

    2015-05-01

    Incorporating peer-review steps in the laboratory report writing process provides benefits to students, but it also can create additional work for laboratory instructors. The laboratory report writing process described here allows the instructor to grade only one lab report for every two to four students, while giving the students the benefits of peer review and prompt feedback on their laboratory reports. Here we present the application of this process to a sophomore level genetics course and a freshman level cellular biology course, including information regarding class time spent on student preparation activities, instructor preparation, prerequisite student knowledge, suggested learning outcomes, procedure, materials, student instructions, faculty instructions, assessment tools, and sample data. T-tests comparing individual and group grading of the introductory cell biology lab reports yielded average scores that were not significantly different from each other (p = 0.13, n = 23 for individual grading, n = 6 for group grading). T-tests also demonstrated that average laboratory report grades of students using the peer-review process were not significantly different from those of students working alone (p = 0.98, n = 9 for individual grading, n = 6 for pair grading). While the grading process described here does not lead to statistically significant gains (or reductions) in student learning, it allows student learning to be maintained while decreasing instructor workload. This reduction in workload could allow the instructor time to pursue other high-impact practices that have been shown to increase student learning. Finally, we suggest possible modifications to the procedure for application in a variety of settings.

  8. Facilitating Improvements in Laboratory Report Writing Skills with Less Grading: A Laboratory Report Peer-Review Process

    Directory of Open Access Journals (Sweden)

    Jennifer R. Brigati

    2015-02-01

    Full Text Available Incorporating peer-review steps in the laboratory report writing process provides benefits to students, but it also can create additional work for laboratory instructors. The laboratory report writing process described here allows the instructor to grade only one lab report for every two to four students, while giving the students the benefits of peer review and prompt feedback on their laboratory reports. Here we present the application of this process to a sophomore level genetics course and a freshman level cellular biology course, including information regarding class time spent on student preparation activities, instructor preparation, prerequisite student knowledge, suggested learning outcomes, procedure, materials, student instructions, faculty instructions, assessment tools, and sample data. T-tests comparing individual and group grading of the introductory cell biology lab reports yielded average scores that were not significantly different from each other (p = 0.13, n = 23 for individual grading, n = 6 for group grading. T-tests also demonstrated that average laboratory report grades of students using the peer-review process were not significantly different from those of students working alone (p = 0.98, n = 9 for individual grading, n = 6 for pair grading. While the grading process described here does not lead to statistically significant gains (or reductions in student learning, it allows student learning to be maintained while decreasing instructor workload. This reduction in workload could allow the instructor time to pursue other high-impact practices that have been shown to increase student learning. Finally, we suggest possible modifications to the procedure for application in a variety of settings.

  9. How to be a great dad: parental care in a flock of greater flamingo (Phoenicopterus roseus

    Directory of Open Access Journals (Sweden)

    Camillo Sandri

    2017-05-01

    Full Text Available In the last years, studies on captive greater flamingos have increased. Research on zoo animals is important to improve the knowledge on these species and to improve their ex-situ and in-situ conservation. The aim of the present study was to investigate the parental behaviour of a captive colony of greater flamingo hosted at Parco Natura Viva, an Italian zoological garden, to improve the knowledge on this species in zoos. In particular, the present study investigated and compared the parental care of females and males in 35 breeding pairs of greater flamingos. For each pair, we collected durations of parental care behaviour of both females and males, recording their position in relation to the nest (near the nest, on the nest, away from the nest and individual and social behaviours performed. First, both partners were involved in parental care and displayed species-specific behaviours reported in the wild. The main results were that males spent more time than females on the nest (P = 0.010 and near it (P = 0.0001 and were more aggressive toward other flamingos than females, both when sitting on the nest (P = 0.003 and when near the nest (P = 0.0003. Therefore, male flamingos seem to be more involved in incubation duties and nest protection than females. This kind of research is important not only to expand the knowledge on bird species such as flamingos, but also to improve their husbandry and breeding in controlled environment. Indeed, understanding animal behaviour allows us to gain insights into their individual and social needs, addressing potential animal welfare issues.

  10. Improvement of the structure of reports of Ukrainian higher educational institutions in terms of deregulation and state authority decentralization

    Directory of Open Access Journals (Sweden)

    V.S. Ambarchian

    2015-09-01

    Full Text Available Improvement of the structure and content of financial and budgetary reports of domestic higher educational institutions, enhance of financial statements completeness in order to enable citizens to control a university activity. During the research both general scientific and specific scientific economic methods were implemented. The general methods include induction, deduction, analogy and comparison. Among specific methods of economic research grouping, table method, graphical method, method of informational and logical analysis were used. The paper characterizes legal documents which regulate the process of university financial statements preparation and presentation in different countries. Financial reports of Ukrainian, American and British universities are compared. The author determines the major directions of improvement of the structure and content of domestic university reports with the purpose of their completeness enhancing. As a result of the research performed the proper recommendations of improvement of domestic universities reporting are suggested. The author conforms the reporting information with the Managerial report which discloses the information about the reporting period achievements and the efficiency of budget resources expenditure.

  11. The design, conduct and report of single-case research: resources to improve the quality of the neurorehabilitation literature.

    Science.gov (United States)

    Tate, Robyn L; Perdices, Michael; McDonald, Skye; Togher, Leanne; Rosenkoetter, Ulrike

    2014-01-01

    Published reports describing interventions featuring a single participant are common in neurorehabilitation. Yet, not all such reports use rigorous single-case methodology and there is mounting evidence to suggest that the design, conduct and report of single-case research in the behavioural sciences (including neurorehabilitation) needs improvement. The first part of this article describes resources that will guide the improved design, conduct and critical appraisal of single-case research, including recently published standards in the field of special education and the Risk of Bias in N-of-1 Trials (RoBiNT) Scale for evaluating internal and external validity of designs using a single participant. The second part of the article reports on work currently in progress in developing a reporting guideline in the CONSORT tradition specifically for single-case experimental designs in the behavioural sciences, entitled the Single-Case Reporting guideline In BEhavioural interventions (SCRIBE). It is anticipated that adoption and use of these resources by authors, reviewers and journal editors will improve the reporting and, potentially, the quality of the single-case literature.

  12. Improving linear accelerator service response with a real- time electronic event reporting system.

    Science.gov (United States)

    Hoisak, Jeremy D P; Pawlicki, Todd; Kim, Gwe-Ya; Fletcher, Richard; Moore, Kevin L

    2014-09-08

    To track linear accelerator performance issues, an online event recording system was developed in-house for use by therapists and physicists to log the details of technical problems arising on our institution's four linear accelerators. In use since October 2010, the system was designed so that all clinical physicists would receive email notification when an event was logged. Starting in October 2012, we initiated a pilot project in collaboration with our linear accelerator vendor to explore a new model of service and support, in which event notifications were also sent electronically directly to dedicated engineers at the vendor's technical help desk, who then initiated a response to technical issues. Previously, technical issues were reported by telephone to the vendor's call center, which then disseminated information and coordinated a response with the Technical Support help desk and local service engineers. The purpose of this work was to investigate the improvements to clinical operations resulting from this new service model. The new and old service models were quantitatively compared by reviewing event logs and the oncology information system database in the nine months prior to and after initiation of the project. Here, we focus on events that resulted in an inoperative linear accelerator ("down" machine). Machine downtime, vendor response time, treatment cancellations, and event resolution were evaluated and compared over two equivalent time periods. In 389 clinical days, there were 119 machine-down events: 59 events before and 60 after introduction of the new model. In the new model, median time to service response decreased from 45 to 8 min, service engineer dispatch time decreased 44%, downtime per event decreased from 45 to 20 min, and treatment cancellations decreased 68%. The decreased vendor response time and reduced number of on-site visits by a service engineer resulted in decreased downtime and decreased patient treatment cancellations.

  13. Improving clinical cognitive testing: report of the AAN Behavioral Neurology Section Workgroup.

    Science.gov (United States)

    Daffner, Kirk R; Gale, Seth A; Barrett, A M; Boeve, Bradley F; Chatterjee, Anjan; Coslett, H Branch; D'Esposito, Mark; Finney, Glen R; Gitelman, Darren R; Hart, John J; Lerner, Alan J; Meador, Kimford J; Pietras, Alison C; Voeller, Kytja S; Kaufer, Daniel I

    2015-09-08

    To evaluate the evidence basis of single-domain cognitive tests frequently used by behavioral neurologists in an effort to improve the quality of clinical cognitive assessment. Behavioral Neurology Section members of the American Academy of Neurology were surveyed about how they conduct clinical cognitive testing, with a particular focus on the Neurobehavioral Status Exam (NBSE). In contrast to general screening cognitive tests, an NBSE consists of tests of individual cognitive domains (e.g., memory or language) that provide a more comprehensive diagnostic assessment. Workgroups for each of 5 cognitive domains (attention, executive function, memory, language, and spatial cognition) conducted evidence-based reviews of frequently used tests. Reviews focused on suitability for office-based clinical practice, including test administration time, accessibility of normative data, disease populations studied, and availability in the public domain. Demographic and clinical practice data were obtained from 200 respondents who reported using a wide range of cognitive tests. Based on survey data and ancillary information, between 5 and 15 tests in each cognitive domain were reviewed. Within each domain, several tests are highlighted as being well-suited for an NBSE. We identified frequently used single-domain cognitive tests that are suitable for an NBSE to help make informed choices about clinical cognitive assessment. Some frequently used tests have limited normative data or have not been well-studied in common neurologic disorders. Utilizing standardized cognitive tests, particularly those with normative data based on the individual's age and educational level, can enhance the rigor and utility of clinical cognitive assessment. © 2015 American Academy of Neurology.

  14. Improved techniques for fluid diversion in oil recovery. First annual report

    Energy Technology Data Exchange (ETDEWEB)

    Seright, R.S.

    1993-12-01

    This three-year project has two general objectives. The first objective is to compare the effectiveness of gels in fluid diversion with those of other types of processes. Several different types of fluid-diversion processes are being compared, including those using gels, foams, emulsions, and particulates. The ultimate goals of these comparisons are to (1) establish which of these processes are most effective in a given application, and (2) determine whether aspects of one process can be combined with those of other processes to improve performance. Analyses and experiments are being performed to verify which materials are the most effective in entering and blocking high-permeability zones. Another objective of the project is to identify the mechanisms by which materials (particularly gels) selectively reduce permeability to water more than to oil. This report describes work performed during the first year of the project. Following the introduction, Chapters 2 through 5 present several surveys concerning field applications of gel treatments. Based on the results of the surveys, guidelines are proposed in Chapter 5 for the selection of candidates for gel treatments (both injection wells and production wells). Chapters 6, 7, 8, and 11 discuss theoretical work that was performed during the project. Chapter 6 examines whether Hall plots indicated selectivity during gelant placement. Chapter 7 discusses several important theoretical aspects of gel treatments in production wells with water-coning problems. Chapter 8 considers exploitation of density differences during gelant placement. Chapter 11 presents a preliminary consideration of the use of precipitates as blocking agents. Chapters 9 and 10 detail the experimental work for the project. Chapter 9 describes an experimental investigation of gelant placement in fractured systems. Chapter 10 describes experiments that probe the mechanisms for disproportionate permeability reduction by gels.

  15. Improving maternal care with a continuous quality improvement strategy: a report from the Interventions to Minimize Preterm and Low Birth Weight Infants through Continuous Improvement Techniques (IMPLICIT) Network.

    Science.gov (United States)

    Bennett, Ian M; Coco, Andrew; Anderson, Janice; Horst, Michael; Gambler, Angela S; Barr, Wendy Brooks; Ratcliffe, Stephen

    2009-01-01

    Maternal medical care (prenatal and postpartum) involves a set of clinical interventions addressing risk factors associated with important maternal and infant outcomes. Programs to increase the rate of delivery of these interventions in clinical practice have not been widely implemented. A practice-based research network focused on developing continuous quality improvement (CQI) processes for maternal care among 10 family medicine residency training sites in the northeastern United States (the IMPLICIT Network) from January 2003 through September 2007. Documented delivery of 5 standard maternal care interventions was assessed before and after initiating a program to increase their frequency. Proportion chart analyses were conducted comparing the period before and after implementation of the CQI interventions. Data were available for 3936 pregnancies during the course of the study period. Results varied across the clinical interventions. Significant improvement in care processes was seen for 3 screening activities: (1) prenatal depression symptomatology (by 15 weeks' gestation); (2) screening for smoking at 30 weeks' gestation; (3) and postpartum contraception planning. Screening for smoking by 15 weeks' gestation and testing for asymptomatic bacteriuria were already conducted >90% of the time during the baseline period and did not increase significantly after initiating the CQI program. Screening for postpartum depression symptomatology was recorded in 50% to 60% of women before the CQI program and did not increase significantly. A practice-based research network of family medicine residency practices focused on CQI outcomes was successful in increasing the delivery of some maternal care interventions.

  16. IMPROVED ANTIFOAM AGENT STUDY END OF YEAR REPORT, EM PROJECT 3.2.3

    Energy Technology Data Exchange (ETDEWEB)

    Lambert, D.; Koopman, D.; Newell, J.

    2011-09-30

    issues above is that DWPF had three antifoam needs in FY2011: (1) Determine the cause of the poor Antifoam 747 performance during caustic boiling; (2) Determine the decomposition products of Antifoam 747 during CPC processing; and (3) Improve the effectiveness of Antifoam 747, in order to minimize the amount used. Testing was completed by Illinois Institute of Technology (IIT) and Savannah River National Laboratory (SRNL) researchers to address these questions. The testing results reported were funded by both DWPF and DOE/EM 31. Both sets of results are reported in this document for completeness. The results of this research are summarized: (1) The cause for the poor Antifoam 747 performance during caustic boiling was the high hydrolysis rate, cleaving the antifoam molecule in two, leading to poor antifoam performance. In testing with pH solutions from 1 to 13, the antifoam degraded quickly at a pH < 4 and pH > 10. As the antifoam decomposed it lost its spreading ability (wetting agent performance), which is crucial to its antifoaming performance. During testing of a caustic sludge simulants, there was more foam in tests with added Antifoam 747 than in tests without added antifoam. (2) Analyses were completed to determine the composition of the two antifoam components and Antifoam 747. In addition, the decomposition products of Antifoam 747 were determined during CPC processing of sludge simulants. The main decomposition products were identified primarily as Long Chain Siloxanes, boiling point > 400 C. Total antifoam recovery was 33% by mass. In a subsequent study, various compounds potentially related to antifoam were found using semi-volatile organic analysis and volatile organic analysis on the hexane extractions and hexane rinses. These included siloxanes, trimethyl silanol, methoxy trimethyl silane, hexamethyl disiloxane, aliphatic hydrocarbons, dioctyl phthalate, and emulsifiers. Cumulatively, these species amounted to less than 3% of the antifoam mass. The

  17. Natural Propagation and Habitat Improvement, Volume 2, Idaho, 1985 Annual and Final Reports.

    Energy Technology Data Exchange (ETDEWEB)

    Hair, Don

    1986-09-01

    The individual reports in this volume have been separately abstracted for inclusion in the data base. The reports describe fish habitat enhancement projects on the Lochsa River, Eldorado and Camas Creeks, and the Clearwater River. (ACR)

  18. Flue gas conditioning for improved particle collection in electrostatic precipitators. First topical report, Results of laboratory screening of additives

    Energy Technology Data Exchange (ETDEWEB)

    Durham, M.D.

    1993-04-16

    Several tasks have been completed in a program to evaluate additives to improve fine particle collection in electrostatic precipitators. Screening tests and laboratory evaluations of additives are summarized in this report. Over 20 additives were evaluated; four were found to improve flyash precipitation rates. The Insitec particle analyzer was also evaluated; test results show that the analyzer will provide accurate sizing and counting information for particles in the size range of {le} 10 {mu}m dia.

  19. Challenges of implementation and implementation research: Learning from an intervention study designed to improve tumor registry reporting

    Directory of Open Access Journals (Sweden)

    Ann Scheck McAlearney

    2016-08-01

    Full Text Available Objectives: Implementation of interventions designed to improve the quality of medical care often proceeds differently from what is planned. Improving existing conceptual models to better understand the sources of these differences can help future projects avoid these pitfalls and achieve desired effectiveness. To inform an adaptation of an existing theoretical model, we examined unanticipated changes that occurred in an intervention designed to improve reporting of adjuvant therapies for breast cancer patients at a large, urban academic medical center. Methods: Guided by the complex innovation implementation conceptual framework, our study team observed and evaluated the implementation of an intervention designed to improve reporting to a tumor registry. Findings were assessed against the conceptual framework to identify boundary conditions and modifications that could improve implementation effectiveness. Results: The intervention successfully increased identification of the managing medical oncologist and treatment reporting. During implementation, however, unexpected external challenges including hospital acquisitions of community practices and practices’ responses to government incentives to purchase electronic medical record systems led to unanticipated changes and associated threats to implementation. We present a revised conceptual model that incorporates the sources of these unanticipated challenges. Conclusion: This report of our experience highlights the importance of monitoring implementation over time and accounting for changes that affect both implementation and measurement of intervention impact. In this article, we use our study to examine the challenges of implementation research in health care, and our experience can help future implementation efforts.

  20. Reporting diagnostic accuracy studies : some improvements after 10 years of STARD

    NARCIS (Netherlands)

    Korevaar, Daniël A; Wang, Junfeng; van Enst, W Annefloor; Leeflang, Mariska M; Hooft, Lotty; Smidt, Nynke; Bossuyt, Patrick M M

    2015-01-01

    PURPOSE: To evaluate how diagnostic accuracy study reports published in 2012 adhered to the Standards for Reporting of Diagnostic Accuracy (STARD) statement and whether there were any differences in reporting compared with 2000 and 2004. MATERIALS AND METHODS: PubMed was searched for studies publish

  1. Reporting Diagnostic Accuracy Studies : Some Improvements after 10 Years of STARD

    NARCIS (Netherlands)

    Korevaar, Daniel A.; Wang, Junfeng; van Enst, W. Annefloor; Leeflang, Mariska M.; Hooft, Lotty; Smidt, Nynke; Bossuyt, Patrick M. M.

    2015-01-01

    Purpose: To evaluate how diagnostic accuracy study reports published in 2012 adhered to the Standards for Reporting of Diagnostic Accuracy (STARD) statement and whether there were any differences in reporting compared with 2000 and 2004. Materials and Methods: PubMed was searched for studies publish

  2. Critical Evaluation as an Aid to Improved Report Writing: A Case Study

    Science.gov (United States)

    Walker, Mirabelle; Williams, Judith

    2014-01-01

    Report writing is an important employability skill for Engineers and Technologists, and this case study describes how a Technology degree module took a novel approach to developing students' report writing skills. Students learned how to use a criterion-referenced critical evaluation framework for reports and other technological documents. They…

  3. Critical Evaluation as an Aid to Improved Report Writing: A Case Study

    Science.gov (United States)

    Walker, Mirabelle; Williams, Judith

    2014-01-01

    Report writing is an important employability skill for Engineers and Technologists, and this case study describes how a Technology degree module took a novel approach to developing students' report writing skills. Students learned how to use a criterion-referenced critical evaluation framework for reports and other technological documents. They…

  4. Critical Evaluation as an Aid to Improved Report Writing: A Case Study

    Science.gov (United States)

    Walker, Mirabelle; Williams, Judith

    2014-01-01

    Report writing is an important employability skill for Engineers and Technologists, and this case study describes how a Technology degree module took a novel approach to developing students' report writing skills. Students learned how to use a criterion-referenced critical evaluation framework for reports and other technological documents.…

  5. Plastic Foam Withstands Greater Temperatures And Pressures

    Science.gov (United States)

    Cranston, John A.; Macarthur, Doug

    1993-01-01

    Improved plastic foam suitable for use in foam-core laminated composite parts and in tooling for making fiber/matrix-composite parts. Stronger at high temperatures, more thermally and dimensionally stable, machinable, resistant to chemical degradation, and less expensive. Compatible with variety of matrix resins. Made of polyisocyanurate blown with carbon dioxide and has density of 12 to 15 pounds per cubic feet. Does not contibute to depletion of ozone from atmosphere. Improved foam used in cores of composite panels in such diverse products as aircraft, automobiles, railroad cars, boats, and sporting equipment like surfboards, skis, and skateboards. Also used in thermally stable flotation devices in submersible vehicles. Machined into mandrels upon which filaments wound to make shells.

  6. 职务犯罪举报线索成案率的提高对策%Countermeasure for Improving Case Rates from Reporting Clues of Official Crimes

    Institute of Scientific and Technical Information of China (English)

    宁玲玲

    2012-01-01

    Low case rates through clues to preliminary investigation and difficult clues investigating have become the bottleneck in current investigation work of official crimes.At present,there are many reasons for the low case rates from reporting clues of official crimes in procuratorial organs.They can be improved through making greater efforts to investigate official crimes,strengthening propaganda of reporting,widening channels for clues,increasing the number of clues reporting,and enhancing management and evaluation of clues.%线索初查成案率不高、线索查处难度大,成了目前职侦工作的瓶颈。目前检察机关职务犯罪举报线索成案率低,原因是多方面的。提高职务犯罪举报线索成案率须通过加大查办职务犯罪案件力度、加强举报宣传、扩宽线索渠道、增加线索举报数量以及加强线索管理和评估等多途径来实现。

  7. Reporting systems in gastrointestinal endoscopy: Requirements and standards facilitating quality improvement: European Society of Gastrointestinal Endoscopy position statement

    Science.gov (United States)

    Aabakken, Lars; Dekker, Evelien; Kaminski, Michal F; Rösch, Thomas; Hultcrantz, Rolf; Suchanek, Stepan; Jover, Rodrigo; Kuipers, Ernst J; Bisschops, Raf; Spada, Cristiano; Valori, Roland; Domagk, Dirk; Rees, Colin; Rutter, Matthew D

    2016-01-01

    To develop standards for high quality of gastrointestinal endoscopy, the European Society of Gastrointestinal Endoscopy (ESGE) has established the ESGE Quality Improvement Committee. A prerequisite for quality assurance and improvement for all gastrointestinal endoscopy procedures is state-of-the-art integrated digital reporting systems for standardized documentation of the procedures. The current paper describes the ESGE’s viewpoints on requirements for high-quality endoscopy reporting systems. The following recommendations are issued: Endoscopy reporting systems must be electronic.Endoscopy reporting systems should be integrated into hospital patient record systems.Endoscopy reporting systems should include patient identifiers to facilitate data linkage to other data sources.Endoscopy reporting systems shall restrict the use of free text entry to a minimum, and be based mainly on structured data entry.Separate entry of data for quality or research purposes is discouraged. Automatic data transfer for quality and research purposes must be facilitated.Double entry of data by the endoscopist or associate personnel is discouraged. Available data from outside sources (administrative or medical) must be made available automatically.Endoscopy reporting systems shall enable the inclusion of information on histopathology of detected lesions; patient’s satisfaction; adverse events; surveillance recommendations.Endoscopy reporting systems must facilitate easy data retrieval at any time in a universally compatible format.Endoscopy reporting systems must include data fields for key performance indicators as defined by quality improvement committees.Endoscopy reporting systems must facilitate changes in indicators and data entry fields as required by professional organizations. PMID:27087943

  8. Reducing the carbon footprint of the operating theatre: a multicentre quality improvement report.

    Science.gov (United States)

    Southorn, T; Norrish, A R; Gardner, K; Baxandall, R

    2013-06-01

    Currently, there are very few provisions for recycling in theatres. We measured the weight of clinical waste for several orthopaedic operations. This waste was then examined and sorted into domestic waste and clinical waste. With staff education it is possible to reduce the amount of clinical waste generated by the operating theatre by roughly 50%. A greater awareness of disposal options leads to a reduction in waste disposed of by incineration.

