WorldWideScience

Sample records for soufflerie multisites menes

  1. Mening i arbejdslivet

    DEFF Research Database (Denmark)

    Ravn, Ib

    2008-01-01

    begrebet, hvorfor det defineres her: Et fænomen giver mening, når man indser, hvordan det indgår i en større sammenhæng. Mening i arbejdslivet gives da af oplevelsen af, at man gennem sit arbejde indgår i en større sammenhæng. En konceptualisering med fire delfaktorer udledes, der tilsammen skønnes at give...... mening i arbejdslivet: 1. Styrkerealisering: Den enkelte bruger sine styrker og talenter; 2. Værdiskabelse: Ens arbejdsplads skaber reel værdi og livskvalitet for kunder og brugere. 3. Bidrag: Man oplever at yde et vigtigt bidrag gennem sit arbejde. 4. Fællesskab: Man indgår i et produktivt fællesskab...

  2. Historiemisbrug - giver det mening?

    DEFF Research Database (Denmark)

    Peters, Rikke Louise Alberg; Brunbech, Peter Johan Yding

    2018-01-01

    Giver det mening at tale om ”historiemisbrug” i en undervisningssammenhæng, eller er misbrug en uklar moralsk motiveret dom, vi fælder over det, vi tager afstand fra? Denne artikel er en redigeret diskussion af dette spørgsmål mellem Rikke Alberg Peters og Peter Brunbech....

  3. Mening eller måling?

    DEFF Research Database (Denmark)

    Kruse, Tove Elisabeth

    2008-01-01

    Artiklen diskuterer med udgangspunkt i regeringens universitetspolitiske strategi og tiltag , hvad der motiverer mennesker, der arbejder på et universitet, og hvad der giver deres arbejdsliv mening, og argumenterer for, at de stadigt mere udbredte præstationsmålinger, der ensretter og sammenligne...

  4. Análisis de regímenes aduaneros

    OpenAIRE

    Maruri P., Cristina

    2010-01-01

    El presente documento contiene el análisis de cada Régimen Aduanero que las empresas en calidad de Exportadores e Importadores deben utilizar para un mejor manejo de sus actividades comerciales Internacionales. Los Regímenes Aduaneros se clasifican: Regímenes Comunes, Especiales, Particulares y de Excepción cada uno de ellos con subdivisión, sus definiciones, los requisitos y garantías que se debe cumplir de acuerdo a cada actividad empresarial. El documento cuenta también con ejemplo de Regí...

  5. Multi-Sited Resilience

    DEFF Research Database (Denmark)

    Olwig, Mette Fog

    2012-01-01

    with natural disasters and climate change. In a globalized world, however, it is hard to discern what is “local” as global organizations play an increasingly visible and powerful role. This paper will argue that local understandings and practices of resilience cannot be disentangled from global understandings...... flooding in northern Ghana, this paper examines the mutual construction of “local” and “global” notions and practices of resilience through multi-sited processes. It is based on interviews and participant observation in multiple sites at the “local,” “regional” and “global” levels....

  6. WordPress multisite administration

    CERN Document Server

    Longren, Tyler

    2013-01-01

    This is a simple, concise guide with a step-by-step approach, packed with screenshots and examples to set up and manage a network blog using WordPress.WordPress Multisite Administration is ideal for anyone wanting to familiarize themselves with WordPress Multisite. You'll need to know the basics about WordPress, and having at least a broad understanding of HTML, CSS, and PHP will help, but isn't required.

  7. La imprescriptibilidad de los crímenes contra la humanidad en Uruguay

    Directory of Open Access Journals (Sweden)

    José Manuel Sánchez Patrón

    2014-06-01

    Full Text Available La ratificación del Convenio sobre la imprescriptibilidad de los crímenes de guerra y de los crímenes de lesa humanidad por parte de Uruguay, constituye un primer paso dirigido a limitar la impunidad de los partícipes en la comisión de estas infracciones internacionales. Para la consecución de esta misma finalidad, el Estado Uruguayo ha dado un segundo paso, consistente en la ratificación del Estatuto de la Corte Penal Internacional, lo que ha llevado a efecto casi un año después del anterior. Ambas decisiones demuestran la intención de Uruguay de comprometerse Internacionalmente con el fin de evitar la impunidad de los responsables de la comisión de determinadas figuras delictivas, especialmente los crímenes de guerra y los crímenes contra la humanidad, ya que en tomo a estas dos infracciones internacionales gravitan los convenios internacionales a los que nos acabamos de referir.Contenido: imprescriptibilidad de los crímenes contra la humanidad en el pasado. Imprescriptibilidad de los crímenes contra la humanidad en el presente. Imprescriptibilidad de los crímenes contra la humanidad en el futuro. Conclusiones

  8. Una aproximación al concepto de crímenes contra la humanidad

    Directory of Open Access Journals (Sweden)

    José Manuel Díaz Soto

    2012-12-01

    Full Text Available El presente artículo explora el concepto de “crímenes contra la humanidad”, a partir de una revisión histórica y del análisis de los distintos instrumentos internacionales que han consagrado esta categoría normativa. De igual modo, pretende ilustrar al lector acerca de la teoría de los crímenes contra la humanidad formulada por el profesor de la Universidad de Georgetown David J. Luban, para quien el rasgo definidor de estos delitos es que atentan contra la naturaleza política del ser humano. Por último, se destaca la influencia del pensamiento de Luban en la reciente jurisprudencia de la Corte Suprema de Justicia de Colombia acerca de los crímenes contra la humanidad.

  9. Algunos interrogantes sobre las modalidades de juzgamiento de los crímenes estatales masivos

    Directory of Open Access Journals (Sweden)

    Daniel Feierstein

    2013-09-01

    Full Text Available El artículo propone un análisis criminológico de las categorías jurídicas creadas para lidiar con los crímenes estatales masivos (crímenes de guerra, crímenes contra la humanidad, genocidio, señalando las potencialidades, límites y desafíos de cada una de ellas, al tratarse de figuras que por primera vez aplican la capacidad de juzgar sobre el propio poder punitivo, lo cual genera ciertas paradojas. Se destaca la problematicidad de la figura de crímenes contra la humanidad como un posible "tipo abierto" y su utilización como ariete para vulnerar los ordenamientos jurídicos y derechos soberanos de las naciones en desarrollo. Se señala la necesidad de una mejor codificación del concepto de genocidio que, garantizando la inclusión de todos los grupos y la igualdad ante la ley, podría resultar una figura más sólida y menos peligrosa que la de crímenes contra la humanidad. Asimismo, el texto propone repensar los modos procesales en el juzgamiento de crímenes estatales masivos, con el fin de enfrentar con eficiencia aquellos delitos que son organizados por el propio poder punitivo, en condiciones de clandestinidad,  y donde la propia lógica de la prueba del delito es puesta en cuestión.

  10. Seasonality and potential of Ceranisus menes for control of thrips on ...

    African Journals Online (AJOL)

    Seasonality and potential of Ceranisus menes for control of thrips on French beans. LM Gitonga. Abstract. No Abstract. Journal of Agriculture, Science and Technology Vol. 10 (1) 2008: pp. 56-69. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  11. Cztery kategorie menedżerów projektów

    DEFF Research Database (Denmark)

    Ritter, Thomas; Lund Pedersen, Carsten

    2018-01-01

    Niewiele kwestii w większym stopniu przyciąga uwagę kadr zarządzających niż optymalny sposób rozwoju ich organizacji. Niemniej niewielu menedżerów najwyższego szczebla systematycznie pracuje z osobami, które są im niezbędne do zrealizowania rozmaitych szans rozwojowych....

  12. Menedžment projektov in finančna dodana vrednost

    Directory of Open Access Journals (Sweden)

    Marko Brcar

    2017-03-01

    Full Text Available Raziskovalno vprašanje (RV: Ali obstajajo statistično značilne povezave med dejavniki planiranja, organiziranja, vodenja in kontroliranja in finančno dodano vrednostjo gradbenih projektov. Namen: Namen raziskave je bil opraviti empirično raziskavo o vplivu dejavnikov menedžment projektov na finančno dodano vrednost v izbranih slovenskih gradbenih podjetjih ter podati predloge za izboljšanje stanja. Metoda: V kvantitativni raziskavi je sodelovalo 77 anketirancev iz slovenskih gradbenih podjetij, med katerimi je bila večina menedžerjev projektov. Rezultati: Na podlagi raziskave je razvidno, da imajo natančneje planirani gradbeni projekti statistično značilen vpliv na finančno dodano vrednost projektov, pri čemer imata največji vpliv ustrezno planiranje in preverjanje ciljev ter obvladovanje sprememb na projektu. Organizacija: Izidi raziskave bodo lahko v praktično pomoč vsem tistim, ki se ukvarjajo s področjem gradbenih projektov in njihovo uspešnostjo. Empirične ugotovitve iz raziskave naj bi spodbudile podjetja in druge organizacije, da bodo več časa namenila planiranju projekta. Originalnost: Prispevek raziskave k menedžerski znanosti in stroki je opravljena empirična raziskava in analiza vpliva dejavnikov menedžmenta na finančno dodano vrednost projekta, saj v zadnjih desetih letih v gradbeništvu ni bilo podobne raziskave. Omejitve: V raziskavi smo se omejili le na finančno dodano vrednost projektov, nismo se osredotočali na ostale dejavnike učinkovitosti projektov, na primer kakovost proizvoda ali procesa, zadovoljstvo uporabnika, zadovoljstvo odjemalcev in podobno.

  13. Multi-Sited Comparison of "Doing Regulation"

    DEFF Research Database (Denmark)

    Sørensen, Estrid

    2008-01-01

    tertium comparationis. Artiklen foreslåt en multi-sited sammenligning, som ikke tager udgangspunkt i tertium comparationis, men derimod identificerer dette som sit resultat. Artiklen redegør for udviklingen af denne metode gennem en undersøgelse af medieregulering med henblik på børnebeskyttelse....

  14. Terrorismo de Estado y subjetividad : Escenarios actuales: juicios por crímenes de lesa humanidad

    OpenAIRE

    Cicconi, María Luján; Oñativia, Xavier Andrés; Vedio, Marta; Shapiro, Hernán

    2011-01-01

    El desarrollo de los juicios por crímenes de lesa humanidad cometidos por el Terrorismo de Estado durante la última dictadura cívico-militar configura un nuevo espacio de interés para la Psicología Pese a lo reciente de la implementación de estos procesos judiciales ya se cuenta con algunos antecedentes que proporcionan la suficiente información para revisar indicadores de impacto en la subjetividad de los actores intervinientes en dichas experiencias. Este Taller propone un espacio para la p...

  15. REFORMA A LOS REGÍMENES DE PENSIONES EN COSTA RICA

    Directory of Open Access Journals (Sweden)

    Rodrigo Briceño Briceño

    2011-09-01

    Full Text Available Desde inicios de la década de los ochenta el tema de la reforma a los sistemas de pensión en América Latina ha sido fuente de las más diversas polémicas. La disyuntiva entre los conceptos de solidaridad y subsidariedad que persiguen estos sistemas ha puesto en boga diferentes mecanismos para paliar la crisis en el área de la seguridad social. En el presente artículo se analizan de forma sucinta algunas de las principales características que ha asumido el proceso de reforma de los sistemas de pensión en América Latina, donde el ejemplo más notable ha sido el caso de Chile. Luego se hace referencia al proceso de reforma que se ha aplicado a los diferentes regímenes de pensiones existentes en el país. El énfasis se pone en los regímenes de Invalidez, Vejez y Muerte de la Caja Costarricense del Seguro Social y en el del Magisterio Nacional por ser los de mayor participación relativa, tanto en lo que respecta a funcionarios cotizantes como pensionados.

  16. Estrategias de aprendizaje y ansiedad ante los exámenes en estudiantes universitarios

    Directory of Open Access Journals (Sweden)

    Luis Alberto Furlan

    2009-01-01

    Full Text Available Diversas investigaciones coinciden en señalar que la elevada ansiedad frente a los exámenes está asociada a la baja habilidad para el estudio y al uso de estrategias superficiales de procesamiento de la información, existendo influencias recíprocas entre dichas variables. De acuerdo a esta perspectiva, se evaluó el uso de estrategias de aprendizaje en 816 estudiantes universitarios con elevada, media o baja ansiedad frente a los exámenes. Adicionalmente, se analizaron las relaciones entre las cuatro dimensiones de la ansiedad y las estrategias de aprendizaje. Los estudiantes con elevada ansiedad utilizaron más frecuentemente estrategias de repetición y búqueda de ayuda académica y los de baja ansiedad, estrategias de estudio reflexivo. La falta de confianza correlacionó negativamente con estrategias de estudio reflexivo, repetición, búsqueda de ayuda académica y regulación del tiempo y esfuerzo. En sentido opuesto, la preocupación se asoció positivamente con tres de estas estrategias.

  17. High prevalence of daily and multi-site pain

    DEFF Research Database (Denmark)

    Rathleff, Michael Skovdal; Roos, Ewa M.; Olesen, Jens Lykkegaard

    2013-01-01

    Daily pain and multi-site pain are both associated with reduction in work ability and health-related quality of life (HRQoL) among adults. However, no population-based studies have yet investigated the prevalence of daily and multi-site pain among adolescents and how these are associated...... with respondent characteristics. The purpose of this study was to investigate the prevalence of self-reported daily and multi-site pain among adolescents aged 12--19 years and associations of almost daily pain and multi-site pain with respondent characteristics (sex, age, body mass index (BMI), HRQoL and sports...

  18. A Mixed Methods Sampling Methodology for a Multisite Case Study

    Science.gov (United States)

    Sharp, Julia L.; Mobley, Catherine; Hammond, Cathy; Withington, Cairen; Drew, Sam; Stringfield, Sam; Stipanovic, Natalie

    2012-01-01

    The flexibility of mixed methods research strategies makes such approaches especially suitable for multisite case studies. Yet the utilization of mixed methods to select sites for these studies is rarely reported. The authors describe their pragmatic mixed methods approach to select a sample for their multisite mixed methods case study of a…

  19. The Role of Involvement and Use in Multisite Evaluations

    Science.gov (United States)

    Lawrenz, Frances; King, Jean A.; Ooms, Ann

    2011-01-01

    A cross-case analysis of four National Science Foundation (NSF) case studies identified both unique details and common themes related to promoting the use and influence of multisite evaluations. The analysis provided evidence of diverse evaluation use by stakeholders and suggested that people taking part in the multisite evaluations perceived…

  20. Mecanismos fisiológicos implicados en la ansiedad previa a exámenes

    Directory of Open Access Journals (Sweden)

    Annia Yolanda del Toro Añel

    2014-10-01

    Full Text Available En el campo de la salud mental, llama la atención de clínicos e investigadores la situación de los estudiantes universitarios en cuanto al estrés académico, puesto que las exigencias en este sentido, particularmente la presión ante los exámenes, es reconocida por los propios jóvenes como uno de los factores más estresantes que genera estados de ansiedad en ellos y, por ende, afecta su rendimiento académico. En este artículo se destacan las interacciones entre el sistema nervioso y endocrino, así como las influencias del estrés psicológico sobre el rendimiento académico

  1. La insurgencia reprimida. Regímenes de Seguridad Nacional contra la revolución

    Directory of Open Access Journals (Sweden)

    Pedro Rivas Nieto

    2010-01-01

    Full Text Available En este artículo se estudia tanto el concepto que los regímenes de Seguridad Nacional tenían de la llamada guerra revolucionaria como la respuesta que le dieron. Allá en donde implantaron su dominio -especialmente en el Cono Sur de América- pensaban que las guerras revolucionarias eran nuevas técnicas de lucha más que un tipo definido de guerra, que todas respondían al mismo modelo revolucionario y que eran la estrategia del comunismo internacional para adueñarse del mundo. Por eso atacaron con especial dureza a los movimientos de izquierda, pensando que eran la avanzadilla moscovita para acabar con las democracias latinoamericanas.

  2. Mechanism of MenE inhibition by acyl-adenylate analogues and discovery of novel antibacterial agents.

    Science.gov (United States)

    Matarlo, Joe S; Evans, Christopher E; Sharma, Indrajeet; Lavaud, Lubens J; Ngo, Stephen C; Shek, Roger; Rajashankar, Kanagalaghatta R; French, Jarrod B; Tan, Derek S; Tonge, Peter J

    2015-10-27

    MenE is an o-succinylbenzoyl-CoA (OSB-CoA) synthetase in the bacterial menaquinone biosynthesis pathway and is a promising target for the development of novel antibacterial agents. The enzyme catalyzes CoA ligation via an acyl-adenylate intermediate, and we have previously reported tight-binding inhibitors of MenE based on stable acyl-sulfonyladenosine analogues of this intermediate, including OSB-AMS (1), which has an IC50 value of ≤25 nM for Escherichia coli MenE. Herein, we show that OSB-AMS reduces menaquinone levels in Staphylococcus aureus, consistent with its proposed mechanism of action, despite the observation that the antibacterial activity of OSB-AMS is ∼1000-fold lower than the IC50 for enzyme inhibition. To inform the synthesis of MenE inhibitors with improved antibacterial activity, we have undertaken a structure-activity relationship (SAR) study stimulated by the knowledge that OSB-AMS can adopt two isomeric forms in which the OSB side chain exists either as an open-chain keto acid or a cyclic lactol. These studies revealed that negatively charged analogues of the keto acid form bind, while neutral analogues do not, consistent with the hypothesis that the negatively charged keto acid form of OSB-AMS is the active isomer. X-ray crystallography and site-directed mutagenesis confirm the importance of a conserved arginine for binding the OSB carboxylate. Although most lactol isomers tested were inactive, a novel difluoroindanediol inhibitor (11) with improved antibacterial activity was discovered, providing a pathway toward the development of optimized MenE inhibitors in the future.

  3. Multisite Interactions in Lattice-Gas Models

    Science.gov (United States)

    Einstein, T. L.; Sathiyanarayanan, R.

    For detailed applications of lattice-gas models to surface systems, multisite interactions often play at least as significant a role as interactions between pairs of adatoms that are separated by a few lattice spacings. We recall that trio (3-adatom, non-pairwise) interactions do not inevitably create phase boundary asymmetries about half coverage. We discuss a sophisticated application to an experimental system and describe refinements in extracting lattice-gas energies from calculations of total energies of several different ordered overlayers. We describe how lateral relaxations complicate matters when there is direct interaction between the adatoms, an issue that is important when examining the angular dependence of step line tensions. We discuss the connector model as an alternative viewpoint and close with a brief account of recent work on organic molecule overlayers.

  4. Multisite EPR oximetry from multiple quadrature harmonics.

    Science.gov (United States)

    Ahmad, R; Som, S; Johnson, D H; Zweier, J L; Kuppusamy, P; Potter, L C

    2012-01-01

    Multisite continuous wave (CW) electron paramagnetic resonance (EPR) oximetry using multiple quadrature field modulation harmonics is presented. First, a recently developed digital receiver is used to extract multiple harmonics of field modulated projection data. Second, a forward model is presented that relates the projection data to unknown parameters, including linewidth at each site. Third, a maximum likelihood estimator of unknown parameters is reported using an iterative algorithm capable of jointly processing multiple quadrature harmonics. The data modeling and processing are applicable for parametric lineshapes under nonsaturating conditions. Joint processing of multiple harmonics leads to 2-3-fold acceleration of EPR data acquisition. For demonstration in two spatial dimensions, both simulations and phantom studies on an L-band system are reported. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Ansiedad ante los exámenes en alumnos de Educación Secundaria Obligatoria || Anxiety in students from junior high-school

    Directory of Open Access Journals (Sweden)

    Alba Rodríguez

    2014-12-01

    Full Text Available El presente trabajo tiene como objetivo identificar el grado de ansiedad ante los exámenes. Para llevar a cabo el estudio se ha utilizado el Cuestionario de Evaluación de Ansiedad ante los Exámenes (CAEX administrado a 325 estudiantes de ESO. Los resultados pusieron de manifiesto que el perfil de estudiante que posee mayores niveles de ansiedad ante los exámenes es una mujer de 12 años, que estudia 1º ESO en un colegio privado-concertado y aprueba todas las asignaturas. Se puede concluir en primer lugar que la ansiedad ante los exámenes afecta significativamente a los estudiantes de la muestra, y en segundo lugar, se han encontrado diferencias estadísticamente significativas en las variables edad, sexo, tipo de centro, curso y rendimiento académico.

  6. PRE-EXÁMENES COMO UNA ESTRATEGIA DIDÁCTICA EN LOS CURSOS DE FÍSICA

    Directory of Open Access Journals (Sweden)

    Herbert Morales Ríos

    2010-01-01

    Full Text Available Se describe la experiencia del uso de pre-exámenes o exámenes de prueba como una estrategia didáctica para el mejoramiento en el rendimiento y en el desempeño estudiantil en los cursos propios de la carrera de física. El objetivo principal de la experiencia era determinar, a priori, las deficiencias, tanto matemáticas como físicas, que tiene el estudiantado, corregirlas antes de administrarle el examen definitivo y establecer una evaluación formativa en el curso. En particular, el tema evaluado era el de oscilaciones lineales del curso de Mecánica Teórica. Se detalla en qué consiste dicha estrategia, la motivación de su implementación y los roles tanto docente como estudiantil. Se analizan los resultados de la experiencia para concluir con las bondades, limitaciones y proyecciones futuras del uso de los pre-exámenes, con el fin de mostrarlos como una herramienta más dentro de la labor docente universitaria.

  7. Shared worlds: multi-sited ethnography and nursing research.

    Science.gov (United States)

    Molloy, Luke; Walker, Kim; Lakeman, Richard

    2017-03-22

    Background Ethnography, originally developed for the study of supposedly small-scale societies, is now faced with an increasingly mobile, changing and globalised world. Cultural identities can exist without reference to a specific location and extend beyond regional and national boundaries. It is therefore no longer imperative that the sole object of the ethnographer's practice should be a geographically bounded site. Aim To present a critical methodological review of multi-sited ethnography. Discussion Understanding that it can no longer be taken with any certainty that location alone determines culture, multi-sited ethnography provides a method of contextualising multi-sited social phenomena. The method enables researchers to examine social phenomena that are simultaneously produced in different locations. It has been used to undertake cultural analysis of diverse areas such as organ trafficking, global organisations, technologies and anorexia. Conclusion The authors contend that multi-sited ethnography is particularly suited to nursing research as it provides researchers with an ethnographic method that is more relevant to the interconnected world of health and healthcare services. Implications for practice Multi-sited ethnography provides nurse researchers with an approach to cultural analysis in areas such as the social determinants of health, healthcare services and the effects of health policies across multiple locations.

  8. Conducting a Multisite Education Research Project: Strategies to Overcome the Barriers to Achieve the Benefits.

    Science.gov (United States)

    Beischel, Kelly P; Hart, Julie; Turkelson, Sandra L

    2016-01-01

    Multisite education research projects have many benefits as well as perceived barriers. In this article, we share our experiences with a multisite education research project and the barriers we overcame to reap the benefits. The outcome of our research resulted in increased rigor, role-modeling professional collaboration, and promotion of future multisite education studies. The strategies presented in this article will help alleviate perceived barriers and ameliorate the process of conducting multisite education research studies.

  9. Examinando exámenes. Consideraciones acerca de las pruebas de medición en ELE

    Directory of Open Access Journals (Sweden)

    Yagüe Barredo, Agustín

    2010-02-01

    Full Text Available El objetivo de este artículo es reflexionar acerca del concepto y el diseño de exámenes de español como lengua extranjera. Con criterios empíricos se subrayan las limitaciones técnicas de las pruebas y la pobreza de información que ofrecen a docentes y a candidatos sobre su actuación. El trabajo propone algunas alternativas que deben ser refrendadas en situaciones de aula.

  10. ¿Qué hay detrás del miedo a los exámenes?

    Directory of Open Access Journals (Sweden)

    R. Sender

    Full Text Available Introducción: Se analizan las características psicológicas de una muestra de 32 estudiantes de medicina que solicitan ayuda para afrontar el miedo a los exámenes. Material y método: Las pruebas seleccionadas para el análisis de esta población son el GHQ-28, el STAI de rasgo, la escala de percepción de estrés del UNCAHS y la Sensibilidad al Castigo y a la Recompensa (SCRS. Los puntajes obtenidos se compararon con los de un grupo control de estudiantes de primer curso. Resultados: 90 % de los sujetos de la muestra fueron mujeres y el 25 % recibieron o estaban recibiendo atención psicológica o psiquiátrica. Entre los estudiantes que solicitaron ayuda había un nivel más alto de psicopatología, una más alta sensibilidad al castigo y una más baja sensibilidad a la recompensa que en el grupo control. Conclusiones: Los estudiantes con ansiedad ante los exámenes presentan más sensibilidad al castigo y menos sensibilidad a la recompensa, y muestran más síntomas depresivos y obsesivos que los estudiantes del grupo control.

  11. Ansiedad ante exámenes y estrategias de aprendizaje en estudiantes de secundaria de Lima Metropolitana

    Directory of Open Access Journals (Sweden)

    Alberto A. Alegre

    2013-06-01

    Full Text Available El estudio buscó determinar la relación entre la ansiedad ante exámenes y las estrategias de aprendizaje en estudiantes de cuarto y quinto grados de educación secundaria de colegios estatales de Lima Metropolitana. La muestra se obtuvo por un procedimiento intencional, evaluándose a 469 estudiantes, siendo el 45.6% de sexo masculino y el 54.4% femenino, pertenecientes a cuatro colegios estatales de Lima Metropolitana. Se evaluó a los estudiantes con el Cuestionario de Ansiedad y Rendimiento – CAR y la Escala de Estrategias de Aprendizaje – ACRA. Se encontró que la ansiedad ante exámenes (puntuaciones en sus tres dimensiones: preocupación, emocionalidad y facilitación y las estrategias de aprendizaje (puntuaciones en sus cuatro dimensiones: adquisición, codificación, recuperación y apoyo al procesamiento de la información presentaron correlaciones bajas y en algunos casos negativas; siendo todas estas significativas.

  12. A Gateway MultiSite recombination cloning toolkit.

    Directory of Open Access Journals (Sweden)

    Lena K Petersen

    Full Text Available The generation of DNA constructs is often a rate-limiting step in conducting biological experiments. Recombination cloning of single DNA fragments using the Gateway system provided an advance over traditional restriction enzyme cloning due to increases in efficiency and reliability. Here we introduce a series of entry clones and a destination vector for use in two, three, and four fragment Gateway MultiSite recombination cloning whose advantages include increased flexibility and versatility. In contrast to Gateway single-fragment cloning approaches where variations are typically incorporated into model system-specific destination vectors, our Gateway MultiSite cloning strategy incorporates variations in easily generated entry clones that are model system-independent. In particular, we present entry clones containing insertions of GAL4, QF, UAS, QUAS, eGFP, and mCherry, among others, and demonstrate their in vivo functionality in Drosophila by using them to generate expression clones including GAL4 and QF drivers for various trp ion channel family members, UAS and QUAS excitatory and inhibitory light-gated ion channels, and QUAS red and green fluorescent synaptic vesicle markers. We thus establish a starter toolkit of modular Gateway MultiSite entry clones potentially adaptable to any model system. An inventory of entry clones and destination vectors for Gateway MultiSite cloning has also been established (www.gatewaymultisite.org.

  13. Real-time enrollment dashboard for multisite clinical trials

    Directory of Open Access Journals (Sweden)

    William A. Mattingly

    2015-10-01

    Conclusion: We have designed and implemented a visualization dashboard for managing multi-site clinical trial enrollment in two community acquired pneumonia studies. Information dashboards are useful for clinical trial management. They can be used in a standalone trial or can be included into a larger management system.

  14. Developing and evaluating a multisite and multispecies NIR ...

    African Journals Online (AJOL)

    To elevate NIR from proof-of-concept to a pilot scale, a large multisite, multispecies calibration was developed over iterative cycles to: (1) determine whether KPY in eucalypts can be predicted from a single calibration independent of site and species, and (2) identify the potential limits of accuracy and precision. This paper ...

  15. Multi-Sited Ethnography and the Field of Educational Research

    Science.gov (United States)

    Pierides, Dean

    2010-01-01

    This paper responds to the challenge of how educational research might be practised in a contemporary world that is no longer necessarily organised by nearness and unity. Focusing on ethnography, it argues for what a multi-sited imaginary contributes to research in the field of education. By giving prominence to the notion of multi-sited…

  16. Hydrological modeling using a multi-site stochastic weather generator

    Science.gov (United States)

    Weather data is usually required at several locations over a large watershed, especially when using distributed models for hydrological simulations. In many applications, spatially correlated weather data can be provided by a multi-site stochastic weather generator which considers the spatial correl...

  17. Eficacia de una Intervención para Disminuir la Ansiedad frente a los Exámenes en Estudiantes Universitarios Argentinos

    Directory of Open Access Journals (Sweden)

    Luis Alberto Furlan

    2013-01-01

    Full Text Available Se evaluó la efectividad de un programa para disminuir la ansiedad ante los exámenes, la procrastinación académica e incrementar la autoeficacia regulatoria, con 19 estudiantes universitarios de Argentina. El programa estimula el automonitoreo de las estrategias de aprendizaje implementadas, el aprendizaje de técnicas cognitivo-conductuales de control de la ansiedad y el ensayo anticipado de exámenes. Al comparar los resultados pre- y posintervención, se constataron mejorías moderadas. Se deben revisar los procedimientos para incrementar la adherencia al programa y la validez de los resultados.

  18. Insomnio, latencia al sueño y cantidad de sueño en estudiantes universitarios chilenos durante el periodo de clases y exámenes

    OpenAIRE

    Samuel Durán Agüero; Giovanni Rosales Soto; Cristóbal Moya Cantillana; Paula García Milla

    2017-01-01

    Objetivo:Determinar los factores asociados a la cantidad de horas de sueño, somnolenciadiurna e insomnio antes y durante un periodo de clases y exámenes.Material y métodos:Se evaluó a 384 alumnos de ambos sexos (74,1% mujeres), quienesreportaron su peso y estatura. A cada estudiante se le aplicó el Cuestionario de Insomnio y laEscala De Somnolencia de Epworth en el periodo de clases y periodo de exámenes.Resultados:Al comparar la somnolencia diurna, insomnio, latencia al sueño y cantidad deho...

  19. Crímenes de frontera: la criminalidad en la frontera sur de Brasil (1845-1889

    Directory of Open Access Journals (Sweden)

    Mariana Flores da Cunha Thompson Flores

    2012-12-01

    Full Text Available Los espacios de frontera establecen el límite y el contacto a la vez, concertando la paradoja de inestabilidad e integración, sobretodo en el siglo XIX cuando los Estados intentaban demarcarse constantemente. De esta manera, estos espacios limítrofes ofrecían márgenes de acción y negociación a los individuos que actuaban a través de la frontera valiéndose de las brechas existentes entre las soberanías yuxtapuestas a fin de mantenerse e reproducirse en este espacio complejo. Considerando que el contexto de frontera constituía un elemento importante a ser llevado en cuenta en las estrategias cotidianas de los fronterizos, el presente artículo pretende demostrar la valencia estratégica de la frontera en el campo de la criminalidad, analizando crímenes ocurridos en este espacio

  20. Environmental and Geologic Assessment to Locate a Manual Sanitary Refill in the Mene de Mauroa Church, Venezuela

    Directory of Open Access Journals (Sweden)

    Simón E. Morales-Soto

    2016-05-01

    Full Text Available The inadequate disposal of urban wastes is nowadays an environmental issue having a negative impact on several communities. The objective of this investigation is to select the most adequate place to locate a manual sanitary landfill to dump the solid wastes from the Mene de Mauroa (Venezuela church. A total of 19 variables were subjected to a series of evaluations applying the scale and weight method. This method consists of comparing the variables according to their level of priority. The area with the highest score is to be selected as the most adequate area for the sanitary landfill according to a weighting scale of 5 values for the scoring of each variable.

  1. Multisite rainfall downscaling and disaggregation in a tropical urban area

    Science.gov (United States)

    Lu, Y.; Qin, X. S.

    2014-02-01

    A systematic downscaling-disaggregation study was conducted over Singapore Island, with an aim to generate high spatial and temporal resolution rainfall data under future climate-change conditions. The study consisted of two major components. The first part was to perform an inter-comparison of various alternatives of downscaling and disaggregation methods based on observed data. This included (i) single-site generalized linear model (GLM) plus K-nearest neighbor (KNN) (S-G-K) vs. multisite GLM (M-G) for spatial downscaling, (ii) HYETOS vs. KNN for single-site disaggregation, and (iii) KNN vs. MuDRain (Multivariate Rainfall Disaggregation tool) for multisite disaggregation. The results revealed that, for multisite downscaling, M-G performs better than S-G-K in covering the observed data with a lower RMSE value; for single-site disaggregation, KNN could better keep the basic statistics (i.e. standard deviation, lag-1 autocorrelation and probability of wet hour) than HYETOS; for multisite disaggregation, MuDRain outperformed KNN in fitting interstation correlations. In the second part of the study, an integrated downscaling-disaggregation framework based on M-G, KNN, and MuDRain was used to generate hourly rainfall at multiple sites. The results indicated that the downscaled and disaggregated rainfall data based on multiple ensembles from HadCM3 for the period from 1980 to 2010 could well cover the observed mean rainfall amount and extreme data, and also reasonably keep the spatial correlations both at daily and hourly timescales. The framework was also used to project future rainfall conditions under HadCM3 SRES A2 and B2 scenarios. It was indicated that the annual rainfall amount could reduce up to 5% at the end of this century, but the rainfall of wet season and extreme hourly rainfall could notably increase.

  2. Multisite Case Study of Florida's Millennium High School Reform Model

    Directory of Open Access Journals (Sweden)

    Carol A. Mullen

    2002-10-01

    Full Text Available This study should have immediate utility for the United States and beyond its borders. School-to-work approaches to comprehensive reform are increasingly expected of schools while legislative funding for this purpose gets pulled back. This multisite case study launches the first analysis of the New Millennium High School (NMHS model in Florida. This improvement program relies upon exemplary leadership for preparing students for postsecondary education

  3. Multisite bias correction of precipitation data from regional climate models

    Czech Academy of Sciences Publication Activity Database

    Hnilica, Jan; Hanel, M.; Puš, V.