  9. Force Structure: Actions Needed to Improve DOD’s Ability to Manage, Assess, and Report on Global Defense Posture Initiatives

    Science.gov (United States)

    2009-07-02

    Representatives Subject: Force Structure: Actions Needed to Improve DOD’s Ability to Manage, Assess, and Report on Global Defense Posture ...as well as the fidelity of the global basing plan given the rapidly changing global security environment. GAO-09-706R Global Defense Posture ...to Manage, Assess, and Report on Global Defense Posture Initiatives 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S

  10. Report on best practice for improved μ-IM injection moulding simulation

    DEFF Research Database (Denmark)

    Tosello, Guido; Costa, Franco; Hansen, Hans Nørgaard

    2010-01-01

    Data analysis and simulations on micro-moulding experiments have been conducted. Micro moulding simulations have been executed taking into account actual processing conditions implementation in the software. Numerous aspects of the simulation set-up have been considered in order to improve the si....... However, the major role of heat transfer coefficient has been highlighted and simulated results in terms of flow length prediction improved. A best practice methodology for improved micro moulding simulations has been established....

  11. Report on best practice for improved μ-IM injection moulding simulation

    DEFF Research Database (Denmark)

    Tosello, Guido; Costa, Franco; Hansen, Hans Nørgaard

    2010-01-01

    Data analysis and simulations on micro-moulding experiments have been conducted. Micro moulding simulations have been executed taking into account actual processing conditions implementation in the software. Numerous aspects of the simulation set-up have been considered in order to improve the si....... However, the major role of heat transfer coefficient has been highlighted and simulated results in terms of flow length prediction improved. A best practice methodology for improved micro moulding simulations has been established....

  12. An improved ARS2-derived nuclear reporter enhances the efficiency and ease of genetic engineering in Chlamydomonas.

    Science.gov (United States)

    Specht, Elizabeth A; Nour-Eldin, Hussam Hassan; Hoang, Kevin T D; Mayfield, Stephen P

    2015-03-01

    The model alga Chlamydomonas reinhardtii has been used to pioneer genetic engineering techniques for high-value protein and biofuel production from algae. To date, most studies of transgenic Chlamydomonas have utilized the chloroplast genome due to its ease of engineering, with a sizeable suite of reporters and well-characterized expression constructs. The advanced manipulation of algal nuclear genomes has been hampered by limited strong expression cassettes, and a lack of high-throughput reporters. We have improved upon an endogenous reporter gene - the ARS2 gene encoding an arylsulfatase enzyme - that was first cloned and characterized decades ago but has not been used extensively. The new construct, derived from ARS2 cDNA, expresses significantly higher levels of reporter protein and transforms more efficiently, allowing qualitative and quantitative screening using a rapid, inexpensive 96-well assay. The improved arylsulfatase expression cassette was used to screen a new transgene promoter from the ARG7 gene, and found that the ARG7 promoter can express the ARS2 reporter as strongly as the HSP70-RBCS2 chimeric promoter that currently ranks as the best available promoter, thus adding to the list of useful nuclear promoters. This enhanced arylsulfatase reporter construct improves the efficiency and ease of genetic engineering within the Chlamydomonas nuclear genome, with potential application to other algal strains.

  13. Grassroots Action Research and the Greater Good

    Directory of Open Access Journals (Sweden)

    Rainey Isobel

    2011-04-01

    Full Text Available

    This study examines the action research topics and topic preferences of two groups of grassroots teachers: active researchers, and potential researchers. The analysis of the topics appears to indicate that, over the past decade, action research at the teaching of English at the grassroots level to speakers of other languages has been principally understood in terms of professional development with respect to teachers’ methodologies and learners’ learning behaviours. A nascent concern for a more ample approach to professional development and issues conducive to the greater good of the profession can, it is mooted, flourish only with the collaboration of all relevant stakeholders.

    En este estudio se examinan los temas de investigación acción y los temas preferidos por dos grupos de profesores de base: uno de investigadores activos y otro de investigadores potenciales. El análisis sugiere que, durante la última década, la investigación acción en el aula de inglés para hablantes de otras lenguas se ha entendido principalmente en términos del desarrollo profesional con respecto a las metodologías de los profesores y las conductas estudiantiles de aprendizaje. Se considera que un incipiente interés por un enfoque más amplio y por asuntos conducentes al beneficio general de la profesión, solamente puede florecer con la colaboración de todos los actores más importantes.

  14. Development of an Automated Bone Mineral Density Software Application: Facilitation Radiologic Reporting and Improvement of Accuracy.

    Science.gov (United States)

    Tsai, I-Ta; Tsai, Meng-Yuan; Wu, Ming-Ting; Chen, Clement Kuen-Huang

    2016-06-01

    The conventional method of bone mineral density (BMD) report production by dictation and transcription is time consuming and prone to error. We developed an automated BMD reporting system based on the raw data from a dual energy X-ray absorptiometry (DXA) scanner for facilitating the report generation. The automated BMD reporting system, a web application, digests the DXA's raw data and automatically generates preliminary reports. In Jan. 2014, 500 examinations were randomized into an automatic group (AG) and a manual group (MG), and the speed of report generation was compared. For evaluation of the accuracy and analysis of errors, 5120 examinations during Jan. 2013 and Dec. 2013 were enrolled retrospectively, and the context of automatically generated reports (AR) was compared with the formal manual reports (MR). The average time spent for report generation in AG and in MG was 264 and 1452 s, respectively (p Z scores in AR is 100 %. The overall accuracy of AR and MR is 98.8 and 93.7 %, respectively (p < 0.001). The mis-categorization rate in AR and MR is 0.039 and 0.273 %, respectively (p = 0.0013). Errors occurred in AR and can be grouped into key-in errors by technicians and need for additional judgements. We constructed an efficient and reliable automated BMD reporting system. It facilitates current clinical service and potentially prevents human errors from technicians, transcriptionists, and radiologists.

  15. Report of improved performance in Talbot–Lau phase-contrast computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Weber, Thomas, E-mail: thomas.weber@fau.de; Pelzer, Georg; Rieger, Jens; Ritter, André; Anton, Gisela [Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics (ECAP), Radiation and Detector Physics Group, Erwin-Rommel-Str. 1, 91058 Erlangen (Germany)

    2015-06-15

    Purpose: Many expectations have been raised since the use of conventional x-ray tubes on grating-based x-ray phase-contrast imaging. Despite a reported increase in contrast-to-noise ratio (CNR) in many publications, there is doubt on whether phase-contrast computed tomography (CT) is advantageous in clinical CT scanners in vivo. The aim of this paper is to contribute to this discussion by analyzing the performance of a phase-contrast CT laboratory setup. Methods: A phase-contrast CT performance analysis was done. Projection images of a phantom were recorded, and image slices were reconstructed using standard filtered back projection methods. The resulting image slices were analyzed by determining the CNRs in the attenuation and phase image. These results were compared to analytically calculated expectations according to the already published phase-contrast CT performance analysis by Raupach and Flohr [Med. Phys. 39, 4761–4774 (2012)]. There, a severe mistake was found leading to wrong predictions of the performance of phase-contrast CT. The error was corrected and with the new formulae, the experimentally obtained results matched the analytical calculations. Results: The squared ratios of the phase-contrast CNR and the attenuation CNR obtained in the authors’ experiment are five- to ten-fold higher than predicted by Raupach and Flohr [Med. Phys. 39, 4761–4774 (2012)]. The effective lateral spatial coherence length deduced outnumbers the already optimistic assumption of Raupach and Flohr [Med. Phys. 39, 4761–4774 (2012)] by a factor of 3. Conclusions: The authors’ results indicate that the assumptions made in former performance analyses are pessimistic. The break-even point, when phase-contrast CT outperforms attenuation CT, is within reach even with realistic, nonperfect gratings. Further improvements to state-of-the-art clinical CT scanners, like increasing the spatial resolution, could change the balance in favor of phase-contrast computed tomography

  16. Using digital interventions to improve the cardiometabolic health of populations: a meta-review of reporting quality.

    Science.gov (United States)

    O'Neil, Adrienne; Cocker, Fiona; Rarau, Patricia; Baptista, Shaira; Cassimatis, Mandy; Barr Taylor, C; Lau, Annie Y S; Kanuri, Nitya; Oldenburg, Brian

    2017-07-01

    We conducted a meta-review to determine the reporting quality of user-centered digital interventions for the prevention and management of cardiometabolic conditions. Using predetermined inclusion criteria, systematic reviews published between 2010 and 2015 were identified from 3 databases. To assess whether current evidence is sufficient to inform wider uptake and implementation of digital health programs, we assessed the quality of reporting of research findings using (1) endorsement of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, (2) a quality assessment framework (eg, Cochrane risk of bias assessment tool), and (3) 8 parameters of the Consolidated Standards of Reporting Trials of Electronic and Mobile HEalth Applications and onLine TeleHealth (CONSORT-eHEALTH) guidelines (developed in 2010). Of the 33 systematic reviews covering social media, Web-based programs, mobile health programs, and composite modalities, 6 reported using the recommended PRISMA guidelines. Seven did not report using a quality assessment framework. Applying the CONSORT-EHEALTH guidelines, reporting was of mild to moderate strength. To our knowledge, this is the first meta-review to provide a comprehensive analysis of the quality of reporting of research findings for a range of digital health interventions. Our findings suggest that the evidence base and quality of reporting in this rapidly developing field needs significant improvement in order to inform wider implementation and uptake. The inconsistent quality of reporting of digital health interventions for cardiometabolic outcomes may be a critical impediment to real-world implementation.

  17. Usefulness of case reports to improve medical knowledge regarding trigemino-cardiac reflex in skull base surgery

    Directory of Open Access Journals (Sweden)

    Sadr-Eshkevari Pooan

    2011-04-01

    Full Text Available Abstract We describe the discovery of the trigemino-cardiac reflex by Schaller in 1999 and the continued improvement of the knowledge about the trigemino-cardiac reflex involved in neurosurgery, especially in skull base surgery, during the past several years. The achieved medical progress could be gained only by the practical experience described by different case reports and later case series that have been published in several principal scientific journals. Additionally, we explain the scientific as well as clinical importance of the communication of the case reports on TCR. Special reference has been given to the validity of the case reports for new phenomena in clinical medicine.

  18. Usefulness of case reports to improve medical knowledge regarding trigemino-cardiac reflex in skull base surgery.

    Science.gov (United States)

    Sandu, Nora; Sadr-Eshkevari, Pooan; Schaller, Bernhard J

    2011-04-15

    We describe the discovery of the trigemino-cardiac reflex by Schaller in 1999 and the continued improvement of the knowledge about the trigemino-cardiac reflex involved in neurosurgery, especially in skull base surgery, during the past several years. The achieved medical progress could be gained only by the practical experience described by different case reports and later case series that have been published in several principal scientific journals. Additionally, we explain the scientific as well as clinical importance of the communication of the case reports on TCR. Special reference has been given to the validity of the case reports for new phenomena in clinical medicine.

  19. Disaggregated Financial-Accounting Information for Users (Concrete Measures to Improve International Financial Reporting)

    OpenAIRE

    Gheorghe Lepadatu

    2011-01-01

    With the increased complexity of business and with the growing popularity of the conglomerates business forms has become clear that enhanced financial reporting can not provide users with enough information to make decisions for high yield. Therefore, segment reporting is presenting disaggregated financial information relating to the operations of reporting entities in different areas of business or in different geographical regions. Because of the perception that domestic and foreign operati...

  20. Potentials for Heat Savings in Greater Copenhagen

    DEFF Research Database (Denmark)

    Nørgaard, Jørgen; Karlsson, Kenneth

    1998-01-01

    are suggested. Two scenarios for future heat savings are established, deviating in the rates of renovation, demolition, and construction of buildings, as well as in the thermal insulation standards, ventilation systems ,and in the daily behaviour. The results are that compared to the base year 1995, heat......This report describes methodologies for analysing heat saving potentials. The background for the lack of activities in that field is suggested. Various elements of heat savings are described, including changes in daily behaviour and life styles. Definition of various levels of potentials...

  1. Appeal for legislation on greater safety.

    Science.gov (United States)

    Baillie, Jonathan

    2011-10-01

    An Essex-headquartered company which claims to manufacture the world's leading "brand" of glass vision panel, is calling for legislation to regulate the quality and design of such products. With no statutory governance currently in place, it is concerned that a rash of badly-designed, poorer quality variants, that it says have emerged in recent years, pose a significant self-harm and ligature risk to mentally unwell patients in hospitals, and a potential danger to staff when components like internal fittings and the glass itself, especially should the latter be too thin and thus easy to break, are used as "weapons". HEJ editor Jonathan Baillie reports.

  2. 76 FR 64174 - Public Input on the Report to Congress on How To Modernize and Improve the System of Insurance...

    Science.gov (United States)

    2011-10-17

    ... coordination of insurance regulation; 7. The costs and benefits of potential Federal regulation of insurance... policyholder claims over other unsecured general creditor claims; iii. In the case of life insurance companies... Public Input on the Report to Congress on How To Modernize and Improve the System of Insurance...

  3. Improving the Social Status of Peer-Rejected Youth with Disabilities: Extending the Research on Positive Peer Reporting

    Science.gov (United States)

    Bowers, Frank E.; Jensen, Marcia E.; Cook, Clayton R.; McEachern, Amber D.; Snyder, Tara

    2008-01-01

    Peer rejection is a common experience for youth with emotional and behavioral disabilities and it is associated with increased risk of negative short- and long-term outcomes. There is a high premium on interventions that can improve the social status and functioning of these youth. Positive Peer Reporting (PPR) is a behavior analytic intervention…

  4. Astym Therapy Improves Bilateral Hamstring Flexibility and Achilles Tendinopathy in a Child with Cerebral Palsy: A Retrospective Case Report

    Science.gov (United States)

    Scheer, Nicole A.; Alstat, Lucas R.; Van Zant, Robert S.

    2016-01-01

    PURPOSE The purpose of this case report was to describe the use of Astym therapy to improve hamstring flexibility and Achilles tendinopathy in a child with cerebral palsy. CASE DESCRIPTION An eight-year-old female with cerebral palsy was referred to physical therapy for the treatment of bilateral hamstring inflexibility and Achilles tendinopathy. Treatment focused on an Astym therapy protocol of eccentric exercise, stretching, active and passive range of motion, gait training, and a home exercise program. The patient underwent a total of 11 physical therapy treatment sessions. OUTCOMES At the conclusion of treatment, the patient demonstrated improved resting muscle tone in bilateral lower extremities with active 90/90 hamstring flexibility measured at 165° and ankle dorsiflexion active range of motion of 5° without pain at 0° and 90° knee flexion. The patient exhibited an improved gait pattern with even stride length and diminished genu recurvatum, decreased pain with standing and walking, discontinued use of ankle–foot orthoses, and improved activity tolerance and overall function for daily activities. DISCUSSION The results of this case report indicate that physical therapy rehabilitation utilizing an Astym therapy protocol can successfully achieve gains in flexibility and strength and allow for improved function of bilateral lower extremities in a patient with cerebral palsy. CONCLUSION Based on the findings of this case report, clinicians should consider the use of Astym therapy in treating musculoskeletal soft tissue dysfunction in pediatric patients with cerebral palsy.

  5. Improving treatment satisfaction and other patient-reported outcomes in people with type 2 diabetes: the role of once-daily insulin glargine.

    Science.gov (United States)

    Bradley, C; Gilbride, C J B

    2008-07-01

    Insulin therapy becomes essential for many people with type 2 diabetes. After starting insulin, people with diabetes that is poorly controlled with oral agents typically report improved well-being and treatment satisfaction. However, healthcare professionals and people with type 2 diabetes are often reluctant to begin insulin treatment, citing concerns such as time/resources needed to educate patients, increased risks of hypoglycaemia and fear of injections, which lead them to focus on intensifying conventional oral therapy. Insulin glargine, which offers people with diabetes a once-a-day injection regimen with low risk of hypoglycaemia, is more likely to overcome such initial barriers than other more complex insulin regimens. Once-daily insulin glargine, in combination with modern glucose-dependent oral agents that do not need to be chased with food to prevent hypoglycaemia, does not require the fixed mealtimes and set amounts of carbohydrates necessary with twice-daily injection mixes and older sulphonylureas. We know that it is such dietary restrictions that cause the most damage to quality of life (QoL). To avoid damaging QoL unnecessarily and to ensure optimal satisfaction with treatment, it is important to evaluate the effects of treatment on QoL, treatment satisfaction and other patient-reported outcomes (PROs) using questionnaires validated for this purpose, such as the widely used Diabetes Treatment Satisfaction Questionnaire and the Audit of Diabetes-Dependent Quality of Life measure. A systematic electronic literature search identified reports of studies evaluating PROs associated with insulin glargine in comparison with other treatments. The studies show that insulin glargine is usually associated with greater improvements in treatment satisfaction and other PROs compared with intensifying oral therapy or alternative insulin regimens.

  6. Inferior glenohumeral joint dislocation with greater tuberosity avulsion

    Institute of Scientific and Technical Information of China (English)

    Mohd Faizan; Latif Zafar Jilani; Mazhar Abbas; Yasir Salam Siddiqui; Aamir Bin Sabir; M.K.A.Sherwani; Saifullah Khalid

    2015-01-01

    Inferior glenohumeral dislocation is the least common type of glenohumeral dislocations.It may be associated with fractures of the adjacent bones and neurovascular compromise.It should be treated immediately by close reduction.The associated neuropraxia usually recovers with time.Traction-counter traction method is commonly used for reduction followed by immobilization of the shoulder for three weeks.Here,we report a case of inferior glenohumeral joint dislocation with greater tuberosity fracture with transient neurovascular compromise and present a brief review of the literature.

  7. Recommendations for improving the quality of reporting clinical electrochemotherapy studies based on qualitative systematic review

    DEFF Research Database (Denmark)

    Campana, LG; Clover, AJ; Valpione, S

    2016-01-01

    Electrochemotherapy is becoming a well-established treatment for malignancies of skin and non-skin origin and its use is widening across Europe. The technique was developed and optimized from solid experimental and clinical evidence. A consensus document is now warranted to formalize reporting...... studies and to provide the recommendations for reporting clinical trials on electrochemotherapy....

  8. Closing the quality gap: revisiting the state of the science (vol. 5: public reporting as a quality improvement strategy).

    Science.gov (United States)

    Totten, Annette M; Wagner, Jesse; Tiwari, Arpita; O'Haire, Christen; Griffin, Jessica; Walker, Miranda

    2012-07-01

    The goal of this review was to evaluate the effectiveness of public reporting of health care quality information as a quality improvement strategy. We sought to determine if public reporting results in improvements in health care delivery and patient outcomes. We also considered whether public reporting affects the behavior of patients or of health care providers. Finally we assessed whether the characteristics of the public reports and the context affect the impact of public reports. Articles available between 1980 and 2011 were identified through searches of the following bibliographical databases: MEDLINE®, Embase, EconLit, PsychINFO, Business Source Premier, CINAHL, PAIS, Cochrane Database of Systematic Reviews, EPOC Register of Studies, DARE, NHS EED, HEED, NYAM Grey Literature Report database, and other sources (experts, reference lists, and gray literature). We screened citations based on inclusion and exclusion criteria developed based on our definition of public reporting. We initially did not exclude any studies based on study design. Of the 11,809 citations identified through title and abstract triage, we screened and reviewed 1,632 articles. A total of 97 quantitative and 101 qualitative studies were included, abstracted, entered into tables, and evaluated. The heterogeneity of outcomes as well as methods prohibited formal quantitative synthesis. Systematic reviews were used to identify studies, but their conclusions were not incorporated into this review. For most of the outcomes, the strength of the evidence available to assess the impact of public reporting was moderate. This was due in part to the methodological challenges researchers face in designing and conducting research on the impact of population-level interventions. Public reporting is associated with improvement in health care performance measures such as those included in Nursing Home Compare. Almost all identified studies found no evidence or only weak evidence that public reporting

  9. Introducing radiology report checklists among residents: adherence rates when suggesting versus requiring their use and early experience in improving accuracy.

    Science.gov (United States)

    Powell, Daniel K; Lin, Eaton; Silberzweig, James E; Kagetsu, Nolan J

    2014-03-01

    To retrospectively compare resident adherence to checklist-style structured reporting for maxillofacial computed tomography (CT) from the emergency department (when required vs. suggested between two programs). To compare radiology resident reporting accuracy before and after introduction of the structured report and assess its ability to decrease the rate of undetected pathology. We introduced a reporting checklist for maxillofacial CT into our dictation software without specific training, requiring it at one program and suggesting it at another. We quantified usage among residents and compared reporting accuracy, before and after counting and categorizing faculty addenda. There was no significant change in resident accuracy in the first few months, with residents acting as their own controls (directly comparing performance with and without the checklist). Adherence to the checklist at program A (where it originated and was required) was 85% of reports compared to 9% of reports at program B (where it was suggested). When using program B as a secondary control, there was no significant difference in resident accuracy with or without using the checklist (comparing different residents using the checklist to those not using the checklist). Our results suggest that there is no automatic value of checklists for improving radiology resident reporting accuracy. They also suggest the importance of focused training, checklist flexibility, and a period of adjustment to a new reporting style. Mandatory checklists were readily adopted by residents but not when simply suggested. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

  10. Improved recovery demonstration for Williston Basin carbonates. Annual report, June 10, 1995--June 9, 1996

    Energy Technology Data Exchange (ETDEWEB)

    Carrell, L.A.; Sippel, M.A.

    1996-09-01

    The purpose of this project is to demonstrate targeted infill and extension drilling opportunities, better determinations of oil-in-place, methods for improved completion efficiency and the suitability of waterflooding in Red River and Ratcliffe shallow-shelf carbonate reservoirs in the Williston Basin, Montana, North Dakota and South Dakota. Improved reservoir characterization utilizing three-dimensional and multi-component seismic are being investigated for identification of structural and stratigraphic reservoir compartments. These seismic characterization tools are integrated with geological and engineering studies. Improved completion efficiency is being tested with extended-reach jetting lance and other ultra-short-radius lateral technologies. Improved completion efficiency, additional wells at closer spacing and better estimates of oil in place will result in additional oil recovery by primary and enhanced recovery processes.

  11. Final Report Collaborative Project: Improving the Representation of Coastal and Estuarine Processes in Earth System Models

    Energy Technology Data Exchange (ETDEWEB)

    Bryan, Frank [Univ. of Connecticut, Storrs, CT (United States); Dennis, John [Univ. of Connecticut, Storrs, CT (United States); MacCready, Parker [Univ. of Connecticut, Storrs, CT (United States); Whitney, Michael M. [Univ. of Connecticut, Storrs, CT (United States)

    2016-09-30

    This project aimed to improve long term global climate simulations by resolving and enhancing the representation of the processes involved in the cycling of freshwater through estuaries and coastal regions. This was a collaborative multi-institution project consisting of physical oceanographers, climate model developers, and computational scientists. It specifically targeted the DOE objectives of advancing simulation and predictive capability of climate models through improvements in resolution and physical process representation.

  12. Final Technical Report: Improvement of Zymomonas mobilis for Commercial Use in Corn-based Biorefineries

    Energy Technology Data Exchange (ETDEWEB)

    Hitz, William D.

    2010-12-07

    Between 2007 and 2010 DuPont conducted a program under DOE award DE-FC36-07GO17056 to develop and improve Zymomonas mobilis as an ethanologen for commercial use in biorefineries to produce cellulosic ethanol. This program followed upon an earlier DOE funded program in which DuPont, in collaboration with the National Renewable Energy Laboratory (NREL) had developed a Zymomonas strain in conjunction with the development of an integrated cellulosic ethanol process. In the current project, we sought to maximize the utility of Zymomonas by adding the pathway to allow fermentation of the minor sugar arabinose, improve the utilization of xylose, improve tolerance to process hydrolysate and reduce the cost of producing the ethanologen. We undertook four major work streams to address these tasks, employing a range of approaches including genetic engineering, adaptation, metabolite and pathway analysis and fermentation process development. Through this project, we have developed a series of strains with improved characteristics versus the starting strain, and demonstrated robust scalability to at least the 200L scale. By a combination of improved ethanol fermentation yield and titer as well as reduced seed train costs, we have been able to reduce the capital investment and minimum ethanol selling price (MESP) by approximately 8.5% and 11% respectively vs. our starting point. Furthermore, the new strains we have developed, coupled with the learnings of this program, provide a platform for further strain improvements and advancement of cellulosic ethanol technology.

  13. Facilitated Nurse Medication-Related Event Reporting to Improve Medication Management Quality and Safety in Intensive Care Units.

    Science.gov (United States)

    Xu, Jie; Reale, Carrie; Slagle, Jason M; Anders, Shilo; Shotwell, Matthew S; Dresselhaus, Timothy; Weinger, Matthew B

    Medication safety presents an ongoing challenge for nurses working in complex, fast-paced, intensive care unit (ICU) environments. Studying ICU nurse's medication management-especially medication-related events (MREs)-provides an approach to analyze and improve medication safety and quality. The goal of this study was to explore the utility of facilitated MRE reporting in identifying system deficiencies and the relationship between MREs and nurses' work in the ICUs. We conducted 124 structured 4-hour observations of nurses in three different ICUs. Each observation included measurement of nurse's moment-to-moment activity and self-reports of workload and negative mood. The observer then obtained MRE reports from the nurse using a structured tool. The MREs were analyzed by three experts. MREs were reported in 35% of observations. The 60 total MREs included four medication errors and seven adverse drug events. Of the 49 remaining MREs, 65% were associated with negative patient impact. Task/process deficiencies were the most common contributory factor for MREs. MRE occurrence was correlated with increased total task volume. MREs also correlated with increased workload, especially during night shifts. Most of these MREs would not be captured by traditional event reporting systems. Facilitated MRE reporting provides a robust information source about potential breakdowns in medication management safety and opportunities for system improvement.

  14. Intraoral Vertical Ramus Osteotomy Improved the Stomatognathic Function in an Elderly Patient with Mandibular Protrusion:A Case Report

    Directory of Open Access Journals (Sweden)

    Ishihara,Yoshihito

    2010-10-01

    Full Text Available This article reports the successful surgical-orthodontic treatment of an elderly patient with dentofacial deformity and signs and symptoms of temporomandibular disorder (TMD. The patient was a 63-year-old woman with a concave profile due to mandibular protrusion. To correct skeletal deformities, the mandible was posteriorly repositioned by employing intraoral vertical ramus osteotomy (IVRO following presurgical orthodontic treatment. After active treatment for 31 months, the facial profile was significantly improved and satisfactory occlusion was achieved. In addition, TMD symptoms of clicking sounds on the left side and difficulty in mouth opening were resolved. Regarding the findings of magnetic resonance imaging, anterior disc displacement in the opening phase was improved in the temporomandibular joint on the left side. Furthermore, stomatognathic functions were also improved without any aggravation of age-related problems. In conclusion, surgical repositioning of the mandible using IVRO leads to both morphological and functional improvements even in elderly patients.

  15. Community Teaching Practice for Greater Learning

    Directory of Open Access Journals (Sweden)

    Siao-cing Guo

    2013-01-01

    Full Text Available Field experience has been considered a vital part of teacher education. Universities have to search for ways for student teachers to gain experience in an authentic teaching environment. Several successful models incorporating service learning have been reported across fields (Brooks & Schramm, 2007; Nandan, 2010; Salas, Safaradan, & Ugarte, 2008, but there is still insufficient research found that combined English teacher preparation and service learning (Hsieh, 2002. Consequently, this researcher incorporated service learning into an English methodology course in Taiwan to engage students in higher learning experiences that take them beyond traditional teacher training. This paper describes a four-stage process of community service teaching, presenting its benefits and challenges. This study which incorporated quantitative and qualitative methodologies proved that teaching practices in collaboration with community libraries created three-way benefits: advancing the quality of college education and bringing valuable learning opportunities to the student teachers as well as the children who participated; and creating memorable experiences for the students and the communities that participated. Keywords: service learning, teacher preparation, university partnership, higher education

  16. Report: Controls and Oversight Needed to Improve Administration of EPA’s Customer Service Lines

    Science.gov (United States)

    Report #13-P-0432, September 26, 2013. The EPA has a variety of resources—including telephone hotlines, Web clearinghouses, and other online reference information—which the OIG has categorized as customer service lines (CSLs).

  17. Improving Energy Efficiency at U.S. Plastics Manufacturing Plants Summary Report and Case Studies

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2010-06-25

    Industrial Technologies Program’s BestPractices report based on a comprehensive plant assessment project with ITP’s Industrial Assessment Center, The Society of the Plastics Industry, Inc., and several of its member companies.

  18. Improving Energy Efficiency at U.S. Plastics Manufacturing Plants: Summary Report and Case Studies

    Energy Technology Data Exchange (ETDEWEB)

    2005-09-01

    Industrial Technologies Programs BestPractices report based on a comprehensive plant assessment project with ITP's Industrial Assessment Center, The Society of the Plastics Industry, Inc., and several of its member companies.

  19. Designing a Safety Reporting Smartphone Application to Improve Patient Safety After Total Hip Arthroplasty.

    Science.gov (United States)

    Krumsvik, Ole Andreas; Babic, Ankica

    2017-01-01

    This paper presents a safety reporting smartphone application which is expected to reduce the occurrence of postoperative adverse events after total hip arthroplasty (THA). A user-centered design approach was utilized to facilitate optimal user experience. Two main implemented functionalities capture patient pain levels and well-being, the two dimensions of patient status that are intuitive and commonly checked. For these and other functionalities, mobile technology could enable timely safety reporting and collection of patient data out of a hospital setting. The HCI expert, and healthcare professionals from the Haukeland University Hospital in Bergen have assessed the design with respect to the interaction flow, information content, and self-reporting functionalities. They have found it to be practical, intuitive, sufficient and simple for users. Patient self-reporting could help recognizing safety issues and adverse events.

  20. Report: Wells Band Council Needs to Improve Its Accounting System to Comply With Federal Regulations

    Science.gov (United States)

    Report #14-2-0316, July 14, 2014. The Wells Band Council’s accounting system did not comply with federal regulations, which resulted in $390,000 of questioned costs and proposed high-risk designation for the grantee.

  1. Improving the creation and reporting of structured findings during digital pathology review

    Directory of Open Access Journals (Sweden)

    Ida Cervin

    2016-01-01

    Full Text Available Background: Today, pathology reporting consists of many separate tasks, carried out by multiple people. Common tasks include dictation during case review, transcription, verification of the transcription, report distribution, and report the key findings to follow-up registries. Introduction of digital workstations makes it possible to remove some of these tasks and simplify others. This study describes the work presented at the Nordic Symposium on Digital Pathology 2015, in Linköping, Sweden. Methods: We explored the possibility to have a digital tool that simplifies image review by assisting note-taking, and with minimal extra effort, populates a structured report. Thus, our prototype sees reporting as an activity interleaved with image review rather than a separate final step. We created an interface to collect, sort, and display findings for the most common reporting needs, such as tumor size, grading, and scoring. Results: The interface was designed to reduce the need to retain partial findings in the head or on paper, while at the same time be structured enough to support automatic extraction of key findings for follow-up registry reporting. The final prototype was evaluated with two pathologists, diagnosing complicated partial mastectomy cases. The pathologists experienced that the prototype aided them during the review and that it created a better overall workflow. Conclusions: These results show that it is feasible to simplify the reporting tasks in a way that is not distracting, while at the same time being able to automatically extract the key findings. This simplification is possible due to the realization that the structured format needed for automatic extraction of data can be used to offload the pathologists′ working memory during the diagnostic review.

  2. [SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): Revised publication guidelines from a detailed consensus process].

    Science.gov (United States)

    Ogrinc, Greg; Davies, Louise; Goodman, Daisy; Batalden, Paul; Davidoff, Frank; Stevens, David

    2015-11-20

    Since the publication of Standards for Quality Improvement Reporting Excellence (SQUIRE 1.0) guidelines in 2008, the science of the field has advanced considerably. In this manuscript, we describe the development of SQUIRE 2.0 and its key components. We undertook the revision between 2012 and 2015 using (1) semi-structured interviews and focus groups to evaluate SQUIRE 1.0 plus feedback from an international steering group, (2) two face-to-face consensus meetings to develop interim drafts, and (3) pilot testing with authors and a public comment period. SQUIRE 2.0 emphasizes the reporting of three key components of systematic efforts to improve the quality, value, and safety of healthcare: the use of formal and informal theory in planning, implementing, and evaluating improvement work; the context in which the work is done; and the study of the intervention(s). SQUIRE 2.0 is intended for reporting the range of methods used to improve healthcare, recognizing that they can be complex and multi-dimensional. It provides common ground to share these discoveries in the scholarly literature (www.squire-statement.org).

  3. SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): revised publication guidelines from a detailed consensus process.

    Science.gov (United States)

    Ogrinc, Greg; Davies, Louise; Goodman, Daisy; Batalden, Paul; Davidoff, Frank; Stevens, David

    2016-12-01

    Since the publication of Standards for QUality Improvement Reporting Excellence (SQUIRE 1.0) guidelines in 2008, the science of the field has advanced considerably. In this manuscript, we describe the development of SQUIRE 2.0 and its key components. We undertook the revision between 2012 and 2015 using (1) semistructured interviews and focus groups to evaluate SQUIRE 1.0 plus feedback from an international steering group, (2) two face-to-face consensus meetings to develop interim drafts and (3) pilot testing with authors and a public comment period. SQUIRE 2.0 emphasises the reporting of three key components of systematic efforts to improve the quality, value and safety of healthcare: the use of formal and informal theory in planning, implementing and evaluating improvement work; the context in which the work is done and the study of the intervention(s). SQUIRE 2.0 is intended for reporting the range of methods used to improve healthcare, recognising that they can be complex and multidimensional. It provides common ground to share these discoveries in the scholarly literature (http://www.squire-statement.org). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. Mayors and Public Education: The Case for Greater Involvement

    Science.gov (United States)

    Usdan, Michael D.

    2006-01-01

    Over the last generation, a new politics of education has evolved throughout the United States. Since the 1983 watershed report "A Nation at Risk" (National Commission on Excellence in Education, 1983), the country's most influential business and political leaders--and, more recently, mayors--have spearheaded efforts to improve student achievement…

  5. Mayors and Public Education: The Case for Greater Involvement

    Science.gov (United States)

    Usdan, Michael D.

    2006-01-01

    Over the last generation, a new politics of education has evolved throughout the United States. Since the 1983 watershed report "A Nation at Risk" (National Commission on Excellence in Education, 1983), the country's most influential business and political leaders--and, more recently, mayors--have spearheaded efforts to improve student achievement…

  6. Educating early childhood care and education providers to improve knowledge and attitudes about reporting child maltreatment: A randomized controlled trial

    Science.gov (United States)

    Yang, Chengwu; Lehman, Erik B.; Mincemoyer, Claudia; Verdiglione, Nicole; Levi, Benjamin H.

    2017-01-01

    Early childhood care and education providers (CCPs) work with over 7 million young children. These children are vulnerable to physical, sexual and emotional abuse, and neglect. However, CCPs make less than 1% of all reports of suspected child abuse and neglect that are made to child protective services. CCPs are therefore an untapped resource in the public health response to child maltreatment. However, their knowledge and attitudes about duties to report child maltreatment are poorly understood. Moreover, no rigorous research has tested whether their knowledge and attitudes about reporting child maltreatment can be improved. These gaps in knowledge are important because knowledge of the duty and positive attitudes towards it produce more effective reporting, and little evidence exists about how to enhance cognitive and affective attributes. Using the CONSORT approach, we report a single-blind test-retest randomized controlled trial evaluating iLook Out for Child Abuse, a customized online educational intervention for CCPs to increase knowledge and attitudes towards the reporting duty. 762 participants were randomized with results analyzed for 741 participants (372 in the intervention group; 369 in the control). Knowledge of the reporting duty increased in the intervention group from 13.54 to 16.19 out of 21 (2.65 increase, 95% CI: (2.37, 2.93); large effect size 0.95, p education for CCPs and other professions. Future research should also explore effects of education on reporting behavior. Trial registration: US National Institutes of Health NCT02225301 PMID:28542285

  7. [Vertical social mobility in Spain and ways to improve it. SESPAS report 2014].

    Science.gov (United States)

    García-Altés, Anna; Ortún, Vicente

    2014-06-01

    In this article, we analyze the extent to which an individual's socioeconomic status is inherited and how equality of opportunity could be increased to improve social mobility. Poverty and deprivation can stop being dynastic-like if the social elevator works. In Spain, income inequality, measured by the Gini coefficient, rose from 0.31 in 2006 to 0.35 in 2012 (moving away from Scandinavia and Central Europe and more closely resembling income inequality in the UK or the United States), while the degree of intergenerational mobility is half-way between that in Italy and the United States. To change this situation and make the social elevator work, primary education should be improved and the health system should be steered toward primary healthcare. This will not be feasible without an improvement in politics and the institutional framework that determine these factors. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  8. Quality improvement activity in radiology reading and reporting in a rural setting hospital in Indonesia.

    Science.gov (United States)

    Frelita, Grace; Wongso, Christlyn; Pasaribu, Marganda Dapot Asi

    2012-01-01

    The Republic of Indonesia is an archipelago country, which is located between Asia and Australia. With a population of more than 200 million people, Indonesia only has about 600 Radiologists, whose majority resides in urban areas. In such a challenging situation, the Siloam Hospitals Group (SHG) established a strategy to improve its remote hospitals' Radiologists' quality care standard of patient safety. Although the strategy has produced a positive result, resistance towards cultural change was unavoidable throughout the strategy implementation. By learning from several resources and experiences, SHG's leaders tried to develop a strategy improvement towards better processes, particularly in recognizing and solving interpersonal conflicts.

  9. Improved Structure and Fabrication of Large, High-Power KHPS Rotors - Final Scientific/Technical Report

    Energy Technology Data Exchange (ETDEWEB)

    Corren, Dean [Verdant Power, Inc.; Colby, Jonathan [Verdant Power, Inc.; Adonizio, Mary Ann [Verdant Power, Inc.

    2013-01-29

    Verdant Power, Inc, working in partnership with the National Renewable Energy Laboratory (NREL), Sandia National Laboratories (SNL), and the University of Minnesota St. Anthony Falls Laboratory (SAFL), among other partners, used evolving Computational Fluid Dynamics (CFD) and Finite Element Analysis (FEA) models and techniques to improve the structure and fabrication of large, high-power composite Kinetic Hydropower System (KHPS) rotor blades. The objectives of the project were to: design; analyze; develop for manufacture and fabricate; and thoroughly test, in the lab and at full scale in the water, the improved KHPS rotor blade.

  10. Improving bethesda reporting in thyroid cytology: A team effort goes a long way and still miles to go…

    Directory of Open Access Journals (Sweden)

    Subramanian Kannan

    2017-01-01

    Full Text Available Context: Fine-needle aspiration cytology is the first step in evaluation of thyroid nodules. Although the Bethesda classification for reporting thyroid cytology has been purported that this uniformity in reporting cytology thereby facilitating clinical decision-making, there are also studies indicating that the reporting percentage and the rates of malignancy in each category vary considerably from center to center making the clinical decision more difficult. Aim and Materials and Methods: We looked at our retrospective cytology and histopathology data of thyroid nodules operated between 2012 and 2014 and then prospectively collected data during 2015–2016. In the prospective arm, for every thyroid nodule that was sampled, there was a discussion between the endocrinologist and the cytopathologist on the risk of thyroid cancer (based on the patient's history, examination findings, sonographic pattern, and the cytological appearance. Results: We noted that there was considerable improvement in reporting standards with the rates of nondiagnostic cytology dropping from 11% to 5%, an increased reporting of Bethesda Category 2 and 6 which are the definitive strata of benign and malignant nodules (38% to 41% in Category 2 and 7% to 11% in Category 6 with a high specificity (100%. There was a decline in numbers of Category 4 and 5 (13% to 9% in Category 4 and 12% to 3% in Category 5. The reporting prevalence of Category 3 increased from 19% to 27%. Conclusions: We conclude that a team approach between the clinician who performs the ultrasound and the reporting cytopathologist improves Bethesda reporting, its predictive value, and thus potentially avoiding unnecessary thyroidectomies in benign thyroid nodules and hemithyroidectomies in thyroid cancers.

  11. Dot Hill reports third quarter 2001 results operating results continue to improve

    CERN Multimedia

    2001-01-01

    Dot Hill Systems Corp., a leading supplier of carrier-class data storage and storage area network solutions announced slighly improved financial results for the period ending Sept. 30, 2001. Of their products, SANnet Axis and the SANnet 7100 Fibre Channel storage system were selected as the essential storage components for the GRID demonstration at the High Performance Networking Forum Conference at CERN.

  12. Fuel performance improvement program. Quarterly progress report, April--June 1978. [LWR

    Energy Technology Data Exchange (ETDEWEB)

    Crouthamel, C.E. (comp.)

    1978-07-01

    The Fuel Performance Improvement Program has as its objective the identification and demonstration of fuel concepts with improved power ramp performance. Improved fuels are being sought to allow reduction or elimination of fuel related operating guidelines on nuclear power plants such that the fuel may be power maneuvered within the rates allowed by the system technical specifications. The program contains a combination of out-of-reactor studies, in-reactor experiments and in-reactor demonstrations. Fuel concepts initially being considered include annular pellets, cladding internally coated with graphite and packed-particle fuels. The performance capability of each concept will be compared to a reference fuel of contemporary pellet design by irradiations in the Halden Boiling Water Reactor. Fuel design and process development is being completed and fuel rod fabrication will begin for the Halden test rods and for the first series of in-reactor experiments. The in-reactor demonstrations are being performed in the Big Rock Point reactor to show that the concepts pose no undue risk to commercial operation. Additional concepts may be considered as the result of a state-of-the-technology review of fuel-cladding interaction and assessment of fuel concepts and the out-of-reactor studies. The results of the program will be used to establish the technical bases for design of fuels with improved power ramp performance.

  13. Educational Seduction: Implications for the Evaluation and Improvement of Teaching. Report #7.

    Science.gov (United States)

    Perry, Raymond P.

    Issues pertaining to the validity of student ratings of teacher effectiveness, research on "educational seduction," and implications of the research for the evaluation and improvement of teaching are reviewed. Criteria that have been used to validate student ratings include student achievement, faculty ratings, self-ratings, research productivity,…

  14. Final Report: Systematic Development of a Subgrid Scaling Framework to Improve Land Simulation

    Energy Technology Data Exchange (ETDEWEB)

    Dickinson, Robert Earl [Univ. of Texas, Austin, TX (United States)

    2016-07-11

    We carried out research to development improvements of the land component of climate models and to understand the role of land in climate variability and change. A highlight was the development of a 3D canopy radiation model. More than a dozen publications resulted.

  15. 76 FR 42590 - Retrospective Review Under E.O. 13563; Improving Common Acreage Reporting Processes

    Science.gov (United States)

    2011-07-19

    ...: This document requests input to help us improve services and reduce duplication of effort, including... additional public input, and allows us to clarify some misunderstandings about the initiative. Who are FFAS... economy. Within the current legislative authority, policies, and procedures, FSA is the agency that...