    2017-01-01

    Roč. 37, č. 6 (2017), s. 2934-2946 ISSN 0899-8418 R&D Projects: GA ČR GA16-05665S Grant - others:Grantová agentura ČR - GA ČR(CZ) 16-16549S Institutional support: RVO:67985874 Keywords : bias correction * regional climate model * correlation * covariance * multivariate data * multisite correction * principal components * precipitation Subject RIV: DA - Hydrology ; Limnology OBOR OECD: Climatic research Impact factor: 3.760, year: 2016

  4. Multisite accelerometry for sleep and wake classification in children.

    Science.gov (United States)

    Lamprecht, Marnie L; Bradley, Andrew P; Tran, Tommy; Boynton, Alison; Terrill, Philip I

    2015-01-01

    Actigraphy is a useful alternative to the gold standard polysomnogram for non-invasively measuring sleep and wakefulness. However, it is unable to accurately assess sleep fragmentation due to its inability to differentiate restless sleep from wakefulness and quiet wake from sleep. This presents significant limitations in the assessment of sleep-related breathing disorders where sleep fragmentation is a common symptom. We propose that this limitation may be caused by hardware constraints and movement representation techniques. Our objective was to determine if multisite tri-axial accelerometry improves sleep and wake classification. Twenty-four patients aged 6-15 years (median: 8 years, 16 male) underwent a diagnostic polysomnogram while simultaneously recording motion from the left wrist and index fingertip, upper thorax and left ankle and great toe using a custom accelerometry system. Movement was quantified using several features and two feature selection techniques were employed to select optimal features for restricted feature set sizes. A heuristic was also applied to identify movements during restless sleep. The sleep and wake classification performance was then assessed and validated against the manually scored polysomnogram using discriminant analysis. Tri-axial accelerometry measured at the wrist significantly improved the wake detection when compared to uni-axial accelerometry (specificity at 85% sensitivity: 71.3(14.2)% versus 55.2(24.7)%, p < 0.01). Multisite accelerometry significantly improved the performance when compared to the single wrist placement (specificity at 85% sensitivity: 82.1(12.5)% versus 71.3(14.2)%, p < 0.05). Our results indicate that multisite accelerometry offers a significant performance benefit which could be further improved by analysing movement in raw multisite accelerometry data.

  5. Proton adsorption onto alumina: extension of multisite complexation (MUSIC) theory

    Energy Technology Data Exchange (ETDEWEB)

    Nagashima, K.; Blum, F.D.

    1999-09-01

    The adsorption isotherm of protons onto a commercial {gamma}-alumina sample was determined in aqueous nitric acid with sodium nitrate as a background electrolyte. Three discrete regions could be discerned in the log-log plots of the proton isotherm determined at the solution pH 5 to 2. The multisite complexation (MUSIC) model was modified to analyze the simultaneous adsorption of protons onto various kinds of surface species.

  6. Expansion of the gateway multisite recombination cloning toolkit.

    Science.gov (United States)

    Shearin, Harold K; Dvarishkis, Alisa R; Kozeluh, Craig D; Stowers, R Steven

    2013-01-01

    Precise manipulation of transgene expression in genetic model organisms has led to advances in understanding fundamental mechanisms of development, physiology, and genetic disease. Transgene construction is, however, a precondition of transgene expression, and often limits the rate of experimental progress. Here we report an expansion of the modular Gateway MultiSite recombination-cloning platform for high efficiency transgene assembly. The expansion includes two additional destination vectors and entry clones for the LexA binary transcription system, among others. These new tools enhance the expression levels possible with Gateway MultiSite generated transgenes and make possible the generation of LexA drivers and reporters with Gateway MultiSite cloning. In vivo data from transgenic Drosophila functionally validating each novel component are presented and include neuronal LexA drivers, LexAop2 red and green fluorescent synaptic vesicle reporters, TDC2 and TRH LexA, GAL4, and QF drivers, and LexAop2, UAS, and QUAS channelrhodopsin2 T159C reporters.

  7. Multiperiod planning tool for multisite pig production systems.

    Science.gov (United States)

    Nadal-Roig, E; Plà, L M

    2014-09-01

    This paper presents a multiperiod planning tool for multisite pig production systems based on Linear Programming (LP). The aim of the model is to help pig managers of multisite systems in making short-term decisions (mainly related to pig transfers between farms and batch management in fattening units) and mid-term or long-term decisions (according to company targets and expansion strategy). The model skeleton follows the structure of a three-site system that can be adapted to any multisite system present in the modern pig industry. There are three basic phases, namely, piglet production, rearing pigs, and fattening. Each phase involves a different set of farms; therefore, transportation between farms and delivering of pigs to the abattoir are under consideration. The model maximizes the total gross margin calculated from the income of sales to the abattoir and the production costs over the time horizon considered. Production cost depends on each type of farm involved in the process. Parameters like number of farms per phase and distance, farm capacity, reproduction management policies, feeding and veterinary expenses, and transportation costs are taken into account. The model also provides a schedule of transfers between farms in terms of animals to be transported and number of trucks involved. The use of the model is illustrated with a case study based on a real instance of a company located in Catalonia (Spain).

  8. Insomnio, latencia al sueño y cantidad de sueño en estudiantes universitarios chilenos durante el periodo de clases y exámenes

    Directory of Open Access Journals (Sweden)

    Samuel Durán Agüero

    2017-01-01

    Full Text Available Objetivo:Determinar los factores asociados a la cantidad de horas de sueño, somnolenciadiurna e insomnio antes y durante un periodo de clases y exámenes.Material y métodos:Se evaluó a 384 alumnos de ambos sexos (74,1% mujeres, quienesreportaron su peso y estatura. A cada estudiante se le aplicó el Cuestionario de Insomnio y laEscala De Somnolencia de Epworth en el periodo de clases y periodo de exámenes.Resultados:Al comparar la somnolencia diurna, insomnio, latencia al sueño y cantidad dehoras de sueño entre periodo de clases y exámenes se observó un incremento en la latencia alsueño (p<0,05 durante los exámenes. Al realizar la comparación según estado nutricional seobservó, en el caso de las mujeres, que aquellas que presentan sobrepeso/obesidad tienen unamenor cantidad de horas de sueño en ambos periodos (p<0,05; en hombres, los que presentansobrepeso/obesidad tienen una mayor somnolencia diurna en exámenes (p<0,01. Al realizarla regresión logística tomando como variable dependiente somnolencia diurna, en mujeres seincrementa el riesgo de somnolencia diurna:OR=3,1 (IC95 % 1,1-8,8; en cambio, la ausenciade insomnio es un factor protector para somnolencia diurna:OR=0,06 (IC95 % 0,01-0,35.Conclusión:En periodo de exámenes se incrementa significativamente la latencia al sueño, enespecial en mujeres; en hombres se observa una disminución de las horas de sueño. Finalmente, las mujeres presentan un mayor riesgo de somnolencia diurna; en cambio, la ausencia deinsomnio es un factor protector. Ni el estado nutricional ni el consumo de cafeína se asociaroncon problemas de sueño.

  9. Multi-Sited Global Ethnography and Travel: Gendered Journeys in Three Registers

    Science.gov (United States)

    Epstein, Debbie; Fahey, Johannah; Kenway, Jane

    2013-01-01

    This paper joins a barely begun conversation about multi-sited and global ethnography in educational research; a conversation that is likely to intensify along with growing interest in the links between education, globalisation, internationalisation and transnationalism. Drawing on an ongoing multi-sited global ethnography of elite schools and…

  10. Efecto de diferentes regímenes de fertilización sobre la relación fitoplancton-bacteríoplancton en mesocosmos

    OpenAIRE

    Monserrate Vite, Marita Elizabeth

    2003-01-01

    Efecto de diferentes regímenes de fertilización sobre la relación fitoplancton-bacterioplancton en mesocosmos Se estudió el efecto de la adición de fertilizantes inorgánicos y orgánicos sobre la relación bacterioplancton – fitoplancton en mesocosmos (24 tanques de una tonelada de capacidad), llenados con agua del canal reservorio de la camaronera COFIMAR (Palmar, Ecuador).

  11. Modelo climático de los páramos de la Cordillera Oriental colombiana aplicado a regímenes de temperatura del suelo

    Directory of Open Access Journals (Sweden)

    Carlos Enrique Castro Méndez

    2016-06-01

    Full Text Available La aplicación (con criterios consistentes de los regímenes de temperatura del suelo, no había sido necesaria y decisiva, hasta ahora, ya que se consideraba suficiente esta información de carácter descriptivo. La temperatura asignada al suelo provenía de la reclasificación directa del clima ambiental al edáfico con valores medios anuales dados a cada franja altitudinal hace más de 200 años, esto no es acorde con los cambios, que desde la geografía biofísica, se han percibido en el ambiente. Se propone un modelo climático, basado en isotermas del suelo, para determinar los regímenes de temperatura a partir de información bajo coberturas vegetales y del suelo, para cada vertiente montañosa en particular. Se encontraron gradientes de temperatura (ºC/100 m de 0,73 y 0,61 en la vertiente occidental y oriental, respectivamente. La temperatura del suelo fue 1.9 ºC mayor que la del aire y se delimitaron los regímenes térmicos del suelo cryico, isofrígido e isomésico.

  12. Reading Profiles in Multi-Site Data With Missingness.

    Science.gov (United States)

    Eckert, Mark A; Vaden, Kenneth I; Gebregziabher, Mulugeta

    2018-01-01

    Children with reading disability exhibit varied deficits in reading and cognitive abilities that contribute to their reading comprehension problems. Some children exhibit primary deficits in phonological processing, while others can exhibit deficits in oral language and executive functions that affect comprehension. This behavioral heterogeneity is problematic when missing data prevent the characterization of different reading profiles, which often occurs in retrospective data sharing initiatives without coordinated data collection. Here we show that reading profiles can be reliably identified based on Random Forest classification of incomplete behavioral datasets, after the missForest method is used to multiply impute missing values. Results from simulation analyses showed that reading profiles could be accurately classified across degrees of missingness (e.g., ∼5% classification error for 30% missingness across the sample). The application of missForest to a real multi-site dataset with missingness ( n = 924) showed that reading disability profiles significantly and consistently differed in reading and cognitive abilities for cases with and without missing data. The results of validation analyses indicated that the reading profiles (cases with and without missing data) exhibited significant differences for an independent set of behavioral variables that were not used to classify reading profiles. Together, the results show how multiple imputation can be applied to the classification of cases with missing data and can increase the integrity of results from multi-site open access datasets.

  13. Reading Profiles in Multi-Site Data With Missingness

    Directory of Open Access Journals (Sweden)

    Mark A. Eckert

    2018-05-01

    Full Text Available Children with reading disability exhibit varied deficits in reading and cognitive abilities that contribute to their reading comprehension problems. Some children exhibit primary deficits in phonological processing, while others can exhibit deficits in oral language and executive functions that affect comprehension. This behavioral heterogeneity is problematic when missing data prevent the characterization of different reading profiles, which often occurs in retrospective data sharing initiatives without coordinated data collection. Here we show that reading profiles can be reliably identified based on Random Forest classification of incomplete behavioral datasets, after the missForest method is used to multiply impute missing values. Results from simulation analyses showed that reading profiles could be accurately classified across degrees of missingness (e.g., ∼5% classification error for 30% missingness across the sample. The application of missForest to a real multi-site dataset with missingness (n = 924 showed that reading disability profiles significantly and consistently differed in reading and cognitive abilities for cases with and without missing data. The results of validation analyses indicated that the reading profiles (cases with and without missing data exhibited significant differences for an independent set of behavioral variables that were not used to classify reading profiles. Together, the results show how multiple imputation can be applied to the classification of cases with missing data and can increase the integrity of results from multi-site open access datasets.

  14. On multi-site damage identification using single-site training data

    Science.gov (United States)

    Barthorpe, R. J.; Manson, G.; Worden, K.

    2017-11-01

    This paper proposes a methodology for developing multi-site damage location systems for engineering structures that can be trained using single-site damaged state data only. The methodology involves training a sequence of binary classifiers based upon single-site damage data and combining the developed classifiers into a robust multi-class damage locator. In this way, the multi-site damage identification problem may be decomposed into a sequence of binary decisions. In this paper Support Vector Classifiers are adopted as the means of making these binary decisions. The proposed methodology represents an advancement on the state of the art in the field of multi-site damage identification which require either: (1) full damaged state data from single- and multi-site damage cases or (2) the development of a physics-based model to make multi-site model predictions. The potential benefit of the proposed methodology is that a significantly reduced number of recorded damage states may be required in order to train a multi-site damage locator without recourse to physics-based model predictions. In this paper it is first demonstrated that Support Vector Classification represents an appropriate approach to the multi-site damage location problem, with methods for combining binary classifiers discussed. Next, the proposed methodology is demonstrated and evaluated through application to a real engineering structure - a Piper Tomahawk trainer aircraft wing - with its performance compared to classifiers trained using the full damaged-state dataset.

  15. Multisite Reliability of MR-Based Functional Connectivity

    Science.gov (United States)

    Noble, Stephanie; Scheinost, Dustin; Finn, Emily S.; Shen, Xilin; Papademetris, Xenophon; McEwen, Sarah C.; Bearden, Carrie E.; Addington, Jean; Goodyear, Bradley; Cadenhead, Kristin S.; Mirzakhanian, Heline; Cornblatt, Barbara A.; Olvet, Doreen M.; Mathalon, Daniel H.; McGlashan, Thomas H.; Perkins, Diana O.; Belger, Aysenil; Seidman, Larry J.; Thermenos, Heidi; Tsuang, Ming T.; van Erp, Theo G.M.; Walker, Elaine F.; Hamann, Stephan; Woods, Scott W.; Cannon, Tyrone D.; Constable, R. Todd

    2016-01-01

    Recent years have witnessed an increasing number of multisite MRI functional connectivity (fcMRI) studies. While multisite studies are an efficient way to speed up data collection and increase sample sizes, especially for rare clinical populations, any effects of site or MRI scanner could ultimately limit power and weaken results. Little data exists on the stability of functional connectivity measurements across sites and sessions. In this study, we assess the influence of site and session on resting state functional connectivity measurements in a healthy cohort of traveling subjects (8 subjects scanned twice at each of 8 sites) scanned as part of the North American Prodrome Longitudinal Study (NAPLS). Reliability was investigated in three types of connectivity analyses: (1) seed-based connectivity with posterior cingulate cortex (PCC), right motor cortex (RMC), and left thalamus (LT) as seeds; (2) the intrinsic connectivity distribution (ICD), a voxel-wise connectivity measure; and (3) matrix connectivity, a whole-brain, atlas-based approach assessing connectivity between nodes. Contributions to variability in connectivity due to subject, site, and day-of-scan were quantified and used to assess between-session (test-retest) reliability in accordance with Generalizability Theory. Overall, no major site, scanner manufacturer, or day-of-scan effects were found for the univariate connectivity analyses; instead, subject effects dominated relative to the other measured factors. However, summaries of voxel-wise connectivity were found to be sensitive to site and scanner manufacturer effects. For all connectivity measures, although subject variance was three times the site variance, the residual represented 60–80% of the variance, indicating that connectivity differed greatly from scan to scan independent of any of the measured factors (i.e., subject, site, and day-of-scan). Thus, for a single 5 min scan, reliability across connectivity measures was poor (ICC=0.07–0

  16. Modeling multisite streamflow dependence with maximum entropy copula

    Science.gov (United States)

    Hao, Z.; Singh, V. P.

    2013-10-01

    Synthetic streamflows at different sites in a river basin are needed for planning, operation, and management of water resources projects. Modeling the temporal and spatial dependence structure of monthly streamflow at different sites is generally required. In this study, the maximum entropy copula method is proposed for multisite monthly streamflow simulation, in which the temporal and spatial dependence structure is imposed as constraints to derive the maximum entropy copula. The monthly streamflows at different sites are then generated by sampling from the conditional distribution. A case study for the generation of monthly streamflow at three sites in the Colorado River basin illustrates the application of the proposed method. Simulated streamflow from the maximum entropy copula is in satisfactory agreement with observed streamflow.

  17. Patterns of Technochange Management in ERP Multisite Implementations

    DEFF Research Database (Denmark)

    Carugati, Andrea; Gibson, Cyrus; Mola, Lapo

    2009-01-01

    % of the total costs of implementation, small in comparison to installation and testing (45%) and, most significantly, deployment or actually achieving effective use of technology (36%). Douplaga and Astani [7] in a survey conducted among companies of various size to discovered the major issues concerning ERP......, customizations and training. This study focus therefore on the knowledge and training issues in multisite ERP implementations and proposes a contingent approach to implementation strategies in accordance to the level of knowledge possessed by the company in the ERP technology. ...... problems in getting business results from pervasive IT-related "technochanges". Technochange [4] refers to big, technology-driven, technology-dependent change seeking significant strategic benefits and requiring significant organizational change. From the management point of view these projects differ from...

  18. Ledelse der giver mening

    DEFF Research Database (Denmark)

    Conrad, Torsten

    2014-01-01

    supervision i praksis (Joyce & Showers, 2002). Artiklen sigter mod at bidrage med en øget forståelse af implementeringen af politiske beslutninger ved at belyse de forhold, der præger implementeringen med særligt fokus på skoleledelsen, medarbejderne og deres relation. Artiklen søger også at belyse, hvordan...

  19. Mening med tiden

    DEFF Research Database (Denmark)

    Nærværende antologis mangeartede bidrag er fælles om at udforske temaer inden for triaden tid, logik og etik. Den handler om tid, tilblivelse, øjeblikket og evigheden i relation til sproget, logikken, universet, etikken og litteraturen. Antologien giver et grundlæggende indblik i disse temaer, som...

  20. Meninger om mening

    DEFF Research Database (Denmark)

    Schultz Hansen, Søren; Skakon, Janne

    2013-01-01

    Artiklen handler om forståelsen af de digitale indfødte som medarbejdere er begrænset og præget af sparsom forskning – denne generation er kun netop blevet voksne, og det har ikke tidligere været muligt at kortlægge generationen i forhold til arbejdsmarkedet. Bl.a. derfor er opfattelsen stadig pr...

  1. PRE-EXÁMENES COMO UNA ESTRATEGIA DIDÁCTICA EN LOS CURSOS DE FÍSICA (SAMPLE TEST AS A TEACHING STRATEGY IN PHYSICS COURSES

    Directory of Open Access Journals (Sweden)

    Morales Ríos Herbert

    2010-04-01

    Full Text Available Resumen:Se describe la experiencia del uso de pre-exámenes o exámenes de prueba como una estrategia didáctica para el mejoramiento en el rendimiento y en el desempeño estudiantil en los cursos propios de la carrera de física. El objetivo principal de la experiencia era determinar, a priori, las deficiencias, tanto matemáticas como físicas, que tiene el estudiantado, corregirlas antes de administrarle el examen definitivo y establecer una evaluación formativa en el curso. En particular, el tema evaluado era el de oscilaciones lineales del curso de Mecánica Teórica. Se detalla en qué consiste dicha estrategia, la motivación de su implementación y los roles tanto docente como estudiantil. Se analizan los resultados de la experiencia para concluir con las bondades, limitaciones y proyecciones futuras del uso de los pre-exámenes, con el fin de mostrarlos como una herramienta más dentro de la labor docente universitaria.Abstract:We discuss our experience of using sample tests as a teaching strategy that allows us to improve the student grades in courses that belong to the College Physics Program. The main purpose of our experience was to find out the common mistakes both in mathematics and in physics made by the students and to correct them before the actual test, so that we could accomplish a formative evaluation. In particular, the evaluated subject was linear oscillations in the Classical Mechanics course. We describe what the strategy consists of, our motivation for using it and both the professor and the student roles. We analyze our results obtained in its implementation to conclude with the pros and cons of this teaching strategy and also with its future applications as a useful tool for improving college teaching.

  2. Relación entre ansiedad ante los exámenes, tipos de pruebas y rendimiento académico en estudiantes universitarios

    Directory of Open Access Journals (Sweden)

    José Hernando Ávila-Toscano

    2011-07-01

    Full Text Available Abstract This research paper shows the results of the assessment of anxiety in university students of different careers in relation to examinations, the types of tests made and their academic performance. 200 students at a private university were evaluated through a correlational design to determine cognitive manifestations, physiological and motor anxiety. Data were analyzed using Pearson Chi square and showed significant relationships for each set of symptoms with academic performance (p<.05. Group work, tests such debates, argumentative tests, among others were significantly related to anxious symptoms. It can be concluded that test anxiety significantly affects university students which becomes a problem that requires comprehensive interventions. Resumen El presente artículo de investigación muestra los resultados de la evaluación de la ansiedad en universitarios de diferentes carreras con relación a los exámenes, los tipos de pruebas académicas realizadas y su rendimiento académico. Se evaluaron 200 estudiantes de una universidad privada mediante un diseño correlacional para determinar manifestaciones cognitivas, fisiológicas y motoras de ansiedad. Los datos se analizaron con Chi cuadrado de Pearson, mostrando relaciones significativas de cada conjunto de síntomas con el rendimiento académico (p<.05. Los trabajos grupales, exámenes tipo debates, las pruebas argumentativas, entre otras, se relacionaron significativamente con los síntomas ansiosos. Se puede concluir que la ansiedad ante los exámenes afecta significativamente a estudiantes universitarios, constituyéndose en una problemática que requiere intervenciones integrales.

  3. Regímenes estacionales de precipitación en la vertiente mediterránea de la Península Ibérica

    OpenAIRE

    Luis Arrillaga, Martín de; González Hidalgo, José Carlos; Longares, Luis Alberto; Stepanek, Petr

    2008-01-01

    Ponencia presentada en: VI Congreso Internacional de la Asociación Española de Climatología celebrado en Tarragona del 8 al 11 de octubre de 2008. [ES]En este trabajo analizamos los regímenes estacionales de precipitación de la fachada Mediterránea de la Península Ibérica empleando la base de datos de precipitaciones mensuales MOPREDAMES (1113 series mensuales; periodo 1951-2000). En cada observatorio se estimó el régimen de precipitación promedio y anualmente se calculó el régime...

  4. Responsabilidad internacional del individuo y responsabilidad internacional del Estado: Encuentros y desencuentros en torno a la figura de los `crímenes de derecho internacional´

    OpenAIRE

    Chinchón Álvarez, Javier

    2009-01-01

    Lo que nos va a ocupar en la presente contribución es la necesidad de una clara distinción entre lo propio de la responsabilidad internacional del Estado y lo relativo a la responsabilidad internacional del individuo; en un ámbito singular como es el de los conocidos como "crímenes de derecho internacional". Cuestión que, a nadie escapa, tiene unas implicaciones esenciales para no naufragar en los procelosos mares del Derecho internacional contemporáneo

  5. Resultados comparativos de exámenes estatales del 2006 al 2012 en la Facultad de Estomatología de Camagüey

    Directory of Open Access Journals (Sweden)

    Sarah Teresita Gutiérrez Martore

    Full Text Available Fundamento: La ampliación de matrícula con la diversidad de vías de ingreso ha constituido un reto en la educación médica y la evaluación de graduación implica la certificación de la competencia de los egresados, por eso se hace necesario analizar los resultados obtenidos en estas etapas. Objetivo: Comparar los resultados de los ejercicios prácticos, teóricos y notas finales obtenidas por los estudiantes presentados a Exámenes Estatales Ordinarios de los cursos del 2006 al 2012 de la Facultad de Estomatología en la Universidad de Ciencias Médicas de Camagüey. Métodos: Se realizó una investigación descriptiva con 410 estudiantes presentados a exámenes estatales ordinarios en el período 2006-2012. Se clasificaron los grupos con menos o más de 40 estudiantes por cursos. Se obtuvieron las calificaciones de cada ejercicio y nota final estatal por cursos. Se utilizó el método porcentual, media aritmética y mediana obtenida en cada curso. Resultados: Los cursos del 2006-2009 sumaron 99 estudiantes y en los cursos del 2009-2012 se incrementaron hasta 311 educandos. En los exámenes estatales prácticos, los grupos pequeños obtuvieron calificación media de 99,2 y una mediana de 99 y 100; en los grupos numerosos las calificaciones disminuyeron hasta llegar a una media de 93 y una mediana de 95. En los exámenes teóricos, en los tres primeros cursos la media de calificación fue 83,5 y en el grupo numeroso de 83,7. Conclusiones: En los resultados se mantiene la calidad de la base científica de la actuación en todos los cursos, pero ha disminuido la del desempeño en los cursos con incremento de estudiantes.

  6. Afrontamiento ante exámenes : desarrollos de los principales modelos teóricos para su definición y medición

    OpenAIRE

    Piemontesi, Sebastián Eduardo; Heredia, Daniel Esteban

    2009-01-01

    El modelo transaccional del afrontamiento desarrollado por Lazarus y Folkman (1984) ha sido el más aceptado en la investigación sobre afrontamiento. Sus aportes han permitido el estudio de los exámenes como una situación de estrés especifica caracterizada como un proceso complejo con cambios significativos en el uso de varias estrategias a través de sus distintas etapas. Si bien existen numerosos estudios y medidas de afrontamiento creadas a partir de este modelo, sus desarrollos se han compl...

  7. Ejercicios resueltos de investigación operativa : exámenes propuestos en la Facultad de Ciencias Económicas y Empresariales

    OpenAIRE

    Castro Íñigo, Belén; Díez Sánchez, Henar; Urrutia Careaga, Ana Marta

    2011-01-01

    La asignatura Investigación Operativa es una asignatura cuatrimestral dedicada fundamentalmente a la introducción de los modelos deterministas más elementales dentro de la investigación de operaciones. Esta asignatura se ha impartido en los últimos años en el tercer curso de la Licenciatura de Administración y Dirección de Empresas (L.A.D.E.) en la Facultad de Ciencias Económicas y Empresariales de la UPV/EHU. Esta publicación recoge los problemas resueltos propuestos en los exámenes de la...

  8. Realización y corrección automática de exámenes con hoja de cálculo

    Directory of Open Access Journals (Sweden)

    Sánchez García, Juan Francisco

    2007-01-01

    Full Text Available La forma habitual de realizar exámenes de tipo test es mediante formularios en papel que posteriormente son tratados con un escáner y un software específico que facilita la corrección así como la emisión de informes y la exportación de datos a aplicaciones de hoja de cálculo. En las asignaturas de informática de gestión llama la atención que en algunos casos se hace evaluación de términos informáticos y utilización de aplicaciones informáticas sobre papel, cuando el hacerlo directamente sobre el ordenador permitiría además comprobar los conocimientos prácticos del alumno.Con la idea de facilitar al alumno la cumplimentación de este tipo de exámenes hemos desarrollado una metodología propia utilizando la hoja de cálculo Microsoft Excel. De esta forma el formulario de examen se sustituye por un fichero de hoja de cálculo que posteriormente será tratado para obtener los resultados contenido en el mismo y facilitar su corrección, la cual también se efectuará con la propia hoja de cálculo, utilizando programación en Visual Basic para Aplicaciones (VBA.

  9. La política de la protesta en regímenes autoritarios: síntesis crítica

    Directory of Open Access Journals (Sweden)

    Felipe Sánchez Barría

    Full Text Available RESUMEN Introducción A través de una revisión crítica de la literatura reciente, el ensayo explora la relación entre protesta contenciosa y regímenes autoritarios, y examina las dinámicas y consecuencias que emergen durante el conflicto político. Métodos Para lo anterior se discuten tres elementos que los especialistas han identificado como los principales en esta relación: oportunidades y amenazas políticas; ciclos de protesta y sostenibilidad de los movimientos sociales; y la relación entre violencia estatal y acción colectiva. Resultados La recurrencia de la protesta en regímenes represivos muestra la capacidad de la sociedad civil para articular este tipo de acciones contenciosas. Discusión No obstante, las trayectorias y resultados dependen, por una parte, de las características políticas del régimen y la competencia del gobierno para responder a los desafíos colectivos; y, por otra parte, de la capacidad de los oponentes de montar ciclos de protestas densos en participación durante un periodo significativo, del tipo de tácticas adoptadas, y de la capacidad de adaptación y resiliencia a la violencia estatal.

  10. Simulation-optimization framework for multi-site multi-season hybrid stochastic streamflow modeling

    Science.gov (United States)

    Srivastav, Roshan; Srinivasan, K.; Sudheer, K. P.

    2016-11-01

    A simulation-optimization (S-O) framework is developed for the hybrid stochastic modeling of multi-site multi-season streamflows. The multi-objective optimization model formulated is the driver and the multi-site, multi-season hybrid matched block bootstrap model (MHMABB) is the simulation engine within this framework. The multi-site multi-season simulation model is the extension of the existing single-site multi-season simulation model. A robust and efficient evolutionary search based technique, namely, non-dominated sorting based genetic algorithm (NSGA - II) is employed as the solution technique for the multi-objective optimization within the S-O framework. The objective functions employed are related to the preservation of the multi-site critical deficit run sum and the constraints introduced are concerned with the hybrid model parameter space, and the preservation of certain statistics (such as inter-annual dependence and/or skewness of aggregated annual flows). The efficacy of the proposed S-O framework is brought out through a case example from the Colorado River basin. The proposed multi-site multi-season model AMHMABB (whose parameters are obtained from the proposed S-O framework) preserves the temporal as well as the spatial statistics of the historical flows. Also, the other multi-site deficit run characteristics namely, the number of runs, the maximum run length, the mean run sum and the mean run length are well preserved by the AMHMABB model. Overall, the proposed AMHMABB model is able to show better streamflow modeling performance when compared with the simulation based SMHMABB model, plausibly due to the significant role played by: (i) the objective functions related to the preservation of multi-site critical deficit run sum; (ii) the huge hybrid model parameter space available for the evolutionary search and (iii) the constraint on the preservation of the inter-annual dependence. Split-sample validation results indicate that the AMHMABB model is

  11. Multisite musculoskeletal pain predicts medically certified disability retirement among Finns.

    Science.gov (United States)

    Haukka, E; Kaila-Kangas, L; Ojajärvi, A; Saastamoinen, P; Holtermann, A; Jørgensen, M B; Karppinen, J; Heliövaara, M; Leino-Arjas, P

    2015-09-01

    Musculoskeletal pain at several sites (multisite pain) is more common than single-site pain. Little is known on its effects on disability pension (DP) retirement. A nationally representative sample comprised 4071 Finns in the workforce aged 30 to 63. Data (questionnaire, interview, clinical examination) were gathered in 2000-2001 and linked with national DP registers for 2000-2011. Pain during the preceding month in 18 locations was combined into four sites (neck, upper limbs, low back, lower limbs). Hazard ratios (HR) of DP were estimated by Cox regression. The HR of any DP (n = 477) was 1.6 (95% confidence interval 1.2-2.1) for one, 2.5 (1.9-3.3) for two, 3.1 (2.3-4.3) for three and 5.6 (4.0-7.8) for four pain sites, when adjusted for age and gender. When additionally adjusted for clinically assessed chronic diseases, the HRs varied from 1.4 (1.0-1.8) to 3.5 (2.5-4.9), respectively. When further adjusted for physical and psychosocial workload, education, body mass index, smoking, exercise and sleep disorders, the HRs were 1.3 (0.9-1.7), 1.6 (1.2-2.2), 1.8 (1.3-2.5) and 2.5 (1.8-3.6). The number of pain sites was especially strong in predicting DPs due to musculoskeletal diseases (HRs in the full model; 3.1 to 4.3), but it also predicted DPs due to other somatic diseases (respective HRs 1.3 to 2.3); pain in all four sites was also predictive of DPs due to mental disorders (full model HR 2.2). The number of pain sites independently predicted DP retirement. Employees with multisite pain may need specific support to maintain their work ability. © 2014 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC®.

  12. Afrontamiento de la ansiedad ante los exámenes universitarios mediante un programa de Inoculación de Estrés: Caso Clínico

    OpenAIRE

    Escolar-Llamazares, M.C.; Serrano-Pintado, I.

    2016-01-01

    Introducción: Partiendo de la definición del constructo ansiedad ante los exámenes que realiza Spielberger y de la diferenciación de Wolpe entre problemas de ansiedad racional y problemas de ansiedad irracional se ha aplicado un programa basado en Inoculación de Estrés. Objetivo: Disminuir la ansiedad ante los exámenes que manifestaba una estudiante de Enfermería de la Universidad de Salamanca. Método: Se trata de un estudio cuasi-experimental de caso único con diseño AB sin retirada del trat...

  13. Colección de exámenes de la asignatura Aplicación de Ordenadores 2005 – 2011: fundamentos de programación y algoritmia

    OpenAIRE

    Quereda Gómez, Emmanuel David; Bañón Blázquez, Luis

    2011-01-01

    Esta divulgación docente recoge los ejercicios resueltos de aquellos exámenes realizados durante los curso 2005-2011, correspondientes a la asignatura Aplicación de Ordenadores de 3º curso de la titulación de Ingeniería Técnica de Obras Públicas de la Escuela Politécnica Superior de la Universidad de Alicante. El contenido de esta colección de exámenes versa sobre fundamentos de programación y algoritmos.

  14. Real-Time Enrollment Dashboard For Multisite Clinical Trials.

    Science.gov (United States)

    Mattingly, William A; Kelley, Robert R; Wiemken, Timothy L; Chariker, Julia H; Peyrani, Paula; Guinn, Brian E; Binford, Laura E; Buckner, Kimberley; Ramirez, Julio

    2015-10-30

    Achieving patient recruitment goals are critical for the successful completion of a clinical trial. We designed and developed a web-based dashboard for assisting in the management of clinical trial screening and enrollment. We use the dashboard to assist in the management of two observational studies of community-acquired pneumonia. Clinical research associates and managers using the dashboard were surveyed to determine its effectiveness as compared with traditional direct communication. The dashboard has been in use since it was first introduced in May of 2014. Of the 23 staff responding to the survey, 77% felt that it was easier or much easier to use the dashboard for communication than to use direct communication. We have designed and implemented a visualization dashboard for managing multi-site clinical trial enrollment in two community acquired pneumonia studies. Information dashboards are a useful tool for clinical trial management. They can be used as a standalone trial information tool or included into a larger management system.

  15. Cuestión social y regímenes militares. Argentina y Chile durante los años setenta

    Directory of Open Access Journals (Sweden)

    Gabriela Gomes

    2015-01-01

    Full Text Available En este artículo se analizan las políticas sociales destinadas a la búsqueda del consenso que llevaron adelante la Secretaría de Estado de Promoción y Asistencia a la Comunidad del Ministerio de Bienestar Social durante la “Revolución Argentina” (1966-1973 y la Dirección de Organizaciones Civiles y el Ministerio del Interior durante la dictadura chilena (1973-1988. El abordaje propuesto apunta a complejizar la noción de Estado burocrático autoritario, puesto que se considera como hipótesis que ambos regímenes no solo se dedicaron a reprimir las actividades políticas de los sectores populares, sino que buscaron reorganizarlos bajo nuevas coordenadas sociales.