  16. Transformational change: nurses substituting for ophthalmologists for intravitreal injections – a quality-improvement report

    Directory of Open Access Journals (Sweden)

    Michelotti MM

    2014-04-01

    Full Text Available Monica M Michelotti,1 Salwa Abugreen,2 Simon P Kelly,1 Jiten Morarji,1 Debra Myerscough,2 Tina Boddie,2 Ann Haughton,1 Natalie Nixon,2 Brenda Mason,1 Evangelos Sioras11Ophthalmology Department, Royal Bolton Hospital NHS Foundation Trust, Bolton, UK; 2Ophthalmology Department, East Lancashire NHS Trust, Blackburn, UKBackground: The dramatic increase in need for anti-vascular endothelial growth factor (anti-VEGF intravitreal therapy in the treatment of retinal disease and the absence of an equivalent increase in ophthalmologists to undertake such intravitreal injections created a patient-safety risk. Timing of intravitreal therapy (IVT is critical to prevent vision loss and local clinics lacked capacity to treat patients appropriately. We aimed to improve capacity for IVT by nurse injections.Materials and methods: A multidisciplinary prospective service-improvement process was undertaken at two adjacent general hospitals in the northwest of England. IVT injections by nurses were a principal component of solution development. After we had obtained appropriate institutional approval, experienced ophthalmic nurses were trained, supervised, and assessed to undertake IVT. Ophthalmologists directly supervised the first 200 injections, and a retina specialist was always on site.Results: Nurses undertook 3,355 intravitreal injections between June 2012 and November 2013, with minor adverse events (0.3% subconjunctival hemorrhage and corneal abrasion. There were no patient complaints at either hospital.Conclusion: Experienced ophthalmic nurses quickly learned how to perform such injections safely. IVT by nurses was well accepted by patients and staff. Hospital A trained three nurses sequentially for improved flexibility in scheduling. Novel use of appropriately trained nonmedical staff can improve efficiency and access in an overburdened service with time-sensitive disease. Retinal assessment was undertaken by ophthalmologists only. Improved access to IVT

  17. Tai Chi and vestibular rehabilitation improve vestibulopathic gait via different neuromuscular mechanisms: Preliminary report

    Directory of Open Access Journals (Sweden)

    Parker Stephen W

    2005-02-01

    Full Text Available Abstract Background Vestibular rehabilitation (VR is a well-accepted exercise program intended to remedy balance impairment caused by damage to the peripheral vestibular system. Alternative therapies, such as Tai Chi (TC, have recently gained popularity as a treatment for balance impairment. Although VR and TC can benefit people with vestibulopathy, the degree to which gait improvements may be related to neuromuscular adaptations of the lower extremities for the two different therapies are unknown. Methods We examined the relationship between lower extremity neuromuscular function and trunk control in 36 older adults with vestibulopathy, randomized to 10 weeks of either VR or TC exercise. Time-distance measures (gait speed, step length, stance duration and step width, lower extremity sagittal plane mechanical energy expenditures (MEE, and trunk sagittal and frontal plane kinematics (peak and range of linear and angular velocity, were measured. Results Although gait time-distance measures were improved in both groups following treatment, no significant between-groups differences were observed for the MEE and trunk kinematic measures. Significant within groups changes, however, were observed. The TC group significantly increased ankle MEE contribution and decreased hip MEE contribution to total leg MEE, while no significant changes were found within the VR group. The TC group exhibited a positive relationship between change in leg MEE and change in trunk velocity peak and range, while the VR group exhibited a negative relationship. Conclusion Gait function improved in both groups consistent with expectations of the interventions. Differences in each group's response to therapy appear to suggest that improved gait function may be due to different neuromuscular adaptations resulting from the different interventions. The TC group's improvements were associated with reorganized lower extremity neuromuscular patterns, which appear to promote a faster

  18. Report: EPA’s Contract Oversight and Controls Over Personal Computers Need Improvement

    Science.gov (United States)

    Report #11-P-0705, September 26, 2011. EPA paid the CTS contractor a total of $489,734 over an 11-month period for 3,343 seats—a standard seat includes a leased computer with accessories and technical support—not ordered by the Agency during the period.

  19. Parent-Reported Homework Problems in the MTA Study: Evidence for Sustained Improvement with Behavioral Treatment

    Science.gov (United States)

    Langberg, Joshua M.; Arnold, L. Eugene; Flowers, Amanda M.; Epstein, Jeffery N.; Altaye, Mekibib; Hinshaw, Stephen P.; Swanson, James M.; Kotkin, Ronald; Simpson, Stephen; Molina, Brooke S. G.; Jensen, Peter S.; Abikoff, Howard; Pelham, William E., Jr.; Vitiello, Benedetto; Wells, Karen C.; Hechtman, Lily

    2010-01-01

    Parent-report of child homework problems was examined as a treatment outcome variable in the MTA-Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (ADHD). Five hundred seventy-nine children ages 7.0 to 9.9 were randomly assigned to either medication management, behavioral treatment, combination treatment, or…

  20. Report on Teaching: 5. Analyses of Some of the Most Notable Improvements in American Undergraduate Teaching.

    Science.gov (United States)

    Change, 1978

    1978-01-01

    In this fifth Report on Teaching compiled by Change Magazine, focus is on anthropology, foreign languages, and physics. Articles dealing with teaching competence at the higher education level in anthropology deal with both classroom and field instruction, written by: Francis L K. Hsu, Nathaniel Sheppard, Jr., Ronald Henkoff, Evan Jenkins, Liva…

  1. The Medicare Cost Report and the limits of hospital accountability: improving financial accounting data.

    Science.gov (United States)

    Kane, N M; Magnus, S A

    2001-02-01

    Health policy makers, legislators, providers, payers, and a broad range of other players in the health care market routinely seek information on hospital financial performance. Yet the data at their disposal are limited, especially since hospitals' audited financial statements--the "gold standard" in hospital financial reporting--are not publicly available in many states. As a result, the Medicare Cost Report (MCR), filed annually by most U.S. hospitals in order to receive payment for treating Medicare patients, has become the primary public source of hospital financial information. However, financial accounting elements in the MCR are unreliable, poorly defined, and lacking in critical detail. Comparative analyses of MCRs and matched, audited financial statements reveal long-standing problems with the MCR's data, including major differences in reported profits; variations in the reporting of both revenues and expenses; an absence of relevant details, such as charity care, bad debt, operating versus nonoperating income, and affiliate transactions; an inconsistent classification of changes in net assets; and a failure to provide cash flow statements. Because of these problems, MCR financial data give only a limited and often inaccurate picture of the financial position of hospitals. Audited financial statements provide a more complete perspective, enabling analysts to address important questions left unanswered by the MCR data. Regulatory action is needed to create a national database of financial information based upon audited statements.

  2. Local Authorities' Experiences of Improving Parental Confidence in the Special Educational Needs Process. LGA Research Report

    Science.gov (United States)

    White, Richard; Macleod, Shona; Jeffes, Jennifer; Atkinson, Mary

    2010-01-01

    How can we help parents to understand the special educational needs (SEN) process? What sort of information and support do they need? This report details the results of research with SEN officers (or their equivalent) in 26 local authorities, covering: (1) the referral process; (2) early identification and intervention; (3) local authority and…

  3. Creating the Missing Connection. Final Report on The Fund for the Improvement of Collegiate Education Grant.

    Science.gov (United States)

    Eveslage, Sonja A.; Wiesner, Linda

    Thomas A. Edison State College's Center for Corporate Partnerships and its 3-year program "Creating the Missing Connection" are reported. The Center connects Edison with business and government agencies so that they can play a role in making college education more accessible to their employees. The program contributed to the development of the…

  4. Report: EPA Needs to Improve Internal Controls to Increase Cost Recovery

    Science.gov (United States)

    Report #09-P-0144, April 27, 2009. Within a sample of removal actions we reviewed, EPA collected from responsible parties approximately 11 percent ($31.4 of $294.5 million) of the Federal Government’s costs for conducting the removal actions.

  5. Improved radioimmunotherapy of hematologic malignancies. Progress report, November 1, 1993--October 31, 1994

    Energy Technology Data Exchange (ETDEWEB)

    Press, O.W.

    1994-08-04

    This report summaries progress made during the time interval between November 1, 1993 and October 31, 1994 and briefly describes studies on the metabolism of antibodies targeting B cell antigens, retention of labeled antibodies by human B cell lymphocytes, and tissue distribution of Chloramine T and tyramine cellobiose labeled antibodies in mice harboring a human erythroleukemia tumor transplant.

  6. Need to Improve Efficiency of Reserve Training. Report to the Congress.

    Science.gov (United States)

    Comptroller General of the U.S., Washington, DC.

    The report discusses the need to vary the training of Reserve and Guard units by skill and readiness requirements and to make more efficient use of training time. It contains recommendations to the Secretaries of Defense, Transportation, Army, Navy, and Air Force. The review was based on questionnaires mailed to 2,209 randomly selected reservists…

  7. Can Extended Learning Opportunities Improve Student Achievement? E&R Report.

    Science.gov (United States)

    Baenen, Nancy R.; Lindblad, Mark; Yaman, Kim

    The Accelerated Learning Program (ALP) is the major initiative that the Wake County Public School System (WCPSS) is using to help all students reach grade level performance in reading and mathematics. In 2000-2001, ALP's second year of implementation, the program expanded from grades 3-8 to grades K-12. The focus of this report is on the program…

  8. The Power of Teacher Selection to Improve Education. Evidence Speaks Reports, Vol 1, #12

    Science.gov (United States)

    Jacob, Brian A.

    2016-01-01

    This report describes the findings from a new study of the teacher selection process in Washington, DC public schools. In 2009, the district created a centralized application process to streamline hiring by screening out less desirable candidates. Following the collection of standard information, applicants are asked to complete up to three…

  9. Improving Child Management Practices of Parents and Teachers. Maxi I Practicum. Final Report.

    Science.gov (United States)

    Adreani, Arnold J.; McCaffrey, Robert

    The practicum design reported in this document was based on one basic assumption, that the adult perceptions of children influence adult behavior toward children which in turn influences the child's behavior. Therefore, behavior changes by children could best be effected by changing the adult perception of, and behavior toward, the child.…

  10. Parent-Reported Homework Problems in the MTA Study: Evidence for Sustained Improvement with Behavioral Treatment

    Science.gov (United States)

    Langberg, Joshua M.; Arnold, L. Eugene; Flowers, Amanda M.; Epstein, Jeffery N.; Altaye, Mekibib; Hinshaw, Stephen P.; Swanson, James M.; Kotkin, Ronald; Simpson, Stephen; Molina, Brooke S. G.; Jensen, Peter S.; Abikoff, Howard; Pelham, William E., Jr.; Vitiello, Benedetto; Wells, Karen C.; Hechtman, Lily

    2010-01-01

    Parent-report of child homework problems was examined as a treatment outcome variable in the MTA-Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (ADHD). Five hundred seventy-nine children ages 7.0 to 9.9 were randomly assigned to either medication management, behavioral treatment, combination treatment, or…

  11. Mental contrasting of a dieting wish improves self-reported health behaviour

    DEFF Research Database (Denmark)

    Johannessen, Kim Berg; Oettingen, Gabriele; Mayer, Doris

    2012-01-01

    Mentally contrasting a desired future with present reality standing in its way promotes commitment to feasible goals, whereas mentally indulging in a desired future does not. Dieting students (N¼134) reported their most important dieting wish that they deemed attainable within a 2-week period. Th...

  12. A brief Patient-Reported Outcomes Quality of Life (PROQOL instrument to improve patient care.

    Directory of Open Access Journals (Sweden)

    Jennifer L Ridgeway

    2013-11-01

    Full Text Available Jeff Sloan and colleagues describe the development of the Patient-Reported Outcomes Quality of Life (PROQOL instrument, which captures and stores patient-recorded outcomes in the medical record for patients with diabetes. Please see later in the article for the Editors' Summary.

  13. Fuel performance improvement program. Quarterly/annual progress report, October 1978-September 1979

    Energy Technology Data Exchange (ETDEWEB)

    Crouthamel, C.E. (comp.)

    1979-10-01

    The objective of the Fuel Performance Improvement Program is to develop, test, and demonstrate basically two advanced fuel designs with the capability for improved power ramping performance and thus increase the capability of achieving extended burnup levels to better utilize uranium resources. The irradiations are being supported by out-of-reactor experiments to evaluate the effect of graphite coatings to inhibit stress-corrosion-cracking type cladding failures that are related to pellet-cladding interaction. Instrumented test irradiations in the Halden Boiling Water Reactor (HBWR) have achieved peak burnups of 697 GJ/kgM (8.1 MWd/kgM) with reference, annular-coated-pressurized, and sphere-pac rods.

  14. Improvements are needed in reporting of accuracy studies for diagnostic tests used for detection of finfish pathogens.

    Science.gov (United States)

    Gardner, Ian A; Burnley, Timothy; Caraguel, Charles

    2014-12-01

    Indices of test accuracy, such as diagnostic sensitivity and specificity, are important considerations in test selection for a defined purpose (e.g., screening or confirmation) and affect the interpretation of test results. Many biomedical journals recommend that authors clearly and transparently report test accuracy studies following the Standards for Reporting of Diagnostic Accuracy (STARD) guidelines ( www.stard-statement.org ). This allows readers to evaluate overall study validity and assess potential bias in diagnostic sensitivity and specificity estimates. The purpose of the present study was to evaluate the reporting quality of studies evaluating test accuracy for finfish diseases using the 25 items in the STARD checklist. Based on a database search, 11 studies that included estimates of diagnostic accuracy were identified for independent evaluation by three reviewers. For each study, STARD checklist items were scored as "yes," "no," or "not applicable." Only 10 of the 25 items were consistently reported in most (≥80%) papers, and reporting of the other items was highly variable (mostly between 30% and 60%). Three items ("number, training, and expertise of readers and testers"; "time interval between index tests and reference standard"; and "handling of indeterminate results, missing data, and outliers of the index tests") were reported in less than 10% of papers. Two items ("time interval between index tests and reference standard" and "adverse effects from testing") were considered minimally relevant to fish health because test samples usually are collected postmortem. Modification of STARD to fit finfish studies should increase use by authors and thereby improve the overall reporting quality regardless of how the study was designed. Furthermore, the use of STARD may lead to the improved design of future studies.

  15. The combination of a nylon and traditional partial removable dental prosthesis for improved esthetics: a clinical report.

    Science.gov (United States)

    Ito, Masayasu; Wee, Alvin G; Miyamoto, Takanari; Kawai, Yasuhiko

    2013-01-01

    A benefit of a nylon partial removable dental prosthesis (PRDP) is the absence of a metal framework, providing improved esthetics. Unfortunately, the lack of a traditional framework reduces rigidity and the support of occlusal rests. This clinical report describes a combination of a nylon PRDP (polyamide denture base resin) and a traditional PRDP (framework/resin) for a Kennedy Class II, Modification 1, partially edentulous mandible.

  16. Identification of at-risk students and strategies to improve academic success in first year health programs. A Practice Report

    Directory of Open Access Journals (Sweden)

    Andrew Gerard Pearson

    2013-04-01

    Full Text Available The transition to university is a difficult process for many students, having a negative impact on their academic performance, ultimately resulting in failure or withdrawal from one or more courses in their first semester. This practice report describes a profile analysis and readiness assessment designed to identify students at high academic risk. Students so identified were offered additional workshops to address assumed knowledge and academic skills. Attendance at the workshops correlated with improved academic outcomes.

  17. Improving CERN's Presence on Wikipedia - Project Report, Summer Student Lecture Program 2017

    CERN Document Server

    Storehaug, Ida

    2017-01-01

    Dissemination of information on high energy physics and related technologies is at the core of CERN’s mission, making research done at CERN available, both to the public and other researchers. Wikipedia, being the most used social media site for researchers and a popular source of science information for the public, is an obvious platform for CERN to be present on. Between 19 June and 25 August 2017, as part of the CERN Summer Student Program, a project to improve CERN’s presence on Wikipedia was carried out in the department of Scientific Information Service at CERN. In the following the use of references in the collection of CERN-related Wikipedia articles is discussed, and the topics of plagiarism and licenses are raised. Furthermore, methods to benefit from the CERN community and archives are described, followed by a summary of how to get a Wikipedia article accepted by the Wikipedia community. Lists of Wikipedia articles created or improved and of Wikipedia articles in need of improvement are given.

  18. Development of improved iron Fischer-Tropsch catalysts. Final technical report: Project 6464

    Energy Technology Data Exchange (ETDEWEB)

    Bukur, D.B.; Ledakowicz, S.; Koranne, M. [Texas A and M Univ., College Station, TX (United States). Dept. of Chemical Engineering] [and others

    1994-02-28

    Despite the current worldwide oil glut, the United States will ultimately require large-scale production of liquid (transportation) fuels from coal. Slurry phase Fischer Tropsch (FT) technology, with its versatile product slate, may be expected to play a major role in production of transportation fuels via indirect coal liquefaction. Texas A&M University (TAMU) with sponsorship from the US Department of Energy, Center for Energy and Mineral Resources at TAMU, Texas Higher Education Coordinating Board, and Air Products and Chemicals, Inc., has been working on development of improved iron FT catalysts and characterization of hydrodynamic parameters in two- and three-phase bubble columns with FT derived waxes. Our previous studies have provided an improved understanding of the role of promoters (Cu and K), binders (silica) and pretreatment procedures on catalyst activity, selectivity and longevity (deactivation). The objective of the present contract was to develop improved catalysts with enhanced slurry phase activity and higher selectivity to liquid fuels and wax. This was accomplished through systematic studies of the effects of pretreatment procedures and variations in catalyst composition (promoters and binders). The major accomplishments and results in each of these two main areas of research are summarized here.

  19. Leveraging health information exchange to improve population health reporting processes: lessons in using a collaborative-participatory design process.

    Science.gov (United States)

    Revere, Debra; Dixon, Brian E; Hills, Rebecca; Williams, Jennifer L; Grannis, Shaun J

    2014-01-01

    Surveillance, or the systematic monitoring of disease within a population, is a cornerstone function of public health. Despite significant investment in information technologies (IT) to improve the public's health, health care providers continue to rely on manual, spontaneous reporting processes that can result in incomplete and delayed surveillance activities. Participatory design principles advocate including real users and stakeholders when designing an information system to ensure high ecological validity of the product, incorporate relevance and context into the design, reduce misconceptions designers can make due to insufficient domain expertise, and ultimately reduce barriers to adoption of the system. This paper focuses on the collaborative and informal participatory design process used to develop enhanced, IT-enabled reporting processes that leverage available electronic health records in a health information exchange to prepopulate notifiable-conditions report forms used by public health authorities. Over nine months, public health stakeholders, technical staff, and informatics researchers were engaged in a multiphase participatory design process that included public health stakeholder focus groups, investigator-engineering team meetings, public health survey and census regarding high-priority data elements, and codesign of exploratory prototypes and final form mock-ups. A number of state-mandated report fields that are not highly used or desirable for disease investigation were eliminated, which allowed engineers to repurpose form space for desired and high-priority data elements and improve the usability of the forms. Our participatory design process ensured that IT development was driven by end user expertise and needs, resulting in significant improvements to the layout and functionality of the reporting forms. In addition to informing report form development, engaging with public health end users and stakeholders through the participatory design

  20. Land cover mapping of Greater Mesoamerica using MODIS data

    Science.gov (United States)

    Giri, Chandra; Jenkins, Clinton N.

    2005-01-01

    A new land cover database of Greater Mesoamerica has been prepared using moderate resolution imaging spectroradiometer (MODIS, 500 m resolution) satellite data. Daily surface reflectance MODIS data and a suite of ancillary data were used in preparing the database by employing a decision tree classification approach. The new land cover data are an improvement over traditional advanced very high resolution radiometer (AVHRR) based land cover data in terms of both spatial and thematic details. The dominant land cover type in Greater Mesoamerica is forest (39%), followed by shrubland (30%) and cropland (22%). Country analysis shows forest as the dominant land cover type in Belize (62%), Cost Rica (52%), Guatemala (53%), Honduras (56%), Nicaragua (53%), and Panama (48%), cropland as the dominant land cover type in El Salvador (60.5%), and shrubland as the dominant land cover type in Mexico (37%). A three-step approach was used to assess the quality of the classified land cover data: (i) qualitative assessment provided good insight in identifying and correcting gross errors; (ii) correlation analysis of MODIS- and Landsat-derived land cover data revealed strong positive association for forest (r2 = 0.88), shrubland (r2 = 0.75), and cropland (r2 = 0.97) but weak positive association for grassland (r2 = 0.26); and (iii) an error matrix generated using unseen training data provided an overall accuracy of 77.3% with a Kappa coefficient of 0.73608. Overall, MODIS 500 m data and the methodology used were found to be quite useful for broad-scale land cover mapping of Greater Mesoamerica.

  1. Improving disclosure and consent: "is it safe?": new ethics for reporting personal exposures to environmental chemicals.

    Science.gov (United States)

    Brody, Julia Green; Morello-Frosch, Rachel; Brown, Phil; Rudel, Ruthann A; Altman, Rebecca Gasior; Frye, Margaret; Osimo, Cheryl A; Pérez, Carla; Seryak, Liesel M

    2007-09-01

    The recent flood of research concerning pollutants in personal environmental and biological samples-blood, urine, breastmilk, household dust and air, umbilical cord blood, and other media-raises questions about whether and how to report results to individual study participants. Clinical medicine provides an expert-driven framework, whereas community-based participatory research emphasizes participants' right to know and the potential to inform action even when health effects are uncertain. Activist efforts offer other models. We consider ethical issues involved in the decision to report individual results in exposure studies and what information should be included. Our discussion is informed by our experience with 120 women in a study of 89 pollutants in homes and by interviews with other researchers and institutional review board staff.

  2. Cognitive Behavioral Treatment to Improve Adherence to Hemodialysis Fluid Restrictions: A Case Report

    Directory of Open Access Journals (Sweden)

    Heather M. Anson

    2009-01-01

    Full Text Available This case report describes outpatient psychological treatment targeting adherence to fluid restrictions in a hemodialysis patient. The consequences of nonadherence to fluid restrictions in hemodialysis patients range from minor discomfort to increased hospitalizations and mortality rates. In addition, when patients chronically fail to adhere, they may no longer be candidates for kidney transplant. The interventions focused on polydipsia, characterized by excessive fluid intake. The methods involved 11-sessions of individual psychotherapy incorporating strategies including increasing awareness, decreasing motivation, increasing effort, engaging in competing events, conducting thought stopping, breaking repetitive routines, eliciting social support, and receiving reinforcement. Results demonstrated that the patient successfully restricted his fluid intake at or below recommended levels 83% of days after fading of treatment began. This case report demonstrates the success of cognitive behavioral treatment strategies with a nonpsychiatric hemodialysis patient.

  3. Improving the regulation of safety at DOE nuclear facilities. Final report: Appendices

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-01

    The report strongly recommends that, with the end of the Cold War, safety and health at DOE facilities should be regulated by outside agencies rather than by any regulatory scheme, DOE must maintain a strong internal safety management system; essentially all aspects of safety at DOE`s nuclear facilities should be externally regulated; and existing agencies rather than a new one should be responsible for external regulation.

  4. Improving the regulation of safety at DOE nuclear facilities. Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-01

    The report strongly recommends that, with the end of the Cold War, safety and health at DOE facilities should be regulated by outside agencies rather than by DOE itself. The three major recommendations are: under any regulatory scheme, DOE must maintain a strong internal safety management system; essentially all aspects of safety at DOE`s nuclear facilities should be externally regulated; and existing agencies rather than a new one should be responsible for external regulation.

  5. Army Reserve Components: Improvements Needed to Data Quality and Management Procedures to Better Report Soldier Availability

    Science.gov (United States)

    2015-07-01

    Department of Defense DQI Data Quality Index HIV Human Immunodeficiency Virus MEDPROS Medical Protection System RCMS Reserve Component Manpower System...immunizations; • current on required medical laboratory studies such as an HIV test and a DNA sample; • possession of individual medical equipment items...be completed within 75 days after the soldier reports the incident. See figure 1 for an explanation of the processes and requirements of informal

  6. Improved Duct Systems Task Report with StageGate 2 Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Moyer, Neil [Florida Solar Energy Center, Cocoa, FL (United States); Stroer, Dennis [Calcs-Plus, Venice, FL (United States)

    2007-12-31

    This report is about Building America Industrialized Housing Partnership's work with two industry partners, Davalier Homes and Southern Energy Homes, in constructing and evaluating prototype interior duct systems. Issues of energy performance, comfort, DAPIA approval, manufacturability and cost is addressed. A stage gate 2 analysis addresses the current status of project showing that there are still refinements needed to the process of incorporating all of the ducts within the air and thermal boundaries of the envelope.

  7. Molten carbonate fuel cell product design and improvement. Quarterly report, January 1--March 30, 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-12-31

    Objective is to establish by 1998 the commercial readiness of MW- class IMHEX{reg_sign} MCFC power plants for distributed generation, cogeneration, and compressor station applications. This will require an advanced IMHEX{reg_sign} technology base, lower-cost manufacturing processes, verified balance-of-plant components, proven packaging and assembly approaches, demonstrated prototype power plants, finalized manufacturing and market distribution plans, and a committed commercialization team. Various tasks are reported on.

  8. AREDS Formula, Warfarin, and Bleeding: A Case Report from the Michigan Anticoagulation Quality Improvement Initiative

    Science.gov (United States)

    Heidt, Steven T.; Haymart, Brian; Froehlich, James B.; Kline-Rogers, Eva; Barnes, Geoffrey D.

    2014-01-01

    Importance. The anticoagulant warfarin has been shown to interact with other medications, vitamin K containing foods, and over-the-counter products. These interactions may inhibit or potentiate the effect of warfarin, resulting in serious clotting or bleeding events. Observations. We report the case of an 84-year-old woman with atrial fibrillation, prescribed warfarin in May 2010 for stroke prevention. Her international normalized ratio (INR) was stable until April 2013, when she was prescribed AREDS (Age Related Eye Disease Study) formula pills, an eye vitamin compound, to slow the progression of age-related macular degeneration. This change was not reported to the Anticoagulation Service. Eighteen days later, she presented to the ED with groin and back pain and an INR of 10.4. An abdominal CT revealed a retroperitoneal hemorrhage with extension in multiple muscles. Both warfarin and AREDS were discontinued and the patient was discharged to subacute rehabilitation. This case was reviewed by the Anticoagulation Service and actions were taken to prevent similar adverse events. Conclusions. This report provides an example of the potential danger of supplement use, in this case, AREDS formula, in patients prescribed warfarin, and the importance of communicating medication changes to the providers responsible for warfarin management. PMID:25250052

  9. AREDS Formula, Warfarin, and Bleeding: A Case Report from the Michigan Anticoagulation Quality Improvement Initiative

    Directory of Open Access Journals (Sweden)

    Eric Puroll

    2014-01-01

    Full Text Available Importance. The anticoagulant warfarin has been shown to interact with other medications, vitamin K containing foods, and over-the-counter products. These interactions may inhibit or potentiate the effect of warfarin, resulting in serious clotting or bleeding events. Observations. We report the case of an 84-year-old woman with atrial fibrillation, prescribed warfarin in May 2010 for stroke prevention. Her international normalized ratio (INR was stable until April 2013, when she was prescribed AREDS (Age Related Eye Disease Study formula pills, an eye vitamin compound, to slow the progression of age-related macular degeneration. This change was not reported to the Anticoagulation Service. Eighteen days later, she presented to the ED with groin and back pain and an INR of 10.4. An abdominal CT revealed a retroperitoneal hemorrhage with extension in multiple muscles. Both warfarin and AREDS were discontinued and the patient was discharged to subacute rehabilitation. This case was reviewed by the Anticoagulation Service and actions were taken to prevent similar adverse events. Conclusions. This report provides an example of the potential danger of supplement use, in this case, AREDS formula, in patients prescribed warfarin, and the importance of communicating medication changes to the providers responsible for warfarin management.

  10. Improving energy use in Canada: Report to Parliament under the Energy Efficiency Act, 1996-1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-31

    Progress in energy efficiency and alternative energy (EAE) initiatives during the 1996-1997 fiscal year are reported in this fifth annual report to Parliament under the Energy Efficiency Act. These initiatives are considered critical to the National Action Program on Climate Change, which sets out Canada`s strategic objectives and directions to limit the emission of greenhouse gases. These initiatives are designed to reduce carbon dioxide emissions by various means, including replacing carbon-intensive energy sources with energy generated from sources that produce fewer, or no carbon dioxide emissions, such as wind power or small hydro power. Four policy instruments are used to pursue these objectives: regulation; information; voluntary action; and science and technology. This report contains details of achievements under each of these policy instruments, reviews the policy context of energy efficiency and alternative energy programs, describes the Act and relevant Regulations, and the connection between energy use and greenhouse gas emissions. Each energy use sector is reviewed individually, with descriptions of initiatives, progress indicators and achievements. Renewable and district energy, and inter-governmental cooperation in EAE activities are also discussed, Wherever possible, quantifiable indicators have been used. 8 tabs., 45 figs.

  11. Module process optimization and device efficiency improvement for stable, low-cost, large-area, cadmium telluride-based photovoltaic module production. Final subcontract report, 1 July 1990--30 April 1994

    Energy Technology Data Exchange (ETDEWEB)

    Albright, S P; Johnson, S X [Golden Photon, Inc., CO (United States)

    1994-06-01

    This report describes work performed under a three-phase subcontract. The objectives of the program include (1) achievement of active-area efficiencies of greater than 14% on small cells; (2) achievement of aperture-area efficiencies of greater than 13% on 0.09-m{sup 2} (1 ft{sup 2}) modules; (3) achievement of aperture-area efficiencies of greater than 12.5% on 0.37-m{sup 2} (4 ft{sup 2}) modules; and achievement of greater than 20-year module life (based on life testing extrapolations) with no greater than 10% efficiency degradation. The results obtained and described herein include the following: (1) efficiencies of 12.7% were achieved on small-area devices; (2) 0.09-m{sup 2} (1 ft{sup 2}) modules achieved greater than 8% aperture-area efficiency, but work for further efficiency improvement was redirected toward the 0.37-M{sup 2} (4 if) modules; (3) 0.37-m{sup 2} (4 ft{sup 2}) modules achieved 26.5-W output, which calculates to 8.0% aperture-area efficiency; (4) consistent prototype production was focused on and substantially achieved within Phase 2; (5) life testing at the National Renewable Energy Laboratory showed no inherent stability problems with the CdTe technology, and the accuracy of module measurement was satisfactorily resolved; and (6) a ``cradle-to-cradle`` recycling program was begun based upon the philosophy that the establishment of such mechanisms will be required to ensure maximum recapture and recycling of all manufacturing waste materials and/or modules returned from the field.

  12. A stakeholder-collaborative evaluation of intervention for students with greater psychosocial needs.

    Science.gov (United States)

    Shek, Daniel T L; Yu, Lu

    2012-01-17

    The Tier 2 Program of Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes) in Hong Kong was designed and implemented by school social workers targeting adolescents with greater psychosocial needs. Based on the responses of 237 participants, 48 program implementers wrote down five conclusions on the program effectiveness in their reports submitted to the funding body. Based on a stakeholder-collaborative approach involving secondary data analyses, results showed that most conclusions were positive regarding participants' perceptions of the program, instructors and their perceived program effectiveness, although there were also conclusions reflecting difficulties encountered and suggestions for improvements. In conjunction with the previous evaluation findings, the present study suggests that the Tier 2 Program was well received by the stakeholders and the program was beneficial to the development of the program participants.

  13. A quality improvement project to tackle under-reporting of hazards by doctors by using an anonymous telephone hotline.

    Science.gov (United States)

    Johnson, Sarah

    2016-01-01

    An anonymous hazard reporting hotline was established for doctors to use on two general medical wards at Weston General Hospital (WGH) in North Somerset in England during an eight day period in July/August 2014. Doctors were encouraged to report hazards and near misses or just start a conversation about a concern. The existing computer based significant event system remained alongside the hotline and was to be used where actual harm had come to a patient. A team of consultants and quality improvement administrators monitored the hotline on a daily basis, categorized the level of risk being reported and ensured, where possible, that action was taken to address the doctors' concerns. The hotline increased reporting rates from two per month to 25 in eight days. The system identified 13 amber (medium risk) and five red (high risk) hazards which would otherwise not have been known about. This author believes these five high risk reports alone make the case for a new, quicker, easier, and anonymous reporting system for doctors at WGH urgent and irrefutable.

  14. Physiotherapists report improved understanding of and attitude toward the cognitive, psychological and social dimensions of chronic low back pain after Cognitive Functional Therapy training: a qualitative study.

    Science.gov (United States)

    Synnott, Aoife; O'Keeffe, Mary; Bunzli, Samantha; Dankaerts, Wim; O'Sullivan, Peter; Robinson, Katie; O'Sullivan, Kieran

    2016-10-01

    What are physiotherapists' perspectives on managing the cognitive, psychological and social dimensions of chronic low back pain after intensive biopsychosocial training? Qualitative study design using semi-structured interviews to explore physiotherapists' perceptions of their identification and treatment of the biopsychosocial dimensions of chronic low back pain after intensive Cognitive Functional Therapy (CFT) training. Thirteen qualified physiotherapists from four countries who had received specific CFT training. The training involved supervised implementation of CFT in clinical practice with patients. Interviews were audio-recorded and transcribed verbatim. An interpretive descriptive analysis was performed using a qualitative software package. Four main themes emerged from the data: self-reported changes in understanding and attitudes; self-reported changes in professional practice; altered scope of practice; and increased confidence and satisfaction. Participants described increased understanding of the nature of pain, the role of patient beliefs, and a new appreciation of the therapeutic alliance. Changes in practice included use of new assessments, changes in communication, and adoption of a functional approach. Since undertaking CFT training, participants described a greater awareness of their role and scope of practice as clinicians in identifying and addressing these factors. Physiotherapists expressed confidence in their capacity and skill set to manage the biopsychosocial dimensions of chronic low back pain after CFT training, and identified a clear role for including these skills within the physiotherapy profession. Despite this, further clinical trials are needed to justify the time and cost of training, so that intensive CFT training may be made more readily accessible to clinicians, which to date has not been the case. [Synnott A, O'Keeffe M, Bunzli S, Dankaerts W, O'Sullivan P, Robinson K, O'Sullivan K (2016) Physiotherapists report improved

  15. Natural Propagation and Habitat Improvement, Volume 1, Oregon, 1985 Annual and Final Reports.

    Energy Technology Data Exchange (ETDEWEB)

    McDonald, Ken

    1986-10-01

    The Hot Springs Fork of the Collawash River is a major sub-drainage in the Clackamas River drainage. Emphasis species for natural production are spring chinook, coho salmon, and winter steelhead. Increased natural production appears limited by a lack of quality rearing habitat. Habitat complexity over approximately 70% of accessible area to anadromous fish has been reduced over the last 40 years by numerous factors. Natural passage barriers limit anadromous fish access to over 7 miles of high quality habitat. In the first year of a multi-year effort to improve fish habitat in the Hot Springs Fork drainage, passage enhancement on two tributaries and channel rehabilitation on one of those tributaries was completed. Three waterfalls on Nohorn Creek were evaluated and passage improved on the uppermost waterfall to provide steelhead full access to 2.4 miles of good quality habitat. The work was completed in October 1985 and involved blasting three jump pools and two holding pools into the waterfall. On Pansy Creek, four potential passage barriers were evaluated and passage improvement work conducted on two logjams and one waterfall. Minor modifications were made to a waterfall to increase flow into a side channel which allows passage around the waterfall. Channel rehabilitation efforts on Pansy Creek (RM 0.0 to 0.3) to increase low flow pool rearing habitat and spawning habitat including blasting five pools into areas of bedrock substrate and using a track-mounted backhoe to construct instream structures. On site materials were used to construct three log sills, three boulder berms, a boulder flow deflector, and five log and boulder structures. Also, an alcove was excavated to provide overwinter rearing habitat. Pre-project monitoring consisting of physical and biological data collection was completed in the project area.

  16. 'Is Ash Falling?', an online ashfall reporting tool in support of improved ashfall warnings and investigations of ashfall processes

    Science.gov (United States)

    Wallace, Kristi; Snedigar, Seth; Cameron, Cheryl

    2015-01-01

    The primary volcano hazard in Alaska is airborne ash, which endangers aircraft flying the busy North Pacific air routes and consequently affects global commerce. Downwind ashfall is also a significant threat to commerce, transportation and day-to-day activities in nearby Alaska communities. A web-enabled database, "Is Ash Falling?" has been developed to collect ashfall observations and encourage sample collections from the public during eruptions, enabling volcano observatory staff to concentrate on eruption response. Knowing the locations of filed ashfall reports improves public ashfall warnings and forecasts by providing on-the-ground checks for ash dispersion and fallout computer models and satellite imagery interpretation. Reports of ashfall are shared with emergency management agencies and the wider public. These reports also give scientists a more complete record of the amount, duration and other conditions of ashfall.

  17. Improvement of shrimp allergy after sublingual immunotherapy for house dust mites: a case report.

    Science.gov (United States)

    Cortellini, G; Spadolini, I; Santucci, A; Cova, V; Conti, C; Corvetta, A; Passalacqua, G

    2011-10-01

    The appropriateness of house dust mite specific immunotherapy in patients allergic to shrimps still remains unclear We present a clinical case as an immunological model for the strong sensitization to tropomyosin with symptoms of anaphylaxis due to shrimps and coexisting asthma due to house dust mite. The improvement in respiratory symptoms for house dust mite and in the food challenge for shrimps during mite immunotherapy with a known and high dosage of tropomyosin suggests the hypothesis that efficacy of mite immunotherapy in food allergy to tropomyosin may be dose dependent.

  18. Improved Advanced Actuated Hybrid Mirrors Final Report CRADA No. TC02130.0

    Energy Technology Data Exchange (ETDEWEB)

    Barbee, T. W. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Ealey, M. A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2017-08-25

    This was a collaborative effort to develop and demonstrate an improved Advanced Actuated Hybrid Mirrors (AAHM) for commercial or Government purposes. The AAHM consists of a nanolaminate film replicating a precision optical surface bonded to a Silicon Carbide (SiC) substrate with active figure control capability. The goal of this project was to further the development of specific AAHM technologies. The intent of the CRADA was to combine the expertise of LLNL and NG Xinetics in the manufacture and test of a very high quality AAHM, incorporating lessons learned from earlier joint efforts.

  19. Report on the feasibility study for improving electric motor service centers in Ghana

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, J.S.; Jallouk, P.A.; Staunton, R.H.

    1999-12-10

    On March 3 and 4, 1998, a visit was made to Oak Ridge National Laboratory (ORNL) by two officials from Ghana: Mr. I.K. Mintah, Acting Executive Director, Technical Wing, Ministry of Mines and Energy (MOME) and Dr. A.K. Ofosu-Ahenkorah, Coordinator, Energy Efficiency and Conservation Program, MOME. As a result of this visit, Dr. John S. Hsu of ORNL was invited by MOME to visit the Republic of Ghana in order to study the feasibility of improving electric motor service centers in Ghana.

  20. Final Report Collaborative Project. Improving the Representation of Coastal and Estuarine Processes in Earth System Models

    Energy Technology Data Exchange (ETDEWEB)

    Bryan, Frank [National Center for Atmospheric Research, Boulder, CO (United States); Dennis, John [National Center for Atmospheric Research, Boulder, CO (United States); MacCready, Parker [Univ. of Washington, Seattle, WA (United States); Whitney, Michael [Univ. of Connecticut

    2015-11-20

    This project aimed to improve long term global climate simulations by resolving and enhancing the representation of the processes involved in the cycling of freshwater through estuaries and coastal regions. This was a collaborative multi-institution project consisting of physical oceanographers, climate model developers, and computational scientists. It specifically targeted the DOE objectives of advancing simulation and predictive capability of climate models through improvements in resolution and physical process representation. The main computational objectives were: 1. To develop computationally efficient, but physically based, parameterizations of estuary and continental shelf mixing processes for use in an Earth System Model (CESM). 2. To develop a two-way nested regional modeling framework in order to dynamically downscale the climate response of particular coastal ocean regions and to upscale the impact of the regional coastal processes to the global climate in an Earth System Model (CESM). 3. To develop computational infrastructure to enhance the efficiency of data transfer between specific sources and destinations, i.e., a point-to-point communication capability, (used in objective 1) within POP, the ocean component of CESM.

  1. Development of a new method for improving load turndown in fluidized bed combustors: Final report

    Energy Technology Data Exchange (ETDEWEB)

    Brown, R.C.

    1988-12-01

    The objective of this research was to investigate a new concept in fluidized bed design that improves load turndown capability. This improvement is accomplished by independently controlling heat transfer and combustion in the combustor. The design consists of two fluidized beds, one central and one annular. The central bed serves as the combustion bed. The annular bed is fluidized separately from the combustion bed and its level of fluidization determine the overall heat transfer rate from the combustion bed to the surrounding water jacket. Early theoretical considerations suggested a load turndown exceeding ten was possible for this design. This research consisted of three major phases: development of a computational model to predict heat transfer in the two-bed combustor, heat transfer measurements in hot-and-cold flow models of the combustor, and combustion tests in an optimally designed combustor. The computation model was useful in selecting the design of the combustor. Annular bed width and particle sizes were chosen with the aid of the model. The heat transfer tests were performed to determine if the existing correlations for fluidized bed heat transfer coefficients were sufficiently accurate for high aspect ratio fluidized beds (such as the annular bed in the combustor). Combustion tests were performed in an optimally designed combustor. Three fuel forms were used: double screened, crushed coal, coal-water-limestone mixtures (CWLM), and coal-limestone briquettes. 18 refs., 30 figs., 8 tabs.

  2. Camas Creek (Meyers Cove) Anadromous Species Habitat Improvement: Annual Report 1989.

    Energy Technology Data Exchange (ETDEWEB)

    Hardy, Terry

    1989-12-01

    Historical agricultural practices and natural events contributed to severe degradation of riparian zones and instream fish habitat in the Meyers Cove area of Camas Creek. In 1984, Salmon National Forest personnel began implementing specific management activities in riparian areas and the stream channel to accelerate habitat recovery. In 1987--88, 4.3 miles of fence was constructed establishing a riparian livestock exclosure in the Meyers Cove area of Camas Creek. One end-gap and two water-crossing corridors were constructed in 1989 to complete the fence system. The riparian exclosure has been fertilized with phosphorous-rich fertilizer to promote root growth. A stream crossing ford was stabilized with angular cobble. Streambank stabilization/habitat cover work was completed at three sites and three additional habitat structures were placed. Extensive habitat inventories were completed to identify quality/quantity of habitat available to anadromous fish. The work accomplished was designed to promote natural revegetation of the riparian area to improve rearing habitat cover and streambank stability. Streambank work was limited to extremely unstable sites. Enhancement activities will improve spawning, incubation, and rearing habitat for wild populations of steelhead trout and chinook salmon. Anadromous species population increases resulting from these enhancement activities will provide partial compensation for downstream losses resulting from hydroelectric developments on the Columbia River system. 9 refs., 6 figs., 7 tabs.

  3. Using Primary Care Parenting Interventions to Improve Outcomes in Children with Developmental Disabilities: A Case Report

    Directory of Open Access Journals (Sweden)

    Cassandra L. Tellegen

    2012-01-01

    Full Text Available Parenting is central to the health and well-being of children. Children with developmental disabilities have been shown to be at increased risk of developing emotional and behavioral problems. Parent training programs are effective interventions for improving child behavior and family functioning. This paper describes the outcomes of a brief 4-session parenting intervention (Primary Care Stepping Stones Triple P targeting compliance and cooperative play skills in an 8-year-old girl with Asperger’s disorder and ADHD combined type. The intervention was associated with decreases in child behavior problems, increases in parenting confidence, and decreases in dysfunctional parenting styles. This paper demonstrates that low-intensity parenting interventions can lead to significant improvements in child behavior and family functioning. Such brief interventions are cost effective, can be widely disseminated, and have been designed to be delivered within primary health care settings. Pediatricians can play a key role in identifying parents in need of assistance and in helping them access evidence-based parenting interventions.

  4. Solitary fibrous tumor of the greater omentum mimicking an ovarian tumor in a young woman

    Directory of Open Access Journals (Sweden)

    Elisabet Rodriguez Tarrega

    2016-08-01

    Full Text Available We report a case of solitary fibrous tumor (SFT of greater omentum in a young woman. SFT arising from the greater omentum can mimic a gynecologic neoplasm. SFTs are generally benign but some of them are malignant and have uncertain prognosis. An adequate follow-up is essential in these patients.

  5. How to simplify and improve incident and near miss reporting in wards:I.R.G.E. (Incident Reporting with Gravity Effect system

    Directory of Open Access Journals (Sweden)

    Francesco De Caro

    2011-09-01

    Full Text Available

    In this paper, an improved system that allows a simplified reporting of errors and near misses in wards, and permits operators to accurately manage all data recorded, is presented. IRGE (Incident Reporting with Gravity Effect System is based on the use of a paper form for reporting accidents and near misses. The severity of an error can be evidenced through the choice of a color similar to the well-known method used in the emergency medicine triage, thus leading to the most evident and immediate understanding of the magnitude of error. In addition, the system is provided with a report form for its users to be compiled with the highest completeness of information.


    A dedicated software for the storage of records and data analysis has been created, which gives one the possibility of alerting key figures within the health facility promptly. The system allows us to store and share records among different care units and also among different hospitals, thus providing a basis for a national database. Moreover, through this system, it is possible to assess the “risk attitude” of the health facility monitored.

  6. Development of an improved permissible miners' caplamp. Open file report (Final) 1978-88

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, E.; Charkey, A.

    1988-02-01

    The report describes the design and development work performed to reduce the volume and weight of the miners' caplamp battery, as well as a headpiece with a swivel mechanism containing a halogen bulb with two filaments. Work was also conducted in the development of a maintenance-free battery. The design concept is based on nonsintered Ni-Cd technology, with an energy density of 22 Wh/lb. The caplamp system developed has been approved by the Mine Safety and Health Administration and can be manufactured for mine use.

  7. Improving cancer treatment with cyclotron produced radionuclides. Progress report, February 1987--September 1989

    Energy Technology Data Exchange (ETDEWEB)

    Larson, S.M.

    1989-12-31

    This report is divided into six sections, each section dealing with a separate aspect of the program. The six sections are entitled (1) In Vivo Measurement of Amino Acid Transport and Protein Synthesis, (2) Angiogenesis in Human Gliomas: Correlations with Blood Flow and Transport of C-11 AIB, (3) Use of F-18 Fluoropyrimidines for Design and Evaluation of Regional and Systemic Chemotherapeutic Strategies in Human Adenocarcinomas of the Gastrointestinal Tract, (4) Enzymatic Synthesis of Metabolites Labeled with N-13 or C-11, (5) Synthesis of Amino Acids Labeled with C-11, and (6) Instrumentation: Cyclotron and Imaging Systems.

  8. Preliminary report of a gas conditioner to improve operational reliability of cryotherapy in developing countries

    Directory of Open Access Journals (Sweden)

    Broekhuizen Fredrik

    2006-02-01

    Full Text Available Abstract Background Cryotherapy is a safe, affordable, and effective method of treatment for cervical intraepithelial neoplasia. In some low-resource settings, environmental conditions or qualities of the refrigerant gas can lead to blockage of cryotherapy equipment, terminating treatment. A prototype of a gas conditioner to prevent operational failure was designed, built, and field tested. Methods The prototype conditioner device consists of an expansion chamber that filters and dries the refrigerant gas. Users in Peru and Kenya reported on their experience with the prototype conditioner. In Ghana, simulated cryotherapy procedures were used to test the effects of the prototype conditioner, as well as the commonly used "cough technique." Results Anecdotal reports from field use of the device were favorable. During simulated cryotherapy, the prevalence of blockage during freezing were 0% (0/25 with the device alone, 23.3% (7/30 with the cough technique alone, 5.9% (1/17 with both, and 55.2% (16/29 with neither (Pearson's Chi square = 26.6, df = 3, p Conclusion This prototype design of a cryotherapy gas conditioner is a potential solution for low-resource settings that are experiencing cryotherapy device malfunction.