  16. SURGIMIENTO Y CONSOLIDACIÓN DE LA RESPONSABILIDAD INTERNACIONAL INDIVIDUAL POR CRÍMENES DE GUERRA COMETIDOS EN CONFLICTOS ARMADOS NO INTERNACIONALES

    Directory of Open Access Journals (Sweden)

    Juan Pablo Pérez-León Acevedo

    2007-01-01

    Full Text Available La presente investigación busca estudiar el proceso de surgimiento y afianzamiento de la figura de la responsabilidad internacional individual por crímenes de guerra cometidos en el contexto de conflictos armados no internacionales, los cuales han caracterizado el Derecho internacional contemporáneo. Para tal efecto, se hace un estudio de la respectiva norma de Derecho internacional consuetudinario la cual se cristalizó en el Derecho internacional convencional, representado por el Estatuto de la Corte Penal InternacionalThe present research seeks to study the process of emergence and consolidation of the institution of international individual responsibility for war crimes committed in the context of non-international armed conflicts, which have characterized contemporary International law. In order to reach that purpose, it is studied the respective customary international humanitarian law rule which crystallized in the treaty international law, represented by the International Criminal Court Statute

  17. Analizando los regímenes de violación en la intersección entre la guerra y la paz en el Perú

    OpenAIRE

    Boesten, Jelke

    2011-01-01

    Utilizando el conflicto político en el Perú (1980-2000) como estudio de caso, en este trabajo sostengo que el hecho de entender la violación como arma de guerra oculta otros regímenes de violación que tuvieron lugar durante el conflicto armado interno y que no encajan necesariamente con esta definición.Estas prácticas incluyen la violación como consumo, la violación oportunista, la violación perpetrada por vecinos o miembros de la familia, la prostitución forzada y la violación en el periodo ...

  18. Stable analogues of OSB-AMP: potent inhibitors of MenE, the o-succinylbenzoate-CoA synthetase from bacterial menaquinone biosynthesis.

    Science.gov (United States)

    Lu, Xuequan; Zhou, Rong; Sharma, Indrajeet; Li, Xiaokai; Kumar, Gyanendra; Swaminathan, Subramanyam; Tonge, Peter J; Tan, Derek S

    2012-01-02

    MenE, the o-succinylbenzoate (OSB)-CoA synthetase from bacterial menaquinone biosynthesis, is a promising new antibacterial target. Sulfonyladenosine analogues of the cognate reaction intermediate, OSB-AMP, have been developed as inhibitors of the MenE enzymes from Mycobacterium tuberculosis (mtMenE), Staphylococcus aureus (saMenE) and Escherichia coli (ecMenE). Both a free carboxylate and a ketone moiety on the OSB side chain are required for potent inhibitory activity. OSB-AMS (4) is a competitive inhibitor of mtMenE with respect to ATP (K(i) =5.4±0.1 nM) and a noncompetitive inhibitor with respect to OSB (K(i) =11.2±0.9 nM). These data are consistent with a Bi Uni Uni Bi Ping-Pong kinetic mechanism for these enzymes. In addition, OSB-AMS inhibits saMenE with K(i)(app) =22±8 nM and ecMenE with K(i)(OSB) =128±5 nM. Putative active-site residues, Arg222, which may interact with the OSB aromatic carboxylate, and Ser302, which may bind the OSB ketone oxygen, have been identified through computational docking of OSB-AMP with the unliganded crystal structure of saMenE. A pH-dependent interconversion of the free keto acid and lactol forms of the inhibitors is also described, along with implications for inhibitor design. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. Stable Analogues of OSB-AMP: Potent Inhibitors of MenE the o-succinylbenzoate-CoA Synthetase from Bacterial Menaquinone Biosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Lu X.; Swaminathan S.; Zhou R.; Sharma I.; Li X.; Kumar G.; Tonge P. J.; Tan D. S.

    2012-01-02

    MenE, the o-succinylbenzoate (OSB)-CoA synthetase from bacterial menaquinone biosynthesis, is a promising new antibacterial target. Sulfonyladenosine analogues of the cognate reaction intermediate, OSB-AMP, have been developed as inhibitors of the MenE enzymes from Mycobacterium tuberculosis (mtMenE), Staphylococcus aureus (saMenE) and Escherichia coli (ecMenE). Both a free carboxylate and a ketone moiety on the OSB side chain are required for potent inhibitory activity. OSB-AMS (4) is a competitive inhibitor of mtMenE with respect to ATP (K{sub i} = 5.4 {+-} 0.1 nM) and a noncompetitive inhibitor with respect to OSB (K{sub i} = 11.2 {+-} 0.9 nM). These data are consistent with a Bi Uni Uni Bi Ping-Pong kinetic mechanism for these enzymes. In addition, OSB-AMS inhibits saMenE with K{sub i}{sup app} = 22 {+-} 8 nM and ecMenE with K{sub i}{sup OSB} = 128 {+-} 5 nM. Putative active-site residues, Arg222, which may interact with the OSB aromatic carboxylate, and Ser302, which may bind the OSB ketone oxygen, have been identified through computational docking of OSB-AMP with the unliganded crystal structure of saMenE. A pH-dependent interconversion of the free keto acid and lactol forms of the inhibitors is also described, along with implications for inhibitor design.

  20. Ethics Review for a Multi-Site Project Involving Tribal Nations in the Northern Plains.

    Science.gov (United States)

    Angal, Jyoti; Petersen, Julie M; Tobacco, Deborah; Elliott, Amy J

    2016-04-01

    Increasingly, Tribal Nations are forming ethics review panels, which function separately from institutional review boards (IRBs). The emergence of strong community representation coincides with a widespread effort supported by the U.S. Department of Health & Human Services and other federal agencies to establish a single IRB for all multi-site research. This article underscores the value of a tribal ethics review board and describes the tribal oversight for the Safe Passage Study-a multi-site, community-based project in the Northern Plains. Our experience demonstrates the benefits of tribal ethics review and makes a strong argument for including tribal oversight in future regulatory guidance for multi-site, community-based research. © The Author(s) 2016.

  1. A risk assessment method for multi-site damage

    Science.gov (United States)

    Millwater, Harry Russell, Jr.

    This research focused on developing probabilistic methods suitable for computing small probabilities of failure, e.g., 10sp{-6}, of structures subject to multi-site damage (MSD). MSD is defined as the simultaneous development of fatigue cracks at multiple sites in the same structural element such that the fatigue cracks may coalesce to form one large crack. MSD is modeled as an array of collinear cracks with random initial crack lengths with the centers of the initial cracks spaced uniformly apart. The data used was chosen to be representative of aluminum structures. The structure is considered failed whenever any two adjacent cracks link up. A fatigue computer model is developed that can accurately and efficiently grow a collinear array of arbitrary length cracks from initial size until failure. An algorithm is developed to compute the stress intensity factors of all cracks considering all interaction effects. The probability of failure of two to 100 cracks is studied. Lower bounds on the probability of failure are developed based upon the probability of the largest crack exceeding a critical crack size. The critical crack size is based on the initial crack size that will grow across the ligament when the neighboring crack has zero length. The probability is evaluated using extreme value theory. An upper bound is based on the probability of the maximum sum of initial cracks being greater than a critical crack size. A weakest link sampling approach is developed that can accurately and efficiently compute small probabilities of failure. This methodology is based on predicting the weakest link, i.e., the two cracks to link up first, for a realization of initial crack sizes, and computing the cycles-to-failure using these two cracks. Criteria to determine the weakest link are discussed. Probability results using the weakest link sampling method are compared to Monte Carlo-based benchmark results. The results indicate that very small probabilities can be computed

  2. Tools and Methods for Risk Management in Multi-Site Engineering Projects

    Science.gov (United States)

    Zhou, Mingwei; Nemes, Laszlo; Reidsema, Carl; Ahmed, Ammar; Kayis, Berman

    In today's highly global business environment, engineering and manufacturing projects often involve two or more geographically dispersed units or departments, research centers or companies. This paper attempts to identify the requirements for risk management in a multi-site engineering project environment, and presents a review of the state-of-the-art tools and methods that can be used to manage risks in multi-site engineering projects. This leads to the development of a risk management roadmap, which will underpin the design and implementation of an intelligent risk mapping system.

  3. Using linear integer programming for multi-site land-use allocation

    NARCIS (Netherlands)

    Aerts, J.C.J.H.; Eisinger, E.; Heuvelink, G.B.M.; Stewart, Th.J.

    2003-01-01

    Research in the area of spatial decision support (SDS) and resource allocation has recently generated increased attention for integrating optimization techniques with GIS. In this paper we address the use of spatial optimization techniques for solving multi-site land-use allocation (MLUA) problems,

  4. Bias and Bias Correction in Multi-Site Instrumental Variables Analysis of Heterogeneous Mediator Effects

    Science.gov (United States)

    Reardon, Sean F.; Unlu, Faith; Zhu, Pei; Bloom, Howard

    2013-01-01

    We explore the use of instrumental variables (IV) analysis with a multi-site randomized trial to estimate the effect of a mediating variable on an outcome in cases where it can be assumed that the observed mediator is the only mechanism linking treatment assignment to outcomes, as assumption known in the instrumental variables literature as the…

  5. Bias and Bias Correction in Multisite Instrumental Variables Analysis of Heterogeneous Mediator Effects

    Science.gov (United States)

    Reardon, Sean F.; Unlu, Fatih; Zhu, Pei; Bloom, Howard S.

    2014-01-01

    We explore the use of instrumental variables (IV) analysis with a multisite randomized trial to estimate the effect of a mediating variable on an outcome in cases where it can be assumed that the observed mediator is the only mechanism linking treatment assignment to outcomes, an assumption known in the IV literature as the exclusion restriction.…

  6. Statistical Analysis for Multisite Trials Using Instrumental Variables with Random Coefficients

    Science.gov (United States)

    Raudenbush, Stephen W.; Reardon, Sean F.; Nomi, Takako

    2012-01-01

    Multisite trials can clarify the average impact of a new program and the heterogeneity of impacts across sites. Unfortunately, in many applications, compliance with treatment assignment is imperfect. For these applications, we propose an instrumental variable (IV) model with person-specific and site-specific random coefficients. Site-specific IV…

  7. Work characteristics predict the development of multi-site musculoskeletal pain

    NARCIS (Netherlands)

    Oakman, J.; Wind, A. de; Heuvel, S.G. van den; Beek, A.J. van der

    2017-01-01

    Purpose. Musculoskeletal pain in more than one body region is common and a barrier to sustaining employment. We aimed to examine whether work characteristics predict the development of multi-site pain (MSP), and to determine differences in work-related predictors between age groups. Methods. This

  8. Integrative invasion science: model systems, multi-site studies, focused meta-analysis, and invasion syndromes

    Czech Academy of Sciences Publication Activity Database

    Kueffer, C.; Pyšek, Petr; Richardson, D. M.

    2013-01-01

    Roč. 200, č. 3 (2013), s. 615-633 ISSN 1469-8137 R&D Projects: GA ČR(CZ) GAP504/11/1028; GA ČR GA206/09/0563 Institutional support: RVO:67985939 Keywords : model systems * invasion syndromes * multi-site studies Subject RIV: EF - Botanics Impact factor: 6.545, year: 2013

  9. A multi-site study on medical school selection, performance, motivation and engagement

    NARCIS (Netherlands)

    Wouters, A.; Croiset, G.; Schripsema, N. R.; Cohen-Schotanus, J.; Spaai, G. W. G.; Hulsman, R. L.; Kusurkar, R. A.

    Medical schools seek ways to improve their admissions strategies, since the available methods prove to be suboptimal for selecting the best and most motivated students. In this multi-site cross-sectional questionnaire study, we examined the value of (different) selection procedures compared to a

  10. Network cyberinfrastructure as a shared platform to support multi-site research

    Science.gov (United States)

    Multi-site research across the Long-term Agroecosystem Research (LTAR) network requires access to data and information. We present some existing examples where you can get data from across the network and summarize the rich inventory of measurements taken across LTAR sites. But data management suppo...

  11. Assessing the Utility of Diagnostic Criteria: A Multisite Study on Gender Identity Disorder

    NARCIS (Netherlands)

    Paap, M.C.S.; Kreukels, B.P.C.; Cohen-Kettenis, P.T.; Richter-Appelt, H.; De Cuypere, G.; Haraldsen, I.R.

    2011-01-01

    Studies involving patients with gender identity disorder (GID) are inconsistent with regard to outcomes and often difficult to compare because of the vague descriptions of the diagnostic process. A multisite study is needed to scrutinize the utility and generality of different aspects of the

  12. Assessing the utility of diagnostic criteria: a multi-site study on gender identity disorder

    NARCIS (Netherlands)

    Paap, Muirne; Kreukels, Baudewijntje P.C.; Cohen-Kettenis, Peggy; Richter-Appelt, Hertha; De Cuypere, Griet; Haraldsen, Ira R.

    2011-01-01

    Introduction: Studies involving patients with gender identity disorder (GID) are inconsistent with regard to outcomes and often difficult to compare because of the vague descriptions of the diagnostic process. A multisite study is needed to scrutinize the utility and generality of different aspects

  13. A novel biometric signature: multi-site, remote (> 100 m) photo-plethysmography using ambient light

    NARCIS (Netherlands)

    Verkruijsse, W.; Bodlaender, M.P.

    2010-01-01

    We propose a novel biometric signature based on the principle of multi-site remote photo-plethysmography (remote PPG). This signature can be measured using video cameras. Traditional PPG uses a contact sensor to measure slight skin color changes that occur with every heartbeat. Recently we have

  14. Multi-site solar power forecasting using gradient boosted regression trees

    DEFF Research Database (Denmark)

    Persson, Caroline Stougård; Bacher, Peder; Shiga, Takahiro

    2017-01-01

    The challenges to optimally utilize weather dependent renewable energy sources call for powerful tools for forecasting. This paper presents a non-parametric machine learning approach used for multi-site prediction of solar power generation on a forecast horizon of one to six hours. Historical pow...

  15. Positive Family Intervention for Severe Challenging Behavior I: A Multisite Randomized Clinical Trial

    Science.gov (United States)

    Durand, V. Mark; Hieneman, Meme; Clarke, Shelley; Wang, Mo; Rinaldi, Melissa L.

    2013-01-01

    The present study was a multisite randomized clinical trial assessing the effects of adding a cognitive-behavioral intervention to positive behavior support (PBS). Fifty-four families who met the criteria of (a) having a child with a developmental disability, (b) whose child displayed serious challenging behavior (e.g., aggression, self-injury,…

  16. A Qualitative Multi-Site Case Study: Examining Principals' Leadership Styles and School Performance

    Science.gov (United States)

    Preyear, Loukisha

    2015-01-01

    The purpose of this qualitative multi-site case study was to explore the impact of principals' leadership styles on student academic achievement in a high-poverty low-performing school district in Louisiana. A total of 17 participants, principals and teachers, from this school district were used in this study. Data source triangulation of…

  17. A Multi-Site Campaign to Measure Solar-Like Oscillations in Procyon. II. Mode Frequencies

    DEFF Research Database (Denmark)

    Bedding, Timothy R.; Kjeldsen, Hans; Campante, Tiago L.

    2010-01-01

      We have analyzed data from a multi-site campaign to observe oscillations in the F5 star Procyon. The data consist of high-precision velocities that we obtained over more than three weeks with 11 telescopes. A new method for adjusting the data weights allows us to suppress the sidelobes in the p...

  18. Real-Time Analysis and Forecasting of Multisite River Flow Using a Distributed Hydrological Model

    Directory of Open Access Journals (Sweden)

    Mingdong Sun

    2014-01-01

    Full Text Available A spatial distributed hydrological forecasting system was developed to promote the analysis of river flow dynamic state in a large basin. The research presented the real-time analysis and forecasting of multisite river flow in the Nakdong River Basin using a distributed hydrological model with radar rainfall forecast data. A real-time calibration algorithm of hydrological distributed model was proposed to investigate the particular relationship between the water storage and basin discharge. Demonstrate the approach of simulating multisite river flow using a distributed hydrological model couple with real-time calibration and forecasting of multisite river flow with radar rainfall forecasts data. The hydrographs and results exhibit that calibrated flow simulations are very approximate to the flow observation at all sites and the accuracy of forecasting flow is gradually decreased with lead times extending from 1 hr to 3 hrs. The flow forecasts are lower than the flow observation which is likely caused by the low estimation of radar rainfall forecasts. The research has well demonstrated that the distributed hydrological model is readily applicable for multisite real-time river flow analysis and forecasting in a large basin.

  19. Predictibilidad de los exámenes de conocimientos para ingresar a las preparatorias de la Universidad De La Salle Bajío

    Directory of Open Access Journals (Sweden)

    Humberto de Anda Padilla

    2010-01-01

    Full Text Available En el presente estudio se determinó, como una medida del grado de predictibilidad, la correlación que hay entre los exámenes de conocimientos que sustentan los alumnos al ingresar a la preparatoria en la Universidad De La Salle Bajío y el desempeño académico durante el primer año de estudios de los propios alumnos. Adicionalmente a lo anterior se trabajó con una tercera variable que corresponde al promedio de los dos primeros años de secundaria y que conjuntamente con el examen de conocimientos aumenta el grado de predictibilidad. Se utilizó estadística descriptiva y se calcularon los coeficientes de correlación entre las puntuaciones obtenidas en el examen de admisión, global y por área evaluada, y las calificaciones finales obtenidas en cada materia al terminar el primero y segundo semestre, así como el promedio de calificaciones del primer año. Fueron analizadas las características del instrumento para medir cada una de las áreas que lo componen y sus posibles variaciones entre las versiones equivalentes aplicadas a dos cohortes diferentes en los campi que componen la Universidad (2005 y 2006. La hipótesis de investigación plantea que los coeficientes de correlación entre las puntuaciones de los exámenes de conocimientos y las calificaciones del primer año serán al menos del 0.3. Se trabajó con datos correspondientes al total de sustentantes que concluyeron el segundo semestre de estudios de la preparatoria. Entre los resultados se encontró que el promedio de los dos primeros años de estudio de secundaria y las puntuaciones obtenidas en el examen de admisión presentan junto con el promedio de cada materia una correlación mayor a 0.3 en las 20 materias que se cursan en los dos primeros semestres de preparatoria. Alcanzando la relación más importante con los promedios de calificaciones de 1° y 2° semestre y todo el primer año, con coeficientes de correlación de r1er sem=0.57, r2do sem=0.58 y r1er año=0

  20. Características de los exámenes de laboratorio en pacientes con dengue grave en un hospital de Puerto Maldonado - Perú

    Directory of Open Access Journals (Sweden)

    Jesús Rojas-Jaimes

    2014-07-01

    Full Text Available Introducción: Puerto Maldonado, capital del Departamento de Madre de Dios, es catalogado como zona endémica de dengue. La clasificación de dengue considera al dengue grave (hemorrágico cuando se produce shock, distrés respiratorio o compromiso de órgano blanco. Objetivos: Determinar las características de los exámenes de laboratorio en pacientes con dengue grave hospitalizados en la Unidad de Cuidados Intermedios del Hospital Santa Rosa de Puerto Maldonado, Madre de Dios, Perú. Diseño: Estudio retrospectivo de corte transversal. Institución: Laboratorio Central y Departamento de Epidemiología del Hospital Santa Rosa, Madre de Dios, Perú. Materiales: Cincuenta y cinco historias clínicas de pacientes con diagnóstico de dengue grave hospitalizados en la Unidad de Cuidados Intermedios, en el periodo junio de 2010 a noviembre de 2011. Métodos: Se analizó los resultados de exámenes de laboratorio solicitados durante la hospitalización. Principales medidas de resultados: Valores de transaminasas, creatinina, hemograma completo y examen de orina. Resultados: El mayor número de pacientes con dengue grave procedió de Puerto Maldonado (84%. El grupo etario mayormente afectado fue el de 40 a 49 años (32%. En 83% de los pacientes hospitalizados se presentó elevación de las transaminasas y de la creatinina sérica. El recuento de plaquetas estuvo dentro de rangos normales, excepto en el grupo de 10 a 19 años (11%, en quienes se halló concentraciones séricas de plaquetas menores a 150 000/mL. Conclusiones: En la mayoría de pacientes hospitalizados por dengue grave en Puerto Maldonado existió elevación sérica de transaminasas y creatinina. El recuento de plaquetas fue normal, pero existió plaquetopenia en el grupo de 10 a 19 años.

  1. ¿Qué hay detrás del miedo a los exámenes? Why do people fear exams?

    Directory of Open Access Journals (Sweden)

    R. Sender

    2004-03-01

    Full Text Available Introducción: Se analizan las características psicológicas de una muestra de 32 estudiantes de medicina que solicitan ayuda para afrontar el miedo a los exámenes. Material y método: Las pruebas seleccionadas para el análisis de esta población son el GHQ-28, el STAI de rasgo, la escala de percepción de estrés del UNCAHS y la Sensibilidad al Castigo y a la Recompensa (SCRS. Los puntajes obtenidos se compararon con los de un grupo control de estudiantes de primer curso. Resultados: 90 % de los sujetos de la muestra fueron mujeres y el 25 % recibieron o estaban recibiendo atención psicológica o psiquiátrica. Entre los estudiantes que solicitaron ayuda había un nivel más alto de psicopatología, una más alta sensibilidad al castigo y una más baja sensibilidad a la recompensa que en el grupo control. Conclusiones: Los estudiantes con ansiedad ante los exámenes presentan más sensibilidad al castigo y menos sensibilidad a la recompensa, y muestran más síntomas depresivos y obsesivos que los estudiantes del grupo control.Introduction: Psychological traits are analysed in a sample of medicine students (n=32 who requested treatment for their fear of examinations. Material and method: Psychopathological variables were evaluated by GHQ-28 and STAI; perceived stress by the UNCAHS, and sensitivity to punishment and reward by the SPSR questionnaire. The group’s scores were compared with those obtained by a control group comprising first-year medicine students. Results: 90% of the sample were woman and 25% had received (or were receiving psychological or psychiatric attention. Among students who asked for treatment there was a higher rate of psychopathology, a higher sensitivity to punishment and lower sensitivity to reward than among controls. Conclusions: Students with fear of examinations were more sensitive to punishment and less sensitive to reward, and showed more depressive and obsessive symptoms than controls.

  2. La marea autoritaria: nacimiento, desarrollo y consolidación de regímenes parafascistas en Austria y España

    Directory of Open Access Journals (Sweden)

    Miguel Ángel del Arco Blanco

    2009-12-01

    Full Text Available En el presente trabajo se explica el nacimiento y propagación de los movimientos fascistas a partir de las secuelas de la I Guerra Mundial y del escenario político y social que le siguió. Los casos que analizamos en el presente trabajo, Austria y España, encajan perfectamente en ese contexto; y de ello deriva el interés de su estudio para la comprensión de la llegada e implantación del fascismo en Europa, así como del parafascismo (regímenes que, aunque no fueron plenamente fascistas, sí compartieron algunas características y fueron fuertemente influenciados por el fascismo en su nacimiento, implantación y consolidación. El análisis y comparación de regímenes como el Ständestaat y el franquista quizá pongan de manifiesto que el parafascismo pudo ser más la norma que la excepción a la alternativa plenamente fascista en la Europa de entreguerras.______________________ABSTRACT:The present work tries to explain the birth and the spread of facist movements from the consequences of theFirst World War and the political and social scene that followed it. The cases that we analyzed in this work, Austria and Spain, fit perfectly in that context; this kind of analysis facilitates the understanding of the coming and implantation of fascism in Europe, as well as of parafascism phenomenon (a kind of regime that, although is not totally facist, it shares some characteristics and is strongly influenced by the fascism in its birth, implantation and consolidation. The analysis and comparison of regimes just as the Ständestaat and the Franquista's one can show that the parafascism could be the norm in lieu of the exception to the totally facist alternative in the inter-war Europe.

  3. Las urgencias en la atención primaria: uso de exámenes complementarios y medicamentos Emergencies in primary health care: use of complementary tests and drugs

    Directory of Open Access Journals (Sweden)

    José Díaz Novás

    2008-09-01

    Full Text Available INTRODUCCIÓN: los servicios de urgencias requieren de un soporte de exámenes y medicamentos que apoyen su capacidad resolutiva y que se utilicen con eficiencia. OBJETIVOS: identificar el uso de exámenes complementarios y medicamentos, sus costos y relación con la morbilidad observada. MÉTODOS: se realizó un estudio observacional, descriptivo, longitudinal y retrospectivo sobre la utilización de exámenes complementarios, medicamentos y sus costos, en el servicio de urgencias del Policlínico-Hospital "Raúl Gómez García", en el período de enero a marzo de 2007. Se correlacionó el uso de exámenes y medicamentos con la morbilidad observada. RESULTADOS: el chequeo de la tensión arterial, las infecciones respiratorias agudas y las crisis agudas de asma bronquial fueron las causas más frecuentes de consulta. Se observó 1 de cada 21,3 pacientes atendidos. El 19,7 % de los pacientes requirieron la realización de exámenes complementarios. El laboratorio clínico, fue el medio diagnóstico más utilizado. Los medicamentos más utilizados fueron: el aerosol de salbutamol, la dipirona y la aminofilina. La indicación de exámenes y medicamentos, generalmente, estuvo justificada por los problemas de salud atendidos. Los exámenes de rayos X, los electrocardiogramas y entre los medicamentos la hidrocortisona, fueron los que más gastos ocasionaron. CONCLUSIONES: la morbilidad observada estuvo acorde con lo esperado para un servicio de urgencias primario, y justificó, en la mayoría de los casos, los exámenes y medicamentos utilizados. El empleo racional del método clínico puede mejorar el uso de recursos y los costos.INTRODUCTION: the emergency services require tests and drugs that support their resolving capacity and that be used with efficiency. OBJECTIVES: to identify the use of complementary tests and drugs, their costs and their connection with the morbidity observed. METHODS: an observational descriptive, longitudinal and

  4. Los exámenes preliminares de la Corte Penal Internacional en América Latina: el caso colombiano y su impacto sobre futuras negociaciones de paz en la región

    Directory of Open Access Journals (Sweden)

    Héctor Olásolo Alonso

    2014-06-01

    Full Text Available El artículo comienza analizando la función de la Fiscalía de la Corte Penal Internacional en la aplicación del principio de complementariedad, a través de los exámenes preliminares realizados durante los diez primeros años de funcionamiento de la Corte Penal Internacional. Se subraya la relevancia de los exámenes preliminares para fortalecer los órganos jurisdiccionales nacionales y el Estado de Derecho en los Estados afectados, y se constata que cada situación bajo examen requiere de una estrategia de actuación diferente debido a las particulares circunstancias que la rodean. A continuación, se analizan las características del fenómeno de la lesa humanidad en Colombia y las consecuencias de su configuración como crímenes internacionales de ius cogens. A la luz de lo anterior, se aborda el impacto del examen preliminar que la Fiscalía de la CPI viene desarrollando sobre la situación de Colombia para las actuales negociaciones de paz entre el Gobierno y las FARC. Para finalizar, el autor realiza algunas observaciones finales sobre la importancia de este examen preliminar más allá de Colombia para futuras negociaciones de paz en la región.

  5. Diseño y validación de la plataforma PLEVALEX como respuesta a los retos de diseño de exámenes de lenguas para fines específicos

    Directory of Open Access Journals (Sweden)

    Jesús García Laborda

    2007-10-01

    Full Text Available Este artículo describe las necesidades de diseño y validación que llevaron al desarrollo de la Plataforma de Evaluación Valenciana de Lenguas Extranjeras (PLEVALEX para exámenes orales y escritos a través de Internet. Aunque la plataforma es multilingüe, en este trabajo nos referiremos a su uso para exámenes de inglés con fines específicos. La plataforma fue desarrollada por el Grupo de Investigación en Lenguas para Fines Específicos (GILFE de la Universidad Politécnica de Valencia. La validación se hizo en cooperación con el Centro de Investigación en Tecnologías Gráficas (CITG de la misma universidad. La prueba de ergonomía se realizó a tres niveles: diseñadores, expertos y usuarios. El seguimiento realizado con estudiantes de comunicación audiovisual y profesores de la Universidad Politécnica de Valencia indicó una reacción positiva hacia la plataforma de exámenes en red.

  6. Work-related determinants of multi-site musculoskeletal pain among employees in the health care sector.

    Science.gov (United States)

    Neupane, Subas; Nygård, Clas-Håkan; Oakman, Jodi

    2016-06-16

    Work-related musculoskeletal pain is a major occupational problem. Those with pain in multiple sites usually report worse health outcomes than those with pain in one site. This study explored prevalence and associated predictors of multi-site pain in health care sector employees. Survey responses from 1348 health care sector employees across three organisations (37% response rate) collected data on job satisfaction, work life balance, psychosocial and physical hazards, general health and work ability. Musculoskeletal discomfort was measured across 5 body regions with pain in ≥ 2 sites defined as multi-site pain. Generalized linear models were used to identify relationships between work-related factors and multi-site pain. Over 52% of the employees reported pain in multiple body sites and 19% reported pain in one site. Poor work life balance (PRR = 2.33, 95% CI = 1.06-5.14). physical (PRR = 7.58, 95% CI = 4.89-11.77) and psychosocial (PRR = 1.59, 95% CI = 1.00-2.57) hazard variables were related to multi-site pain (after controlling for age, gender, health and work ability. Older employees and females were more likely to report multi-site pain. Effective risk management of work related multi-site pain must include identification and control of psychosocial and physical hazards.

  7. Reliability of instruments in a cooperative, multisite study: employment intervention demonstration program.

    Science.gov (United States)

    Salyers, M P; McHugo, G J; Cook, J A; Razzano, L A; Drake, R E; Mueser, K T

    2001-09-01

    Reliability of well-known instruments was examined in 202 people with severe mental illness participating in a multisite vocational study. We examined interrater reliability of the Positive and Negative Syndrome Scale (PANSS) and the internal consistency and test-retest reliability of the PANSS, the Rosenberg Self-Esteem Scale, the Medical Outcomes Study Short Form-36 (SF-36), and the Quality of Life Interview. Most scales had good levels of reliability, with intraclass correlation coefficients (ICCs) and coefficient alphas above .70. However, the SF-36 scales were generally less stable over time, particularly Social Functioning (ICC = .55). Test-retest reliability was lower among less educated respondents and among ethnic minorities. We recommend close monitoring of psychometric issues in future multisite studies.

  8. From Controlled Trial to Community Adoption: The Multisite Translational Community Trial

    Science.gov (United States)

    Murimi, Mary; Gonzalez, Anjelica; Njike, Valentine; Green, Lawrence W.

    2011-01-01

    Methods for translating the findings of controlled trials, such as the Diabetes Prevention Program, into real-world community application have not been clearly defined. A standardized research methodology for making and evaluating such a transition is needed. We introduce the multisite translational community trial (mTCT) as the research analog to the multisite randomized controlled trial. The mTCT is adapted to incorporate the principles and practices of community-based participatory research and the increased relevance and generalizability gained from diverse community settings. The mTCT is a tool designed to bridge the gap between what a clinical trial demonstrates can work in principle and what is needed to make it workable and effective in real-world settings. Its utility could be put to the test, in particular with practice-based research networks such as the Prevention Research Centers. PMID:21680935

  9. Development of a continuous multisite accelerometry system for studying movements during sleep.

    Science.gov (United States)

    Terrill, Philip I; Mason, David G; Wilson, Stephen J

    2010-01-01

    Actigraphy has proven to be a useful tool in the assessment of circadian rhythms, and more recently in the automatic staging of sleep and wake states. Whilst accuracy of commercial systems appears good over 24 hour periods, the sensitivity of detecting wake during time in bed is poor. One possible explanation for these poor results is the technical limitations of currently available commercial actigraphs. In particular, raw data is generally not available to the user. Instead, activity counts for each epoch (typically between 10-60 secs) are calculated using various algorithms, from which sleep state is identified. Consequently morphologically different movements observed during sleep and wake states may not be detected as such. In this paper, the development of a continuous multisite, accelerometry system (CMAS) is described. Initial results, comparing data collected using a commercial actigraph (Actiwatch- Mini Motionlogger), and the continuous multisite accelerometry system are presented. The CMAS is able to differentiate brief movement "twitches" from postural changes.

  10. Follow the link: Digital Tracings of a Multi-Sited Space of Research

    DEFF Research Database (Denmark)

    Munk, Anders Kristian

    The paper discusses the use of digital methods as an alternative way of generating what George Marcus calls 'posited logics of association' for use in multi-sited fieldwork. I draw on cases from an ongoing research project on the new nordic food movement and its on- and off-line assemblages. I do...... doing so I demonstrate how methods which are native to the digital domain - such as the link or the like as a valuation metric - may be re-appropriated as strategies in more ethnographic styles of work.......The paper discusses the use of digital methods as an alternative way of generating what George Marcus calls 'posited logics of association' for use in multi-sited fieldwork. I draw on cases from an ongoing research project on the new nordic food movement and its on- and off-line assemblages. I...

  11. Progress in centralised ethics review processes: Implications for multi-site health evaluations.

    Science.gov (United States)

    Prosser, Brenton; Davey, Rachel; Gibson, Diane

    2015-04-01

    Increasingly, public sector programmes respond to complex social problems that intersect specific fields and individual disciplines. Such responses result in multi-site initiatives that can span nations, jurisdictions, sectors and organisations. The rigorous evaluation of public sector programmes is now a baseline expectation. For evaluations of large and complex multi-site programme initiatives, the processes of ethics review can present a significant challenge. However in recent years, there have been new developments in centralised ethics review processes in many nations. This paper provides the case study of an evaluation of a national, inter-jurisdictional, cross-sector, aged care health initiative and its encounters with Australian centralised ethics review processes. Specifically, the paper considers progress against the key themes of a previous five-year, five nation study (Fitzgerald and Phillips, 2006), which found that centralised ethics review processes would save time, money and effort, as well as contribute to more equitable workloads for researchers and evaluators. The paper concludes with insights for those charged with refining centralised ethics review processes, as well as recommendations for future evaluators of complex multi-site programme initiatives. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Multisite Kinetic Modeling of 13C Metabolic MR Using [1-13C]Pyruvate

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    Pedro A. Gómez Damián

    2014-01-01

    Full Text Available Hyperpolarized 13C imaging allows real-time in vivo measurements of metabolite levels. Quantification of metabolite conversion between [1-13C]pyruvate and downstream metabolites [1-13C]alanine, [1-13C]lactate, and [13C]bicarbonate can be achieved through kinetic modeling. Since pyruvate interacts dynamically and simultaneously with its downstream metabolites, the purpose of this work is the determination of parameter values through a multisite, dynamic model involving possible biochemical pathways present in MR spectroscopy. Kinetic modeling parameters were determined by fitting the multisite model to time-domain dynamic metabolite data. The results for different pyruvate doses were compared with those of different two-site models to evaluate the hypothesis that for identical data the uncertainty of a model and the signal-to-noise ratio determine the sensitivity in detecting small physiological differences in the target metabolism. In comparison to the two-site exchange models, the multisite model yielded metabolic conversion rates with smaller bias and smaller standard deviation, as demonstrated in simulations with different signal-to-noise ratio. Pyruvate dose effects observed previously were confirmed and quantified through metabolic conversion rate values. Parameter interdependency allowed an accurate quantification and can therefore be useful for monitoring metabolic activity in different tissues.