  9. Differential Die-Away Instrument: Report on Neutron Detector Recovery Performance and Proposed Improvements

    Energy Technology Data Exchange (ETDEWEB)

    Goodsell, Alison Victoria [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Swinhoe, Martyn Thomas [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Henzl, Vladimir [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Ianakiev, Kiril Dimitrov [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Iliev, Metodi [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Rael, Carlos D. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Desimone, David J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2014-09-22

    Four helium-3 (3He) detector/preamplifier packages (¾”/KM200, DDSI/PDT-A111, DDA/PDT-A111, and DDA/PDT10A) were experimentally tested to determine the deadtime effects at different DT neutron generator output settings. At very high count rates, the ¾”/KM200 package performed best. At high count rates, the ¾”/KM200 and the DDSI/PDT-A111 packages performed very well, with the DDSI/PDT-A111 operating with slightly higher efficiency. All of the packages performed similarly at mid to low count rates. Proposed improvements include using a fast recovery LANL-made dual channel preamplifier, testing smaller diameter 3He tubes, and further investigating quench gases.

  10. Improved design for large wind turbine blades of fibre composites (Phase 4) - Summary report

    DEFF Research Database (Denmark)

    Sørensen, Bent F.; Toftegaard, Helmuth Langmaack; Goutianos, Stergios

    growth with large scale bridging and the use of cohesive laws in finite element programmes for simulating wind turbine blade failure. An overview is given of the methods and the major research results of the project. The implementation of the knowledge in the industry is discussed. Finally, some ideas......Results are summarised for the project "Improved design for large wind turbine blades (Phase 4)", partially supported by the Danish Energy Agency under the Ministry of Climate and Energy through the EUDP journal no.: 33033-0267. The aim of the project was to develop new and better design methods...... for wind turbine blades, so that uncertainties associated with damage and defects can be reduced. The topics that are studied include buckling-driven delamination of flat load-carrying laminates, cracking along interfaces in material joints (fracture mechanical characterisation and modelling), cyclic crack...

  11. Self-reports of induced abortion: an empathetic setting can improve the quality of data

    DEFF Research Database (Denmark)

    Rasch, V; Muhammad, H; Urassa, E;

    2000-01-01

    OBJECTIVES: This study estimated the proportion of incomplete abortions that are induced in hospital-based settings in Tanzania. METHODS: A cross-sectional questionnaire study was conducted in 2 phases at 3 hospitals in Tanzania. Phase 1 included 302 patients with a diagnosis of incomplete abortion......, and phase 2 included 823 such patients. RESULTS: In phase 1, in which cases were classified by clinical criteria and information from the patient, 3.9% to 16.1% of the cases were classified as induced abortion. In phase 2, in which the structured interview was changed to an empathetic dialogue...... and previously used clinical criteria were omitted, 30.9% to 60.0% of the cases were classified as induced abortion. CONCLUSIONS: An empathetic dialogue improves the quality of data collected among women with induced abortion....

  12. Flue gas conditioning for improved particle collection in electrostatic precipitators. Quarterly technical report

    Energy Technology Data Exchange (ETDEWEB)

    Durham, M.D.

    1992-04-27

    The purpose of this research program is to identify and evaluate a variety of additives capable of increasing particle cohesion which could be used for improving collection efficiency in an ESP. A three-phase screening process will be used to provide the, evaluation of many additives in a logical and cost-effective manner. The three step approach involves the following experimental setups: 1. Provide a preliminary screening in the laboratory by measuring the effects of various conditioning agents on reentrainment of flyash particles in an electric field operating at simulated flue gas conditions. 2. Evaluate the successful additives using a 100 acfm bench-scale ESP operating on actual flue gas. 3. Obtain the data required for scaling up the technology by testing the two or three most promising conditioning agents at the pilot scale.

  13. Application of modern diagnostic methods to environmental improvement. Annual progress report, October 1994--September 1995

    Energy Technology Data Exchange (ETDEWEB)

    Shepard, W.S.

    1995-12-01

    The Diagnostic Instrumentation and Analysis Laboratory (DIAL), an interdisciplinary research department in the College of Engineering at Mississippi State University (MSU), is under contract with the US Department of Energy (DOE) to develop and apply advanced diagnostic instrumentation and analysis techniques to aid in solving DOE`s nuclear waste problem. The program is a comprehensive effort which includes five focus areas: advanced diagnostic systems; development/application; torch operation and test facilities; process development; on-site field measurement and analysis; technology transfer/commercialization. As part of this program, diagnostic methods will be developed and evaluated for characterization, monitoring and process control. Also, the measured parameters, will be employed to improve, optimize and control the operation of the plasma torch and the overall plasma treatment process. Moreover, on-site field measurements at various DOE facilities are carried out to aid in the rapid demonstration and implementation of modern fieldable diagnostic methods. Such efforts also provide a basis for technology transfer.

  14. Improved design for large wind turbine blades of fibre composites (Phase 4) - Summary report

    Energy Technology Data Exchange (ETDEWEB)

    Soerensen, B.F.; Toftegaard, H.; Goutanos, S. (Risoe DTU, Materials Research Div., Roskilde (Denmark)); Branner, K.; Berring, P. (Risoe DTU, Wind Energy Div., Roskilde (Denmark)); Lund, E. (Aalborg Univ., Dept. of Mechanical Engineering, Aalborg (Denmark)); Wedel-Heinen, J. (Vestas Wind System, Randers (Denmark)); Garm, J.H. (LM Wind Power, Kolding (Denmark))

    2010-06-15

    Results are summarised for the project 'Improved design for large wind turbine blades (Phase 4)', partially supported by the Danish Energy Agency under the Ministry of Climate and Energy through the EUDP journal no.: 33033-0267. The aim of the project was to develop new and better design methods for wind turbine blades, so that uncertainties associated with damage and defects can be reduced. The topics that are studied include buckling-driven delamination of flat load-carrying laminates, cracking along interfaces in material joints (fracture mechanical characterisation and modelling), cyclic crack growth with large scale bridging and the use of cohesive laws in finite element programmes for simulating wind turbine blade failure. An overview is given of the methods and the major research results of the project. The implementation of the knowledge in the industry is discussed. Finally, some ideas for future research activities are considered. (author)

  15. Improved design for large wind turbine blades of fibre composites (Phase 3) - Summary report

    Energy Technology Data Exchange (ETDEWEB)

    Soerensen, B.F. (Risoe DTU, Materials Research Div., Roskilde (Denmark)); Branner, K. (Risoe DTU, Wind Energy Div., Roskilde (Denmark)); Lund, E. (Aalborg Univ., Dept. of Mechanical Engineering, Aalborg (Denmark)); Wedel-Heinen, J. (Vestas Wind System, Randers (Denmark)); Garm, J.H. (LM Glasfiber, Kolding (Denmark))

    2009-06-15

    An overview is given of the activities of the project 'Improved design for large wind turbine blades (Phase 3)', partially supported by the Danish Energy Agency under the Ministry of Climate and Energy through the EFP-grant no. 33031-0078. The project was focussed at the development of new design methods for wind turbine blades, so that uncertainties associated with damage and defects can be reduced. The following topics with respect to failure modes were covered: Buckling-driven delamination of load-carrying laminates, cracking along interfaces in material joints, implementation of cohesive laws in finite element programmes and hierarchical finite element models. Methods and major research results of the project are summarised. Some future goals for future research activities are briefly discussed. (author)

  16. Linking Sleep to Hypertension: Greater Risk for Blacks

    Directory of Open Access Journals (Sweden)

    A. Pandey

    2013-01-01

    Full Text Available Background. Evidence suggests that insufficient sleep duration is associated with an increased likelihood for hypertension. Both short (8 hour sleep durations as well as hypertension are more prevalent among blacks than among whites. This study examined associations between sleep duration and hypertension, considering differential effects of race and ethnicity among black and white Americans. Methods. Data came from a cross-sectional household interview with 25,352 Americans (age range: 18–85 years. Results. Both white and black short sleepers had a greater likelihood of reporting hypertension than those who reported sleeping 6 to 8 hours. Unadjusted logistic regression analysis exploring the race/ethnicity interactions between insufficient sleep and hypertension indicated that black short (8 hours sleepers were more likely to report hypertension than their white counterparts (OR = 1.34 and 1.37, resp.; P<0.01. Significant interactions of insufficient sleep with race/ethnicity were observed even after adjusting to effects of age, sex, income, education, body mass index, alcohol use, smoking, emotional distress, diabetes, coronary heart disease, and stroke. Conclusion. Results suggest that the race/ethnicity interaction is a significant mediator in the relationship between insufficient sleep and likelihood of having a diagnosis of hypertension.

  17. Mild coal pretreatment to improve liquefaction reactivity. Final technical report, September 1990--February 1994

    Energy Technology Data Exchange (ETDEWEB)

    Miller, R.L.; Shams, K.G.

    1994-07-01

    Recent research efforts in direct coal liquefaction are focused on lowering the level of reaction severity, identification and determination of the causes of retrogressive reactions, and improving the economics of the process. Ambient pretreatment of coals using methanol and a trace amount of hydrochloric acid was extensively studied in connection with low severity coal liquefaction. Ambient pretreatment of eight Argonne coals using methanol/HCl improved THF-soluble conversions 24.5 wt % (maf basis) for Wyodak subbituminous coal and 28.4 wt % for Beulah-Zap lignite with an average increase of 14.9 wt % for the eight Argonne coals at 623 K (350{degrees}C) reaction temperature and 30 minutes reaction time. Optimal pretreatment conditions were determined using Wyodak and Illinois No. 6 coals. Acid concentration was the most important pretreatment variable studied; liquefaction reactivity increased with increasing acid concentration up to 2 vol %. The FTIR spectra of treated and untreated Wyodak coal samples demonstrated formation of carboxylic functional groups during pretreatment, a result of divalent (Ca, Mg) cationic bridge destruction. The extent of liquefaction reactivity directly correlated with the amount of calcium removed during pretreatment, and results from calcium ``addback`` experiments supported the observation that calcium adversely affected coal reactivity at low severity reaction conditions. Model compound studies using benzyl phenyl ether demonstrated that calcium cations catalyzed retrogressive reactions, inhibited hydrogenation reactions at low severity reaction conditions, and were more active at higher reaction temperatures. Based on kinetic data, mechanisms for hydrogenation-based inhibition and base-catalyzed retrogressive reactions are proposed. The base-catalyzed retrogressive reactions are shown to occur via a hydrogen abstraction mechanism where hydrogenation inhibition reactions are shown to take place via a surface quenching mechanism.

  18. Reducing Information's Speed Improves Verbal Cognition and Behavior in Autism: A 2-Cases Report.

    Science.gov (United States)

    Tardif, Carole; Latzko, Laura; Arciszewski, Thomas; Gepner, Bruno

    2017-06-01

    According to the temporal theory of autism spectrum disorders (ASDs), audiovisual changes in environment, particularly those linked to facial and verbal language, are often too fast to be faced, perceived, and/or interpreted online by many children with ASD, which could help explain their facial, verbal, and/or socioemotional interaction impairments. Our goal here was to test for the first time the impact of slowed-down audiovisual information on verbal cognition and behavior in 2 boys with ASD and verbal delay. Using 15 experimental sessions during 4 months, both boys were presented with various stimuli (eg, pictures, words, sentences, cartoons) and were then asked questions or given instructions regarding stimuli. The audiovisual stimuli and instructions/questions were presented on a computer's screen and were always displayed twice: at real-time speed (RTS) and at slowed-down speed (SDS) using the software Logiral. We scored the boys' verbal cognition performance (ie, ability to understand questions/instructions and answer them verbally/nonverbally) and their behavioral reactions (ie, attention, verbal/nonverbal communication, social reciprocity), and analyzed the effects of speed and order of the stimuli presentation on these factors. According to the results, both participants exhibited significant improvements in verbal cognition performance with SDS presentation compared with RTS presentation, and they scored better with RTS presentation when having SDS presentation before rather than after RTS presentation. Behavioral reactions were also improved in SDS conditions compared with RTS conditions. This initial evidence of a positive impact of slowed-down audiovisual information on verbal cognition should be tested in a large cohort of children with ASD and associated speech/language impairments. Copyright © 2017 by the American Academy of Pediatrics.

  19. Improved oil recovery in fluvial dominated reservoirs of Kansas--near-term. Annual report

    Energy Technology Data Exchange (ETDEWEB)

    Green, D.W.; Willhite, G.P.; Walton, A.; Schoeling, L.; Reynolds, R.; Michnick, M.; Watney, L.

    1996-11-01

    Common oil field problems exist in fluvial dominated deltaic reservoirs in Kansas. The problems are poor waterflood sweep efficiency and lack of reservoir management. The poor waterflood sweep efficiency is due to (1) reservoir heterogeneity, (2) channeling of injected water through high permeability zones or fractures, and (3) clogging of injection wells due to solids in the injection water. In many instances the lack of reservoir management results from (1) poor data collection and organization, (2) little or no integrated analysis of existing data by geological and engineering personnel, (3) the presence of multiple operators within the field, and (4) not identifying optimum recovery techniques. Two demonstration sites operated by different independent oil operators are involved in this project. The Stewart Field is located in Finney County, Kansas and is operated by North American Resources Company. This field was in the latter stage of primary production at the beginning of this project and is currently being waterflooded as a result of this project. The Nelson Lease (an existing waterflood) is located in Allen County, Kansas, in the N.E. Savonburg Field and is operated by James E. Russell Petroleum, Inc. The objective is to increase recovery efficiency and economics in these type of reservoirs. The technologies being applied to increase waterflood sweep efficiency are (1) in situ permeability modification treatments, (2) infill drilling, (3) pattern changes, and (4) air flotation to improve water quality. The technologies being applied to improve reservoir management are (1) database development, (2) reservoir simulation, (3) transient testing, (4) database management and (5) integrated geological and engineering analysis. Results of these two field projects are discussed.

  20. Improved electrical efficiency and bottom ash quality on waste combustion plants. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Jensen, Peter A.; Nesterov, I.; Boejer, M.; Hyks, J.; Astrup, T.; Kloeft, H.; Dam-Johansen, K.; Lundtorp, K.; Hedegaard Madsen, O.; Frandsen, F. (Technical Univ. of Denmark, Kgs. Lyngby (Denmark)); Mogensen, Erhardt (Babcock and Wilcox Voelund A/S, Glostrup (Denmark))

    2010-07-01

    Investigations making it possible to evaluate and further develop concepts to improve electrical efficiency in a waste combustion plant were performed. Furthermore, one objective of the study was to investigate the possibilities of improving waste bottom ash leaching properties by use of a rotary kiln treatment. The project work included construction of a bench-scale rotary kiln, performing ash rotary kiln treatment experiments, conducting gas suction probe measurements on a waste incineration plant and making some concept evaluations. The influence of the rotary kiln thermal treatment on the leaching of Ca, Al, Si, Mg, Ba, Sr, Cl, Cu, Pb, Zn, Cr, Mo, sulfate, DOC and carbonate was determined. As a result of these tests, the rotary kiln thermal treatment of bottom ashes can be recommended for reducing the leaching of Cu, Pb, Cl, Zn and DOC; however, an increased leaching of Cr and Mo should be expected. The combustion conditions above the grate of a waste incineration plant were investigated and the release and concentration of volatile ash species in the flue gas such as Cl, Na, K, Ca, Pb, Zn and S were measured. The conducted measurements show that flue gas from grate sections 3 and 4 can produce a sufficiently hot flue gas that contains only low concentrations of corrosive species, and therefore can be used to increase superheater temperatures. Implementation of the so-called flue gas split concept together with other steam circle modifications on a waste combustion plant, and using a reasonable increase in final steam temperature from 400 to 500 deg. C, have the potential to increase electrical efficiency from 24 to 30% (with respect to lower fuel heating value) in a waste combustion plant. (Author)

  1. Effectiveness of public report cards for improving the quality of cardiac care: the EFFECT study: a randomized trial.

    Science.gov (United States)

    Tu, Jack V; Donovan, Linda R; Lee, Douglas S; Wang, Julie T; Austin, Peter C; Alter, David A; Ko, Dennis T

    2009-12-02

    Publicly released report cards on hospital performance are increasingly common, but whether they are an effective method for improving quality of care remains uncertain. To evaluate whether the public release of data on cardiac quality indicators effectively stimulates hospitals to undertake quality improvement activities that improve health care processes and patient outcomes. Population-based cluster randomized trial (Enhanced Feedback for Effective Cardiac Treatment [EFFECT]) of 86 hospital corporations in Ontario, Canada, with patients admitted for acute myocardial infarction (AMI) or congestive heart failure (CHF). Participating hospital corporations were randomized to early (January 2004) or delayed (September 2005) feedback of a public report card on their baseline performance (between April 1999 and March 2001) on a set of 12 process-of-care indicators for AMI and 6 for CHF. Follow-up performance data (between April 2004 and March 2005) also were collected. The coprimary outcomes were composite AMI and CHF indicators based on 12 AMI and 6 CHF process-of-care indicators. Secondary outcomes were the individual process-of-care indicators, a hospital report card impact survey, and all-cause AMI and CHF mortality. The publication of the early feedback hospital report card did not result in a significant systemwide improvement in the early feedback group in either the composite AMI process-of-care indicator (absolute change, 1.5%; 95% confidence interval [CI], -2.2% to 5.1%; P = .43) or the composite CHF process-of-care indicator (absolute change, 0.6%; 95% CI, -4.5% to 5.7%; P = .81). During the follow-up period, the mean 30-day AMI mortality rates were 2.5% lower (95% CI, 0.1% to 4.9%; P = .045) in the early feedback group compared with the delayed feedback group. The hospital mortality rates for CHF were not significantly different. Public release of hospital-specific quality indicators did not significantly improve composite process-of-care indicators for AMI

  2. Using reporting requirements to improve employer wellness incentives and their regulation.

    Science.gov (United States)

    Madison, Kristin; Schmidt, Harald; Volpp, Kevin G

    2014-10-01

    Employer interest in offering financial incentives for healthy behaviors has been increasing. Some employers have begun to tie health plan-based rewards or penalties to standards involving tobacco use or biometric measures such as body mass index. The Patient Protection and Affordable Care Act attempts to strike a balance between the potential benefits and risks of wellness incentive programs by permitting these incentives but simultaneously limiting their use. Evidence about the implications of the newest generation of incentive programs for health, health costs, and burdens on individual employees will be critical for informing both private and public decision makers. After describing the many pieces of information that would be valuable for assessing these programs, this article proposes more narrowly targeted reporting requirements that could facilitate incentive program development, evaluation, and oversight. Copyright © 2014 by Duke University Press.

  3. IMPER: Characterization of the wind field over a large wind turbine rotor - final report; Improved performance

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt Paulsen, U.; Wagner, R.

    2012-01-15

    A modern wind turbine rotor with a contemporary rotor size would easily with the tips penetrate the air between 116 m and 30 m and herby experience effects of different wind. With current rules on power performance measurements such as IEC 61400-121 the reference wind speed is measured at hub height, an oversimplification of the wind energy power over the rotor disk area is carried out. The project comprised a number of innovative and coordinated measurements on a full scale turbine with remote sensing technology and simulations on a 500 kW wind turbine for the effects of wind field characterization. The objective with the present report is to give a short overview of the different experiments carried out and results obtained within the final phase of this project. (Author)

  4. Development of a Natural Rearing System to Improve Supplemental Fish Quality, 1999-2003 Progress Report.

    Energy Technology Data Exchange (ETDEWEB)

    Maynard, Desmond J.

    2003-02-25

    The National Marine Fisheries Service (NMFS) has been conducting Natural Rearing Enhancement System (NATURES) research since the early 1990s. NATURES studies have looked at a variety of mechanisms to enhance production of wild-like salmonids from hatcheries. The goal of NATURES research is to develop fish culture techniques that enable hatcheries to produce salmon with more wild-like characteristics and increased postrelease survival. The development of such techniques is called for in the Columbia Basin Fish and Wildlife Program. This document is the draft report for the Supplemental Fish Quality Contract DE-AI79-91BP20651 Over the history of the project, the effects of seminatural raceway habitats, automated underwater feeders, exercise current velocities, live food diets, and predator avoidance training have been investigated. The findings of these studies are reported in an earlier contract report (Maynard et al. 1996a). The current report focuses on research that has been conducted between 1999 and 2002. This includes studies on the effect of exercise on salmon and steelhead trout, effects of predator avoid training, integration of NATUES protocols into production hatcheries, and the study of social behavior of steelhead grown in enriched and conventional environments. Traditionally, salmon (Oncorhynchus spp.) are reared in barren concrete raceways that lack natural substrate, in-stream structure, or overhead cover. The fish are fed in an unnatural manner with artificial feeds mechanically or hand broadcast across the water surface. This traditional approach has increased the egg-to-smolt survival of hatchery-reared fish by an order of magnitude over that experienced by wild-reared salmon. However, once hatchery-reared fish are released into the wild their smolt-to-adult survival is usually much lower than wild-reared salmon. The reduced postrelease survival of hatchery-reared fish may stem from differences in their behavior and morphology compared to wild

  5. The Case Report of Trigger Finger Improved with Hominis Placenta Pharmacopuncture Treatment

    Directory of Open Access Journals (Sweden)

    Jeong-Won Kim

    2010-12-01

    Full Text Available Objectives : The Purpose of this study is to investigate and report the effectiveness of Hominis Placenta using Pharmacopuncture treatment for trigger finger. Methods : 3 Patients are admitted at Dept. of Oriental Rehabilitation, Bu-Chun Jaseng Oriental Medicine Hospital, diagnosed as Trigger finger and treated with Hominis Placenta Pharmacopuncture. Each cases are measured and assessed by Quinnell's classification of triggering and VAS (Visual Analogue Scale scores. Results : 3 Patients of trigger finger have a different kind of cause and fingers lesion they have, but nodules are not significantly found up, so we could classify all of 3 patients to diffuse type. After treatment of Hominis placenta Pharmacopuncture, spontaneous pain and tenderness, grades of triggering are decreased significantly. We would expect that Hominis placenta Pharmacopuncture has a effect on degenerative diseases of diffuse type's tendon sheath. Conclusions : Trigger finger is generally divided into two stages, inflammatory and degenerative stage, and when degenerative stage, Hominis placenta pharmacopuncture appears to be effective.

  6. Does work-site physical activity improve self-reported psychosocial workplace factors and job satisfaction?

    DEFF Research Database (Denmark)

    Roessler, K K; Rugulies, R; Bilberg, R

    2013-01-01

    , with 199 participants in the training group and 228 in the control group. Influence at work, sense of community, time pressure, and job satisfaction were measured with the Copenhagen Psychosocial Questionnaire at baseline and post-intervention after 20 weeks. RESULTS: There was no statistically significant...... change in any of the four variables in the training group from baseline to follow-up (all p ≥ 0.39). When we used MANOVA to test for between-group effects over time, we did not find any statistically significant result (all p > 0.14). CONCLUSIONS: This study does not provide evidence for an effect......PURPOSE: To investigate whether a work-site strength-training program has a positive effect on self-reported psychosocial workplace factors and job satisfaction. METHODS: We conducted a randomized controlled trial among laboratory technicians implementing neck and shoulder exercises for pain relief...

  7. Program to develop improved downhole drilling motors. Semi-annual report

    Energy Technology Data Exchange (ETDEWEB)

    Maurer, W.C.

    1976-11-01

    Research progress is reported in two main sections: downhole drilling motor design and design of downhole motor seal, bearing, and test lubrication systems. Information on downhole drilling motor design is presented under the following subsection headings: Turbodrill development; positive displacement motor development; theory of Turbodrills; theory of positive displacement motors; basic motor components; forces on thrust bearings; thrust bearing design; radial bearing design; rotary seal design; sealed lubrication system; lubricants; and project status. The appendix contains information on high temperature lubricants. Information on the design of downhole motor seal, bearing, and test lubrication systems is presented under the following subsection headings: seal, bearing, and lubrication test design criteria; basic test conditions; independent and dependent variable parameters; alternative concepts for seal test apparatus; design of the seal test system; and bearing test system description. A schedule for remaining tasks is included. (JGB)

  8. Enhanced catalysis by solvent improvement. Quarterly technical progress report, 1 April-30 June 1983

    Energy Technology Data Exchange (ETDEWEB)

    Garg, D.; Miller, R.N.; Givens, E.N.; Tarrer, A.R.; Guin, J.A.; Curtis, C.W.

    1983-11-01

    This report describes the results from liquefaction solvent modification, coal liquefaction with original and modified solvents, catalyst selection, coal pretreatment, and pretreatment followed by liquefaction experiments. The effect of liquefaction reaction conditions on product distribution is also covered in this report. Significant removal of nitrogen compounds from coal-derived liquefaction solvent was obtained by treating it with anhydrous hydrochloric acid or silica gel. The removal of nitrogen compounds with HCl or silica gel was also accompanied by 25 to 40% removal of oxygen compounds. Treating liquefaction solvent with aqueous NaOH or zeolite removed significant amounts of phenolic compounds. Oxygen removal was also accompanied by a partial removal of nitrogen compounds. Sequential treatment of coal-derived liquefaction solvent with HCl followed by silica gel or NaOH followed by HCl resulted in complete removal of nitrogen compounds. Liquefying coals in the presence of coal-derived liquefaction solvents modified by the removal of nitrogen or oxygen compounds or both significantly increased the oil yield in the absence of catalyst. The overall coal conversion, however, decreased only slightly with these treated solvents. A significant increase in the oil yield was also noted during catalytic liquefaction with the pretreated solvents. The overall coal conversion also increased during catalytic liquefaction of coal. At a concentration level of 250 ppM metal based on coal molybdenum catalyst was more active than nickel. At this level the activity of molybdenum was also higher than that noted with 1 wt% iron or zinc. Combination of metals such as iron and molybdenum or zinc and molybdenum yielded significantly higher oil yield compared to individual metals alone. 1 ref., 2 figs., 28 tabs.

  9. Embedded Sensors and Controls to Improve Component Performance and Reliability -- Loop-scale Testbed Design Report

    Energy Technology Data Exchange (ETDEWEB)

    Melin, Alexander M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Kisner, Roger A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2016-09-01

    Embedded instrumentation and control systems that can operate in extreme environments are challenging to design and operate. Extreme environments limit the options for sensors and actuators and degrade their performance. Because sensors and actuators are necessary for feedback control, these limitations mean that designing embedded instrumentation and control systems for the challenging environments of nuclear reactors requires advanced technical solutions that are not available commercially. This report details the development of testbed that will be used for cross-cutting embedded instrumentation and control research for nuclear power applications. This research is funded by the Department of Energy's Nuclear Energy Enabling Technology program's Advanced Sensors and Instrumentation topic. The design goal of the loop-scale testbed is to build a low temperature pump that utilizes magnetic bearing that will be incorporated into a water loop to test control system performance and self-sensing techniques. Specifically, this testbed will be used to analyze control system performance in response to nonlinear and cross-coupling fluid effects between the shaft axes of motion, rotordynamics and gyroscopic effects, and impeller disturbances. This testbed will also be used to characterize the performance losses when using self-sensing position measurement techniques. Active magnetic bearings are a technology that can reduce failures and maintenance costs in nuclear power plants. They are particularly relevant to liquid salt reactors that operate at high temperatures (700 C). Pumps used in the extreme environment of liquid salt reactors provide many engineering challenges that can be overcome with magnetic bearings and their associated embedded instrumentation and control. This report will give details of the mechanical design and electromagnetic design of the loop-scale embedded instrumentation and control testbed.

  10. Greater Sandhill Crane colt survival on the Ruby Lake National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report details Greater Sandhill Crane colt survival at Ruby lake NWR during the time period from 1984 to 2006. Management recommendations are suggested to...

  11. Improving reproducibility and external validity. The role of standardization and data reporting of laboratory rat husbandry and housing.

    Science.gov (United States)

    Fontoura-Andrade, José Luiz; Amorim, Rivadávio Fernandes Batista de; Sousa, João Batista de

    2017-03-01

    To identify the most relevant flaws in standardization in husbandry practices and lack of transparency to report them. This review proposes some measures in order to improve transparency, reproducibility and eventually external validity in experimental surgery experiments with rat model. We performed a search of scientific articles in PUBMED data base. The survey was conducted from august 2016 to January 2017. The keywords used were "reproducibility", "external validity", "rat model", "rat husbandry", "rat housing", and the time frame was up to January 2017. Articles discarded were the ones which the abstract or the key words did not imply that the authors would discuss any relationship of husbandry and housing with the reproducibility and transparency of reporting animal experiment. Reviews and papers that discussed specifically reproducibility and data reporting transparency were laboriously explored, including references for other articles that could fulfil the inclusion criteria. A total of 246 articles were initially found but only 44 were selected. Lack of transparency is the rule and not the exception when reporting results with rat model. This results in poor reproducibility and low external validity with the consequence of considerable loss of time and financial resources. There are still much to be done to improve compliance and adherence of researchers, editors and reviewers to adopt guidelines to mitigate some of the challenges that can impair reproducibility and external validity. Authors and reviewers should avoid pitfalls of absent, insufficient or inaccurate description of relevant information the rat model used. This information should be correctly published or reported on another source easily available for readers. Environmental conditions are well known by laboratory animal personnel and are well controlled in housing facilities, but usually neglected in experimental laboratories when the rat model is a novelty for the researcher.

  12. Artificial Chemical Reporter Targeting Strategy Using Bioorthogonal Click Reaction for Improving Active-Targeting Efficiency of Tumor.

    Science.gov (United States)

    Yoon, Hong Yeol; Shin, Min Lee; Shim, Man Kyu; Lee, Sangmin; Na, Jin Hee; Koo, Heebeom; Lee, Hyukjin; Kim, Jong-Ho; Lee, Kuen Yong; Kim, Kwangmeyung; Kwon, Ick Chan

    2017-05-01

    Biological ligands such as aptamer, antibody, glucose, and peptide have been widely used to bind specific surface molecules or receptors in tumor cells or subcellular structures to improve tumor-targeting efficiency of nanoparticles. However, this active-targeting strategy has limitations for tumor targeting due to inter- and intraheterogeneity of tumors. In this study, we demonstrated an alternative active-targeting strategy using metabolic engineering and bioorthogonal click reaction to improve tumor-targeting efficiency of nanoparticles. We observed that azide-containing chemical reporters were successfully generated onto surface glycans of various tumor cells such as lung cancer (A549), brain cancer (U87), and breast cancer (BT-474, MDA-MB231, MCF-7) via metabolic engineering in vitro. In addition, we compared tumor targeting of artificial azide reporter with bicyclononyne (BCN)-conjugated glycol chitosan nanoparticles (BCN-CNPs) and integrin αvβ3 with cyclic RGD-conjugated CNPs (cRGD-CNPs) in vitro and in vivo. Fluorescence intensity of azide-reporter-targeted BCN-CNPs in tumor tissues was 1.6-fold higher and with a more uniform distribution compared to that of cRGD-CNPs. Moreover, even in the isolated heterogeneous U87 cells, BCN-CNPs could bind artificial azide reporters on tumor cells more uniformly (∼92.9%) compared to cRGD-CNPs. Therefore, the artificial azide-reporter-targeting strategy can be utilized for targeting heterogeneous tumor cells via bioorthogonal click reaction and may provide an alternative method of tumor targeting for further investigation in cancer therapy.

  13. A surveillance system for monitoring, public reporting, and improving minority access to cancer clinical trials.

    Science.gov (United States)

    Carpenter, William R; Tyree, Seth; Wu, Yang; Meyer, Anne-Marie; DiMartino, Lisa; Zullig, Leah; Godley, Paul A

    2012-08-01

    The Institute of Medicine (IOM) has recommended that each person with cancer should have access to clinical trials, which have been associated with improving care quality and disparities. With no effective enrollment monitoring system, patterns of trial enrollment remain unclear. We developed a population-based, statewide system designed to facilitate monitoring of cancer trial enrollment and targeting of future interventions to improve it. Person-level cancer incidence data from the North Carolina Central Cancer Registry (NCCCR), person-level treatment trial accrual data from the National Cancer Institute (NCI), and county-level Area Resource Files (ARF) measures for 12 years, 1996-2007, were studied. Deidentified person-level data necessitated county-level analysis. Enrollment rates were estimated as the ratio of trial enrollment to cancer incidence for each race, gender, year, and county combination. Multivariable analysis examined factors associated with trial accrual. Sensitivity analyses examined spurious fluctuations and temporal discordance of incidence and enrollment. The NCI treatment trial enrollment rate was 2.39% for whites and 2.20% for minorities from 1996 to 2007, and 2.88% and 2.47%, respectively, from 2005 to 2007. Numerous counties had no minority enrollment. The 2005-2007 enrollment rates for white and minority females was 4.04% and 3.59%, respectively, and for white and minority males was 1.74% and 1.36%, respectively. Counties with a medical school or NCI Community Clinical Oncology Program (CCOP)-affiliated practice had higher trial enrollment. We examined NCI trial accrual only - industry-sponsored and investigator-initiated trials were excluded; however, studies comprise the majority of all clinical trial participants. Delays in data availability may hinder the immediacy of population-based analyses. Model stability and consistency suggest that this system is effective for population-based enrollment surveillance. For North Carolina, it

  14. Improving reservoir conformance using gelled polymer systems. Eleventh quarterly report, April 1, 1995--June 30, 1995

    Energy Technology Data Exchange (ETDEWEB)

    Green, D.W.; Willhite, G.P.; Buller, C.; McCool, S.; Vossoughi, S.; Michnick, M.

    1995-07-24

    The general objectives are to (1) to identify and develop gelled polymer systems which have potential to improve reservoir conformance of fluid displacement processes, (2) to determine the performance of these systems in bulk and in porous media, and (3) to develop methods to predict the capability of these systems to recover oil from petroleum reservoirs. This work focuses on three types of gel systems -- an aqueous polysaccharide (KUSP1) system that gels as a function of pH, the chromium(III)-polyacrylamide system and the aluminum citrate-polyacrylamide system. Laboratory research is directed at the fundamental understanding of the physics and chemistry of the gelation process in bulk form and in porous media. This knowledge will be used to develop conceptual and mathematical models of the gelation process. Mathematical models will then be extended to predict the performance of gelled polymer treatments in oil reservoirs. Technical progress is described for the following tasks: physical and chemical characterization of gel systems; mechanisms of in situ gelation; and mathematical modelling of the gel systems.

  15. Improving reservoir conformance using gelled polymer systems. Annual report, September 25, 1992--September 24, 1993

    Energy Technology Data Exchange (ETDEWEB)

    Green, D.W.; Willhite, G.P.

    1994-08-01

    The general objectives of the research program are to (1) identify and develop gelled polymer systems which have potential to improve reservoir conformance of fluid displacement processes, (2) determine the performance of these systems in bulk and in porous media, and (3) develop methods to predict their performance in field applications. The research focuses on three types of gel systems-an aqueous polysaccharide (KUSPI) that gels as a function of pH, polyacrylamide or xanthan crosslinked by CR(III) and a polyacrylamide-aluminum citrate system. Work to date has focused primarily on development of a database, selection of systems, and work to characterize the gel/polymer physical properties and kinetics. The use of ester hydrolysis to control the rate of pH change of a gel system has been investigated and this approach to gel-time control shows promise. Extensive kinetic data were taken on the uptake of CR(III) oligomers by polyacrylamide. A model was developed which describes very well the monomer uptake rates. The model described the dimer uptake data less well and the trimer uptake data poorly. Studies of the flow and gelation in rock materials have been initiated. A mathematical model of rock-fluid interaction during flow of high pH solutions has been developed.

  16. Improving cancer treatment with cyclotron produced radionuclides. Comprehensive progress report, February 1, 1992--July 15, 1995

    Energy Technology Data Exchange (ETDEWEB)

    Larson, S.M.; Finn, R.D.

    1995-07-17

    This research continues the long term goals of promoting nuclear medicine applications by improving the scientific basis for tumor diagnosis, treatment and treatment follow-up based on the use of cyclotron produced radiotracers in oncology. This program fits into the nuclear medicine component of DOE`s mission, which is aimed at enhancing the beneficial applications of radiation, radionuclides, and stable isotopes in the diagnosis, study and treatment of human diseases. The grant includes 3 interactive components: Radiochemistry/Cyclotron; Pharmacology/Immunology; and Imaging Physics. An essential strategy is as follows: novel radionuclides and radiotracers developed in the Radiochemistry/Section under the DOE grant during the 1992--1995 will be employed in the Pharmacology/Immunology component in the period 1996--1999. Imaging Physics resolves relevant imaging related physics issues that arise during the experimentation that results. In addition to the basic research mission, this project also provides a basis for training of research scientists in radiochemistry, immunology, bioengineering and imaging physics.

  17. Improvement in right ventricular function during reversibility testing in pulmonary arterial hypertension: a case report

    Directory of Open Access Journals (Sweden)

    Naeije Robert

    2009-02-01

    Full Text Available Abstract A right heart catheterization with reversibility testing is recommended for the diagnosis and treatment of pulmonary arterial hypertension. In this 24 years-old woman, the inhalation of 5 μg iloprost transiently decreased mean pulmonary artery pressure from 62 to 36 mmHg and pulmonary vascular resistance from 11.0 to 4.9 Wood units, meeting the criteria of a "positive response". The echocardiographic examination showed normalization of right heart chamber dimensions and of the right ventricular performance (Tei index. Pulsed tissue Doppler imaging of the right ventricle showed a decrease in the isovolumic relaxation time from 102 to 73 ms, and an increase of the E/A ratio from 0.72 to 1.38, together with marked improvements in mid-apical free wall systolic strain and strain rate. A positive response to reversibility testing of pulmonary arterial hypertension may be associated with quasi normalization of right ventricular function, in spite of still elevated pulmonary artery pressure.

  18. Improving long term outcomes in urea cycle disorders-report from the Urea Cycle Disorders Consortium.

    Science.gov (United States)

    Waisbren, Susan E; Gropman, Andrea L; Batshaw, Mark L

    2016-07-01

    The Urea Cycle Disorders Consortium (UCDC) has conducted, beginning in 2006, a longitudinal study (LS) of eight enzyme deficiencies/transporter defects associated with the urea cycle. These include N-acetylglutamate synthase deficiency (NAGSD); Carbamyl phosphate synthetase 1 deficiency (CPS1D); Ornithine transcarbamylase deficiency (OTCD); Argininosuccinate synthetase deficiency (ASSD) (Citrullinemia); Argininosuccinate lyase deficiency (ASLD) (Argininosuccinic aciduria); Arginase deficiency (ARGD, Argininemia); Hyperornithinemia, hyperammonemia, homocitrullinuria (HHH) syndrome (or mitochondrial ornithine transporter 1 deficiency [ORNT1D]); and Citrullinemia type II (mitochondrial aspartate/glutamate carrier deficiency [CITRIN]). There were 678 UCD patients enrolled in 14 sites in the U.S., Canada, and Europe at the writing of this paper. This review summarizes findings of the consortium related to outcome, focusing primarily on neuroimaging findings and neurocognitive function. Neuroimaging studies in late onset OTCD offered evidence that brain injury caused by biochemical dysregulation may impact functional neuroanatomy serving working memory processes, an important component of executive function and regulation. Additionally, there were alteration in white mater microstructure and functional connectivity at rest. Intellectual deficits in OTCD and other urea cycle disorders (UCD) vary. However, when neuropsychological deficits occur, they tend to be more prominent in motor/performance areas on both intelligence tests and other measures. In some disorders, adults performed significantly less well than younger patients. Further longitudinal follow-up will reveal whether this is due to declines throughout life or to improvements in diagnostics (especially newborn screening) and treatments in the younger generation of patients.

  19. Camas Creek (Meyers Cove) Anadromous Species Habitat Improvement: Annual Report 1990.

    Energy Technology Data Exchange (ETDEWEB)

    Seaberg, Glen

    1990-06-01

    Populations of wild salmon and steelhead in the Middle Fork of the Salmon River are at historical lows. Until passage and flow problems associated with Columbia River dams are corrected to reduce mortalities of migrating smolts, continuance of habitat enhancements that decrease sediment loads, increase vegetative cover, remove passage barriers, and provide habitat diversity is imperative to maintain surviving populations of these specially adapted fish. In 1987-1988, 4.3 miles of fence was constructed establishing a riparian livestock exclosure. One end-gap and two water-crossing corridors were constructed in 1989 to complete the fence system. Areas within the exclosure have been fertilized to promote tree and shrub root growth and meadow recovery. A stream crossing ford was stabilized with angular cobble. Streambank stabilization/habitat cover work was completed at three sites and three additional habitat structures were placed. Extensive inventories were completed to identify habitat available to anadromous fish. Streambank stabilization work was limited to extremely unstable banks, minimizing radical alterations to an active stream channel. Enhancement activities will improve spawning, incubation, and rearing habitat for wild populations of steelhead trout and chinook salmon. Anadromous species population increases resulting from these enhancement activities will provide partial compensation for downstream losses resulting from hydroelectric developments on the Columbia River system. 10 refs., 11 figs., 5 tabs.

  20. Improvement of Depression after Treatment of Dural Arteriovenous Fistula: A Case Report and a Review

    Directory of Open Access Journals (Sweden)

    Minoru Nakagawa

    2012-01-01

    the treatment of a dural arteriovenous fistula in the left transverse-sigmoid sinus. A 46-year-old male had suffered from depression and was treated with antidepressants at a local hospital for four years. The patient was temporarily laid off due to his depression. Afterwards, he had Gerstmann's syndrome and came to our hospital. A DAVF in the left transverse-sigmoid sinus was demonstrated on the angiogram. The DAVF was successfully treated with endovascular surgery, coil embolization of the isolated diseased sinus through the mastoid emissary vein which was a draining vein from the fistula. After this treatment, his depression as well as Gerstmann's syndrome was improved and the quantity of the antidepressants decreased. The patient returned to work without any antidepressant two years after the treatment. DAVFs might be one of the causes of depression. It may be necessary to evaluate cerebral vessels in patients suffering from depression by using MRA or 3D-CTA even if there are not any abnormal findings on plain CT scans.

  1. Self-mastery among Chinese Older Adults in the Greater Chicago Area

    Directory of Open Access Journals (Sweden)

    Xinqi Dong

    2014-09-01

    Full Text Available Background: Self-mastery is an important psychological resource to cope with stressful situations. However, we have limited understanding of self-mastery among minority aging populations. Objective: This study aims to examine the presence and levels of self-mastery among U.S. Chinese older adults. Methods: Data were drawn from the PINE study, a population-based survey of U.S. Chinese older adults in the Greater Chicago area. Guided by a community-based participatory research approach, a total of 3,159 Chinese older adults aged 60 and above were surveyed. A Chinese version of the Self-Mastery Scale was used to assess self-mastery. Results: Out of the 7-item Chinese Self-Mastery Scale, approximately 42.8% to 87.5% of Chinese older adults experienced some degree of self-mastery in their lives. Older adults with no formal education and the oldest-old aged 85 and over had the lowest level of self-mastery in our study. A higher mastery level was associated with being married, having fewer children, better self-reported health status, better quality of life, and positive health changes. Conclusion: Although self-mastery is commonly experienced among the Chinese aging population in the Greater Chicago area, specific subgroups are still vulnerable. Future longitudinal studies are needed to improve the understanding of risk factors and outcomes associated with self-mastery among Chinese older adults.

  2. Integration core exercises elicit greater muscle activation than isolation exercises.

    Science.gov (United States)

    Gottschall, Jinger S; Mills, Jackie; Hastings, Bryce

    2013-03-01

    The American College of Sports Medicine and the United States Department of Health and Human Services advocate core training as a means to improve stability, reduce injury, and maintain mobility. There are countless exercises that target the primary core trunk muscles (abdominal and lumbar) with the aim of providing these benefits. However, it is unknown as to which exercises elicit the greatest activation thereby maximizing functional gains and peak performance. Thus, our purpose was to determine whether integration core exercises that require activation of the distal trunk muscles (deltoid and gluteal) elicit greater activation of primary trunk muscles in comparison with isolation core exercises that only require activation of the proximal trunk muscles. Twenty participants, 10 men and 10 women, completed 16 randomly assigned exercises (e.g., crunch, upper body extension, and hover variations). We measured muscle activity with surface electromyography of the anterior deltoid, rectus abdominus, external abdominal oblique, lumbar erector spinae, thoracic erector spinae, and gluteus maximus. Our results indicate that the activation of the abdominal and lumbar muscles was the greatest during the exercises that required deltoid and gluteal recruitment. In conclusion, when completing the core strength guidelines, an integrated routine that incorporates the activation of distal trunk musculature would be optimal in terms of maximizing strength, improving endurance, enhancing stability, reducing injury, and maintaining mobility.

  3. Improved manufacturing techniques for RF and laser hardening of missile domes. Phase I. Technical report

    Energy Technology Data Exchange (ETDEWEB)

    Pawlewicz, W.T.; Mann, I.B.; Martin, P.M.; Hays, D.D.; Graybeal, A.G.