  13. Insomnia, Sleep Duration, Depressive Symptoms, and the Onset of Chronic Multisite Musculoskeletal Pain.

    Science.gov (United States)

    Generaal, Ellen; Vogelzangs, Nicole; Penninx, Brenda W J H; Dekker, Joost

    2017-01-01

    The temporal relationships among sleep, depressive symptoms, and pain are unclear. This longitudinal study examines whether insomnia and sleep duration predict the onset of chronic multisite musculoskeletal pain over 6 years and whether this association is mediated by depressive symptoms. 1860 subjects of the Netherlands Study of Depression and Anxiety, free from chronic multisite musculoskeletal pain at baseline, were followed up for the onset of chronic multisite musculoskeletal pain over 6 years (Chronic Pain Grade Questionnaire). We determined baseline insomnia (Women's Health Initiative Insomnia Rating Scale ≥9) and sleep duration (short: ≤6 hr, normal: 7-9 hr, long: ≥10 hr). Depressive symptoms were assessed at baseline and as a change score over time (Inventory of Depressive Symptomatology). Insomnia (hazard ratio [HR] [95% confidence interval, 95%CI] = 1.60 [1.30-1.96], p insomnia and short sleep with chronic pain onset (∆B = 40% and 26%, respectively). Adding the change score of depressive symptoms further weakened the association for insomnia (∆B = 16%) but not for short sleep. All direct effects for sleep measures with chronic pain onset remained statistically significant (p insomnia and short sleep duration are risk factors for developing chronic pain. Depressive symptoms partially mediate the effect for insomnia and short sleep with developing chronic pain. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  14. Dios, Patria, Autoridad: la Iglesia Católica y la fascistización de los regímenes ibéricos, 1933-1945

    Directory of Open Access Journals (Sweden)

    Manuel Loff

    2013-12-01

    Full Text Available La crisis de los sistemas liberales ibéricos en la Europa de entreguerras es especialmente interesante por el papel específico que ocupa en ella el componente católico de laidentidad y de las coaliciones que sostuvieron los dos regímenes autoritarios. El catolicismo político tuvo un papel muy relevante en el proceso de modernización de las derechas españolas y portuguesas de la primera posguerra. Salazar y Franco presentaron los regímenes que ellosmismos construyeron y sobre los que gobernaron como siendo intrínsicamente católicos, y los católicos fueron actoresprincipales de las coaliciones políticas y sociales que sostuvieron ambos dictadores. En su lucha contra la Primera República Portuguesa (1910-26 y la Segunda República Española (1931-39, las fuerzas políticas conservadoras y de extrema derecha concedieron un papel estratégico a los católicos politicamente organizados en lo que se refiere a la movilización de las masas y en la constitución de un amplia coalición que pudiese crear una alternativa sólida a la democracia liberal y a un movimento obrero cada día más fuerte. En los años centrales de la «Era del Fascismo», las derechas católicas ibéricas y la jerarquía de la Iglesia sancionaron un giro muy notorio hacia una lectura crecientemente fascistizada del contexto político europeo posterior a la Revolución Soviética.The crisis of the Iberian liberal systems in inter-war Europe is especially interesting to study because of the specific role ofthe Catholic component of both the sustaining political coalition and the identity of these two of the European 20th century authoritarian regimes. Political Catholicism was a major actor in the modernisation process of Spanish and Portuguese post-World War I rightwing movements. Salazar and Franco presented the regimes they built up and ruled upon as being intrinsically catholic, and Catholics were major partners in the political and

  15. A la búsqueda de la confiscada facultad de juzgar: Una propuesta iusconstructivista al dilema del juzgamientos de los crímenes de Estado

    Directory of Open Access Journals (Sweden)

    Daniel Feierstein

    2015-10-01

    Full Text Available En este artículo, se busca reflexionar sobre los componentes fundamentales de la facultad humana de juzgar y su vinculación con la tarea del juicio realizada por los jueces en el contexto del marco jurídico. Se intentará poner en cuestión la estricta delimitación que propone el positivismo[1] entre la capacidad humana de juzgar (que proviene del criterio moral y la acción jurídica, ya que dicha delimitación pareciera postular la posibilidad de prescindir del ejercicio de la facultad de juzgar a la hora de aplicar el derecho positivo. Actualizando el dilema ius-naturalismo/ius-positivismo para pensar críticamente el juzgamiento de crímenes de Estado, se aventurará una tercera salida, bautizada como ius-constructivismo y basada en los desarrollos de la psicología y la epistemología genéticas. [1] .- Carlos Nino distingue en las escuelas jurídicas como "positivismo conceptual" (donde ubica a autores Bentham, Austin, Kelsen, Ross o Hart, entre otros a la postulación de que los sistemas normativos no requieren derivar de principios morales previos para ser considerados válidos, sino que su propia existencia y producción normativa los valida como tales. Nino también distingue lo que llama un "positivismo ideológico", que incluso cuestiona la existencia de principios morales. Aquí, sin embargo, se entenderá como positivismo jurídico al positivismo conceptual y será con dichas posiciones que se darán los debates fundamentales. Véase, entre otras obras, Nino (1984, 1985.

  16. Programa para el cálculo de los regímenes de operación de la red soterrada

    Directory of Open Access Journals (Sweden)

    Manuel Barroso Baeza

    2011-03-01

    Full Text Available Este trabajo tiene como objetivo el desarrollo de software para el análisis de los regímenes de trabajo normalesde la red soterrada; específicamente abarca el desarrollo y adecuación de algoritmos para flujo de carga,elaborando el producto informático propuesto empleando las técnicas de la programación visual. El programaobtenido permite analizar estudios completos del comportamiento de la red soterrada, nunca antes posible,pues se carecía de la herramienta adecuada para realizar tales estudios, o bien por falta de capacidadsuficiente en cuanto a memoria requerida para modelar la red completa , lo cual sucedió en las décadasanteriores o porque los programas que existían entonces eran desarrollados para la transmisión.  This work has as objectives the software development for the analysis of the normal load flow of the undergroundsecondary network, specifically sandal the development and adaptation of algorithms for load flow, elaborating theproposed computer product using the techniques of the visual programming. The obtained program allows toanalyze complete studies of the net behavior it was never before possible, because you lacked the appropriatetool to carry out such studies, or for lack of enough capacity as for memory required to model the complete net,that which happened in the previous decades or because the programs that existed then were developed for thetransmission. As a result final of this project a software will be reached that using a base data common to othertechnical studies, facilitate to make any of the mentioned analysis, responding to the particularities of the undergroundsecondary network.

  17. Multi-site musculoskeletal pain in Swedish police: associations with discomfort from wearing mandatory equipment and prolonged sitting.

    Science.gov (United States)

    Larsen, Louise Bæk; Andersson, Elisabeth Elgmark; Tranberg, Roy; Ramstrand, Nerrolyn

    2018-05-01

    Musculoskeletal disorders are considered as a major issue affecting the health and well-being of active duty police. Discomfort from wearing mandatory equipment and sitting for long periods of time in fleet vehicles are workload factors linked to musculoskeletal disorders in police. This study aims to determine the prevalence of multi-site musculoskeletal pain among Swedish police and to explore the possible association to discomfort experience when wearing mandatory equipment and sitting for long periods in fleet vehicles. In this cross-sectional study responses from 4185 police were collected through a self-administered online survey including questions about physical work environment, mandatory equipment and musculoskeletal pain. Multi-site pain was determined through summing pain sites from four body regions. Binomial logistic regression was performed to explore the association between multi-site musculoskeletal pain: (1) discomfort from wearing mandatory equipment and (2) sitting for long periods in fleet vehicles. The prevalence of multi-site musculoskeletal pain at least 1 day per week within the previous 3 months was 41.3%. A statistically significant association between discomfort from wearing mandatory equipment and multi-site musculoskeletal pain was found; duty belt [OR 5.42 (95% CI 4.56-6.43)] as well as body armour [OR 2.69 (95% CI 2.11-3.42)]. Sitting for long periods in fleet vehicles was not significantly associated to multi-site musculoskeletal pain. Multi-site musculoskeletal pain is a considerable problem among Swedish police and modifying mandatory equipment to decrease discomfort is suggested as a potential means of decreasing the musculoskeletal pain experienced by many police officers.

  18. Hans mening om hendes krop

    DEFF Research Database (Denmark)

    Scheuer, Jann

    2017-01-01

    Bidraget handler om søgninger i danske tekstkorpusser efter 'hendes' hhv. 'hans' + nominal inden for en afstand af to ord. Det er ved hjælp af søgninger i big data undersøgt hvad der knyttes til hende og ham, hvad deres ejendom er: hendes lejlighed o.l. og hvilke attributter de tilskrives hans fi...

  19. LAS RELACIONES DE DOS REGÍMENES AUTORITARIOS: ESPAÑA Y CHILE DURANTE LOS GOBIERNOS DE PRIMO DE RIVERA E IBÁÑEZ DEL CAMPO

    Directory of Open Access Journals (Sweden)

    Juan Luis Carrellán Ruiz

    2011-05-01

    Full Text Available RESUMEN Este trabajo quiere poner de relieve la importancia que tuvieron las relaciones diplomáticas y económicas entre España y Chile durante los mandatos de Primo de Rivera e Ibáñez del Campo y para ello se ha analizado la documentación diplomática existente en diversos archivos españoles y chilenos. También refleja las opiniones vertidas en la prensa española sobre la política diseñada por el coronel Carlos Ibáñez. Estas relaciones se basaron en las simpatías ideológicas de los dos regímenes que propiciaron unas conexiones muy intensas en diferentes ámbitos como fueron las de índole política y diplomática con la firma de un tratado de arbitraje y la elevación al máximo nivel de las respectivas legaciones; las de carácter militar con la formación de oficiales chilenos en escuelas españolas; y las de signo comercial con dos acuerdos, uno de rebaja de aranceles y otro para el internamiento de salitre en territorio español. Palabras Claves: Dictadura, España, Primo de Rivera, Chile, Ibáñez del Campo. ABSTRACT This work wants to emphasize the importance of the diplomatic and economic relations, which took place during Primo de Rivera and Ibáñez del Campo mandates, between Spain and Chile. For that purpose, there has been analyzed the diplomatic existing documentation in different Spanish and Chilean Archives. It also reflects the opinions written on the Spanish press about the politics designed by Colonel Carlos Ibanez. These relations were based on the ideological sympathy of both regimes which propitiated very intense connections in different areas, such the political and diplomatic areas with the arbitration agreement signature and the elevation to the maximum level of both legations, those of military character with the Chilean officials training in Spanish training centres, and those of commercial sign with two agreements, the reduction of duties and the internment of saltpetre in Spanish territory. Key Words

  20. Radical, reformist and aborted liberalism: origins of national regimes in Central America Liberalismo radical, reformista y frustrado: orígenes de los regímenes nacionales en América central

    Directory of Open Access Journals (Sweden)

    James MAHONEY

    2011-06-01

    Full Text Available During the twentieth century, the countries of Central America were characterized by remarkably different political regimes: military-authoritarianism in Guatemala and El Salvador, progressive democracy in Costa Rica and traditional-authoritarianism in Honduras and Nicaragua. This article explains these contrasting regime outcomes by exploring the agrarian and state-building reforms pursued by political leaders during the nineteenth– and early twentieth century liberal reform period. Based on differences in the transformation of state and class structures, three types of liberalism are identified: radical liberalism in Guatemala and El Salvador, reformist liberalism in Costa Rica and aborted liberalism in Honduras and Nicaragua. It is argued that these types of liberalism set the Central American countries on contrasting paths of political development, culminating in diverse regime outcomes.Durante el siglo XX, los países de América Central se caracterizaron por tener regímenes políticos muy diferentes: el autoritarismo militar en Guatemala y El Salvador; la democracia progresista en Costa Rica y el autoritarismo tradicional en Honduras y Nicaragua. Este artículo explica los resultados de estos distintos regímenes mediante la exploración de las reformas agrarias y de la construcción del Estado llevadas a cabo por los líderes políticos durante el siglo XIX y principios del periodo de reformas liberales del siglo XX. Basándose en las diferencias de la transformación del Estado y de las estructuras de clases, se pueden identificar tres tipos de liberalismo: liberalismo radical en Guatemala y El Salvador; liberalismo reformista en Costa Rica y liberalismo frustrado en Honduras y Nicaragua. Se argumenta que estos tipos de liberalismo condujeron a los países de América Central a caminos contrarios al desarrollo político, culminando así en regímenes con resultados diversos.

  1. Exploring the feasibility of multi-site flow cytometric processing of gut associated lymphoid tissue with centralized data analysis for multi-site clinical trials.

    Directory of Open Access Journals (Sweden)

    Ian McGowan

    Full Text Available The purpose of this study was to determine whether the development of a standardized approach to the collection of intestinal tissue from healthy volunteers, isolation of gut associated lymphoid tissue mucosal mononuclear cells (MMC, and characterization of mucosal T cell phenotypes by flow cytometry was sufficient to minimize differences in the normative ranges of flow parameters generated at two trial sites. Forty healthy male study participants were enrolled in Pittsburgh and Los Angeles. MMC were isolated from rectal biopsies using the same biopsy acquisition and enzymatic digestion protocols. As an additional comparator, peripheral blood mononuclear cells (PBMC were collected from the study participants. For quality control, cryopreserved PBMC from a single donor were supplied to both sites from a central repository (qPBMC. Using a jointly optimized standard operating procedure, cells were isolated from tissue and blood and stained with monoclonal antibodies targeted to T cell phenotypic markers. Site-specific flow data were analyzed by an independent center which analyzed all data from both sites. Ranges for frequencies for overall CD4+ and CD8+ T cells, derived from the qPBMC samples, were equivalent at both UCLA and MWRI. However, there were significant differences across sites for the majority of T cell activation and memory subsets in qPBMC as well as PBMC and MMC. Standardized protocols to collect, stain, and analyze MMC and PBMC, including centralized analysis, can reduce but not exclude variability in reporting flow data within multi-site studies. Based on these data, centralized processing, flow cytometry, and analysis of samples may provide more robust data across multi-site studies. Centralized processing requires either shipping of fresh samples or cryopreservation and the decision to perform centralized versus site processing needs to take into account the drawbacks and restrictions associated with each method.

  2. Exploring the feasibility of multi-site flow cytometric processing of gut associated lymphoid tissue with centralized data analysis for multi-site clinical trials.

    Science.gov (United States)

    McGowan, Ian; Anton, Peter A; Elliott, Julie; Cranston, Ross D; Duffill, Kathryn; Althouse, Andrew D; Hawkins, Kevin L; De Rosa, Stephen C

    2015-01-01

    The purpose of this study was to determine whether the development of a standardized approach to the collection of intestinal tissue from healthy volunteers, isolation of gut associated lymphoid tissue mucosal mononuclear cells (MMC), and characterization of mucosal T cell phenotypes by flow cytometry was sufficient to minimize differences in the normative ranges of flow parameters generated at two trial sites. Forty healthy male study participants were enrolled in Pittsburgh and Los Angeles. MMC were isolated from rectal biopsies using the same biopsy acquisition and enzymatic digestion protocols. As an additional comparator, peripheral blood mononuclear cells (PBMC) were collected from the study participants. For quality control, cryopreserved PBMC from a single donor were supplied to both sites from a central repository (qPBMC). Using a jointly optimized standard operating procedure, cells were isolated from tissue and blood and stained with monoclonal antibodies targeted to T cell phenotypic markers. Site-specific flow data were analyzed by an independent center which analyzed all data from both sites. Ranges for frequencies for overall CD4+ and CD8+ T cells, derived from the qPBMC samples, were equivalent at both UCLA and MWRI. However, there were significant differences across sites for the majority of T cell activation and memory subsets in qPBMC as well as PBMC and MMC. Standardized protocols to collect, stain, and analyze MMC and PBMC, including centralized analysis, can reduce but not exclude variability in reporting flow data within multi-site studies. Based on these data, centralized processing, flow cytometry, and analysis of samples may provide more robust data across multi-site studies. Centralized processing requires either shipping of fresh samples or cryopreservation and the decision to perform centralized versus site processing needs to take into account the drawbacks and restrictions associated with each method.

  3. La obligación de investigar las desapariciones forzadas y su aplicación a los crímenes del franquismo en España

    OpenAIRE

    Galella, Patricio

    2014-01-01

    La sentencia del Tribunal Supremo de España en el caso por prevaricato contra el juez Garzón por pretender investigar los crímenes del franquismo ha cerrado la vía judicial como medio para canalizar las reclamaciones de los familiares de víctimas del franquismo. En su lugar, el Tribunal sostuvo que otros mecanismos eran los apropiados. La práctica indica, sin embargo, que los juzgados competentes han archivado sistemáticamente las causas y la Ley de Memoria Histórica es insuficiente, colocand...

  4. Formy nauczania poprzez grę w kształtowaniu kompetencji ekonomicznej przyszłych menedżerów oświaty: „Krok po kroku – razem do sukcesu!”

    Directory of Open Access Journals (Sweden)

    Tetiana Burłajenko

    2015-04-01

    Full Text Available Prezentujemy wypracowania optymalnego programu „Krоk po kroku – razem dо sukcesu!” z użyciem nauki w formie gry przy kształtowaniu kompetencji ekonomicznej przyszłych menedżerów oświaty, w którym przyszli zawodowcy mogą zdobyć doświadczenia w komunikacji, aktywnej współpracy, umiejętność mówienia krótko i konstruktywnie, oceniać siebie i innych, zrozumieć innych

  5. Reliability of an fMRI Paradigm for Emotional Processing in a Multisite Longitudinal Study

    Science.gov (United States)

    Gee, Dylan G.; McEwen, Sarah C.; Forsyth, Jennifer K.; Haut, Kristen M.; Bearden, Carrie E.; Addington, Jean; Goodyear, Bradley; Cadenhead, Kristin S.; Mirzakhanian, Heline; Cornblatt, Barbara A.; Olvet, Doreen; Mathalon, Daniel H.; McGlashan, Thomas H.; Perkins, Diana O.; Belger, Aysenil; Seidman, Larry J.; Thermenos, Heidi; Tsuang, Ming T.; van Erp, Theo G.M.; Walker, Elaine F.; Hamann, Stephan; Woods, Scott W.; Constable, Todd; Cannon, Tyrone D.

    2015-01-01

    Multisite neuroimaging studies can facilitate the investigation of brain-related changes in many contexts, including patient groups that are relatively rare in the general population. Though multisite studies have characterized the reliability of brain activation during working memory and motor functional magnetic resonance imaging tasks, emotion processing tasks, pertinent to many clinical populations, remain less explored. A traveling participants study was conducted with eight healthy volunteers scanned twice on consecutive days at each of the eight North American Longitudinal Prodrome Study sites. Tests derived from generalizability theory showed excellent reliability in the amygdala (Eρ2=0.82), inferior frontal gyrus (IFG;Eρ2=0.83), anterior cingulate cortex (ACC;Eρ2=0.76), insula (Eρ2=0.85), and fusiform gyrus (Eρ2=0.91) for maximum activation and fair to excellent reliability in the amygdala (Eρ2=0.44), IFG (Eρ2=0.48), ACC (Eρ2=0.55), insula (Eρ2=0.42), and fusiform gyrus (Eρ2=0.83) for mean activation across sites and test days. For the amygdala, habituation (Eρ2=0.71) was more stable than mean activation. In a second investigation, data from 111 healthy individuals across sites were aggregated in a voxelwise, quantitative meta-analysis. When compared with a mixed effects model controlling for site, both approaches identified robust activation in regions consistent with expected results based on prior single-site research. Overall, regions central to emotion processing showed strong reliability in the traveling participants study and robust activation in the aggregation study. These results support the reliability of blood oxygen level-dependent signal in emotion processing areas across different sites and scanners and may inform future efforts to increase efficiency and enhance knowledge of rare conditions in the population through multisite neuroimaging paradigms. PMID:25821147

  6. Analytical recursive method to ascertain multisite entanglement in doped quantum spin ladders

    Science.gov (United States)

    Roy, Sudipto Singha; Dhar, Himadri Shekhar; Rakshit, Debraj; SenDe, Aditi; Sen, Ujjwal

    2017-08-01

    We formulate an analytical recursive method to generate the wave function of doped short-range resonating valence bond (RVB) states as a tool to efficiently estimate multisite entanglement as well as other physical quantities in doped quantum spin ladders. We prove that doped RVB ladder states are always genuine multipartite entangled. Importantly, our results show that within specific doping concentration and model parameter regimes, the doped RVB state essentially characterizes the trends of genuine multiparty entanglement in the exact ground states of the Hubbard model with large on-site interactions, in the limit that yields the t -J Hamiltonian.

  7. Controlling engineering project changes for multi-unit, multi-site standardized nuclear power plants

    International Nuclear Information System (INIS)

    Randall, E.; Boddeker, G.; McGugin, H.; Strother, E.; Waggoner, G.

    1978-01-01

    Multibillioin dollar multiple nuclear power plant projects have numerous potential sources of engineering changes. The majority of these are internally generated changes, client generated changes, and changes from construction, procurement, other engineering organizations, and regulatory organizations. For multiunit, multisite projects, the use of a standardized design is cost effective. Engineering changes can then be controlled for a single standardized design, and the unit or site unique changes can be treated as deviations. Once an effective change procedure is established for change control of the standardized design, the same procedures can be used for control of unit or site unique changes

  8. Implementation of a novel synchronous multi-site all day high-fidelity simulation.

    Science.gov (United States)

    Abraham, Paul; Verdonk, Franck; Buleon, Clement; Tesniere, Antoine; Lilot, Marc

    2018-01-01

    Integration of simulation in educational curricula for anesthesia and intensive care residents is a hot topic. There is a great interest for simulation centers to share their experiences through multi-site synchronous simulation sessions. The present study results from an experience conducted at three sites in France (Paris, Lyon, and Caen), which involved 16 instructors and 25 residents facing the same scenario across 1 day. Synchronous simulations were performed at each site with local and shared debriefing via teleconference. This innovative approach to simulation was found to be feasible, although certain difficulties were encountered with connectivity.

  9. Demographic characteristics and employment among people with severe mental illness in a multisite study.

    Science.gov (United States)

    Burke-Miller, Jane K; Cook, Judith A; Grey, Dennis D; Razzano, Lisa A; Blyler, Crystal R; Leff, H Stephen; Gold, Paul B; Goldberg, Richard W; Mueser, Kim T; Cook, William L; Hoppe, Sue K; Stewart, Michelle; Blankertz, Laura; Dudek, Kenn; Taylor, Amanda L; Carey, Martha Ann

    2006-04-01

    People with psychiatric disabilities experience disproportionately high rates of unemployment. As research evidence is mounting regarding effective vocational programs, interest is growing in identifying subgroup variations. Data from a multisite research and demonstration program were analyzed to identify demographic characteristics associated with employment outcomes, after adjusting for the effects of program, services, and study site. Longitudinal analyses found that people with more recent work history, younger age, and higher education were more likely to achieve competitive employment and to work more hours per month, while race and gender effects varied by employment outcome. Results provide strong evidence of demographic subgroup variation and need.

  10. BRAF V600E-Positive Multisite Langerhans Cell Histiocytosis in a Preterm Neonate

    Directory of Open Access Journals (Sweden)

    Sara V. Bates

    2013-10-01

    Full Text Available Hemorrhagic pustules with a “blueberry muffin” appearance accompanied by respiratory failure in a neonate present a challenging differential diagnosis that includes infections and neoplasms. We present a case of multiorgan, multisite Langerhans cell histiocytosis (LCH, positive for the oncogenic BRAF V600E mutation, in a preterm neonate. Infants with LCH pose a diagnostic challenge due to their heterogeneous presentations. This case is unusual in that the newborn presented with severe multiorgan involvement. Due to the rare incidence, wide spectrum of clinical manifestations, and high mortality rate, clinicians must maintain a high index of suspicion for LCH.

  11. Robust multi-site MR data processing: iterative optimization of bias correction, tissue classification, and registration.

    Science.gov (United States)

    Young Kim, Eun; Johnson, Hans J

    2013-01-01

    A robust multi-modal tool, for automated registration, bias correction, and tissue classification, has been implemented for large-scale heterogeneous multi-site longitudinal MR data analysis. This work focused on improving the an iterative optimization framework between bias-correction, registration, and tissue classification inspired from previous work. The primary contributions are robustness improvements from incorporation of following four elements: (1) utilize multi-modal and repeated scans, (2) incorporate high-deformable registration, (3) use extended set of tissue definitions, and (4) use of multi-modal aware intensity-context priors. The benefits of these enhancements were investigated by a series of experiments with both simulated brain data set (BrainWeb) and by applying to highly-heterogeneous data from a 32 site imaging study with quality assessments through the expert visual inspection. The implementation of this tool is tailored for, but not limited to, large-scale data processing with great data variation with a flexible interface. In this paper, we describe enhancements to a joint registration, bias correction, and the tissue classification, that improve the generalizability and robustness for processing multi-modal longitudinal MR scans collected at multi-sites. The tool was evaluated by using both simulated and simulated and human subject MRI images. With these enhancements, the results showed improved robustness for large-scale heterogeneous MRI processing.

  12. Multi-Site Calibration of Linear Reservoir Based Geomorphologic Rainfall-Runoff Models

    Directory of Open Access Journals (Sweden)

    Bahram Saeidifarzad

    2014-09-01

    Full Text Available Multi-site optimization of two adapted event-based geomorphologic rainfall-runoff models was presented using Non-dominated Sorting Genetic Algorithm (NSGA-II method for the South Fork Eel River watershed, California. The first model was developed based on Unequal Cascade of Reservoirs (UECR and the second model was presented as a modified version of Geomorphological Unit Hydrograph based on Nash’s model (GUHN. Two calibration strategies were considered as semi-lumped and semi-distributed for imposing (or unimposing the geomorphology relations in the models. The results of models were compared with Nash’s model. Obtained results using the observed data of two stations in the multi-site optimization framework showed reasonable efficiency values in both the calibration and the verification steps. The outcomes also showed that semi-distributed calibration of the modified GUHN model slightly outperformed other models in both upstream and downstream stations during calibration. Both calibration strategies for the developed UECR model during the verification phase showed slightly better performance in the downstream station, but in the upstream station, the modified GUHN model in the semi-lumped strategy slightly outperformed the other models. The semi-lumped calibration strategy could lead to logical lag time parameters related to the basin geomorphology and may be more suitable for data-based statistical analyses of the rainfall-runoff process.

  13. Multisite stochastic simulation of daily precipitation from copula modeling with a gamma marginal distribution

    Science.gov (United States)

    Lee, Taesam

    2018-05-01

    Multisite stochastic simulations of daily precipitation have been widely employed in hydrologic analyses for climate change assessment and agricultural model inputs. Recently, a copula model with a gamma marginal distribution has become one of the common approaches for simulating precipitation at multiple sites. Here, we tested the correlation structure of the copula modeling. The results indicate that there is a significant underestimation of the correlation in the simulated data compared to the observed data. Therefore, we proposed an indirect method for estimating the cross-correlations when simulating precipitation at multiple stations. We used the full relationship between the correlation of the observed data and the normally transformed data. Although this indirect method offers certain improvements in preserving the cross-correlations between sites in the original domain, the method was not reliable in application. Therefore, we further improved a simulation-based method (SBM) that was developed to model the multisite precipitation occurrence. The SBM preserved well the cross-correlations of the original domain. The SBM method provides around 0.2 better cross-correlation than the direct method and around 0.1 degree better than the indirect method. The three models were applied to the stations in the Nakdong River basin, and the SBM was the best alternative for reproducing the historical cross-correlation. The direct method significantly underestimates the correlations among the observed data, and the indirect method appeared to be unreliable.

  14. Stochastic generation of multi-site daily precipitation focusing on extreme events

    Directory of Open Access Journals (Sweden)

    G. Evin

    2018-01-01

    Full Text Available Many multi-site stochastic models have been proposed for the generation of daily precipitation, but they generally focus on the reproduction of low to high precipitation amounts at the stations concerned. This paper proposes significant extensions to the multi-site daily precipitation model introduced by Wilks, with the aim of reproducing the statistical features of extremely rare events (in terms of frequency and magnitude at different temporal and spatial scales. In particular, the first extended version integrates heavy-tailed distributions, spatial tail dependence, and temporal dependence in order to obtain a robust and appropriate representation of the most extreme precipitation fields. A second version enhances the first version using a disaggregation method. The performance of these models is compared at different temporal and spatial scales on a large region covering approximately half of Switzerland. While daily extremes are adequately reproduced at the stations by all models, including the benchmark Wilks version, extreme precipitation amounts at larger temporal scales (e.g., 3-day amounts are clearly underestimated when temporal dependence is ignored.

  15. Educação Corporativa e Desenvolvimento de Lideranças em Empresas Multisite

    Directory of Open Access Journals (Sweden)

    Ticiana Nunes Moscardini

    2015-01-01

    Full Text Available Nowadays in the business world, changes occur faster and faster. Learning in the organizational context turns into Corporate Education (CE, defined as a set of continuous educational strategies aimed at developing competences for business. Leadership development is an organizational need; therefore, many companies structure educational programs through different strategies and Information and Communication Technologies (ICT applications. The objective of this research is to identify strategies and ICT that have been used in corporate education for leadership development in multisite organizations. The research was exploratory and qualitative, based on interviews in twelve companies located in the metropolitan region of Porto Alegre (the capital of the Brazilian state Rio Grande do Sul, with 24 people interviewed in total. The results indicate that the majority of the companies have not yet adopted the C approach as a whole. The most used strategies for teaching and learning are lectures and debates. Face to face training dominates and ICT use is limited, basically the technologies used are Virtual Learning Environments and Web 2.0 tools. The main challenge for leadership development in these multisite companies is learning and dissemination of their organizational culture.

  16. The brain-derived neurotrophic factor pathway, life stress, and chronic multi-site musculoskeletal pain.

    Science.gov (United States)

    Generaal, Ellen; Milaneschi, Yuri; Jansen, Rick; Elzinga, Bernet M; Dekker, Joost; Penninx, Brenda W J H

    2016-01-01

    Brain-derived neurotrophic factor (BDNF) disturbances and life stress, both independently and in interaction, have been hypothesized to induce chronic pain. We examined whether (a) the BDNF pathway (val(66)met genotype, gene expression, and serum levels), (b) early and recent life stress, and (c) their interaction are associated with the presence and severity of chronic multi-site musculoskeletal pain. Cross-sectional data are from 1646 subjects of the Netherlands Study of Depression and Anxiety. The presence and severity of chronic multi-site musculoskeletal pain were determined using the Chronic Pain Grade (CPG) questionnaire. The BDNF val(66)met polymorphism, BDNF gene expression, and BDNF serum levels were measured. Early life stress before the age of 16 was assessed by calculating a childhood trauma index using the Childhood Trauma Interview. Recent life stress was assessed as the number of recent adverse life events using the List of Threatening Events Questionnaire. Compared to val(66)val, BDNF met carriers more often had chronic pain, whereas no differences were found for BDNF gene expression and serum levels. Higher levels of early and recent stress were both associated with the presence and severity of chronic pain (p stress in the associations with chronic pain presence and severity. This study suggests that the BDNF gene marks vulnerability for chronic pain. Although life stress did not alter the impact of BDNF on chronic pain, it seems an independent factor in the onset and persistence of chronic pain. © The Author(s) 2016.

  17. Psychosocial stress and multi-site musculoskeletal pain: a cross-sectional survey of patient care workers.

    Science.gov (United States)

    Sembajwe, Grace; Tveito, Torill Helene; Hopcia, Karen; Kenwood, Christopher; O'Day, Elizabeth Tucker; Stoddard, Anne M; Dennerlein, Jack T; Hashimoto, Dean; Sorensen, Glorian

    2013-03-01

    The aim of this study was to assess the relationship between psychosocial factors at work and multi-site musculoskeletal pain among patient care workers. In a survey of 1,572 workers from two hospitals, occupational psychosocial factors and health outcomes of workers with single and multi-site pain were evaluated using items from the Job Content Questionnaire that was designed to measure psychological demands, decision latitude, and social support. An adapted Nordic Questionnaire provided data on the musculoskeletal pain outcome. Covariates included body mass index, age, gender, and occupation. The analyses revealed statistically significant associations between psychosocial demands and multi-site musculoskeletal pain among patient care associates, nurses, and administrative personnel, both men and women. Supervisor support played a significant role for nurses and women. These results remained statistically significant after adjusting for covariates. These results highlight the associations between workplace psychosocial strain and multi-site musculoskeletal pain, setting the stage for future longitudinal explorations. Copyright 2013, SLACK Incorporated.

  18. Distortions in Distributions of Impact Estimates in Multi-Site Trials: The Central Limit Theorem Is Not Your Friend

    Science.gov (United States)

    May, Henry

    2014-01-01

    Interest in variation in program impacts--How big is it? What might explain it?--has inspired recent work on the analysis of data from multi-site experiments. One critical aspect of this problem involves the use of random or fixed effect estimates to visualize the distribution of impact estimates across a sample of sites. Unfortunately, unless the…

  19. A P&T Committee's Transition to a Complete Electronic Meeting System-A Multisite Institution Experience.

    Science.gov (United States)

    Al-Jedai, Ahmed H; Algain, Roaa A; Alghamidi, Said A; Al-Jazairi, Abdulrazaq S; Amin, Rashid; Bin Hussain, Ibrahim Z

    2017-10-01

    In the last few decades, changes to formulary management processes have taken place in institutions with closed formulary systems. However, many P&T committees continued to operate using traditional paper-based systems. Paper-based systems have many limitations, including confidentiality, efficiency, open voting, and paper wastage. This becomes more challenging when dealing with a multisite P&T committee that handles formulary matters across the whole health care system. In this paper, we discuss the implementation of the first paperless, completely electronic, Web-based formulary management system across a large health care system in the Middle East. We describe the transitioning of a multisite P&T committee in a large tertiary care institution from a paper-based to an all-electronic system. The challenges and limitations of running a multisite P&T committee utilizing a paper system are discussed. The design and development of a Web-based committee floor management application that can be used from notebooks, tablets, and hand-held devices is described. Implementation of a flexible, interactive, easy-to-use, and efficient electronic formulary management system is explained in detail. The development of an electronic P&T committee meeting system that encompasses electronic document sharing, voting, and communication could help multisite health care systems unify their formularies across multiple sites. Our experience might not be generalizable to all institutions because this depends heavily on system features, existing processes and workflow, and implementation across different sites.

  20. Multisite tumor sampling enhances the detection of intratumor heterogeneity at all different temporal stages of tumor evolution.

    Science.gov (United States)

    Erramuzpe, Asier; Cortés, Jesús M; López, José I

    2018-02-01

    Intratumor heterogeneity (ITH) is an inherent process of tumor development that has received much attention in previous years, as it has become a major obstacle for the success of targeted therapies. ITH is also temporally unpredictable across tumor evolution, which makes its precise characterization even more problematic since detection success depends on the precise temporal snapshot at which ITH is analyzed. New and more efficient strategies for tumor sampling are needed to overcome these difficulties which currently rely entirely on the pathologist's interpretation. Recently, we showed that a new strategy, the multisite tumor sampling, works better than the routine sampling protocol for the ITH detection when the tumor time evolution was not taken into consideration. Here, we extend this work and compare the ITH detections of multisite tumor sampling and routine sampling protocols across tumor time evolution, and in particular, we provide in silico analyses of both strategies at early and late temporal stages for four different models of tumor evolution (linear, branched, neutral, and punctuated). Our results indicate that multisite tumor sampling outperforms routine protocols in detecting ITH at all different temporal stages of tumor evolution. We conclude that multisite tumor sampling is more advantageous than routine protocols in detecting intratumor heterogeneity.

  1. Latent Variable Regression 4-Level Hierarchical Model Using Multisite Multiple-Cohorts Longitudinal Data. CRESST Report 801

    Science.gov (United States)

    Choi, Kilchan

    2011-01-01

    This report explores a new latent variable regression 4-level hierarchical model for monitoring school performance over time using multisite multiple-cohorts longitudinal data. This kind of data set has a 4-level hierarchical structure: time-series observation nested within students who are nested within different cohorts of students. These…

  2. EFICACIA DE UNA INTERVENCIÓN PARA DISMINUIR LA ANSIEDAD FRENTE A LOS EXÁMENES EN ESTUDIANTES UNIVERSITARIOS ARGENTINOS/ EFFICACY OF AN INTERVENTION AIMED AT REDUCING TEST ANXIETY IN ARGENTINEAN UNIVERSITY STUDENTS/ EFICÁCIA DE UMA INTERVENÇÃO PARA DIMINUIR A ANSIEDADE ANTE OS EXAMES EM ESTUDANTES UNIVERSITÁRIOS ARGENTINOS

    Directory of Open Access Journals (Sweden)

    Luis Alberto Furlan

    2013-06-01

    Full Text Available Se evaluó la efectividad de un programa para disminuir la ansiedad ante los exámenes, la procrastinación académica e incrementar la autoeficacia regulatoria, con 19 estudiantes universitarios de Argentina. El programa estimula el automonitoreo de las estrategias de aprendizaje implementadas, el aprendizaje de técnicas cognitivo-conductuales de control de la ansiedad y el ensayo anticipado de exámenes. Al comparar los resultados pre- y posintervención, se constataron mejorías moderadas. Se deben revisar los procedimientos para incrementar la adherencia al programa y la validez de los resultados.

  3. Multi-site pain and working conditions as predictors of work ability in a 4-year follow-up among food industry employees.

    Science.gov (United States)

    Neupane, S; Virtanen, P; Leino-Arjas, P; Miranda, H; Siukola, A; Nygård, C-H

    2013-03-01

    We investigated the separate and joint effects of multi-site musculoskeletal pain and physical and psychosocial exposures at work on future work ability. A survey was conducted among employees of a Finnish food industry company in 2005 (n = 1201) and a follow-up survey in 2009 (n = 734). Information on self-assessed work ability (current work ability on a scale from 0 to 10; 7 = poor work ability), multi-site musculoskeletal pain (pain in at least two anatomical areas of four), leisure-time physical activity, body mass index and physical and psychosocial exposures was obtained by questionnaire. The separate and joint effects of multi-site pain and work exposures on work ability at follow-up, among subjects with good work ability at baseline, were assessed by logistic regression, and p-values for the interaction derived. Compared with subjects with neither multi-site pain nor adverse work exposure, multi-site pain at baseline increased the risk of poor work ability at follow-up, allowing for age, gender, occupational class, body mass index and leisure-time physical activity. The separate effects of the work exposures on work ability were somewhat smaller than those of multi-site pain. Multi-site pain had an interactive effect with work environment and awkward postures, such that no association of multi-site pain with poor work ability was seen when work environment was poor or awkward postures present. The decline in work ability connected with multi-site pain was not increased by exposure to adverse physical or psychosocial factors at work. © 2012 European Federation of International Association for the Study of Pain Chapters.

  4. Multi-site calibration, validation, and sensitivity analysis of the MIKE SHE Model for a large watershed in northern China

    Directory of Open Access Journals (Sweden)

    S. Wang

    2012-12-01

    Full Text Available Model calibration is essential for hydrologic modeling of large watersheds in a heterogeneous mountain environment. Little guidance is available for model calibration protocols for distributed models that aim at capturing the spatial variability of hydrologic processes. This study used the physically-based distributed hydrologic model, MIKE SHE, to contrast a lumped calibration protocol that used streamflow measured at one single watershed outlet to a multi-site calibration method which employed streamflow measurements at three stations within the large Chaohe River basin in northern China. Simulation results showed that the single-site calibrated model was able to sufficiently simulate the hydrographs for two of the three stations (Nash-Sutcliffe coefficient of 0.65–0.75, and correlation coefficient 0.81–0.87 during the testing period, but the model performed poorly for the third station (Nash-Sutcliffe coefficient only 0.44. Sensitivity analysis suggested that streamflow of upstream area of the watershed was dominated by slow groundwater, whilst streamflow of middle- and down- stream areas by relatively quick interflow. Therefore, a multi-site calibration protocol was deemed necessary. Due to the potential errors and uncertainties with respect to the representation of spatial variability, performance measures from the multi-site calibration protocol slightly decreased for two of the three stations, whereas it was improved greatly for the third station. We concluded that multi-site calibration protocol reached a compromise in term of model performance for the three stations, reasonably representing the hydrographs of all three stations with Nash-Sutcliffe coefficient ranging from 0.59–072. The multi-site calibration protocol applied in the analysis generally has advantages to the single site calibration protocol.

  5. A DOE/DP multisite approach to safeguards integration with facility operations

    International Nuclear Information System (INIS)

    Ostenak, C.A.

    1987-01-01

    The Accountability Technology Exchange (ATEX) Working Group was established in October 1986 by the plutonium processing technology exchange steering committee under the US Department of Energy/Department of Defense program's materials management executive committee (DOE/DP MMEC). The ATEX Working Group provides a multisite, multidisciplinary forum for discussing, evaluating, and recommending both existing and emerging nuclear materials accountability measurement technologies for implementation into DOE/DP plutonium processing facilities. This forum assists technologists in understanding state-of-the-art plutonium processing and accountability measurement practices throughout the complex, as well as current and projected technical needs. As a result, the ATEX Working Group will contribute to the improvement of plutonium processing technologies by helping to assure that the best possible nuclear materials accountability measurement techniques are made available to all sites to process plutonium safely, securely, and cost-effectively

  6. Self-adaptive tensor network states with multi-site correlators

    Science.gov (United States)

    Kovyrshin, Arseny; Reiher, Markus

    2017-12-01

    We introduce the concept of self-adaptive tensor network states (SATNSs) based on multi-site correlators. The SATNS ansatz gradually extends its variational space incorporating the most important next-order correlators into the ansatz for the wave function. The selection of these correlators is guided by entanglement-entropy measures from quantum information theory. By sequentially introducing variational parameters and adjusting them to the system under study, the SATNS ansatz achieves keeping their number significantly smaller than the total number of full-configuration interaction parameters. The SATNS ansatz is studied for manganocene in its lowest-energy sextet and doublet states; the latter of which is known to be difficult to describe. It is shown that the SATNS parametrization solves the convergence issues found for previous correlator-based tensor network states.

  7. Downscaling atmospheric patterns to multi-site precipitation amounts in southern Scandinavia

    DEFF Research Database (Denmark)

    Gelati, Emiliano; Christensen, O.B.; Rasmussen, P.F.

    2010-01-01

    A non-homogeneous hidden Markov model (NHMM) is applied for downscaling atmospheric synoptic patterns to winter multi-site daily precipitation amounts. The implemented NHMM assumes precipitation to be conditional on a hidden weather state that follows a Markov chain, whose transition probabilities...... depend on current atmospheric information. The gridded atmospheric fields are summarized through the singular value decomposition (SVD) technique. SVD is applied to geopotential height and relative humidity at several pressure levels, to identify their principal spatial patterns co...... products of bivariate distributions. Conditional on the weather state, precipitation amounts are modelled separately at each gauge as independent gamma-distributed random variables. This modelling approach is applied to 51 precipitation gauges in Denmark and southern Sweden for the period 1981...

  8. OPTIMIZING MAINTENANCE PROCESSES ON CUSTOMER SITE IN A DECENTRALIZED ORGANIZATION BASED ON MULTI-SITE TEAMS

    Directory of Open Access Journals (Sweden)

    Jorge Moutinho

    2015-03-01

    Full Text Available This lecture focuses on the complexity to manage and optimize maintenance processes, operations and service tasks to equipments and systems installed at customer sites. Different locations, access and working environment may compromise any standardization of setup's and operations. Multi-site teams based on geographic strategic locations, adds complexity to trainning, communication, supervising and monitoring processes. Logistics and information systems assume relevant rolls to consolidate global performance. Beside efficiency, effectiveness productivity and flexibility, field teams need skills on autonomy responsibility and proactivity. This lecture also explores the needed adaptation of most part of available literature, normally based on production sites, as also of Lean- Kaizen principles to the fact that services can not be stocked, quality is normally more difficult to measure and customer is normally present when and where service is produced.

  9. Efficient multi-site two-photon functional imaging of neuronal circuits.

    Science.gov (United States)

    Castanares, Michael Lawrence; Gautam, Vini; Drury, Jack; Bachor, Hans; Daria, Vincent R

    2016-12-01

    Two-photon imaging using high-speed multi-channel detectors is a promising approach for optical recording of cellular membrane dynamics at multiple sites. A main bottleneck of this technique is the limited number of photons captured within a short exposure time (~1ms). Here, we implement temporal gating to improve the two-photon fluorescence yield from holographically projected multiple foci whilst maintaining a biologically safe incident average power. We observed up to 6x improvement in the signal-to-noise ratio (SNR) in Fluorescein and cultured hippocampal neurons showing evoked calcium transients. With improved SNR, we could pave the way to achieving multi-site optical recording of fluorogenic probes with response times in the order of ~1ms.

  10. Conducting a team-based multi-sited focused ethnography in primary care.

    Science.gov (United States)

    Bikker, A P; Atherton, H; Brant, H; Porqueddu, T; Campbell, J L; Gibson, A; McKinstry, B; Salisbury, C; Ziebland, S

    2017-09-12

    Focused ethnography is an applied and pragmatic form of ethnography that explores a specific social phenomenon as it occurs in everyday life. Based on the literature a problem-focused research question is formulated before the data collection. The data generation process targets key informants and situations so that relevant results on the pre-defined topic can be obtained within a relatively short time-span. As part of a theory based evaluation of alternative forms of consultation (such as video, phone and email) in primary care we used the focused ethnographic method in a multisite study in general practice across the UK. To date there is a gap in the literature on using focused ethnography in healthcare research.The aim of the paper is to build on the various methodological approaches in health services research by presenting the challenges and benefits we encountered whilst conducing a focused ethnography in British primary care. Our considerations are clustered under three headings: constructing a shared understanding, dividing the tasks within the team, and the functioning of the focused ethnographers within the broader multi-disciplinary team.As a result of using this approach we experienced several advantages, like the ability to collect focused data in several settings simultaneously within in a short time-span. Also, the sharing of experiences and interpretations between the researchers contributed to a more holistic understanding of the research topic. However, mechanisms need to be in place to facilitate and synthesise the observations, guide the analysis, and to ensure that all researchers feel engaged. Reflection, trust and flexibility among the team members were crucial to successfully adopt a team focused ethnographic approach. When used for policy focussed applied healthcare research a team-based multi-sited focused ethnography can uncover practices and understandings that would not be apparent through surveys or interviews alone. If conducted with

  11. Model-data fusion across ecosystems: from multisite optimizations to global simulations

    Science.gov (United States)

    Kuppel, S.; Peylin, P.; Maignan, F.; Chevallier, F.; Kiely, G.; Montagnani, L.; Cescatti, A.

    2014-11-01

    This study uses a variational data assimilation framework to simultaneously constrain a global ecosystem model with eddy covariance measurements of daily net ecosystem exchange (NEE) and latent heat (LE) fluxes from a large number of sites grouped in seven plant functional types (PFTs). It is an attempt to bridge the gap between the numerous site-specific parameter optimization works found in the literature and the generic parameterization used by most land surface models within each PFT. The present multisite approach allows deriving PFT-generic sets of optimized parameters enhancing the agreement between measured and simulated fluxes at most of the sites considered, with performances often comparable to those of the corresponding site-specific optimizations. Besides reducing the PFT-averaged model-data root-mean-square difference (RMSD) and the associated daily output uncertainty, the optimization improves the simulated CO2 balance at tropical and temperate forests sites. The major site-level NEE adjustments at the seasonal scale are reduced amplitude in C3 grasslands and boreal forests, increased seasonality in temperate evergreen forests, and better model-data phasing in temperate deciduous broadleaf forests. Conversely, the poorer performances in tropical evergreen broadleaf forests points to deficiencies regarding the modelling of phenology and soil water stress for this PFT. An evaluation with data-oriented estimates of photosynthesis (GPP - gross primary productivity) and ecosystem respiration (Reco) rates indicates distinctively improved simulations of both gross fluxes. The multisite parameter sets are then tested against CO2 concentrations measured at 53 locations around the globe, showing significant adjustments of the modelled seasonality of atmospheric CO2 concentration, whose relevance seems PFT-dependent, along with an improved interannual variability. Lastly, a global-scale evaluation with remote sensing NDVI (normalized difference vegetation index

  12. Multi-Site Diagnostic Classification of Schizophrenia Using Discriminant Deep Learning with Functional Connectivity MRI

    Directory of Open Access Journals (Sweden)

    Ling-Li Zeng

    2018-04-01

    Full Text Available Background: A lack of a sufficiently large sample at single sites causes poor generalizability in automatic diagnosis classification of heterogeneous psychiatric disorders such as schizophrenia based on brain imaging scans. Advanced deep learning methods may be capable of learning subtle hidden patterns from high dimensional imaging data, overcome potential site-related variation, and achieve reproducible cross-site classification. However, deep learning-based cross-site transfer classification, despite less imaging site-specificity and more generalizability of diagnostic models, has not been investigated in schizophrenia. Methods: A large multi-site functional MRI sample (n = 734, including 357 schizophrenic patients from seven imaging resources was collected, and a deep discriminant autoencoder network, aimed at learning imaging site-shared functional connectivity features, was developed to discriminate schizophrenic individuals from healthy controls. Findings: Accuracies of approximately 85·0% and 81·0% were obtained in multi-site pooling classification and leave-site-out transfer classification, respectively. The learned functional connectivity features revealed dysregulation of the cortical-striatal-cerebellar circuit in schizophrenia, and the most discriminating functional connections were primarily located within and across the default, salience, and control networks. Interpretation: The findings imply that dysfunctional integration of the cortical-striatal-cerebellar circuit across the default, salience, and control networks may play an important role in the “disconnectivity” model underlying the pathophysiology of schizophrenia. The proposed discriminant deep learning method may be capable of learning reliable connectome patterns and help in understanding the pathophysiology and achieving accurate prediction of schizophrenia across multiple independent imaging sites. Keywords: Schizophrenia, Deep learning, Connectome, f

  13. FDG PET/CT for therapeutic response monitoring in multi-site non-respiratory tuberculosis

    International Nuclear Information System (INIS)

    Geng Tian; Yong Xiao; Bin Chen; Jun Xia; Hong Guan; Qunyi Deng

    2010-01-01

    Background: Tuberculosis (TB) can produce positive signals during 18 F-fluorodeoxyglucose positron emission/computed tomography (FDG PET/CT) scanning. Until now, there has been no better method than clinical assessment to evaluate the therapeutic response of non-respiratory TB (NRTB). Purpose: To retrospectively assess the ability of FDG PET/CT to evaluate the response to anti-TB treatment in patients with NRTB. Material and Methods: Three patients with multi-site NRTB underwent repeat PET/CT scans during anti-TB treatment. Changes in maximal standard uptake value (SUVmax) of the TB lesions on PET/CT images were analyzed between two scans. Initial PET/CT scans were performed before the start of anti-TB treatment, and later scans were performed after completion of the treatment. Results: Patient 1, a 63-year-old female, and patient 2, a 50-year-old male, were diagnosed as multi-site NRTB by biopsy. Patient 3, a 37-year-old male was diagnosed clinically. These patients demonstrated multiple FDG-avid lesions in whole body on initial PET/CT images. The highest SUVmax of patient 1, 2, and 3 were 13.6, 17.7, and 13.9 separately. After completion of the treatment, all positive signals of patient 1, 2, and 3 decreased to undetectable value on repeated PET/CT scans with intervals of 318 days, 258 days, and 182 days separately. Conclusion: FDG PET/CT scan may be useful for monitoring responses to anti-TB treatment in patients with NRTB

  14. Conducting a team-based multi-sited focused ethnography in primary care

    Directory of Open Access Journals (Sweden)

    A.P. Bikker

    2017-09-01

    Full Text Available Abstract Focused ethnography is an applied and pragmatic form of ethnography that explores a specific social phenomenon as it occurs in everyday life. Based on the literature a problem-focused research question is formulated before the data collection. The data generation process targets key informants and situations so that relevant results on the pre-defined topic can be obtained within a relatively short time-span. As part of a theory based evaluation of alternative forms of consultation (such as video, phone and email in primary care we used the focused ethnographic method in a multisite study in general practice across the UK. To date there is a gap in the literature on using focused ethnography in healthcare research. The aim of the paper is to build on the various methodological approaches in health services research by presenting the challenges and benefits we encountered whilst conducing a focused ethnography in British primary care. Our considerations are clustered under three headings: constructing a shared understanding, dividing the tasks within the team, and the functioning of the focused ethnographers within the broader multi-disciplinary team. As a result of using this approach we experienced several advantages, like the ability to collect focused data in several settings simultaneously within in a short time-span. Also, the sharing of experiences and interpretations between the researchers contributed to a more holistic understanding of the research topic. However, mechanisms need to be in place to facilitate and synthesise the observations, guide the analysis, and to ensure that all researchers feel engaged. Reflection, trust and flexibility among the team members were crucial to successfully adopt a team focused ethnographic approach. When used for policy focussed applied healthcare research a team-based multi-sited focused ethnography can uncover practices and understandings that would not be apparent through surveys or

  15. A multisite validation of whole slide imaging for primary diagnosis using standardized data collection and analysis.

    Science.gov (United States)

    Wack, Katy; Drogowski, Laura; Treloar, Murray; Evans, Andrew; Ho, Jonhan; Parwani, Anil; Montalto, Michael C

    2016-01-01

    Text-based reporting and manual arbitration for whole slide imaging (WSI) validation studies are labor intensive and do not allow for consistent, scalable, and repeatable data collection or analysis. The objective of this study was to establish a method of data capture and analysis using standardized codified checklists and predetermined synoptic discordance tables and to use these methods in a pilot multisite validation study. Fifteen case report form checklists were generated from the College of American Pathology cancer protocols. Prior to data collection, all hypothetical pairwise comparisons were generated, and a level of harm was determined for each possible discordance. Four sites with four pathologists each generated 264 independent reads of 33 cases. Preestablished discordance tables were applied to determine site by site and pooled accuracy, intrareader/intramodality, and interreader intramodality error rates. Over 10,000 hypothetical pairwise comparisons were evaluated and assigned harm in discordance tables. The average difference in error rates between WSI and glass, as compared to ground truth, was 0.75% with a lower bound of 3.23% (95% confidence interval). Major discordances occurred on challenging cases, regardless of modality. The average inter-reader agreement across sites for glass was 76.5% (weighted kappa of 0.68) and for digital it was 79.1% (weighted kappa of 0.72). These results demonstrate the feasibility and utility of employing standardized synoptic checklists and predetermined discordance tables to gather consistent, comprehensive diagnostic data for WSI validation studies. This method of data capture and analysis can be applied in large-scale multisite WSI validations.

  16. Multi-Site Diagnostic Classification of Schizophrenia Using Discriminant Deep Learning with Functional Connectivity MRI.

    Science.gov (United States)

    Zeng, Ling-Li; Wang, Huaning; Hu, Panpan; Yang, Bo; Pu, Weidan; Shen, Hui; Chen, Xingui; Liu, Zhening; Yin, Hong; Tan, Qingrong; Wang, Kai; Hu, Dewen

    2018-04-01

    A lack of a sufficiently large sample at single sites causes poor generalizability in automatic diagnosis classification of heterogeneous psychiatric disorders such as schizophrenia based on brain imaging scans. Advanced deep learning methods may be capable of learning subtle hidden patterns from high dimensional imaging data, overcome potential site-related variation, and achieve reproducible cross-site classification. However, deep learning-based cross-site transfer classification, despite less imaging site-specificity and more generalizability of diagnostic models, has not been investigated in schizophrenia. A large multi-site functional MRI sample (n = 734, including 357 schizophrenic patients from seven imaging resources) was collected, and a deep discriminant autoencoder network, aimed at learning imaging site-shared functional connectivity features, was developed to discriminate schizophrenic individuals from healthy controls. Accuracies of approximately 85·0% and 81·0% were obtained in multi-site pooling classification and leave-site-out transfer classification, respectively. The learned functional connectivity features revealed dysregulation of the cortical-striatal-cerebellar circuit in schizophrenia, and the most discriminating functional connections were primarily located within and across the default, salience, and control networks. The findings imply that dysfunctional integration of the cortical-striatal-cerebellar circuit across the default, salience, and control networks may play an important role in the "disconnectivity" model underlying the pathophysiology of schizophrenia. The proposed discriminant deep learning method may be capable of learning reliable connectome patterns and help in understanding the pathophysiology and achieving accurate prediction of schizophrenia across multiple independent imaging sites. Copyright © 2018 German Center for Neurodegenerative Diseases (DZNE). Published by Elsevier B.V. All rights reserved.

  17. A multisite validation of whole slide imaging for primary diagnosis using standardized data collection and analysis

    Directory of Open Access Journals (Sweden)

    Katy Wack

    2016-01-01

    Full Text Available Context: Text-based reporting and manual arbitration for whole slide imaging (WSI validation studies are labor intensive and do not allow for consistent, scalable, and repeatable data collection or analysis. Objective: The objective of this study was to establish a method of data capture and analysis using standardized codified checklists and predetermined synoptic discordance tables and to use these methods in a pilot multisite validation study. Methods and Study Design: Fifteen case report form checklists were generated from the College of American Pathology cancer protocols. Prior to data collection, all hypothetical pairwise comparisons were generated, and a level of harm was determined for each possible discordance. Four sites with four pathologists each generated 264 independent reads of 33 cases. Preestablished discordance tables were applied to determine site by site and pooled accuracy, intrareader/intramodality, and interreader intramodality error rates. Results: Over 10,000 hypothetical pairwise comparisons were evaluated and assigned harm in discordance tables. The average difference in error rates between WSI and glass, as compared to ground truth, was 0.75% with a lower bound of 3.23% (95% confidence interval. Major discordances occurred on challenging cases, regardless of modality. The average inter-reader agreement across sites for glass was 76.5% (weighted kappa of 0.68 and for digital it was 79.1% (weighted kappa of 0.72. Conclusion: These results demonstrate the feasibility and utility of employing standardized synoptic checklists and predetermined discordance tables to gather consistent, comprehensive diagnostic data for WSI validation studies. This method of data capture and analysis can be applied in large-scale multisite WSI validations.

  18. African American Veterans Storytelling: A Multisite Randomized Trial to Improve Hypertension.

    Science.gov (United States)

    Houston, Thomas K; Fix, Gemmae M; Shimada, Stephanie L; Long, Judith A; Gordon, Howard S; Pope, Charlene; Volkman, Julie; Allison, Jeroan J; DeLaughter, Kathryn; Orner, Michelle; Bokhour, Barbara G

    2017-09-01

    Disparities in hypertension control persist for African American Veterans. To enhance cultural relevance of hypertension control self-management education, in a multisite, stratified randomized trial, we tested an interactive Veteran-to-Veteran storytelling digital video disk (DVD) intervention created with Veteran partners, versus an education-only DVD comparison. At 3 VA facilities, African American Veterans with uncontrolled hypertension were randomized to storytelling DVD intervention or didactic comparison DVD and followed for 6 months. We hypothesized that follow-up blood pressure (BP) would be lower among Veterans in the intervention group. African American Veterans (N=619) were 92% male, 39% over age 65, most had a high-school education, over 50% of both the intervention and comparison group reported a household income of 0.3). Site differences were large; at one, the intervention group improved while the comparison groups deteriorated, resulting in 6.3 and 3.9 mm Hg more improvement for the intervention group in SBP and diastolic BP (P=0.06 and 0.04), respectively; at the other 2 sites, there were positive and negative changes, all small, in the 2 measures, with minimal differences-one site favored the comparison group and the other, the intervention (these comparisons did not approach statistical significance (all P>0.20). In a secondary analysis stratified by baseline BP, there was no intervention effect among those with uncontrolled BP, but intervention patients who were in control at baseline were more likely to stay in control, compared with comparison [SBP increase by 6.3 mm Hg (SD=14.4) among intervention, and by 10.9 mm Hg (SD=16.9) in comparison, P=0.02]. In this multisite trial, we did not find a significant overall storytelling intervention effect (Clinicaltrials.gov Reg. #NCT01276197).

  19. La educación costarricense al servicio de los grupos de poder: Una visión desde de los exámenes estandarizados, las regulaciones y guías disciplinarias.

    Directory of Open Access Journals (Sweden)

    Vivian Carvajal Jiménez

    2004-01-01

    Full Text Available Muchas de las políticas, estatutos y propuestas que orientan la práctica educativa de nuestro país, tienen su origen en intereses económicos y políticos que nada tienen que ver con el enriquecimiento y desarrollo de los implicados en el proceso escolar. Algunas regulaciones, guías disciplinarias y los exámenes estandarizados, promueven la segregación de ciertos grupos y el mantenimiento del estatus de otros. En este sentido, está en manos de los docentes la promoción de un modelo divergente que, a pesar de los lineamientos establecidos, estimule la igualdad y motive la inserción de todos los estudiantes al sistema social y productivo del país.

  20. La doctrina de los cuatro elementos de Crisipo: su lugar en la teoría estoica de la conflagración y sus orígenes en Anaxímenes

    Directory of Open Access Journals (Sweden)

    Ricardo SALLES

    2016-07-01

    Full Text Available En este trabajo discuto el argumento de Crisipo a favor de la indestructibilidad del cosmos que aparece en Eusebio, Praeparatio Evangelica 15.18.1-3. Este argumento complementa al que aparece en Plutarco, De Stoicorum Repugnantiis 1052C, pero descansa sobre una base distinta, a saber, la teoría de la disolución de los cuerpos complejos en los cuatro elementos y la teoría sobre cómo estos últimos se transforman los unos en los otros. Según veremos, existen antecedentes importantes de estas teorías en Anaxímenes y su teoría del cambio. Al final, me ocupo de dos objeciones que los propios estoicos formularon en contra del argumento de Crisipo.

  1. The Politics of Subnational Undemocratic Regime Reproduction in Argentina and Mexico La política de reproducción de los regímenes subnacionales no democráticos en Argentina y México

    Directory of Open Access Journals (Sweden)

    Agustina Giraudy

    2010-01-01

    Full Text Available This article studies the continued existence of subnational undemocraticregimes in Argentina and Mexico, two countries that have recently experiencednational democratization. The first part of the article offers a conceptualizationof subnational democracy and measures its territorial extension across all subnational units. The second part explores a common, albeit not systematically tested explanation about subnational undemocratic regime continuity, namely, that these regimes persist because they meet national incumbents’ strategic political needs. This claim is tested using statistical analyses to contrast patterns of spending across undemocratic subnational units during the presidencies of Menem (1989-1999, De la Rúa (2000-2001, Duhalde (2002, and Kirchner (2003-2007 in Argentina, and Fox (2000-2006 in Mexico. Contradicting conventional wisdom, the results show that presidents only reproduce a handful of subnational undemocratic regimes, as not all of them can meet presidential needs. In addition, the results reveal that the strategic calculation of presidents regarding this  reproduction is dictated by factors that have been largely overlooked by the literature. Este artículo estudia la existencia de regímenes subnacionales no-democráticos en Argentina y México, dos pa��ses que recientemente han experimentado procesos de democratización a nivel nacional. La primera parte del artículo conceptualiza y define la democracia subnacional y mide su extensión territorial en la totalidad de los distritos subnacionales. La segunda parte explora la validez de una de las explicaciones más habituales en esta área de estudio según la cual los regímenes subnacionales no-democráticos permanecen en el poder debido a que son útiles para satisfacer las necesidades políticas de los funcionarios nacionales. La validez de esta explicación se testea con análisis estadísticos que determinan los patrones de distribución territorial de

  2. Multi-Site Quality Assurance Project Plan for Wisconsin Public Service Corporation, Peoples Gas Light and Coke Company, and North Shore Gas

    Science.gov (United States)

    This Multi-Site QAPP presents the organization, data quality objectives (DQOs), a set of anticipated activities, sample analysis, data handling and specific Quality Assurance/Quality Control (QA/QC) procedures associated with Studies done in EPA Region 5

  3. Jurisdicción Universal sobre Crímenes de Guerra: Evolución Histórica y su Codificación en el Derecho de Ginebra

    Directory of Open Access Journals (Sweden)

    Francisco J. Bariffi

    2009-01-01

    Full Text Available En lo que podríamos calificar como una postura doctrinaria ampliamente mayoritaria, se podría afirmar que el derecho internacional humanitario (DIH establece la obligación(en el ámbito convencional o la facultad (en el ámbito consuetudinario de los Estado de la Comunidad Internacional de ejercer su jurisdicción criminal para juzgar y sancionar actos calificados como crímenes de guerra sin necesidad de acreditar vínculo de territorialidad, nacionalidad, carácter de beligerante, o defensa de intereses nacionales. Aunque la práctica internacional en este sentido, es más bien escasa, la incorporación de este principio en las legislaciones nacionales parece evidenciar una clara tendencia.A pesar la anterior afirmación, y que, desde la creación de la Cruz Roja en 1863, y la adopción un año más tarde del Convenio para aliviar la suerte de los militares heridos de los ejércitos en campaña, el DIH aplicable a los conflictos armados no ha cesado de desarrollarse, la represión de la criminalidad de guerra por la sociedad internacionalorganizada no comienza, realmente, hasta la finalización de la Segunda Guerra Mundial(II G.M. Antes de dicho hito histórico, no resulta fácil identificar normas vinculantes sobre represión penal de crímenes guerra, y con posterioridad al mismo, las escasas disposiciones codificadas por el Derecho de Ginebra, no parecen haberse puesto enpráctica.

  4. The IM ABLE Study: A Cross-Sector, Multisite Initiative to Advance Care for Warriors and Veterans Following Neuromusculoskeletal Injury of the Lower Limb

    Science.gov (United States)

    2017-10-01

    AWARD NUMBER: W81XWH-16-1-0738 TITLE: The IM ABLE Study: A Cross-Sector, Multisite Initiative to Advance Care for Warriors and Veterans...REPORT TYPE Annual 3. DATES COVERED 30 Sep 2016 - 29 Sep 2017 4. TITLE AND SUBTITLE The IM ABLE Study: A Cross-Sector, Multisite Initiative to...widely agreed upon, if accepted at all. If the devices truly improve function and comfort, then the initial high costs of provision may be justified

  5. Projection of Climate Change Based on Multi-Site Statistical Downscaling over Gilan area, Iran

    Directory of Open Access Journals (Sweden)

    Vesta Afzali

    2017-01-01

    Full Text Available Introduction: The phenomenon of climate change and its consequences is a familiar topic which is associated with natural disasters such as, flooding, hurricane, drought that cause water crisis and irreparable damages. Studying this phenomenon is a serious warning regarding the earth’s weather change for a long period of time. Materials and Methods: In order to understand and survey the impacts of climate change on water resources, Global Circulation Models, GCMs, are used; their main role is analyzing the current climate and projecting the future climate. Climate change scenarios developing from GCMs are the initial source of information to estimate plausible future climate. For transforming coarse resolution outputs of the GCMs into finer resolutions influenced by local variables, there is a need for reliable downscaling techniques in order to analyze climate changes in a region. The classical statistical methods run the model and generate the future climate just with considering the time variable. Multi-site daily rainfall and temperature time series are the primary inputs in most hydrological analyses such as rainfall-runoff modeling. Water resource management is directly influenced by the spatial and temporal variation of rainfall and temperature. Therefore, spatial-temporal modeling of daily rainfall or temperature including climate change effects is required for sustainable planning of water resources. Results and Discussion: For the first time, in this study by ASD model (Automated regression-based Statistical Downscaling tool developed by M. Hessami et al., multi-site downscaling of temperature and precipitation was done with CGCM3.1A2 outputs and two synoptic stations (Rasht and Bandar Anzali simultaneously by considering the correlations of multiple sites. The model can process conditionally on the occurrence of precipitation or unconditionally for temperature. Hence, the modeling of daily precipitation involves two steps: one step

  6. Quantification of source impact to PM using three-dimensional weighted factor model analysis on multi-site data

    Science.gov (United States)

    Shi, Guoliang; Peng, Xing; Huangfu, Yanqi; Wang, Wei; Xu, Jiao; Tian, Yingze; Feng, Yinchang; Ivey, Cesunica E.; Russell, Armistead G.