    1982-07-01

    This report summarizes key results and accomplishements during the first year of a Manufacturing Methods and Technology project to adapt an existing Pacific Northwest Laboratory (PNL) optical coating capability developed for high-power fusion-laser applications to the case of rf and laser hardening of plastic missile domes used by the US Army (MICOM). The primary objective of the first year's work was to demonstrate rf hardening of Hellfire and Copperhead 1.06-micron missile domes by use of transparent conductive Indium Tin Oxide (ITO) coatings. The project thus involved adaptation of a coating material and process developed for flat glass components used in fusion lasers to the case of hemispherical or conical heat-sensitive plastic domes used on laser-guided missiles. Specific ITO coating property goals were an electrical sheet resistance of 10 Ohms/square, a coated-dome transmission of 80% or more at 1.06 micron wavelength (compared to 90% for a bare dome), and good adhesion. The sheet resistance goal of 10 Ohms/square was expected to result in an rf attenuation of 30 dB at the frequencies of importance.

  4. Improving the Success Rate of Delivering Annual Occupational Dosimetry Reports to Persons Issued Temporary External Dosimeters

    Energy Technology Data Exchange (ETDEWEB)

    Mallett, Michael Wesley [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2014-09-09

    Workers who are not routinely monitored for occupational radiation exposure at LANL may be issued temporary dosimeters in the field. Per 10CFR835 and DOE O 231.1A, the Laboratory's radiation protection program is responsible for reporting these results to the worker at the end of the year. To do so, the identity of the worker and their mailing address must be recorded by the delegated person at the time the dosimeter is issued. Historically, this data has not been consistently captured. A new online application was developed to record the issue of temporary dosimeters. The process flow of the application was structured such that: 1) the worker must be uniquely identified in the Lab's HR database, and 2) the mailing address of record is verified live time via a commercial web service, for the transaction to be completed. A COPQ savings (Type B1) of $96K/year is demonstrated for the new application.

  5. Improved recovery from Gulf of Mexico reservoirs. Quarterly status report, January 1--March 31, 1996

    Energy Technology Data Exchange (ETDEWEB)

    Kimbrell, W.C.; Bassiouni, Z.A.; Bourgoyne, A.T.

    1996-04-30

    On February 18, 1992, Louisiana State University with two technical subcontractors, BDM, Inc. and ICF, Inc., began a research program to estimate the potential oil and gas reserve additions that could result from the application of advanced secondary and enhanced oil recovery technologies and the exploitation of undeveloped and attic oil zones in the Gulf of Mexico oil fields that are related to piercement salt domes. This project is a one year continuation of this research and will continue work in reservoir description, extraction processes, and technology transfer. Detailed data will be collected for two previously studies reservoirs: a South Marsh Island reservoir operated by Taylor Energy and one additional Gulf of Mexico reservoir operated by Mobil. Additional reservoirs identified during the project will also be studied if possible. Data collected will include reprocessed 2-D seismic data, newly acquired 3-D data, fluid data, fluid samples, pressure data, well test data, well logs, and core data/samples. The new data will be used to refine reservoir and geologic characterization of these reservoirs. Further laboratory investigation will provide additional simulation input data in the form of PVT properties, relative permeabilities, capillary pressure, and water compatibility. Geological investigations will be conducted to refine the models of mud-rich submarine fan architectures used by seismic analysts and reservoir engineers. Research on advanced reservoir simulation will also be conducted. This report describes a review of fine-grained submarine fans and turbidite systems.

  6. Study of improved methods for predicting chemical equilibria. Progress report, January 1, 1990--June 30, 1992

    Energy Technology Data Exchange (ETDEWEB)

    Lenz, T.G.; Vaughan, J.D.

    1992-06-01

    The objective of our research has been to develop computational methods that have the capability of accurately predicting equilibrium constants of typical organic reactions in gas and liquid solution phases. We have chosen Diels-Alder reactions as prototypic systems for the investigation, chiefly because there are an adequate number of reported equilibrium constants for the candidate reactions in both gas and solution phases, which data provides a suitable basis for tests of the developed computational methods. Our approach has been to calculate the standard enthalpies of formation ({Delta}H{sub f}{sup 0}) at 298.15K and the standard thermodynamic functions (S{sup 0}, Cp{sup 0}, and (H{sup 0}-H{sub 0}{sup 0})/T) for a range of temperatures for reactants and products, and from these properties to calculate standard enthalpies, entropies, Gibbs free energies, and equilibrium constants ({Delta}H{sub T}{sup 0}, {Delta}S{sub T}{sup 0}, and K{sub a}) at various temperatures for the chosen reaction.

  7. Improving Ventilation and Saving Energy: Relocatable ClassroomField Study Interim Report

    Energy Technology Data Exchange (ETDEWEB)

    Apte, Michael G.; Buchanan, Ian S.; Faulkner, David; Hotchi,Toshifumi; Spears,Michael; Sullivan, Douglas P.; Wang, Duo

    2005-09-01

    The primary goals of this research effort are to develop, evaluate, and demonstrate a very practical HVAC system for classrooms that consistently provides classrooms with the quantity of ventilation in current minimum standards, while saving energy, and reducing HVAC-related noise levels. This research is motivated by the public benefits of energy efficiency, evidence that many classrooms are under-ventilated, and public concerns about indoor environmental quality in classrooms. This report presents an interim status update and preliminary findings from energy and indoor environmental quality (IEQ) measurements in sixteen relocatable classrooms in California. The field study includes measurements of HVAC energy use, ventilation rates, and IEQ conditions. Ten of the classrooms were equipped with a new HVAC technology and six control classrooms were equipped with a standard HVAC system. Energy use and many IEQ parameters have been monitored continuously, while unoccupied acoustic measurements were measured in one of four planned seasonal measurement campaigns. Continuously monitored data are remotely accessed via a LonWorks{reg_sign} network and stored in a relational database at LBNL. Preliminary results are presented here.

  8. Improving Health Outcomes for Patients with Depression: A Population Health Imperative. Report on an Expert Panel Meeting

    Science.gov (United States)

    Skoufalos, Alexis; Medalia, Alice; Fendrick, A. Mark

    2016-01-01

    Improving Health Outcomes for Patients with Depression: A Population Health Imperative. Report on an Expert Panel Meeting Janice L. Clarke, RN, Alexis Skoufalos, EdD, Alice Medalia, PhD, and A. Mark Fendrick, MD Editorial: A Call to Action: David B. Nash, MD, MBA   S-2 Overview: Depression and the Population Health Imperative   S-3 Promoting Awareness of the Issues and Opportunities for Improvement   S-5 Cognitive Dysfunction in Affective Disorders   S-5 Critical Role of Employers in Improving Health Outcomes for Employees with Depression   S-6 Closing the Behavioral Health Professional and Process Gaps   S-6 Achieving the Triple Aim for Patients with Depressive Disorders   S-6 Improving the Experience of Care for Patients with Depression   S-6 Improving Quality of Care and Health Outcomes for Patients with Depression   S-7 Changing the Cost of Care Discussion from How Much to How Well   S-8 Panel Insights and Recommendations   S-9 Conclusion   S-10 PMID:27636743

  9. Improving the Indico Framework at the European Organization for Nuclear Research - Internship Report - LEIC 2006/2007 (FEUP)

    CERN Document Server

    Ferreira, Jose Pedro

    2007-01-01

    This document describes the work developed by José Pedro Macedo Alves Ferreira, Informatics Engineering and Computing (LEIC) undergraduate student at the Engineering Faculty of the University of Porto (FEUP), in the context of the project "Improving the Indico Framework". The project took place at the European Organization for Nuclear Research (CERN), in the framework of both the Technical Student Program of this organization, and the curricular internship of the aforementioned degree. The contents of this report refer to the internship period, the first half of the one-year Technical Student program. The project aimed to introduce usability improvements into an already existing web application, the Indico platform, a integrated system for event scheduling and management, which was initially developed as a European project and continued by CERN, being currently used by several institutions worldwide. Indico presented some usability issues that for long had been noticed by the users and required correction, m...

  10. The dilemma of ischemic heart failure; how FDG-PET can guide therapy and improve outcomes? Case report

    Directory of Open Access Journals (Sweden)

    Mohamed A. Mandour Ali

    2013-06-01

    Full Text Available Patients with ischemic LV dysfunction are at increasing risk of adverse cardiac events including sudden cardiac death. Proper revascularization of viable ischemic myocardium (compared to medical treatment alone is associated with improvement of LV systolic function, less cardiac morbidities & mortalities and better functional capacity and well-being. Many diagnostic tools are used in clinical practice for assessment of myocardial viability. Dobutamine stress Echocardiography (DSE is the most widely used technique, while delayed enhancement cardiac magnetic resonance (DE-CMR and Flourine-18-fluorodeoxy-glucose positron emission tomography (18F-FDG PET are considered the standard of care for assessment of myocardial viability. Our case report illustrates how FDG PET myocardial viability assessment can guide therapy and improve outcomes in a difficult clinical and angiographic situation.

  11. The development of precipitated iron catalysts with improved stability; Final report, September 1987--September 1992

    Energy Technology Data Exchange (ETDEWEB)

    Abrevaya, H.

    1993-12-27

    Precipitated iron catalysts are expected to be used in next generation slurry reactors for large-scale production of transportation fuels from synthesis gas. These reactors are expected to operate at higher temperatures and lower H{sub 2}:CO ratios relative to the Sasol Arge reactor (Table 1A). The feasibility of using iron catalysts has been demonstrated under relatively mild Arge-type conditions but not under more severe slurry conditions. Possibly, an improvement in catalytic stability will be needed to make iron catalysts suitable for slurry operation. This program was aimed at identifying the chemical principles governing the deactivation of precipitated iron catalysts during Fischer-Tropsch synthesis and use of these chemical principles in the design of more stable catalysts. A new precipitated Fe catalyst was developed in this program for slurry reactor operation. The new Fe catalyst is predicted to perform slightly below the performance targets for slurry bubble column operation. Stability targets appear to be achievable. This catalyst did not noticeably deactivate during 1,740 hours on-stream. Compared to the selectivity target, an excess of 2% C{sub 1} + C{sub 2} was formed at 265{degrees}C. Based on the initial catalyst inventory in the autoclave, the catalyst seems to be short of the activity target by a factor of 1.8 at 265{degrees}C and 1.3 at 275{degrees}C. However, actual specific activities are likely to be closer to target because of catalyst inventory loss across the filter during the run and because catalytic activities were underestimated at low conversions.

  12. Improving reservoir conformance using gelled polymer systems. Final report, September 25, 1992--July 31, 1996

    Energy Technology Data Exchange (ETDEWEB)

    Green, D.W.; Willhite, G.P.; Buller, C.; McCool, S.; Vossoughi, S.; Michnick, M.

    1997-06-01

    The objectives of the research program were to (1) identify and develop polymer systems which have potential to improve reservoir conformance of fluid displacement processes, (2) determine the performance of these systems in bulk and in porous media, and (3) develop methods to predict their performance in field applications. The research focused on four types of gel systems--KUSP1 systems that contain an aqueous polysaccharide designated KUSP1, phenolic-aldehyde systems composed of resorcinol and formaldehyde, colloidal-dispersion systems composed of polyacrylamide and aluminum citrate, and a chromium-based system where polyacrylamide is crosslinked by chromium(III). Gelation behavior of the resorcinol-formaldehyde systems and the KUSP1-borate system was examined. Size distributions of aggregates that form in the polyacrylamide-aluminum colloidal-dispersion gel system were determined. Permeabilities to brine of several rock materials were significantly reduced by gel treatments using the KUSP1 polymer-ester (monoethyl phthalate) system, the KUSP1 polymer-boric acid system, and the sulfomethylated resorcinol-formaldehyde system were also shown to significantly reduce the permeability to supercritical carbon dioxide. A mathematical model was developed to simulate the behavior of a chromium redox-polyacrylamide gel system that is injected through a wellbore into a multi-layer reservoir in which crossflow between layers is allowed. The model describes gelation kinetics and filtration of pre-gel aggregates in the reservoir. Studies using the model demonstrated the effect filtration of gel aggregates has on the placement of gel systems in layered reservoirs.

  13. Improving reservoir conformance using gelled polymer systems. Annual report, September 25, 1994--September 24, 1995

    Energy Technology Data Exchange (ETDEWEB)

    Green, D.W.; Willhite, G.P.

    1996-05-01

    The objectives of the research program are to (1) identify and develop polymer systems which have potential to improve reservoir conformance of fluid displacement processes, (2) determine the performance of these systems in bulk and in porous media, and (3) develop methods to predict their performance in field applications. The research focused on four types of gel systems -- KUSP1 systems which contain an aqueous polysaccharide designated KUSP1, phenolic-aldehyde systems composed of resorcinol and formaldehyde, colloidal-dispersion systems composed of polyacrylamide and aluminum citrate, and a chromium-based system where polyacrylamide is crosslinked by chromium(III). Gelation behavior of the resorcinol-formaldehyde systems and the KUSP1-borate system was examined. Size distributions of aggregates that form in the polyacrylamide-aluminum colloidal-dispersion gel system were determined. Permeabilities to brine of several rock materials were significantly reduced by gel treatments using the KUSP1 polymer-ester (monoethylphthalate) system, the KUSP1 polymer-boric acid system, and the sulfomethylated resorcinol-formaldehyde system. The KUSP1 polymer-ester system and the sulfomethylated resorcinol-formaldehyde system were also shown to significantly reduce the permeability to super-critical carbon dioxide. A mathematical model was developed to simulate the behavior of a chromium redox-polyacrylamide gel system that is injected through a wellbore into a multi-layer reservoir in which crossflow between layers is allowed. The model describes gelation kinetics and filtration of pre-gel aggregates in the reservoir. Studies using the model demonstrated the effect filtration of gel aggregates has on the placement of gel systems in layered reservoirs.

  14. Improved methods for water shutoff. Semi-annual report, May 1, 1996--September 30, 1996

    Energy Technology Data Exchange (ETDEWEB)

    Seright, R.S.

    1997-08-01

    In the United States, more than 20 billion barrels of water are produced each year during oilfield operations. Today, the cost of water disposal is typically between $0.25 and $0.50 per bbl for pipeline transport and $1.50 per bbl for trucked water. Therefore, there is a tremendous economic incentive to reduce water production if that can be accomplished without significantly sacrificing hydrocarbon production. For each 1% reduction in water production, the cost-savings to the oil industry could be between $50,000,000 and $100,000,000 per year. Reduced water production would result directly in improved oil recovery (IOR) efficiency in addition to reduced oil-production costs. A substantial positive environmental impact could also be realized if significant reductions are achieved in the amount of water produced during oilfield operations. In an earlier project, we identified fractures (either naturally or artificially induced) as a major factor that causes excess water production and reduced oil recovery efficiency, especially during waterfloods and IOR projects. We also found fractures to be a channeling and water-production problem that has a high potential for successful treatment by gels and certain other chemical blocking agents. By analogy, these blocking materials also have a high potential for treating narrow channels behind pipe and small casing leaks. We also determined that the ability of blocking agents to reduce permeability to water much more than that to oil is critical to the success of these blocking treatments in production wells if zones are not isolated during placement of the blocking agents.

  15. Selective improvement of anosognosia for hemiplegia during transcranial direct current stimulation: a case report.

    Science.gov (United States)

    Gandola, Martina; Sedda, Anna; Manera, Marina; Pingue, Valeria; Salvato, Gerardo; Spitoni, Grazia F; Pistarini, Caterina; Giorgi, Ines; Pizzamiglio, Luigi; Bottini, Gabriella

    2014-12-01

    Right brain damage patients may not complain of a left sided paralysis up to the point of denying it or even claiming of having just moved an otherwise paralyzed limb. This condition is known as anosognosia for hemiplegia (AHP). Recent behavioural experiments suggest that some residual intentionality might be preserved in patients with anosognosia and that the false belief of having moved originates from a failure to notice discrepancies between movement expectancies and the actual state of the motor system. This failure may be caused by a lack of afferent sensory information concerning the movement or alternatively by a direct dysfunction of the brain regions involved in actions' motor monitoring (i.e., the comparator system). Here we examined the effect of anodal transcranial direct current stimulation (tDCS) of the right premotor cortex in a patient with a bilateral lesion, involving predominantly the right hemisphere, and a dense unawareness for his left hemiplegia. During sham or anodal tDCS the patient was requested to judge his ability to perform simple motor actions (i) without actually executing the movement itself ("offline" condition) and after having performed a series of verbally cued finger opposition movements ("online" condition) with (i) eyes-closed or (ii) eyes-open. We found that anodal tDCS induces a significant remission of the false experience of movement only when the patient is requested to actually perform the movement with eyes open. Conversely, the patient's awareness does not improve in both the "offline" condition (in which the patient does not attempt to perform the movement) and in the "online" condition, when vision is precluded ("online" condition, eyes-closed). We conclude that the stimulation of the premotor cortex by tDCS activates brain regions involved in motor monitoring, temporary restoring the ability of the motor comparator system to correctly appreciate afferent information and build up a veridical motor awareness.

  16. Continuous quality improvement in intensive care medicine. The GiViTI Margherita Project - Report 2005.

    Science.gov (United States)

    Boffelli, S; Rossi, C; Anghileri, A; Giardino, M; Carnevale, L; Messina, M; Neri, M; Langer, M; Bertolini, G

    2006-06-01

    The assessment of the quality of intensive care medicine is mandatory in the modern healthcare system. In Italy, the GiViTI (Gruppo Italiano per la Valutazione degli Interventi in Terapia Intensiva) network is working in this field since 1991 and it now involves 295 out of the about 450 Italian intensive care units (ICU). In 2002 GiViTI launched a project for the continuous quality assessment and improvement that is now joined by 180 ICUs. Data collected in 2005 are analyzed and presented. All admitted patients were entered in a validated software, which performs a multitude of validity checks during the data entry. Data were further reviewed by the co-ordinating center; patients admitted in months with more than 10% of incomplete or inconsistent records in each ICU were excluded from the analysis. Each year, a multivariate logistic regression model is fitted to identify predictors of hospital mortality. Starting from the SAPS 2 and the 2004 GiViTI model predictions of hospital mortality, two calibration tables and curves are presented. In 2005, 180 Italian ICUs collected data on 55 246 patients. After excluding those admitted in months with an unjustified lower recruitment rate or with less than 90% of complete and consistent data, we had 52 816 (95.6%) valid cases. Although the rough hospital mortality in 2005 was 1% higher than in 2004 (22.6% vs 21.5%), the adjusted mortality shows a statistically significant 4% reduction (obser-ved-to-expected ratio: 0.96; 95% CI: 0.94-0.97). Italian ICUs in 2005 performed better than in 2004, at a parity of patient severity.

  17. Evaluation of a Positive Youth Development Program for Adolescents with Greater Psychosocial Needs: Integrated Views of Program Implementers

    Directory of Open Access Journals (Sweden)

    Daniel T. L. Shek

    2010-01-01

    Full Text Available To help adolescents with greater psychosocial needs, the Tier 2 Program of the Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes was designed and implemented by school social workers and teachers. Based on subjective outcome evaluation data collected from the program participants (n = 2,542 in 49 schools, program implementers were invited to write down five conclusions based on an integration of the evaluation findings. With reference to 245 conclusions included in the 49 evaluation reports, secondary data analyses showed that most of the conclusions concerning perceptions of the Tier 2 Program, instructors, and program effectiveness were positive. In addition, difficulties encountered and recommendations for program improvement were highlighted. In conjunction with previous evaluation findings, the present study suggests that the Tier 2 Program was well received and was perceived to be beneficial to the development of adolescents with greater psychosocial needs.

  18. Evaluation of a positive youth development program for adolescents with greater psychosocial needs: integrated views of program implementers.

    Science.gov (United States)

    Shek, Daniel T L; Ma, Cecilia M S; Sun, Rachel C F

    2010-10-01

    To help adolescents with greater psychosocial needs, the Tier 2 Program of the Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes) was designed and implemented by school social workers and teachers. Based on subjective outcome evaluation data collected from the program participants (n = 2,542) in 49 schools, program implementers were invited to write down five conclusions based on an integration of the evaluation findings. With reference to 245 conclusions included in the 49 evaluation reports, secondary data analyses showed that most of the conclusions concerning perceptions of the Tier 2 Program, instructors, and program effectiveness were positive. In addition, difficulties encountered and recommendations for program improvement were highlighted. In conjunction with previous evaluation findings, the present study suggests that the Tier 2 Program was well received and was perceived to be beneficial to the development of adolescents with greater psychosocial needs.

  19. Innovation in diabetes care: improving consumption of healthy food through a "chef coaching" program: a case report.

    Science.gov (United States)

    Polak, Rani; Dill, Diana; Abrahamson, Martin J; Pojednic, Rachele M; Phillips, Edward M

    2014-11-01

    Nutrition therapy as part of lifestyle care is recommended for people with type 2 diabetes. However, most people with diabetes do not follow this guideline. Changing eating habits involves obtaining knowledge and building practical skills such as shopping, meal preparation, and food storage. Just as fitness coaches use their specific knowledge base in fitness to enhance the effectiveness of their coaching, credentialed chefs trained as health coaches might combine their culinary expertise with coaching in order to improve clients' food choices and lifestyles. This report documents the case of a 55-year-old white male physician, single and living alone, who was recently diagnosed with type 2 diabetes and reported chronic stress, sedentary behavior, and unhealthy eating habits. He participated in a chef coaching program of 8 weekly one-on-one 30-minute coaching sessions via Skype delivered by a chef trained as a health coach. During the first five meetings, the patient's goals were primarily culinary; however, with his success in accomplishing these goals, the patient progressed and expanded his goals to include other lifestyle domains, specifically exercise and work-life balance. At the end of the program, the patient had improved both his nutritional and exercise habits, his confidence in further self-care improvement, and his health parameters such as HgA1c (8.8% to 6.7%; normal culinary skills and implement them so that they eat better and, further, has the potential to help them improve their overall self-care. We intend to further develop chef coaching and assess its potential as we learn from its implementation.

  20. How neuroscience and behavioral genetics improve psychiatric assessment: Report on a violent murder case

    Directory of Open Access Journals (Sweden)

    Davide Rigoni

    2010-10-01

    Full Text Available Despite the advances in the understanding of neural and genetic foundations of violence, the investigation of the biological bases of a mental disorder is rarely included in psychiatric evaluation of mental insanity. Here we report on a case in which cognitive neuroscience and behavioral genetics methods were applied to a psychiatric forensic evaluation conducted on a young woman, J.F., tried for a violent and impulsive murder. The defendant had a history of multidrug and alcohol abuse and non-forensic clinical evaluation concluded for a diagnosis of borderline personality disorder. We analyzed the defendant’s brain structure in order to underlie possible brain structural abnormalities associated with pathological impulsivity. Voxel-Based Morphometry indexed a reduced gray matter volume in the left prefrontal cortex, in a region specifically associated with response inhibition. Furthermore, J.F.’s DNA was genotyped in order to identify genetic polymorphisms associated with various forms of violence and impulsive behaviour. Five polymorphisms that are known to be associated with impulsivity, violence, and other severe psychiatric illnesses were identified in J.F.’s DNA. Taken together, these data provided evidence for the biological correlates of a mental disorder characterized by high impulsivity and aggressive tendencies. Our claim is that the use of neuroscience and behavioral genetics do not change the rationale underlying the determination of criminal liability, which must be based on a causal link between the mental disorder and the crime. Rather, their use is crucial in providing objective data on the biological bases of a defendant’s mental disorder.