    2017-07-01

    Source apportionment technologies are used to understand the impacts of important sources of particulate matter (PM) air quality, and are widely used for both scientific studies and air quality management. Generally, receptor models apportion speciated PM data from a single sampling site. With the development of large scale monitoring networks, PM speciation are observed at multiple sites in an urban area. For these situations, the models should account for three factors, or dimensions, of the PM, including the chemical species concentrations, sampling periods and sampling site information, suggesting the potential power of a three-dimensional source apportionment approach. However, the principle of three-dimensional Parallel Factor Analysis (Ordinary PARAFAC) model does not always work well in real environmental situations for multi-site receptor datasets. In this work, a new three-way receptor model, called "multi-site three way factor analysis" model is proposed to deal with the multi-site receptor datasets. Synthetic datasets were developed and introduced into the new model to test its performance. Average absolute error (AAE, between estimated and true contributions) for extracted sources were all less than 50%. Additionally, three-dimensional ambient datasets from a Chinese mega-city, Chengdu, were analyzed using this new model to assess the application. Four factors are extracted by the multi-site WFA3 model: secondary source have the highest contributions (64.73 and 56.24 μg/m3), followed by vehicular exhaust (30.13 and 33.60 μg/m3), crustal dust (26.12 and 29.99 μg/m3) and coal combustion (10.73 and 14.83 μg/m3). The model was also compared to PMF, with general agreement, though PMF suggested a lower crustal contribution.

  7. Role of the hospitalist in antimicrobial stewardship: a review of work completed and description of a multisite collaborative.

    Science.gov (United States)

    Rohde, Jeffrey M; Jacobsen, Diane; Rosenberg, David J

    2013-06-01

    Historically, antimicrobial stewardship programs have been led by infectious-disease physicians and pharmacists. With the growing presence of hospitalists in health and hospital systems, combined with their focus on quality improvement and patient safety, this emerging medical specialty has the potential to fill essential roles in antimicrobial stewardship programs. The goal of this article was to present the reasons hospitalists are ideally positioned to fill antimicrobial-stewardship roles, a narrative review of previously reported hospitalist-led antibiotic-stewardship projects, and a description of an ongoing multisite collaborative by the Institute for Healthcare Improvement (IHI) and the Centers for Disease Control and Prevention (CDC). A review of the published literature was performed, including an extensive review of the abstracts submitted to the Society of Hospital Medicine annual meetings. A number of examples of hospitalists developing and leading antimicrobial-stewardship programs are described. The details of a current multisite IHI/CDC hospitalist-focused initiative are discussed in detail. Hospitalists are actively involved with, and even lead, a variety of antimicrobial-stewardship programs in several different hospital systems. A large, multisite collaborative focused on hospitalist-led antimicrobial stewardship is currently in progress. Copyright © 2013 Elsevier HS Journals, Inc. All rights reserved.

  8. A MultiSite GatewayTM vector set for the functional analysis of genes in the model Saccharomyces cerevisiae

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    Nagels Durand Astrid

    2012-09-01

    Full Text Available Abstract Background Recombinatorial cloning using the GatewayTM technology has been the method of choice for high-throughput omics projects, resulting in the availability of entire ORFeomes in GatewayTM compatible vectors. The MultiSite GatewayTM system allows combining multiple genetic fragments such as promoter, ORF and epitope tag in one single reaction. To date, this technology has not been accessible in the yeast Saccharomyces cerevisiae, one of the most widely used experimental systems in molecular biology, due to the lack of appropriate destination vectors. Results Here, we present a set of three-fragment MultiSite GatewayTM destination vectors that have been developed for gene expression in S. cerevisiae and that allow the assembly of any promoter, open reading frame, epitope tag arrangement in combination with any of four auxotrophic markers and three distinct replication mechanisms. As an example of its applicability, we used yeast three-hybrid to provide evidence for the assembly of a ternary complex of plant proteins involved in jasmonate signalling and consisting of the JAZ, NINJA and TOPLESS proteins. Conclusion Our vectors make MultiSite GatewayTM cloning accessible in S. cerevisiae and implement a fast and versatile cloning method for the high-throughput functional analysis of (heterologous proteins in one of the most widely used model organisms for molecular biology research.

  9. PS1-29: Resources to Facilitate Multi-site Collaboration: the PRIMER Research Toolkit

    Science.gov (United States)

    Greene, Sarah; Thompson, Ella; Baldwin, Laura-Mae; Neale, Anne Victoria; Dolor, Rowena

    2010-01-01

    Background and Aims: The national research enterprise has typically functioned in a decentralized fashion, resulting in duplicative or undocumented processes, impeding not only the pace of research, but diffusion of established best practices. To remedy this, many long-standing networks have begun capturing and documenting proven strategies to streamline and standardize various aspects of the research process. The project, “Partnership-driven Resources to IMprove and Enhance Research” (PRIMER), was funded through the Clinical and Translational Science Awards (CTSA) initiative to leverage the collective expertise from two networks: the HMO Research Network and Practice Based Research Networks (PBRNs). Each network has a shared goal of propagating research resources and best practices. Methods: We created and distributed an online survey to 92 CTSA and PBRN representatives in March, 2009 to define critical needs and existing resources that could inform a resource repository. The survey identified barriers and benefits to forming research partnerships, and assessed the perceived utility of various tools that could accelerate the research process. The study team identified, reviewed and organized tools based on the typical research trajectory from design to dissemination. Results: Fifty-five of 92 invitees (59%) completed the survey. Respondents rated the ability to conduct community-relevant research through true academic-community partnerships as the top-rated benefit of multi-site research, followed by the opportunity to accelerate translation of research into practice. The top two perceived barriers to multi-site research were ‘funding opportunities are not adequate (e.g., too few, not enough to support true collaborations), and ‘lack of research infrastructure to support [all] partners (e.g., no IT support, IRB, dedicated research staff). Respondents’ ratings of the utility of various tools and templates was used to guide development of an online

  10. Provision of pandemic disease information by health sciences librarians: a multisite comparative case series.

    Science.gov (United States)

    Featherstone, Robin M; Boldt, R Gabriel; Torabi, Nazi; Konrad, Shauna-Lee

    2012-04-01

    The research provides an understanding of pandemic information needs and informs professional development initiatives for librarians in disaster medicine. Utilizing a multisite, comparative case series design, the researchers conducted semi-structured interviews and examined supplementary materials in the form of organizational documents, correspondence, and websites to create a complete picture of each case. The rigor of the case series was ensured through data and investigator triangulation. Interview transcripts were coded using NVivo to identify common themes and points of comparison. Comparison of the four cases revealed a distinct difference between "client-initiated" and "librarian-initiated" provision of pandemic information. Librarian-initiated projects utilized social software to "push" information, whereas client-initiated projects operated within patron-determined parameters to deliver information. Health care administrators were identified as a key audience for pandemic information, and news agencies were utilized as essential information sources. Librarians' skills at evaluating available information proved crucial for selecting best-quality evidence to support administrative decision making. Qualitative analysis resulted in increased understanding of pandemic information needs and identified best practices for disseminating information during periods of high organizational stress caused by an influx of new cases of an unknown infectious disease.

  11. Out of the frying pan? Streamlining the ethics review process of multisite qualitative research projects.

    Science.gov (United States)

    Iedema, Rick A M; Allen, Suellen; Britton, Kate; Hor, Suyin

    2013-05-01

    This paper describes the ethics approval processes for two multicentre, nationwide, qualitative health service research projects. The paper explains that the advent of the National Ethics Application Form has brought many improvements, but that attendant processes put in place at local health network and Human Research Ethics Committee levels may have become significantly more complicated, particularly for innovative qualitative research projects. The paper raises several questions based on its analysis of ethics application processes currently in place. WHAT IS KNOWN ABOUT THE TOPIC? The complexity of multicentre research ethics applications for research in health services has been addressed by the introduction of the National Ethics Application Form. Uptake of the form across the country's human research ethics committees has been uneven. WHAT DOES THIS PAPER ADD? This paper adds detailed insight into the ethics application process as it is currently enacted across the country. The paper details this process with reference to difficulties faced by multisite and qualitative studies in negotiating access to research sites, ethics committees' relative unfamiliarity with qualitative research , and apparent tensions between harmonisation and local sites' autonomy in approving research. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? Practitioners aiming to engage in research need to be aware that ethics approval takes place in an uneven procedural landscape, made up of variable levels of ethics approval harmonization and intricate governance or site-specific assessment processes.

  12. Work characteristics predict the development of multi-site musculoskeletal pain.

    Science.gov (United States)

    Oakman, Jodi; de Wind, Astrid; van den Heuvel, Swenne G; van der Beek, Allard J

    2017-10-01

    Musculoskeletal pain in more than one body region is common and a barrier to sustaining employment. We aimed to examine whether work characteristics predict the development of multi-site pain (MSP), and to determine differences in work-related predictors between age groups. This study is based on 5136 employees from the Study on Transitions in Employment, Ability and Motivation (STREAM) who reported no MSP at baseline. Measures included physical, emotional, mental, and psychological job demands, social support and autonomy. Predictors of MSP were studied by logistic regression analyses. Univariate and multivariate analyses with age stratification (45-49, 50-54, 55-59, and 60-64 years) were done to explore differences between age groups. All work characteristics with the exception of autonomy were predictive of the development of MSP, with odds ratios varying from 1.21 (95% CI 1.04-1.40) for mental job demands to 1.63 (95% CI 1.43-1.86) for physical job demands. No clear pattern of age-related differences in the predictors of MSP emerged, with the exception of social support, which was predictive of MSP developing in all age groups except for the age group 60-64 years. Adverse physical and psychosocial work characteristics are associated with MSP. Organisations need to comprehensively assess work environments to ensure that all relevant workplace hazards, physical and psychosocial, are identified and then controlled for across all age groups.

  13. User Satisfaction Evaluation of the EHR4CR Query Builder: A Multisite Patient Count Cohort System

    Directory of Open Access Journals (Sweden)

    Iñaki Soto-Rey

    2015-01-01

    Full Text Available The Electronic Health Records for Clinical Research (EHR4CR project aims to develop services and technology for the leverage reuse of Electronic Health Records with the purpose of improving the efficiency of clinical research processes. A pilot program was implemented to generate evidence of the value of using the EHR4CR platform. The user acceptance of the platform is a key success factor in driving the adoption of the EHR4CR platform; thus, it was decided to evaluate the user satisfaction. In this paper, we present the results of a user satisfaction evaluation for the EHR4CR multisite patient count cohort system. This study examined the ability of testers (n=22 and n=16 from 5 countries to perform three main tasks (around 20 minutes per task, after a 30-minute period of self-training. The System Usability Scale score obtained was 55.83 (SD: 15.37, indicating a moderate user satisfaction. The responses to an additional satisfaction questionnaire were positive about the design of the interface and the required procedure to design a query. Nevertheless, the most complex of the three tasks proposed in this test was rated as difficult, indicating a need to improve the system regarding complicated queries.

  14. Simple-MSSM: a simple and efficient method for simultaneous multi-site saturation mutagenesis.

    Science.gov (United States)

    Cheng, Feng; Xu, Jian-Miao; Xiang, Chao; Liu, Zhi-Qiang; Zhao, Li-Qing; Zheng, Yu-Guo

    2017-04-01

    To develop a practically simple and robust multi-site saturation mutagenesis (MSSM) method that enables simultaneously recombination of amino acid positions for focused mutant library generation. A general restriction enzyme-free and ligase-free MSSM method (Simple-MSSM) based on prolonged overlap extension PCR (POE-PCR) and Simple Cloning techniques. As a proof of principle of Simple-MSSM, the gene of eGFP (enhanced green fluorescent protein) was used as a template gene for simultaneous mutagenesis of five codons. Forty-eight randomly selected clones were sequenced. Sequencing revealed that all the 48 clones showed at least one mutant codon (mutation efficiency = 100%), and 46 out of the 48 clones had mutations at all the five codons. The obtained diversities at these five codons are 27, 24, 26, 26 and 22, respectively, which correspond to 84, 75, 81, 81, 69% of the theoretical diversity offered by NNK-degeneration (32 codons; NNK, K = T or G). The enzyme-free Simple-MSSM method can simultaneously and efficiently saturate five codons within one day, and therefore avoid missing interactions between residues in interacting amino acid networks.

  15. Cooperative loading of multisite receptors with lanthanide containers: an approach for organized luminescent metallopolymers.

    Science.gov (United States)

    Babel, Lucille; Guénée, Laure; Besnard, Céline; Eliseeva, Svetlana V; Petoud, Stéphane; Piguet, Claude

    2018-01-14

    Metal-containing (bio)organic polymers are materials of continuously increasing importance for applications in energy storage and conversion, drug delivery, shape-memory items, supported catalysts, organic conductors and smart photonic devices. The embodiment of luminescent components provides a revolution in lighting and signaling with the ever-increasing development of polymeric light-emitting devices. Despite the unique properties expected from the introduction of optically and magnetically active lanthanides into organic polymers, the deficient control of the metal loading currently limits their design to empirical and poorly reproducible materials. We show here that the synthetic efforts required for producing soluble multi-site host systems L k are largely overcome by the virtue of reversible thermodynamics for mastering the metal loading with the help of only two parameters: (1) the affinity of the luminescent lanthanide container for a single binding site and (2) the cooperative effect which modulates the successive fixation of metallic units to adjacent sites. When unsymmetrical perfluorobenzene-trifluoroacetylacetonate co-ligands (pbta - ) are selected for balancing the charge of the trivalent lanthanide cations, Ln 3+ , in six-coordinate [Ln(pbta) 3 ] containers, the explored anti-cooperative complexation processes induce nearest-neighbor intermetallic interactions twice as large as thermal energy at room temperature ( RT = 2.5 kJ mol -1 ). These values have no precedent when using standard symmetrical containers and they pave the way for programming metal alternation in luminescent lanthanidopolymers.

  16. Mobile Phone Use in Psychiatry Residents in the United States: Multisite Cross-Sectional Survey Study.

    Science.gov (United States)

    Gipson, Shih; Torous, John; Boland, Robert; Conrad, Erich

    2017-11-01

    Mobile technology ownership in the general US population and medical professionals is increasing, leading to increased use in clinical settings. However, data on use of mobile technology by psychiatry residents remain unclear. In this study, our aim was to provide data on how psychiatric residents use mobile phones in their clinical education as well as barriers relating to technology use. An anonymous, multisite survey was given to psychiatry residents in 2 regions in the United States, including New Orleans and Boston, to understand their technology use. All participants owned mobile phones, and 79% (54/68) used them to access patient information. The majority do not use mobile phones to implement pharmacotherapy (62%, 42/68) or psychotherapy plans (90%, 61/68). The top 3 barriers to using mobile technology in clinical care were privacy concerns (56%, 38/68), lack of clinical guidance (40%, 27/68), and lack of evidence (29%, 20/68). We conclude that developing a technology curriculum and engaging in research could address these barriers to using mobile phones in clinical practice. ©Shih Gipson, John Torous, Robert Boland, Erich Conrad. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 01.11.2017.

  17. Streamflow prediction using multi-site rainfall obtained from hydroclimatic teleconnection

    Science.gov (United States)

    Kashid, S. S.; Ghosh, Subimal; Maity, Rajib

    2010-12-01

    SummarySimultaneous variations in weather and climate over widely separated regions are commonly known as "hydroclimatic teleconnections". Rainfall and runoff patterns, over continents, are found to be significantly teleconnected, with large-scale circulation patterns, through such hydroclimatic teleconnections. Though such teleconnections exist in nature, it is very difficult to model them, due to their inherent complexity. Statistical techniques and Artificial Intelligence (AI) tools gain popularity in modeling hydroclimatic teleconnection, based on their ability, in capturing the complicated relationship between the predictors (e.g. sea surface temperatures) and predictand (e.g., rainfall). Genetic Programming is such an AI tool, which is capable of capturing nonlinear relationship, between predictor and predictand, due to its flexible functional structure. In the present study, gridded multi-site weekly rainfall is predicted from El Niño Southern Oscillation (ENSO) indices, Equatorial Indian Ocean Oscillation (EQUINOO) indices, Outgoing Longwave Radiation (OLR) and lag rainfall at grid points, over the catchment, using Genetic Programming. The predicted rainfall is further used in a Genetic Programming model to predict streamflows. The model is applied for weekly forecasting of streamflow in Mahanadi River, India, and satisfactory performance is observed.

  18. Determination of emamectin benzoate in medicated fish feed: a multisite study.

    Science.gov (United States)

    Farer, Leslie J

    2005-01-01

    A new method was developed for the quantitation of emamectin benzoate in medicated fish feed at levels between 1 and 30 ppm. The new procedure, based on a previously reported assay, consists of a wet methanolic extraction of ground feed, followed by solid-phase extraction and injection onto a gradient liquid chromatographic system. A multisite study involving 3 laboratories (the developing laboratory and 2 independent laboratories) was performed to evaluate precision, recovery, linearity, and sensitivity. Mean recove;ries for triplicate analyses at 3 levels, performed by 2 analysts per laboratory, were between 89 and 97%, with coefficients of variation ranging from 1.6 to 8.6%. Coefficients of determination (r2) obtained from the plotted data were > or =0.993. The precision of the method, determined from 6 replicate preparations from the same batch of medicated feed assayed in 3 separate trials per laboratory, was between 0.6 and 5.8%. The quantitation limit was established at 0.5 ppm. Specificity and robustness studies were performed by the developing laboratory.

  19. Multisite Infection with Mycobacterium abscessus after Replacement of Breast Implants and Gluteal Lipofilling.

    Science.gov (United States)

    Rüegg, Eva; Cheretakis, Alexandre; Modarressi, Ali; Harbarth, Stephan; Pittet-Cuénod, Brigitte

    2015-01-01

    Introduction. Medical tourism for aesthetic surgery is popular. Nontuberculous mycobacteria (NTM) occasionally cause surgical-site infections. As NTM grow in biofilms, implantations of foreign bodies are at risk. Due to late manifestation, infections occur when patients are back home, where they must be managed properly. Case Report. A 39-year-old healthy female was referred for acute infection of the right gluteal area. Five months before, she had breast implants replacement, abdominal liposuction, and gluteal lipofilling in Mexico. Three months postoperatively, implants were removed for NTM-infection in Switzerland. Adequate antibiotic treatment was stopped after seven days for drug-related hepatitis. At entrance, gluteal puncture for bacterial analysis was performed. MRI showed large subcutaneous collection. Debridement under general anaesthesia was followed by open wound management. Total antibiotic treatment was 20 weeks. Methods. Bacterial analysis of periprosthetic and gluteal liquids included Gram-stain plus acid-fast stain, and aerobic, anaerobic and mycobacterial cultures.  Results. In periprosthetic fluid, Mycobacterium abscessus, Propionibacterium, and Staphylococcus epidermidis were identified. The same M. abscessus strain was found gluteally. The gluteal wound healed within six weeks. At ten months' follow-up, gluteal asymmetry persists for deep scarring. Conclusion. This case presents major complications of multisite aesthetic surgery. Surgical-site infections in context of medical tourism need appropriate bacteriological investigations, considering potential NTM-infections.

  20. Meditation programs for veterans with posttraumatic stress disorder: Aggregate findings from a multi-site evaluation.

    Science.gov (United States)

    Heffner, Kathi L; Crean, Hugh F; Kemp, Jan E

    2016-05-01

    Interest in meditation to manage posttraumatic stress disorder (PTSD) symptoms is increasing. Few studies have examined the effectiveness of meditation programs offered to Veterans within Department of Veterans Affairs (VA) mental health services. The current study addresses this gap using data from a multisite VA demonstration project. Evaluation data collected at 6 VA sites (N = 391 Veterans) before and after a meditation program, and a treatment-as-usual (TAU) program, were examined here using random effects meta-analyses. Site-specific and aggregate between group effect sizes comparing meditation programs to TAU were determined for PTSD severity measured by clinical interview and self-report. Additional outcomes included experiential avoidance and mindfulness. In aggregate, analyses showed medium effect sizes for meditation programs compared to TAU for PTSD severity (clinical interview: effect size (ES) = -0.32; self-report: ES = -0.39). Similarly sized effects of meditation programs were found for overall mindfulness (ES = 0.41) and 1 specific aspect of mindfulness, nonreactivity to inner experience (ES = .37). Additional findings suggested meditation type and program completion differences each moderated program effects. VA-sponsored meditation programs show promise for reducing PTSD severity in Veterans receiving mental health services. Where meditation training fits within mental health services, and for whom programs will be of interest and effective, require further clarification. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  1. Integrating physically based simulators with Event Detection Systems: Multi-site detection approach.

    Science.gov (United States)

    Housh, Mashor; Ohar, Ziv

    2017-03-01

    The Fault Detection (FD) Problem in control theory concerns of monitoring a system to identify when a fault has occurred. Two approaches can be distinguished for the FD: Signal processing based FD and Model-based FD. The former concerns of developing algorithms to directly infer faults from sensors' readings, while the latter uses a simulation model of the real-system to analyze the discrepancy between sensors' readings and expected values from the simulation model. Most contamination Event Detection Systems (EDSs) for water distribution systems have followed the signal processing based FD, which relies on analyzing the signals from monitoring stations independently of each other, rather than evaluating all stations simultaneously within an integrated network. In this study, we show that a model-based EDS which utilizes a physically based water quality and hydraulics simulation models, can outperform the signal processing based EDS. We also show that the model-based EDS can facilitate the development of a Multi-Site EDS (MSEDS), which analyzes the data from all the monitoring stations simultaneously within an integrated network. The advantage of the joint analysis in the MSEDS is expressed by increased detection accuracy (higher true positive alarms and fewer false alarms) and shorter detection time. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Using a computer simulation for teaching communication skills: A blinded multisite mixed methods randomized controlled trial.

    Science.gov (United States)

    Kron, Frederick W; Fetters, Michael D; Scerbo, Mark W; White, Casey B; Lypson, Monica L; Padilla, Miguel A; Gliva-McConvey, Gayle A; Belfore, Lee A; West, Temple; Wallace, Amelia M; Guetterman, Timothy C; Schleicher, Lauren S; Kennedy, Rebecca A; Mangrulkar, Rajesh S; Cleary, James F; Marsella, Stacy C; Becker, Daniel M

    2017-04-01

    To assess advanced communication skills among second-year medical students exposed either to a computer simulation (MPathic-VR) featuring virtual humans, or to a multimedia computer-based learning module, and to understand each group's experiences and learning preferences. A single-blinded, mixed methods, randomized, multisite trial compared MPathic-VR (N=210) to computer-based learning (N=211). Primary outcomes: communication scores during repeat interactions with MPathic-VR's intercultural and interprofessional communication scenarios and scores on a subsequent advanced communication skills objective structured clinical examination (OSCE). Multivariate analysis of variance was used to compare outcomes. student attitude surveys and qualitative assessments of their experiences with MPathic-VR or computer-based learning. MPathic-VR-trained students improved their intercultural and interprofessional communication performance between their first and second interactions with each scenario. They also achieved significantly higher composite scores on the OSCE than computer-based learning-trained students. Attitudes and experiences were more positive among students trained with MPathic-VR, who valued its providing immediate feedback, teaching nonverbal communication skills, and preparing them for emotion-charged patient encounters. MPathic-VR was effective in training advanced communication skills and in enabling knowledge transfer into a more realistic clinical situation. MPathic-VR's virtual human simulation offers an effective and engaging means of advanced communication training. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. Using a computer simulation for teaching communication skills: A blinded multisite mixed methods randomized controlled trial

    Science.gov (United States)

    Kron, Frederick W.; Fetters, Michael D.; Scerbo, Mark W.; White, Casey B.; Lypson, Monica L.; Padilla, Miguel A.; Gliva-McConvey, Gayle A.; Belfore, Lee A.; West, Temple; Wallace, Amelia M.; Guetterman, Timothy C.; Schleicher, Lauren S.; Kennedy, Rebecca A.; Mangrulkar, Rajesh S.; Cleary, James F.; Marsella, Stacy C.; Becker, Daniel M.

    2016-01-01

    Objectives To assess advanced communication skills among second-year medical students exposed either to a computer simulation (MPathic-VR) featuring virtual humans, or to a multimedia computer-based learning module, and to understand each group’s experiences and learning preferences. Methods A single-blinded, mixed methods, randomized, multisite trial compared MPathic-VR (N=210) to computer-based learning (N=211). Primary outcomes: communication scores during repeat interactions with MPathic-VR’s intercultural and interprofessional communication scenarios and scores on a subsequent advanced communication skills objective structured clinical examination (OSCE). Multivariate analysis of variance was used to compare outcomes. Secondary outcomes: student attitude surveys and qualitative assessments of their experiences with MPathic-VR or computer-based learning. Results MPathic-VR-trained students improved their intercultural and interprofessional communication performance between their first and second interactions with each scenario. They also achieved significantly higher composite scores on the OSCE than computer-based learning-trained students. Attitudes and experiences were more positive among students trained with MPathic-VR, who valued its providing immediate feedback, teaching nonverbal communication skills, and preparing them for emotion-charged patient encounters. Conclusions MPathic-VR was effective in training advanced communication skills and in enabling knowledge transfer into a more realistic clinical situation. Practice Implications MPathic-VR’s virtual human simulation offers an effective and engaging means of advanced communication training. PMID:27939846

  4. Intra-operative multi-site stimulation: Expanding methodology for cortical brain mapping of language functions.

    Science.gov (United States)

    Gonen, Tal; Gazit, Tomer; Korn, Akiva; Kirschner, Adi; Perry, Daniella; Hendler, Talma; Ram, Zvi

    2017-01-01

    Direct cortical stimulation (DCS) is considered the gold-standard for functional cortical mapping during awake surgery for brain tumor resection. DCS is performed by stimulating one local cortical area at a time. We present a feasibility study using an intra-operative technique aimed at improving our ability to map brain functions which rely on activity in distributed cortical regions. Following standard DCS, Multi-Site Stimulation (MSS) was performed in 15 patients by applying simultaneous cortical stimulations at multiple locations. Language functioning was chosen as a case-cognitive domain due to its relatively well-known cortical organization. MSS, performed at sites that did not produce disruption when applied in a single stimulation point, revealed additional language dysfunction in 73% of the patients. Functional regions identified by this technique were presumed to be significant to language circuitry and were spared during surgery. No new neurological deficits were observed in any of the patients following surgery. Though the neuro-electrical effects of MSS need further investigation, this feasibility study may provide a first step towards sophistication of intra-operative cortical mapping.

  5. Urban Forest and Rural Cities: Multi-sited Households, Consumption Patterns, and Forest Resources in Amazonia

    Directory of Open Access Journals (Sweden)

    Christine Padoch

    2008-12-01

    Full Text Available In much of the Amazon Basin, approximately 70% of the population lives in urban areas and urbanward migration continues. Based on data collected over more than a decade in two long-settled regions of Amazonia, we find that rural-urban migration in the region is an extended and complex process. Like recent rural-urban migrants worldwide, Amazonian migrants, although they may be counted as urban residents, are often not absent from rural areas but remain members of multi-sited households and continue to participate in rural-urban networks and in rural land-use decisions. Our research indicates that, despite their general poverty, these migrants have affected urban markets for both food and construction materials. We present two cases: that of açaí palm fruit in the estuary of the Amazon and of cheap construction timbers in the Peruvian Amazon. We find that many new Amazonian rural-urban migrants have maintained some important rural patterns of both consumption and knowledge. Through their consumer behavior, they are affecting the areal extent of forests; in the two floodplain regions discussed, tree cover is increasing. We also find changes in forest composition, reflecting the persistence of rural consumption patterns in cities resulting in increased demand for and production of açaí and cheap timber species.

  6. A modular class of multisite monthly rainfall generators for water resource management and impact studies

    Science.gov (United States)

    Serinaldi, Francesco; Kilsby, Chris G.

    2012-09-01

    SummaryThis study introduces a class of stochastic multisite monthly rainfall generators devised for application in water resources management problems, such as the sensitivity analysis of droughts and extreme rainfall scenarios under external climatic and non-climatic forcing mechanisms. The modelling framework relies on three elements: (1) a classical deseasonalisation scheme based on log-transformed observations, (2) the nonparametric bootstrap resampling approach and (3) parametric Generalized Additive Models for Location, Scale and Shape (GAMLSS). As the bootstrap and GAMLSS modules are alternative techniques for simulating each month, the free choice between them makes the structure of the model modular and flexible, so that it can be easily adapted to different climatic conditions, and can be customized based on the specific water resource problem. The model was set up and calibrated to simulate monthly rainfall from six locations in England and Wales to produce a suitable input for drought analysis. The results of the case study point out that the model can capture several characteristics of the rainfall series. In particular, it enables the simulation of low and high rainfall scenarios more extreme than those observed as well as the reproduction of the distribution of the annual accumulated rainfall, and of the relationship between the rainfall and circulation indices such as North Atlantic Oscillation (NAO) and Sea Surface Temperature (SST), thus making the framework well-suited for sensitivity analysis under alternative climate scenarios and additional forcing variables.

  7. Recruiting a representative sample in adherence research-The MALT multisite prospective cohort study experience.

    Science.gov (United States)

    Shemesh, Eyal; Mitchell, Jeffrey; Neighbors, Katie; Feist, Susan; Hawkins, Andre; Brown, Amanda; Wanrong, Yin; Anand, Ravinder; Stuber, Margaret L; Annunziato, Rachel A

    2017-12-01

    Medication adherence is an important determinant of transplant outcomes. Attempts to investigate adherence are frequently undermined by selection bias: It is very hard to recruit and retain non-adherent patients in research efforts. This manuscript presents recruitment strategies and results from the MALT (Medication Adherence in children who had a Liver Transplant) multisite prospective cohort study. MALT sites recruited 400 pediatric liver transplant patients who agreed to be followed for 2 years. The primary purpose was to determine whether a marker of adherence, the Medication Level Variability Index (MLVI), predicts rejection outcomes. The present manuscript describes methods used in MALT to ensure that a representative sample was recruited, and presents detailed recruitment results. MALT sites were able to recruit a nationally representative sample, as determined by a comparison between the MALT cohort and a national sample of transplant recipients. Strategies that helped ensure that the sample was representative included monitoring of the outcome measure in comparison with a national sample, drastically limiting patient burden, and specific recruitment methods. We discuss the importance of a representative sample in adherence research and recommend that future efforts to study adherence pay special attention to sample characteristics. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Multisite, multimodal neuroimaging of chronic urological pelvic pain: Methodology of the MAPP Research Network

    Directory of Open Access Journals (Sweden)

    Jeffry R. Alger

    2016-01-01

    Full Text Available The Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP Research Network is an ongoing multi-center collaborative research group established to conduct integrated studies in participants with urologic chronic pelvic pain syndrome (UCPPS. The goal of these investigations is to provide new insights into the etiology, natural history, clinical, demographic and behavioral characteristics, search for new and evaluate candidate biomarkers, systematically test for contributions of infectious agents to symptoms, and conduct animal studies to understand underlying mechanisms for UCPPS. Study participants were enrolled in a one-year observational study and evaluated through a multisite, collaborative neuroimaging study to evaluate the association between UCPPS and brain structure and function. 3D T1-weighted structural images, resting-state fMRI, and high angular resolution diffusion MRI were acquired in five participating MAPP Network sites using 8 separate MRI hardware and software configurations. We describe the neuroimaging methods and procedures used to scan participants, the challenges encountered in obtaining data from multiple sites with different equipment/software, and our efforts to minimize site-to-site variation.

  9. Abscisic acid-dependent multisite phosphorylation regulates the activity of a transcription activator AREB1.

    Science.gov (United States)

    Furihata, Takashi; Maruyama, Kyonoshin; Fujita, Yasunari; Umezawa, Taishi; Yoshida, Riichiro; Shinozaki, Kazuo; Yamaguchi-Shinozaki, Kazuko

    2006-02-07

    bZIP-type transcription factors AREBs/ABFs bind an abscisic acid (ABA)-responsive cis-acting element named ABRE and transactivate downstream gene expression in Arabidopsis. Because AREB1 overexpression could not induce downstream gene expression, activation of AREB1 requires ABA-dependent posttranscriptional modification. We confirmed that ABA activated 42-kDa kinase activity, which, in turn, phosphorylated Ser/Thr residues of R-X-X-S/T sites in the conserved regions of AREB1. Amino acid substitutions of R-X-X-S/T sites to Ala suppressed transactivation activity, and multiple substitution of these sites resulted in almost complete suppression of transactivation activity in transient assays. In contrast, substitution of the Ser/Thr residues to Asp resulted in high transactivation activity without exogenous ABA application. A phosphorylated, transcriptionally active form was achieved by substitution of Ser/Thr in all conserved R-X-X-S/T sites to Asp. Transgenic plants overexpressing the phosphorylated active form of AREB1 expressed many ABA-inducible genes, such as RD29B, without ABA treatment. These results indicate that the ABA-dependent multisite phosphorylation of AREB1 regulates its own activation in plants.

  10. A comparison of single- and multi-site calibration and validation: a case study of SWAT in the Miyun Reservoir watershed, China

    Science.gov (United States)

    Bai, Jianwen; Shen, Zhenyao; Yan, Tiezhu

    2017-09-01

    An essential task in evaluating global water resource and pollution problems is to obtain the optimum set of parameters in hydrological models through calibration and validation. For a large-scale watershed, single-site calibration and validation may ignore spatial heterogeneity and may not meet the needs of the entire watershed. The goal of this study is to apply a multi-site calibration and validation of the Soil andWater Assessment Tool (SWAT), using the observed flow data at three monitoring sites within the Baihe watershed of the Miyun Reservoir watershed, China. Our results indicate that the multi-site calibration parameter values are more reasonable than those obtained from single-site calibrations. These results are mainly due to significant differences in the topographic factors over the large-scale area, human activities and climate variability. The multi-site method involves the division of the large watershed into smaller watersheds, and applying the calibrated parameters of the multi-site calibration to the entire watershed. It was anticipated that this case study could provide experience of multi-site calibration in a large-scale basin, and provide a good foundation for the simulation of other pollutants in followup work in the Miyun Reservoir watershed and other similar large areas.

  11. Sobre el dominio territorial como requisito del elemento político en la definición de los crímenes de lesa humanidad. Un análisis enfocado en la calificación jurídica de los actos de la izquierda armada en Argentina

    Directory of Open Access Journals (Sweden)

    Juan Francisco Iosa

    2014-03-01

    Full Text Available Ofrezco primero una caracterización  de la teoría de los dos demonios. Esta teoría, tras gozar del rol de discurso de Estado luego de la recuperación democrática en Argentina, ha sido explícitamente rechazada en la segunda generación de juicios: aquí se consideró que sólo los militares (no las organizaciones de izquierda cometieron crímenes contra la humanidad. Mi interés está centrado en evaluar las razones que sustentan esa distinción. Con vistas a ese fin, segundo, presento la figura de los crímenes contra la humanidad tal como está fijada en el Estatuto de Roma y distingo cuatro concepciones relativas a cómo debe delinearse su  elemento político. Tercero, reconstruyo la interpretación que la Corte y los tribunales argentinos hacen de los requisitos necesarios para que un delito califique como crimen contra la humanidad. Hago foco en  el elemento político y específicamente en las condiciones que una organización debe satisfacer para ser capaz de cometer dichos crímenes. Cuarto, comparo las decisiones argentinas con las tomadas por las cortes internacionales. Quinto, ofrezco una reconstrucción de los requisitos que a mi entender deben ser tenidos en cuenta (según la concepción normativa que considero correcta en la definición legal de los crímenes contra la humanidad. Con esta herramienta conceptual en mano evalúo las decisiones jurisprudenciales mencionadas más arriba. Por último, presento la que considero como la calificación jurídica adecuada de los delitos cometidos por la izquierda armada en los setenta. 

  12. Electronic Cigarette Marketing Online: a Multi-Site, Multi-Product Comparison.

    Science.gov (United States)

    Chu, Kar-Hai; Sidhu, Anupreet K; Valente, Thomas W

    2015-01-01

    Electronic cigarette awareness and use has been increasing rapidly. E-cigarette brands have utilized social networking sites to promote their products, as the growth of the e-cigarette industry has paralleled that of Web 2.0. These online platforms are cost-effective and have unique technological features and user demographics that can be attractive for selective marketing. The popularity of multiple sites also poses a risk of exposure to social networks where e-cigarette brands might not have a presence. To examine the marketing strategies of leading e-cigarette brands on multiple social networking sites, and to identify how affordances of the digital media are used to their advantage. Secondary analyses include determining if any brands are benefitting from site demographics, and exploring cross-site diffusion of marketing content through multi-site users. We collected data from two e-cigarette brands from four social networking sites over approximately 2.5 years. Content analysis is used to search for themes, population targeting, marketing strategies, and cross-site spread of messages. Twitter appeared to be the most frequently used social networking site for interacting directly with product users. Facebook supported informational broadcasts, such as announcements regarding political legislation. E-cigarette brands also differed in their approaches to their users, from informal conversations to direct product marketing. E-cigarette makers use different strategies to market their product and engage their users. There was no evidence of direct targeting of vulnerable populations, but the affordances of the different sites are exploited to best broadcast context-specific messages. We developed a viable method to study cross-site diffusion, although additional refinement is needed to account for how different types of digital media are used.

  13. How Accurately Do Consecutive Cohort Audits Predict Phase III Multisite Clinical Trial Recruitment in Palliative Care?

    Science.gov (United States)

    McCaffrey, Nikki; Fazekas, Belinda; Cutri, Natalie; Currow, David C

    2016-04-01

    Audits have been proposed for estimating possible recruitment rates to randomized controlled trials (RCTs), but few studies have compared audit data with subsequent recruitment rates. To compare the accuracy of estimates of potential recruitment from a retrospective consecutive cohort audit of actual participating sites and recruitment to four Phase III multisite clinical RCTs. The proportion of potentially eligible study participants estimated from an inpatient chart review of people with life-limiting illnesses referred to six Australian specialist palliative care services was compared with recruitment data extracted from study prescreening information from three sites that participated fully in four Palliative Care Clinical Studies Collaborative RCTs. The predominant reasons for ineligibility in the audit and RCTs were analyzed. The audit overestimated the proportion of people referred to the palliative care services who could participate in the RCTs (pain 17.7% vs. 1.2%, delirium 5.8% vs. 0.6%, anorexia 5.1% vs. 0.8%, and bowel obstruction 2.8% vs. 0.5%). Approximately 2% of the referral base was potentially eligible for these effectiveness studies. Ineligibility for general criteria (language, cognition, and geographic proximity) varied between studies, whereas the reasons for exclusion were similar between the audit and pain and anorexia studies but not for delirium or bowel obstruction. The retrospective consecutive case note audit in participating sites did not predict realistic recruitment rates, mostly underestimating the impact of study-specific inclusion criteria. These findings have implications for the applicability of the results of RCTs. Prospective pilot studies are more likely to predict actual recruitment. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  14. Quantitative susceptibility mapping of human brain at 3T: a multisite reproducibility study.

    Science.gov (United States)

    Lin, P-Y; Chao, T-C; Wu, M-L

    2015-03-01

    Quantitative susceptibility mapping of the human brain has demonstrated strong potential in examining iron deposition, which may help in investigating possible brain pathology. This study assesses the reproducibility of quantitative susceptibility mapping across different imaging sites. In this study, the susceptibility values of 5 regions of interest in the human brain were measured on 9 healthy subjects following calibration by using phantom experiments. Each of the subjects was imaged 5 times on 1 scanner with the same procedure repeated on 3 different 3T systems so that both within-site and cross-site quantitative susceptibility mapping precision levels could be assessed. Two quantitative susceptibility mapping algorithms, similar in principle, one by using iterative regularization (iterative quantitative susceptibility mapping) and the other with analytic optimal solutions (deterministic quantitative susceptibility mapping), were implemented, and their performances were compared. Results show that while deterministic quantitative susceptibility mapping had nearly 700 times faster computation speed, residual streaking artifacts seem to be more prominent compared with iterative quantitative susceptibility mapping. With quantitative susceptibility mapping, the putamen, globus pallidus, and caudate nucleus showed smaller imprecision on the order of 0.005 ppm, whereas the red nucleus and substantia nigra, closer to the skull base, had a somewhat larger imprecision of approximately 0.01 ppm. Cross-site errors were not significantly larger than within-site errors. Possible sources of estimation errors are discussed. The reproducibility of quantitative susceptibility mapping in the human brain in vivo is regionally dependent, and the precision levels achieved with quantitative susceptibility mapping should allow longitudinal and multisite studies such as aging-related changes in brain tissue magnetic susceptibility. © 2015 by American Journal of Neuroradiology.

  15. A multisite study of the clinical diagnosis of different autism spectrum disorders.

    Science.gov (United States)

    Lord, Catherine; Petkova, Eva; Hus, Vanessa; Gan, Weijin; Lu, Feihan; Martin, Donna M; Ousley, Opal; Guy, Lisa; Bernier, Raphael; Gerdts, Jennifer; Algermissen, Molly; Whitaker, Agnes; Sutcliffe, James S; Warren, Zachary; Klin, Ami; Saulnier, Celine; Hanson, Ellen; Hundley, Rachel; Piggot, Judith; Fombonne, Eric; Steiman, Mandy; Miles, Judith; Kanne, Stephen M; Goin-Kochel, Robin P; Peters, Sarika U; Cook, Edwin H; Guter, Stephen; Tjernagel, Jennifer; Green-Snyder, Lee Anne; Bishop, Somer; Esler, Amy; Gotham, Katherine; Luyster, Rhiannon; Miller, Fiona; Olson, Jennifer; Richler, Jennifer; Risi, Susan

    2012-03-01

    Best-estimate clinical diagnoses of specific autism spectrum disorders (autistic disorder, pervasive developmental disorder-not otherwise specified, and Asperger syndrome) have been used as the diagnostic gold standard, even when information from standardized instruments is available. To determine whether the relationships between behavioral phenotypes and clinical diagnoses of different autism spectrum disorders vary across 12 university-based sites. Multisite observational study collecting clinical phenotype data (diagnostic, developmental, and demographic) for genetic research. Classification trees were used to identify characteristics that predicted diagnosis across and within sites. Participants were recruited through 12 university-based autism service providers into a genetic study of autism. A total of 2102 probands (1814 male probands) between 4 and 18 years of age (mean [SD] age, 8.93 [3.5] years) who met autism spectrum criteria on the Autism Diagnostic Interview-Revised and the Autism Diagnostic Observation Schedule and who had a clinical diagnosis of an autism spectrum disorder. Best-estimate clinical diagnoses predicted by standardized scores from diagnostic, cognitive, and behavioral measures. Although distributions of scores on standardized measures were similar across sites, significant site differences emerged in best-estimate clinical diagnoses of specific autism spectrum disorders. Relationships between clinical diagnoses and standardized scores, particularly verbal IQ, language level, and core diagnostic features, varied across sites in weighting of information and cutoffs. Clinical distinctions among categorical diagnostic subtypes of autism spectrum disorders were not reliable even across sites with well-documented fidelity using standardized diagnostic instruments. Results support the move from existing subgroupings of autism spectrum disorders to dimensional descriptions of core features of social affect and fixated, repetitive behaviors

  16. Assessing the utility of diagnostic criteria: a multisite study on gender identity disorder.

    Science.gov (United States)

    Paap, Muirne C S; Kreukels, Baudewijntje P C; Cohen-Kettenis, Peggy T; Richter-Appelt, Hertha; de Cuypere, Griet; Haraldsen, Ira R

    2011-01-01

    Studies involving patients with gender identity disorder (GID) are inconsistent with regard to outcomes and often difficult to compare because of the vague descriptions of the diagnostic process. A multisite study is needed to scrutinize the utility and generality of different aspects of the diagnostic criteria for GID. To investigate the way in which the diagnosis-specific Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision criteria for GID were used to reach a psychiatric diagnosis in four European countries: the Netherlands (Amsterdam), Norway (Oslo), Germany (Hamburg), and Belgium (Ghent). The main goal was to compare item (symptom) characteristics across countries. The current study included all new applicants to the four GID clinics who were seen between January 2007 and March 2009, were at least 16 years of age at their first visit, and had completed the diagnostic assessment (N = 214, mean age = 32 ± 12.2 years). Mokken scale analysis, a form of Nonparametric Item Response Theory (NIRT) was performed. Operationalization and quantification of the core criteria A and B resulted in a 23-item score sheet that was filled out by the participating clinicians after they had made a diagnosis. We found that, when ordering the 23 items according to their means for each country separately, the rank ordering was similar among the four countries for 21 of the items. Furthermore, only one scale emerged, which combined criteria A and B when all data were analyzed together. Our results indicate that patients' symptoms were interpreted in a similar fashion in all four countries. However, we did not find support for the treatment of A and B as two separate criteria. We recommend the use of NIRT in future studies, especially in studies with small sample sizes and/or with data that show a poor fit to parametric IRT models. © 2010 International Society for Sexual Medicine.

  17. A MULTI-SITE CAMPAIGN TO MEASURE SOLAR-LIKE OSCILLATIONS IN PROCYON. II. MODE FREQUENCIES

    International Nuclear Information System (INIS)

    Bedding, Timothy R.; Bruntt, Hans; Kiss, Laszlo L.; Kjeldsen, Hans; Campante, Tiago L.; Appourchaux, Thierry; Bonanno, Alfio; Chaplin, William J.; Garcia, Rafael A.; Martic, Milena; Mosser, Benoit; Butler, R. Paul; O'Toole, Simon J.; Kambe, Eiji; Izumiura, Hideyuki; Ando, Hiroyasu; Sato, Bun'ei; Hartmann, Michael; Hatzes, Artie

    2010-01-01

    We have analyzed data from a multi-site campaign to observe oscillations in the F5 star Procyon. The data consist of high-precision velocities that we obtained over more than three weeks with 11 telescopes. A new method for adjusting the data weights allows us to suppress the sidelobes in the power spectrum. Stacking the power spectrum in a so-called echelle diagram reveals two clear ridges, which we identify with even and odd values of the angular degree (l = 0 and 2, and l = 1 and 3, respectively). We interpret a strong, narrow peak at 446 μHz that lies close to the l = 1 ridge as a mode with mixed character. We show that the frequencies of the ridge centroids and their separations are useful diagnostics for asteroseismology. In particular, variations in the large separation appear to indicate a glitch in the sound-speed profile at an acoustic depth of ∼1000 s. We list frequencies for 55 modes extracted from the data spanning 20 radial orders, a range comparable to the best solar data, which will provide valuable constraints for theoretical models. A preliminary comparison with published models shows that the offset between observed and calculated frequencies for the radial modes is very different for Procyon than for the Sun and other cool stars. We find the mean lifetime of the modes in Procyon to be 1.29 +0.55 -0.49 days, which is significantly shorter than the 2-4 days seen in the Sun.

  18. Increased mortality among Indigenous persons in a multisite cohort of people living with HIV in Canada.

    Science.gov (United States)

    Benoit, Anita C; Younger, Jaime; Beaver, Kerrigan; Jackson, Randy; Loutfy, Mona; Masching, Renée; Nobis, Tony; Nowgesic, Earl; O'Brien-Teengs, Doe; Whitebird, Wanda; Zoccole, Art; Hull, Mark; Jaworsky, Denise; Benson, Elizabeth; Rachlis, Anita; Rourke, Sean B; Burchell, Ann N; Cooper, Curtis; Hogg, Robert S; Klein, Marina B; Machouf, Nima; Montaner, Julio S G; Tsoukas, Chris; Raboud, Janet

    2017-06-16

    Compare all-cause mortality between Indigenous participants and participants of other ethnicities living with HIV initiating combination antiretroviral therapy (cART) in an interprovincial multi-site cohort. The Canadian Observational Cohort is a collaboration of 8 cohorts of treatment-naïve persons with HIV initiating cART after January 1, 2000. Participants were followed from the cART initiation date until death or last viral load (VL) test date on or before December 31, 2012. Cox proportional hazard models were used to estimate the effect of ethnicity on time until death after adjusting for age, gender, injection drug use, being a man who has sex with men, hepatitis C, province of origin, baseline VL and CD4 count, year of cART initiation and class of antiretroviral medication. The study sample consisted of 7080 participants (497 Indigenous, 2471 Caucasian, 787 African/Caribbean/Black (ACB), 629 other, and 2696 unknown ethnicity). Most Indigenous persons were from British Columbia (BC) (83%), with smaller numbers from Ontario (13%) and Québec (4%). During the study period, 714 (10%) participants died. The five-year survival probability was lower for Indigenous persons (0.77) than for Caucasian (0.94), ACB (0.98), other ethnicities (0.96) and unknown ethnicities (0.85) (p < 0.0001). In an adjusted proportional hazard model for which missing data were imputed, Indigenous persons were more likely to die than Caucasian participants (hazard ratio = 2.69, p < 0.0001). The mortality rate for Indigenous persons was higher than for other ethnicities and is largely reflective of the BC population. Addressing treatment challenges and identifying HIV- and non-HIV-related causes for mortality among Indigenous persons is required to optimize their clinical management.

  19. Randomized Multi-site Trial of the Job Seekers’ Workshop in Patients with Substance Use Disorders

    Science.gov (United States)

    Svikis, Dace S.; Keyser-Marcus, Lori; Stitzer, Maxine; Rieckmann, Traci; Safford, Lauretta; Loeb, Peter; Allen, Tim; Luna-Anderson, Carol; Back, Sudie E.; Cohen, Judith; DeBernardi, Michael A.; Dillard, Bruce; Forcehimes, Alyssa; Jaffee, William; Killeen, Therese; Kolodner, Ken; Levy, Michael; Pallas, Diane; Perl, Harold I.; Potter, Jennifer Sharpe; Provost, Scott; Reese, Karen; Sampson, Royce R.; Sepulveda, Allison; Snead, Ned; Wong, Conrad J.; Zweben, Joan

    2012-01-01

    Background Unemployment is associated with negative outcomes both during and after drug abuse treatment. Interventions designed to increase rates of employment may also improve drug abuse treatment outcomes. The purpose of this multi-site clinical trial was to evaluate the Job Seekers’ Workshop (JSW), a three session, manualized program designed to train patients in the skills needed to find and secure a job. Method Study participants were recruited through the NIDA Clinical Trials Network (CTN) from six psychosocial counseling (n=327) and five methadone maintenance (n=301) drug treatment programs. Participants were randomly assigned to either standard care (program-specific services plus brochure with local employment resources) (SC) or standard care plus JSW. Three 4-hr small group JSW sessions were offered weekly by trained JSW facilitators with ongoing fidelity monitoring. Results JSW and SC participants had similar 12- and 24-week results for the primary outcome measure (i.e., obtaining a new taxed job or enrollment in a training program), Specifically, one-fifth of participants at 12 weeks (20.1 – 24.3%) and nearly one-third at 24 weeks (31.4–31.9%) had positive outcomes, with “obtaining a new taxed job” accounting for the majority of cases. Conclusion JSW group participants did not have higher rates of employment/training than SC controls. Rates of job acquisition were modest for both groups, suggesting more intensive interventions may be needed. Alternate targets (e.g., enhancing patient motivation, training in job-specific skills) warrant further study as well. PMID:21802222

  20. Extraction and characterization of essential discharge patterns from multisite recordings of spiking ongoing activity.

    Directory of Open Access Journals (Sweden)

    Riccardo Storchi

    oscillations with multisite discharge patterns.

  1. A multi-site study on medical school selection, performance, motivation and engagement.

    Science.gov (United States)

    Wouters, A; Croiset, G; Schripsema, N R; Cohen-Schotanus, J; Spaai, G W G; Hulsman, R L; Kusurkar, R A

    2017-05-01

    Medical schools seek ways to improve their admissions strategies, since the available methods prove to be suboptimal for selecting the best and most motivated students. In this multi-site cross-sectional questionnaire study, we examined the value of (different) selection procedures compared to a weighted lottery procedure, which includes direct admission based on top pre-university grade point averages (≥8 out of 10; top-pu-GPA). We also considered whether students had participated in selection, prior to being admitted through weighted lottery. Year-1 (pre-clinical) and Year-4 (clinical) students completed standard validated questionnaires measuring quality of motivation (Academic Self-regulation Questionnaire), strength of motivation (Strength of Motivation for Medical School-Revised) and engagement (Utrecht Work Engagement Scale-Student). Performance data comprised GPA and course credits in Year-1 and clerkship performance in Year-4. Regression analyses were performed. The response rate was 35% (387 Year-1 and 273 Year-4 students). Top-pu-GPA students outperformed selected students. Selected Year-1 students reported higher strength of motivation than top-pu-GPA students. Selected students did not outperform or show better quality of motivation and engagement than lottery-admitted students. Participation in selection was associated with higher engagement and better clerkship performance in Year-4. GPA, course credits and strength of motivation in Year-1 differed between students admitted through different selection procedures. Top-pu-GPA students perform best in the medical study. The few and small differences found raise questions about the added value of an extensive selection procedure compared to a weighted lottery procedure. Findings have to be interpreted with caution because of a low response rate and small group sizes.

  2. Good work ability despite multisite musculoskeletal pain? A study among occupationally active Finns.

    Science.gov (United States)

    Pensola, Tiina; Haukka, Eija; Kaila-Kangas, Leena; Neupane, Subas; Leino-Arjas, Päivi

    2016-05-01

    Although multisite pain (MSP) often threatens work ability (WA), some of those with MSP retain good WA. Our aim was to identify factors associated with good WA among subjects with MSP. A nationally representative sample (the Health 2000-Study, response rate 87%) comprising 3884 occupationally active Finns aged 30-64 years. Data on WA, musculoskeletal pain, physical and psychosocial working conditions, chronic diseases, lifestyle and domestic situation were gathered by questionnaire, interview and clinical examination. Good current WA compared with the lifetime best was defined as ⩾9 on a 0-10 scale. Musculoskeletal pain in 18 body locations was combined into four sites, and thereafter pain in two or more sites was defined as MSP (N=1351). Poisson regression analysis was used to obtain prevalence rate ratios (PRR). Good WA was reported by 48% of the women and 37% of the men with MSP. In a multivariable model good WA was associated with younger age, female gender, physically non-strenuous work (PRR 1.3, 95% CI 1.1-1.5), low job strain (1.2, 1.0-1.4), high supervisor support (1.2, 1.0-1.4), and not having musculoskeletal diseases (1.3, 1.1-1.5), mental disorders (1.4, 1.1-1.9), daytime tiredness (1.4, 1.2-1.7) or economic troubles (1.5, 1.1-1.9). Age-stratified analyses revealed also associations with high coworker support (1.2, 1.0-1.4) and strenuous leisure-time physical exercise (1.2, 1.0-1.4) in those aged 30-44 and low alcohol consumption (1.8, 1.2-2.6) in the age-group 45-64. Several potentially modifiable factors related to health, work, and lifestyle were associated with good WA among occupationally active subjects with MSP. © 2015 the Nordic Societies of Public Health.

  3. Deficient prepulse inhibition in schizophrenia detected by the multi-site COGS.

    Science.gov (United States)

    Swerdlow, Neal R; Light, Gregory A; Sprock, Joyce; Calkins, Monica E; Green, Michael F; Greenwood, Tiffany A; Gur, Raquel E; Gur, Ruben C; Lazzeroni, Laura C; Nuechterlein, Keith H; Radant, Allen D; Ray, Amrita; Seidman, Larry J; Siever, Larry J; Silverman, Jeremy M; Stone, William S; Sugar, Catherine A; Tsuang, Debby W; Tsuang, Ming T; Turetsky, Bruce I; Braff, David L

    2014-02-01

    Startle inhibition by weak prepulses (PPI) is studied to understand the biology of information processing in schizophrenia patients and healthy comparison subjects (HCS). The Consortium on the Genetics of Schizophrenia (COGS) identified associations between PPI and single nucleotide polymorphisms in schizophrenia probands and unaffected relatives, and linkage analyses extended evidence for the genetics of PPI deficits in schizophrenia in the COGS-1 family study. These findings are being extended in a 5-site "COGS-2" study of 1800 patients and 1200 unrelated HCS to facilitate genetic analyses. We describe a planned interim analysis of COGS-2 PPI data. Eyeblink startle was measured in carefully screened HCS and schizophrenia patients (n=1402). Planned analyses of PPI (60 ms intervals) assessed effects of diagnosis, sex and test site, PPI-modifying effects of medications and smoking, and relationships between PPI and neurocognitive measures. 884 subjects met strict inclusion criteria. ANOVA of PPI revealed significant effects of diagnosis (p=0.0005) and sex (pschizophrenia PPI differences were greatest among patients not taking 2nd generation antipsychotics, and were independent of smoking status. Modest but significant relationships were detected between PPI and performance in specific neurocognitive measures. The COGS-2 multi-site study detects schizophrenia-related PPI deficits reported in single-site studies, including patterns related to diagnosis, prepulse interval, sex, medication and other neurocognitive measures. Site differences were detected and explored. The target COGS-2 schizophrenia "endophenotype" of reduced PPI should prove valuable for identifying and confirming schizophrenia risk genes in future analyses. Copyright © 2013 Elsevier B.V. All rights reserved.

  4. Identifying Patterns in Implementation of Hospital Pressure Ulcer Prevention Programs: A Multisite Qualitative Study.

    Science.gov (United States)

    Soban, Lynn M; Finley, Erin P; Miltner, Rebecca S

    2016-01-01

    To describe the presence or absence of key components of hospital pressure ulcer (PU) prevention programs in 6 acute care hospitals. Multisite comparative case study. Using purposeful selection based on PU rates (high vs low) and hospital size, 6 hospitals within the Veterans Health Administration health care system were invited to participate. Key informant interviews (n = 48) were conducted in each of the 6 participating hospitals among individuals playing key roles in PU prevention: senior nursing leadership (n = 9), nurse manager (n = 7), wound care specialist (n = 6), frontline RNs (n = 26). Qualitative data were collected during face-to-face, semistructured interviews. Interview protocols were tailored to each interviewee's role with a core set of common questions covering 3 major content areas: (1) practice environment (eg, policies and wound care specialists), (2) current prevention practices (eg, conduct of PU risk assessment and skin inspection), and (3) barriers to PU prevention. We conducted structured coding of 5 key components of PU prevention programs and cross-case analysis to identify patterns in operationalization and implementation of program components across hospitals based on facility size and PU rates (low vs high). All hospitals had implemented all PU prevention program components. Component operationalization varied considerably across hospitals. Wound care specialists were integral to the operationalization of the 4 other program components examined; however, staffing levels and work assignments of wound care specialists varied widely. Patterns emerged among hospitals with low and high PU rates with respect to wound care specialist staffing, data monitoring, and staff education. We found hospital-level variations in PU prevention programs. Wound care specialist staffing may represent a potential point of leverage in achieving other PU program components, particularly performance monitoring and staff education.

  5. Constraints on eQTL Fine Mapping in the Presence of Multisite Local Regulation of Gene Expression

    Directory of Open Access Journals (Sweden)

    Biao Zeng

    2017-08-01

    Full Text Available Expression quantitative trait locus (eQTL detection has emerged as an important tool for unraveling of the relationship between genetic risk factors and disease or clinical phenotypes. Most studies use single marker linear regression to discover primary signals, followed by sequential conditional modeling to detect secondary genetic variants affecting gene expression. However, this approach assumes that functional variants are sparsely distributed and that close linkage between them has little impact on estimation of their precise location and the magnitude of effects. We describe a series of simulation studies designed to evaluate the impact of linkage disequilibrium (LD on the fine mapping of causal variants with typical eQTL effect sizes. In the presence of multisite regulation, even though between 80 and 90% of modeled eSNPs associate with normally distributed traits, up to 10% of all secondary signals could be statistical artifacts, and at least 5% but up to one-quarter of credible intervals of SNPs within r2 > 0.8 of the peak may not even include a causal site. The Bayesian methods eCAVIAR and DAP (Deterministic Approximation of Posteriors provide only modest improvement in resolution. Given the strong empirical evidence that gene expression is commonly regulated by more than one variant, we conclude that the fine mapping of causal variants needs to be adjusted for multisite influences, as conditional estimates can be highly biased by interference among linked sites, but ultimately experimental verification of individual effects is needed. Presumably similar conclusions apply not just to eQTL mapping, but to multisite influences on fine mapping of most types of quantitative trait.

  6. The effect of simulation courseware on critical thinking in undergraduate nursing students: multi-site pre-post study.

    Science.gov (United States)

    Shin, Hyunsook; Ma, Hyunhee; Park, Jiyoung; Ji, Eun Sun; Kim, Dong Hee

    2015-04-01

    The use of simulations has been considered as opportunities for students to enhance their critical thinking (CT), but previous studies were limited because they did not provide in-depth information on the working dynamics of simulation or on the effects of the number of simulation exposures on CT. This study examined the effect of an integrated pediatric nursing simulation used in a nursing practicum on students' CT abilities and identified the effects of differing numbers of simulation exposures on CT in a multi-site environment. The study used a multi-site, pre-test, post-test design. A total of 237 nursing students at three universities enrolled in a pediatric practicum participated in this study from February to December 2013. All three schools used the same simulation courseware, including the same simulation scenarios, evaluation tools, and simulation equipment. The courseware incorporated high-fidelity simulators and standardized patients. Students at school A completed one simulation session, whereas students at schools B and C completed two and three simulation sessions, respectively. Yoon's Critical Thinking Disposition tool (2008) was used to measure students' CT abilities. The gains in students' CT scores varied according to their numbers of exposures to the simulation courseware. With a single exposure, there were no statistically significant gains in CT, whereas three exposures to the courseware produced significant gains in CT. In seven subcategories of critical thinking, three exposures to the simulation courseware produced CT gains in the prudence and intellectual eagerness subcategories, and the overall simulation experience produced CT gains in the prudence, systematicity, healthy skepticism, and intellectual eagerness subcategories. Simulation courseware may produce positive learning outcomes for prudence in nursing education. In addition, the findings from the multi-site comparative study may contribute to greater understanding of how patient

  7. Unveiling a novel transient druggable pocket in BACE-1 through molecular simulations: Conformational analysis and binding mode of multisite inhibitors

    Science.gov (United States)

    Di Pietro, Ornella; Laughton, Charles A.

    2017-01-01

    The critical role of BACE-1 in the formation of neurotoxic ß-amyloid peptides in the brain makes it an attractive target for an efficacious treatment of Alzheimer’s disease. However, the development of clinically useful BACE-1 inhibitors has proven to be extremely challenging. In this study we examine the binding mode of a novel potent inhibitor (compound 1, with IC50 80 nM) designed by synergistic combination of two fragments—huprine and rhein—that individually are endowed with very low activity against BACE-1. Examination of crystal structures reveals no appropriate binding site large enough to accommodate 1. Therefore we have examined the conformational flexibility of BACE-1 through extended molecular dynamics simulations, paying attention to the highly flexible region shaped by loops 8–14, 154–169 and 307–318. The analysis of the protein dynamics, together with studies of pocket druggability, has allowed us to detect the transient formation of a secondary binding site, which contains Arg307 as a key residue for the interaction with small molecules, at the edge of the catalytic cleft. The formation of this druggable “floppy” pocket would enable the binding of multisite inhibitors targeting both catalytic and secondary sites. Molecular dynamics simulations of BACE-1 bound to huprine-rhein hybrid compounds support the feasibility of this hypothesis. The results provide a basis to explain the high inhibitory potency of the two enantiomeric forms of 1, together with the large dependence on the length of the oligomethylenic linker. Furthermore, the multisite hypothesis has allowed us to rationalize the inhibitory potency of a series of tacrine-chromene hybrid compounds, specifically regarding the apparent lack of sensitivity of the inhibition constant to the chemical modifications introduced in the chromene unit. Overall, these findings pave the way for the exploration of novel functionalities in the design of optimized BACE-1 multisite inhibitors

  8. Safety and Clinical Activity of Pembrolizumab and Multisite Stereotactic Body Radiotherapy in Patients With Advanced Solid Tumors.

    Science.gov (United States)

    Luke, Jason J; Lemons, Jeffrey M; Karrison, Theodore G; Pitroda, Sean P; Melotek, James M; Zha, Yuanyuan; Al-Hallaq, Hania A; Arina, Ainhoa; Khodarev, Nikolai N; Janisch, Linda; Chang, Paul; Patel, Jyoti D; Fleming, Gini F; Moroney, John; Sharma, Manish R; White, Julia R; Ratain, Mark J; Gajewski, Thomas F; Weichselbaum, Ralph R; Chmura, Steven J

    2018-02-13

    Purpose Stereotactic body radiotherapy (SBRT) may stimulate innate and adaptive immunity to augment immunotherapy response. Multisite SBRT is an emerging paradigm for treating metastatic disease. Anti-PD-1-treatment outcomes may be improved with lower disease burden. In this context, we conducted a phase I study to evaluate the safety of pembrolizumab with multisite SBRT in patients with metastatic solid tumors. Patients and Methods Patients progressing on standard treatment received SBRT to two to four metastases. Not all metastases were targeted, and metastases > 65 mL were partially irradiated. SBRT dosing varied by site and ranged from 30 to 50 Gy in three to five fractions with predefined dose de-escalation if excess dose-limiting toxicities were observed. Pembrolizumab was initiated within 7 days after completion of SBRT. Pre- and post-SBRT biopsy specimens were analyzed in a subset of patients to quantify interferon-γ-induced gene expression. Results A total of 79 patients were enrolled; three patients did not receive any treatment and three patients only received SBRT. Patients included in the analysis were treated with SBRT and at least one cycle of pembrolizumab. Most (94.5%) of patients received SBRT to two metastases. Median follow-up for toxicity was 5.5 months (interquartile range, 3.3 to 8.1 months). Six patients experienced dose-limiting toxicities with no radiation dose reductions. In the 68 patients with imaging follow-up, the overall objective response rate was 13.2%. Median overall survival was 9.6 months (95% CI, 6.5 months to undetermined) and median progression-free survival was 3.1 months (95% CI, 2.9 to 3.4 months). Expression of interferon-γ-associated genes from post-SBRT tumor biopsy specimens significantly correlated with nonirradiated tumor response. Conclusion Multisite SBRT followed by pembrolizumab was well tolerated with acceptable toxicity. Additional studies exploring the clinical benefit and predictive biomarkers of combined

  9. Increasing STEM Exposure in K–5 Schools Through MakerSpace Use: A Multi-Site Early Success Case Study

    OpenAIRE

    Ortega, Veronica Inez

    2017-01-01

    Using Brinkerhoff’s success case methodology, this multi-site case study examined early models of MakerSpace implementation in K–5 schools in a single district. Specifically, this study examined the early use of MakerSpaces as well as the supports and barriers affecting teacher use of these spaces. The study also examined curricular connections and MakerSpace use as a conduit for purveying instruction in the soon-to-be-implemented Next Generation Science Standards. The findings of this stud...

  10. Biological Stress Systems, Adverse Life Events, and the Improvement of Chronic Multisite Musculoskeletal Pain Across a 6-Year Follow-Up.

    Science.gov (United States)

    Generaal, Ellen; Vogelzangs, Nicole; Macfarlane, Gary J; Geenen, Rinie; Smit, Johannes H; de Geus, Eco J C N; Dekker, Joost; Penninx, Brenda W J H

    2017-02-01

    Dysfunction of biological stress systems and adverse life events, independently and in interaction, have been hypothesized to predict chronic pain persistence. Conversely, these factors may hamper the improvement of chronic pain. Longitudinal evidence is currently lacking. We examined whether: 1) function of biological stress systems, 2) adverse life events, and 3) their combination predict the improvement of chronic multisite musculoskeletal pain. Subjects of the Netherlands Study of Depression and Anxiety (NESDA) with chronic multisite musculoskeletal pain at baseline (N = 665) were followed-up 2, 4, and 6 years later. The Chronic Pain Grade Questionnaire was used to determine improvement (not meeting the criteria) of chronic multisite musculoskeletal pain at follow-up. Baseline assessment of biological stress systems included function of hypothalamic-pituitary-adrenal axis (1-hour cortisol awakening response, evening level, and post dexamethasone level), the immune system (basal and lipopolysaccharide-stimulated inflammatory markers), the autonomic nervous system (heart rate, pre-ejection period, SD of the normal-to-normal interval, and respiratory sinus arrhythmia). The number of adverse life events were assessed at baseline and 2-year follow-up using the List of Threatening Events Questionnaire. We showed that hypothalamic-pituitary-adrenal axis, immune system, and autonomic nervous system functioning and adverse life events were not associated with the improvement of chronic multisite musculoskeletal pain, either as a main effect or in interaction. This longitudinal study could not confirm that biological stress system dysfunction and adverse life events affect the course of chronic multisite musculoskeletal pain. Biological stress systems and adverse life events are not associated with the improvement of chronic multisite musculoskeletal pain over 6 years of follow-up. Other determinants should thus be considered in future research to identify in which

  11. Evaluation of a multi-site program designed to strengthen relational bonds for siblings separated by foster care.

    Science.gov (United States)

    Waid, Jeffrey; Wojciak, Armeda Stevenson

    2017-10-01

    Sibling relationships in foster care settings have received increased attention in recent years. Despite growing evidence regarding the protective potential of sibling relationships for youth in care, some sibling groups continue to experience foster care related separation, and few programs exist to address the needs of these youth. This study describes and evaluates Camp To Belong, a multi-site program designed to provide short-term reunification to separated sibling groups through a week-long summer camp experience. Using a pre-test post-test survey design, this paper examines changes in youth ratings of sibling conflict and sibling support across camps located in six geographically distinct regions of the United States. The effects of youth age, number of prior camp exposures, and camp location were tested using multilevel modeling procedures. Findings suggest that participation in Camp To Belong may reduce sibling conflict, and improvements in sibling support are noted for youth who have had prior exposure to the camp's programming. Camp-level variance in the sibling support outcome highlight the complex nature of relationships for siblings separated by foster care, and suggest the need for additional research. Lessons learned from this multi-site evaluation and future directions are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Facebook as a tool for communication, collaboration, and informal knowledge exchange among members of a multisite family health team.

    Science.gov (United States)

    Lofters, Aisha K; Slater, Morgan B; Nicholas Angl, Emily; Leung, Fok-Han

    2016-01-01

    To implement and evaluate a private Facebook group for members of a large Ontario multisite Family Health Team (FHT) to facilitate improved communication and collaboration. Program implementation and subsequent survey of team members. A large multisite FHT in Toronto, Ontario. Health professionals of the FHT. Usage patterns and self-reported perceptions of the Facebook group by team members. At the time of the evaluation survey, the Facebook group had 43 members (37.4% of all FHT members). Activity in the group was never high, and posts by team members who were not among the researchers were infrequent throughout the study period. The content of posts fell into two broad categories: 1) information that might be useful to various team members and 2) questions posed by team members that others might be able to answer. Of the 26 team members (22.6%) who completed the evaluation survey, many reported that they never logged into the Facebook page (16 respondents), and never used it to communicate with team members outside of their own site of practice (19 respondents). Only six respondents reported no concerns with using Facebook as a professional communication tool; the most frequent concerns were regarding personal and patient privacy. The use of social media by health care practitioners is becoming ubiquitous. However, the issues of privacy concerns and determining how to use social media without adding to provider workload must be addressed to make it a useful tool in health care.

  13. Valor predictivo de algunos exámenes de laboratorio clínico en la infección neonatal bacteriana precoz Prognostic value of some clinical laboratory examinations related to an early bacterial neonatal infection

    Directory of Open Access Journals (Sweden)

    Tania Roig Álvarez

    2009-06-01

    Full Text Available INTRODUCCIÓN. El diagnóstico microbiológico de la infección neonatal de inicio precoz es complejo. En la mayoría de los recién nacidos se inicia el tratamiento ante la sospecha clínica y la positividad de algunos reactantes de fase aguda y el hemograma. MÉTODOS. Se analizó el valor predictivo utilizando como método de referencia el hemocultivo periférico o el hallazgo anatomopatológico de infección de algunos exámenes de laboratorio clínico de forma aislada. El estudio se realizó en el total de los casos, 32 neonatos con infección de inicio precoz probada y probable, y por localización de la infección. RESULTADOS. Ni la proteína C-reactiva positiva ni las alteraciones de los leucocitos totales fueron buenos predictores de sepsis de inicio precoz de cualquier localización. La trombocitopenia impresionó ser un marcador competente pero no resultó así al calcular el intervalo de confianza al 95 %. Al excluir la localización pulmonar, la proteína C-reactiva positiva se convirtió en un marcador competente. Ninguno de los neonatos con infección pulmonar probada tuvo resultados positivos en los exámenes clínicos realizados. CONCLUSIONES. No se cuenta de momento con ninguna prueba de laboratorio clínico capaz de predecir con certeza la presencia de infección de inicio precoz de cualquier localización. La proteína C-reactiva cualitativa es un marcador competente de infección precoz del torrente sanguíneo y de meninges en los neonatos.INTRODUCTION: Microbiological diagnosis of neonatal infection of early onset is complex. In most of newborns diagnosis is started if there is a clinical suspicion and the positivity of some acute-phase reactants and the hemogran. METHODS: Prognostic value was analyzed using as reference method the peripheral hemoculture or the pathological anatomy findings of infection in some of clinical laboratory examinations in an isolated way. Study was performed in all the cases, in 32 neonates

  14. Improving pain care through implementation of the Stepped Care Model at a multisite community health center

    Directory of Open Access Journals (Sweden)

    Anderson DR

    2016-11-01

    Full Text Available Daren R Anderson,1 Ianita Zlateva,1 Emil N Coman,2 Khushbu Khatri,1 Terrence Tian,1 Robert D Kerns3 1Weitzman Institute, Community Health Center, Inc., Middletown, 2UCONN Health Disparities Institute, University of Connecticut, Farmington, 3VA Connecticut Healthcare System, West Haven, CT, USA Purpose: Treating pain in primary care is challenging. Primary care providers (PCPs receive limited training in pain care and express low confidence in their knowledge and ability to manage pain effectively. Models to improve pain outcomes have been developed, but not formally implemented in safety net practices where pain is particularly common. This study evaluated the impact of implementing the Stepped Care Model for Pain Management (SCM-PM at a large, multisite Federally Qualified Health Center. Methods: The Promoting Action on Research Implementation in Health Services framework guided the implementation of the SCM-PM. The multicomponent intervention included: education on pain care, new protocols for pain assessment and management, implementation of an opioid management dashboard, telehealth consultations, and enhanced onsite specialty resources. Participants included 25 PCPs and their patients with chronic pain (3,357 preintervention and 4,385 postintervention cared for at Community Health Center, Inc. Data were collected from the electronic health record and supplemented by chart reviews. Surveys were administered to PCPs to assess knowledge, attitudes, and confidence. Results: Providers’ pain knowledge scores increased to an average of 11% from baseline; self-rated confidence in ability to manage pain also increased. Use of opioid treatment agreements and urine drug screens increased significantly by 27.3% and 22.6%, respectively. Significant improvements were also noted in documentation of pain, pain treatment, and pain follow-up. Referrals to behavioral health providers for patients with pain increased by 5.96% (P=0.009. There was no

  15. Brief interventions to reduce Ecstasy use: a multi-site randomized controlled trial.

    Science.gov (United States)

    Norberg, Melissa M; Hides, Leanne; Olivier, Jake; Khawar, Laila; McKetin, Rebecca; Copeland, Jan

    2014-11-01

    Studies examining the ability of motivational enhancement therapy (MET) to augment education provision among ecstasy users have produced mixed results and none have examined whether treatment fidelity was related to ecstasy use outcomes. The primary objectives of this multi-site, parallel, two-group randomized controlled trial were to determine if a single-session of MET could instill greater commitment to change and reduce ecstasy use and related problems more so than an education-only intervention and whether MET sessions delivered with higher treatment fidelity are associated with better outcomes. The secondary objective was to assess participants' satisfaction with their assigned interventions. Participants (N=174; Mage=23.62) at two Australian universities were allocated randomly to receive a 15-minute educational session on ecstasy use (n=85) or a 50-minute session of MET that included an educational component (n=89). Primary outcomes were assessed at baseline, and then at 4-, 16-, and 24-weeks postbaseline, while the secondary outcome measure was assessed 4-weeks postbaseline by researchers blind to treatment allocation. Overall, the treatment fidelity was acceptable to good in the MET condition. There were no statistical differences at follow-up between the groups on the primary outcomes of ecstasy use, ecstasy-related problems, and commitment to change. Both intervention groups reported a 50% reduction in their ecstasy use and a 20% reduction in the severity of their ecstasy-related problems at the 24-week follow up. Commitment to change slightly improved for both groups (9%-17%). Despite the lack of between-group statistical differences on primary outcomes, participants who received a single session of MET were slightly more satisfied with their intervention than those who received education only. MI fidelity was not associated with ecstasy use outcomes. Given these findings, future research should focus on examining mechanisms of change. Such work may

  16. Introduction of shared electronic records: multi-site case study using diffusion of innovation theory.

    Science.gov (United States)

    Greenhalgh, Trisha; Stramer, Katja; Bratan, Tanja; Byrne, Emma; Mohammad, Yara; Russell, Jill

    2008-10-23

    To explore the introduction of a centrally stored, shared electronic patient record (the summary care record (SCR)) in England and draw wider lessons about the implementation of large scale information technology projects in health care. Multi-site, mixed method case study applying utilisation focused evaluation. Four early adopter sites for the SCR in England-three in urban areas of relative socioeconomic deprivation and the fourth in a relatively affluent rural area. Data sources and analysis Data included 250 staff interviews, 1500 hours of ethnographic observation, interviews and focus groups with 170 patients and carers, 2500 pages of correspondence and documentary evidence, and incorporation of relevant surveys and statistics produced by others. These were analysed by using a thematic approach drawing on (and extending) a theoretical model of complex change developed in a previous systematic review. Main findings The mixed fortunes of the SCR programme in its first year were largely explained by eight interacting influences. The first was the SCR's material properties (especially technical immaturity and lack of interoperability) and attributes (especially the extent to which potential adopters believed the benefits outweighed the risks). The second was adopters' concerns (especially about workload and the ethicality of sharing "confidential" information on an implied consent model). The third influence was interpersonal influence (for example, opinion leaders, champions, facilitators), and the fourth was organisational antecedents for innovation (for example past experience with information technology projects, leadership and management capacity, effective data capture systems, slack resources). The fifth was organisational readiness for the SCR (for example, innovation-system fit, tension for change, power balances between supporters and opponents, baseline data quality). The sixth was the implementation process (including the nature of the change model and

  17. Enhancing evidence informed policymaking in complex health systems: lessons from multi-site collaborative approaches.

    Science.gov (United States)

    Langlois, Etienne V; Becerril Montekio, Victor; Young, Taryn; Song, Kayla; Alcalde-Rabanal, Jacqueline; Tran, Nhan

    2016-03-17

    There is an increasing interest worldwide to ensure evidence-informed health policymaking as a means to improve health systems performance. There is a need to engage policymakers in collaborative approaches to generate and use knowledge in real world settings. To address this gap, we implemented two interventions based on iterative exchanges between researchers and policymakers/implementers. This article aims to reflect on the implementation and impact of these multi-site evidence-to-policy approaches implemented in low-resource settings. The first approach was implemented in Mexico and Nicaragua and focused on implementation research facilitated by communities of practice (CoP) among maternal health stakeholders. We conducted a process evaluation of the CoPs and assessed the professionals' abilities to acquire, analyse, adapt and apply research. The second approach, called the Policy BUilding Demand for evidence in Decision making through Interaction and Enhancing Skills (Policy BUDDIES), was implemented in South Africa and Cameroon. The intervention put forth a 'buddying' process to enhance demand and use of systematic reviews by sub-national policymakers. The Policy BUDDIES initiative was assessed using a mixed-methods realist evaluation design. In Mexico, the implementation research supported by CoPs triggered monitoring by local health organizations of the quality of maternal healthcare programs. Health programme personnel involved in CoPs in Mexico and Nicaragua reported improved capacities to identify and use evidence in solving implementation problems. In South Africa, Policy BUDDIES informed a policy framework for medication adherence for chronic diseases, including both HIV and non-communicable diseases. Policymakers engaged in the buddying process reported an enhanced recognition of the value of research, and greater demand for policy-relevant knowledge. The collaborative evidence-to-policy approaches underline the importance of iterations and continuity

  18. Impact of Moving From a Widespread to Multisite Pain Definition on Other Fibromyalgia Symptoms.

    Science.gov (United States)

    Dean, Linda E; Arnold, Lesley; Crofford, Leslie; Bennett, Robert; Goldenberg, Don; Fitzcharles, Mary-Ann; Paiva, Eduardo S; Staud, Roland; Clauw, Dan; Sarzi-Puttini, Piercarlo; Jones, Gareth T; Ayorinde, Abimbola; Flüß, Elisa; Beasley, Marcus; Macfarlane, Gary J

    2017-12-01

    To investigate whether associations between pain and the additional symptoms associated with fibromyalgia are different in persons with chronic widespread pain (CWP) compared to multisite pain (MSP), with or without joint areas. Six studies were used: 1958 British birth cohort, Epidemiology of Functional Disorders, Kid Low Back Pain, Managing Unexplained Symptoms (Chronic Widespread Pain) in Primary Care: Involving Traditional and Accessible New Approaches, Study of Health and its Management, and Women's Health Study (WHEST; females). MSP was defined as the presence of pain in ≥8 body sites in adults (≥10 sites in children) indicated on 4-view body manikins, conducted first to include joints (positive joints) and second without (negative joints). The relationship between pain and fatigue, sleep disturbance, somatic symptoms, and mood impairment was assessed using logistic regression. Results are presented as odds ratios (ORs) with 95% confidence intervals (95% CIs). There were 34,818 participants across the study populations (adults age range 42-56 years, male 43-51% [excluding WHEST], and CWP prevalence 12-17%). Among those reporting MSP, the proportion reporting CWP ranged between 62% and 76%. Among those reporting the symptoms associated with fibromyalgia, there was an increased likelihood of reporting pain, the magnitude of which was similar regardless of the definition used. For example, within WHEST, reporting moderate/severe fatigue (Chalder fatigue scale 4-11) was associated with a >5-fold increase in likelihood of reporting pain (CWP OR 5.2 [95% CI 3.9-6.9], MSP-positive joints OR 6.5 [95% CI 5.0-8.6], and MSP-negative joints OR 6.5 [95% CI 4.7-9.0]). This large-scale study demonstrates that regardless of the pain definition used, the magnitude of association between pain and other associated symptoms of fibromyalgia is similar. This finding supports the continued collection of both when classifying fibromyalgia, but highlights the fact that pain may

  19. Bajo el signo de Licurgo: el reformismo atávico de Agis IV y Cleómenes III = Under the sign of Lycurgus: the atavistic reformism of Agis IV and Cleomenes III

    Directory of Open Access Journals (Sweden)

    César Fornis

    2016-04-01

    Full Text Available En el presente estudio se abordan los intentos de reforma en Esparta por los reyes Agis IV y Cleómenes III, que ambos, con finalidad legitimadora, presentaron como una recuperación atávica del kósmos (orden atribuido al legendario Licurgo, aquel que había formado ciudadanos virtuosos y sobre el que se había asentado el glorioso pasado de la ciudad. Se concluye que sus medidas no atacaron las raíces de los males que corroían la polis lacedemonia ni transformaron de modo significativo las vetustas estructuras sociales, políticas y económicas para adaptarlas a los nuevos tiempos, los del Helenismo.In this paper we analyze the attempts of reform of the Spartan state by the kings Agis IV and Cleomenes III. With legitimizing purpose, they presented them as an atavistic recovery of the kosmos (order ascribed to the legendary Lycurgus, which had formed to the citizens in moral virtues and which had settled the glorious past of the city. We conclude that these measures did not attack the roots of the evils corroding the Lacedaimonian polis or significantly transformed the old social, political and economic structures in order to adapt them to the new times, those of the Hellenism. 

  20. Effect of Sporosarcina Pasteurii on the strength properties of compressed earth specimens; Efecto de la Sporosarcina Pasteurii en las propiedades resistentes de especímenes de tierra comprimida

    Energy Technology Data Exchange (ETDEWEB)

    Bernat-Maso, E.; Gil, L.; Escrig, C.; Barbé, J.; Cortés, P.

    2018-04-01

    Microbial biodeposition of calcite induction for improving the performance of rammed earth is a research area that must be analysed in a representative environment. This analysis must consider the compaction force, particle size distribution and curing process as production variables. This paper investigates the effects of adding specific bacteria, Sporosarcina Pasteurii, into compressed earth cubes and the effect of production variables. Uniaxial compressive tests and direct shear tests have been conducted for 80 specimens. The results indicate that calcite precipitation interacts with the drying process of clay/silt resulting in reducing the compressive strength, the apparent cohesion and the friction angle. Finally, bacterial activity, which is more likely in samples cured in a high humidity environment, tends to reduce the dilatancy effect. [Spanish] Inducir la biodeposición microbiana de calcita para mejorar las prestaciones de la tapia es una líneade investigación que necesita ser analizada en condiciones representativas y teniendo en cuenta variables de producción como la fuerza de compactación, la granulometría o el curado a diferentes humedades. Se estudia el efecto de añadir Sporosarcina Pasteurii en cubos de tierra comprimida y la influencia de estas variables de producción. Se han realizado ensayos de compresión simple y corte directo sobre 80 especímenes producidos con dos niveles de compactación y dos granulometrías. Los resultados indican que la precipitación de calcita interactúa con el proceso de secado de los limos/arcillas dando como resultado una reducción de la resistencia a compresión, de la cohesión aparente y del ángulo de fricción. Finalmente, la actividad bacteriana, más probable en las muestras curadas en un entorno de alta humedad, tiende a reducir el efecto de la dilatancia.

  1. Replication and Comparison of the Newly Proposed ADOS-2, Module 4 Algorithm in ASD without ID: A Multi-Site Study

    Science.gov (United States)

    Pugliese, Cara E.; Kenworthy, Lauren; Bal, Vanessa Hus; Wallace, Gregory L.; Yerys, Benjamin E.; Maddox, Brenna B.; White, Susan W.; Popal, Haroon; Armour, Anna Chelsea; Miller, Judith; Herrington, John D.; Schultz, Robert T.; Martin, Alex; Anthony, Laura Gutermuth

    2015-01-01

    Recent updates have been proposed to the Autism Diagnostic Observation Schedule-2 Module 4 diagnostic algorithm. This new algorithm, however, has not yet been validated in an independent sample without intellectual disability (ID). This multi-site study compared the original and revised algorithms in individuals with ASD without ID. The revised…

  2. How Many Interviews Are Enough to Identify Metathemes in Multisited and Cross-Cultural Research? Another Perspective on Guest, Bunce, and Johnson's (2006) Landmark Study

    Science.gov (United States)

    Hagaman, Ashley K.; Wutich, Amber

    2017-01-01

    There is much debate over the number of interviews needed to reach data saturation for themes and metathemes in qualitative research. The primary purpose of this study is to determine the number of interviews needed to reach data saturation for metathemes in multisited and cross-cultural research. The analysis is based on a cross-cultural study on…

  3. Sensitivity of the Modified Children's Yale-Brown Obsessive Compulsive Scale to Detect Change: Results from Two Multi-Site Trials

    Science.gov (United States)

    Scahill, Lawrence; Sukhodolsky, Denis G.; Anderberg, Emily; Dimitropoulos, Anastasia; Dziura, James; Aman, Michael G.; McCracken, James; Tierney, Elaine; Hallett, Victoria; Katz, Karol; Vitiello, Benedetto; McDougle, Christopher

    2016-01-01

    Repetitive behavior is a core feature of autism spectrum disorder. We used 8-week data from two federally funded, multi-site, randomized trials with risperidone conducted by the Research Units on Pediatric Psychopharmacology Autism Network to evaluate the sensitivity of the Children's Yale-Brown Obsessive Compulsive Scale modified for autism…

  4. The surface chemistry of divalent metal carbonate minerals; a critical assessment of surface charge and potential data using the charge distribution multi-site ion complexation model

    NARCIS (Netherlands)

    Wolthers, M.; Charlet, L.; Van Cappellen, P.

    2008-01-01

    The Charge Distribution MUltiSite Ion Complexation or CD–MUSIC modeling approach is used to describe the chemical structure of carbonate mineralaqueous solution interfaces. The new model extends existing surface complexation models of carbonate minerals, by including atomic scale information on

  5. An Investigation of the Relationship between Involvement in and Use of Evaluation in Three Multi-Site Evaluations when Those Involved Are Not the Primary Intended Users

    Science.gov (United States)

    Roseland, Denise L.

    2010-01-01

    This dissertation research describes an investigation that explores the nature of the relationship between participation in evaluation and the use of evaluation findings and processes within three large-scale multisite evaluations. The purpose of this study is to test whether assumptions and theories about participation translate into evaluation…

  6. Multisite Ion Model in Concentrated Solutions of Divalent Cations (MgCl2 and CaCl2): Osmotic Pressure Calculations

    Science.gov (United States)

    2015-01-01

    Accurate force field parameters for ions are essential for meaningful simulation studies of proteins and nucleic acids. Currently accepted models of ions, especially for divalent ions, do not necessarily reproduce the right physiological behavior of Ca2+ and Mg2+ ions. Saxena and Sept (J. Chem. Theor. Comput.2013, 9, 3538–3542) described a model, called the multisite-ion model, where instead of treating the ions as an isolated sphere, the charge was split into multiple sites with partial charge. This model provided accurate inner shell coordination of the ion with biomolecules and predicted better free energies for proteins and nucleic acids. Here, we expand and refine the multisite model to describe the behavior of divalent ions in concentrated MgCl2 and CaCl2 electrolyte solutions, eliminating the unusual ion–ion pairing and clustering of ions which occurred in the original model. We calibrate and improve the parameters of the multisite model by matching the osmotic pressure of concentrated solutions of MgCl2 to the experimental values and then use these parameters to test the behavior of CaCl2 solutions. We find that the concentrated solutions of both divalent ions exhibit the experimentally observed behavior with correct osmotic pressure, the presence of solvent separated ion pairs instead of direct ion pairs, and no aggregation of ions. The improved multisite model for (Mg2+ and Ca2+) can be used in classical simulations of biomolecules at physiologically relevant salt concentrations. PMID:25482831

  7. Multi-site and multi-depth near-infrared spectroscopy in a model of simulated (central) hypovolemia: Lower body negative pressure

    NARCIS (Netherlands)

    S.A. Bartels (Sebastiaan); R. Bezemer (Rick); F.J.W. Wallis de Vries (Floris); D.M.J. Milstein (Dan); A.A.P. Lima (Alexandre ); T.G.V. Cherpanath (Thomas); A.H. van den Meiracker (Anton); J. van Bommel (Jasper); M. Heger (Michal); J.M. Karemaker (John); C. Ince (Can)

    2011-01-01

    textabstractPurpose: To test the hypothesis that the sensitivity of near-infrared spectroscopy (NIRS) in reflecting the degree of (compensated) hypovolemia would be affected by the application site and probing depth. We simultaneously applied multi-site (thenar and forearm) and multi-depth (15-2.5

  8. Research staff training in a multisite randomized clinical trial: Methods and recommendations from the Stimulant Reduction Intervention using Dosed Exercise (STRIDE) trial.

    Science.gov (United States)

    Walker, Robrina; Morris, David W; Greer, Tracy L; Trivedi, Madhukar H

    2014-01-01

    Descriptions of and recommendations for meeting the challenges of training research staff for multisite studies are limited despite the recognized importance of training on trial outcomes. The STRIDE (STimulant Reduction Intervention using Dosed Exercise) study is a multisite randomized clinical trial that was conducted at nine addiction treatment programs across the United States within the National Drug Abuse Treatment Clinical Trials Network (CTN) and evaluated the addition of exercise to addiction treatment as usual (TAU), compared to health education added to TAU, for individuals with stimulant abuse or dependence. Research staff administered a variety of measures that required a range of interviewing, technical, and clinical skills. In order to address the absence of information on how research staff are trained for multisite clinical studies, the current manuscript describes the conceptual process of training and certifying research assistants for STRIDE. Training was conducted using a three-stage process to allow staff sufficient time for distributive learning, practice, and calibration leading up to implementation of this complex study. Training was successfully implemented with staff across nine sites. Staff demonstrated evidence of study and procedural knowledge via quizzes and skill demonstration on six measures requiring certification. Overall, while the majority of staff had little to no experience in the six measures, all research assistants demonstrated ability to correctly and reliably administer the measures throughout the study. Practical recommendations are provided for training research staff and are particularly applicable to the challenges encountered with large, multisite trials.

  9. Wind Tunnel Wall Corrections (la Correction des effets de paroi en soufflerie)

    Science.gov (United States)

    1998-10-01

    M=0.6, oc=0.3 deg, REC=2.Txl 06 5-64 + A.+ -- a- * aa -, II I I +00 00 -q . 00 N V e 0 0 00 C4. ?9 9 0000 9" do td + + + +14 ++0 00 ~. ~ + do do0I...Boundary for the Discrete Slots. NACA RM- L53 -EO7b. [47] Donegan, T.L.; Benek, J. A.; and Erickson, J. C., Jr. 1987: Calculation of Transonic Wall

  10. Mise en oeuvre et etalonnage d'une soufflerie de recherche sur les couches limites

    Science.gov (United States)

    Pioton, Julien

    In order to reproduce a turbulent boundary layer separation bubble in a laboratory at the École de Technologie Supérieure of Montreal, an open-circuit wind tunnel equipped with a blow-down centrifugal fan has been implemented and calibrated for this research project. The methodology for the conception of the wind tunnel components, based on the results obtained from previous experiments, has been validated by the comparison between experimental and theoretical pressure losses along the wind tunnel. Dimensionless mean axial velocity measurements in the working section have showed an irrotational uniform flow zone at the contraction end, which demonstrates the satisfactory performance of the flowconditioning components located upstream from the working section. Mean axial velocity and total pressure measurements along the working section have allowed for estimates of the location of boundary between irrotational and rotational flow at the separation bubble. The maximum mean height of the boundary layer has been estimated at around 15 cm. Oil film visualisations have revealed a mean bubble separation length of approximately 52 cm. Theses oil visualisations, supported by mean lateral velocity measurements in the current configuration of the working section, have indicated important three-dimensional effects and significant dissymmetry in the vicinity of the separation and reattachment zones at the separation bubble.

  11. Der er mening med IS' galskab

    DEFF Research Database (Denmark)

    Schmidt, Søren

    2015-01-01

    I analyse the recent cases of Islamic State terrorism (the immolation of the Jordanian pilot and cutting the throat of 21 Egyptian Christians in Libya) as well as the case of a terrorist act of Irgun in the struggle for Israeli independence. These cases (as well as many of the acts of Al Qaida......) have the purpose of provocation thereby leading Western states to do foolish things and in that process hurting themselves and helping the terrorists....

  12. En undskyldning for slaveriet giver mening

    DEFF Research Database (Denmark)

    Lægaard, Sune

    2017-01-01

    Statsministeren nævnte i sin nytårstale, at det i år er 100 år siden, Danmark solgte De Vestindiske Øer til USA og dermed satte et punktum for »et grusomt kapitel i vores historie«. Statsministeren kaldte slaveriet for »skamfuldt«, og det gav anledning til en diskussion om, hvorvidt vi nu kan und...

  13. Knowledge of practice: A multi-sited event ethnography of border security fairs in Europe and North America.

    Science.gov (United States)

    Baird, Theodore

    2017-06-01

    This article takes the reader inside four border security fairs in Europe and North America to examine the knowledge practices of border security professionals. Building on the border security as practice research agenda, the analysis focuses on the production, circulation, and consumption of scarce forms of knowledge. To explore situated knowledge of border security practices, I develop an approach to multi-sited event ethnography to observe and interpret knowledge that may be hard to access at the security fairs. The analysis focuses on mechanisms for disseminating and distributing scarce forms of knowledge, technological materializations of situated knowledge, expressions of transversal knowledge of security problems, how masculinities structure knowledge in gendered ways, and how unease is expressed through imagined futures in order to anticipate emergent solutions to proposed security problems. The article concludes by reflecting on the contradictions at play at fairs and how to address such contradictions through alternative knowledges and practices.

  14. River Flow Prediction for Future Climate Using Long Series of Multi-Site Synthetic Data and MIKE SHE Model

    Directory of Open Access Journals (Sweden)

    Kuchar Leszek

    2017-01-01

    Full Text Available A new simulation of daily flow for Kaczawa River, south-west Poland for extra long series of generated meteorological data (comparing to previous research and selected climate change scenarios are presented. The Representative Concentration Pathways (RCPs scenarios vs. SRES are introduced for simulations. The flow simulation in the river catchment is made using MIKE SHE hydrological model while the multisite data are generated by spatial weather generator SWGEN. Simulations are done for 2040 and 2060 while the simulations for the year 2000 are used as a background. The large number of new simulated series determined by the lead time, three climate change scenarios (RCP2.6 RCP4.5 and RCP6.0, and number of generated years (1000 for each case is equal to 7000 for a single station. Finally, Pdf function for flow is presented as well probability of exceedance of maximum flow.

  15. Completion Report for Multi-Site Incentive MRT 2779 Implement ASC Tripod Initiative by 30SEP08

    Energy Technology Data Exchange (ETDEWEB)

    East, D; Cerutti, J; Noe, J; Cupps, K; Loncaric, J; Sturtevant, J

    2008-09-22

    This report provides documentation and evidence for the completion of the deployment of the Tripod common operating system (TripodOS, also known as and generally referred to below as TOSS). Background documents for TOSS are provided in Appendices A and B, including the initial TOSS proposal accepted by ASC HQ and Executives in July 2007 and a Governance Model defined by a Tri-Lab working group in September 2007. Appendix C contains a document that clarifies the intent and requirements for the completion criteria associated with MRT 2779. The deployment of TOSS is a Multi-Site Incentive from the ASC FY08-09 Implementation Plan due at the end of Quarter 4 in FY08.

  16. Principles and strategies for monitoring data collection integrity in a multi-site randomized clinical trial of a behavioral intervention.

    Science.gov (United States)

    Phillips-Salimi, Celeste R; Donovan Stickler, Molly A; Stegenga, Kristin; Lee, Melissa; Haase, Joan E

    2011-08-01

    Although treatment fidelity strategies for enhancing the integrity of behavioral interventions have been well described, little has been written about monitoring data collection integrity. This article describes the principles and strategies developed to monitor data collection integrity of the "Stories and Music for Adolescent/Young Adult Resilience During Transplant" study (R01NR008583, U10CA098543, and U10CA095861)-a multi-site Children's Oncology Group randomized clinical trial of a music therapy intervention for adolescents and young adults undergoing stem cell transplant. The principles and strategies outlined in this article provide one model for development and evaluation of a data collection integrity monitoring plan for behavioral interventions that may be adapted by investigators and may be useful to funding agencies and grant application reviewers in evaluating proposals. Copyright © 2011 Wiley Periodicals, Inc.

  17. A Stochastic Programming Approach for a Multi-Site Supply Chain Planning in Textile and Apparel Industry under Demand Uncertainty

    Directory of Open Access Journals (Sweden)

    Houssem Felfel

    2015-11-01

    Full Text Available In this study, a new stochastic model is proposed to deal with a multi-product, multi-period, multi-stage, multi-site production and transportation supply chain planning problem under demand uncertainty. A two-stage stochastic linear programming approach is used to maximize the expected profit. Decisions such as the production amount, the inventory level of finished and semi-finished product, the amount of backorder and the quantity of products to be transported between upstream and downstream plants in each period are considered. The robustness of production supply chain plan is then evaluated using statistical and risk measures. A case study from a real textile and apparel industry is shown in order to compare the performances of the proposed stochastic programming model and the deterministic model.

  18. Facebook as a tool for communication, collaboration, and informal knowledge exchange among members of a multisite family health team

    Directory of Open Access Journals (Sweden)

    Lofters AK

    2016-01-01

    Full Text Available Aisha K Lofters,1,2 Morgan B Slater,1 Emily Nicholas Angl,1 Fok-Han Leung1 1Department of Family and Community Medicine, 2Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto, Toronto, ON, Canada Objective: To implement and evaluate a private Facebook group for members of a large Ontario multisite Family Health Team (FHT to facilitate improved communication and collaboration. Design: Program implementation and subsequent survey of team members. Setting: A large multisite FHT in Toronto, Ontario. Participants: Health professionals of the FHT. Main outcome measures: Usage patterns and self-reported perceptions of the Facebook group by team members. Results: At the time of the evaluation survey, the Facebook group had 43 members (37.4% of all FHT members. Activity in the group was never high, and posts by team members who were not among the researchers were infrequent throughout the study period. The content of posts fell into two broad categories: 1 information that might be useful to various team members and 2 questions posed by team members that others might be able to answer. Of the 26 team members (22.6% who completed the evaluation survey, many reported that they never logged into the Facebook page (16 respondents, and never used it to communicate with team members outside of their own site of practice (19 respondents. Only six respondents reported no concerns with using Facebook as a professional communication tool; the most frequent concerns were regarding personal and patient privacy. Conclusion: The use of social media by health care practitioners is becoming ubiquitous. However, the issues of privacy concerns and determining how to use social media without adding to provider workload must be addressed to make it a useful tool in health care. Keywords: social media, team-based care, communication, interprofessionalism, social network

  19. Una aproximación del efecto en el aprendizaje de una lengua extranjera debida a la obtención de datos a través de exámenes en línea de idiomas

    Directory of Open Access Journals (Sweden)

    Teresa Magal -Royo

    2017-01-01

    Full Text Available La Inteligencia Artificial orientada a la educación (AIEd permite adecuar y/o adaptar los itinerarios del aprendizaje de un usuario mediante procesos inductivos basados en la extracción de datos obtenidos de las evidencias formativas que genera a lo largo de su vida escolar . El Big data , o datos masivos es el almacenamiento de grandes cantidades de datos que pueden ser analizados por diversos procedimientos y que permite encontrar patrones repetitivos o formulas p redictivas que pueden generar un aprendizaje sobre nosotros mismos y sobre todo en la red. En el caso de los datos masivos que se generan a través de los exámenes utilizados en el aprendizaje y certificación de conocimiento de idiomas como segunda lengua a nivel nacional encontramos que podría ser útil aplicar las metodologías de procesamiento del Big Data para conocer mejor si la información generada a través de los test pueden mejorar o crear nuevas estrategias de aprendizaje o establecer criterios forma les en el diseño de las pruebas, teorías de adquisición de se segunda lengua o incluso políticas educativas. La novedad de artículo se centra en establecer directrices viables para aplicar los conceptos más genéricos del Big Data en el contexto específico de los test de evaluación de idiomas como segunda lengua y donde existe a priori una gran cantidad de información a procesar a nivel educativo. El artículo muestra algunas directrices que podrían aplicarse en los mecanismos aplicados en la extracción de da tos educativos del aprendizaje de idiomas a gran escala en el entorno específico de los test de evaluación de idiomas como lengua extranjera .

  20. Relación entre regímenes de bienestar (según Geof Wood-Ian Gough y el índice COP para 54 países

    Directory of Open Access Journals (Sweden)

    Javier Darío Ávila Pita

    2016-01-01

    Full Text Available Introducción: La Caries dental sigue considerándose el principal problema de salud pública en muchos países del mundo. Diversos autores han hipotetizado la relación existente entre: salud oral y regímenes de bienestar. Geof Wood los clasifica basándose en: Índice de Desarrollo Humano, gasto público y flujo de divisas, en cinco categorías: 1. Régimen Social-demócrata, 2. Régimen Liberal, 3. Régimen Conservador, 4. Régimen de Seguridad Informal (A y B y 5. Régimen de Inseguridad (A y B. Propósito: Analizar la relación existente entre el tipo de régimen de bienestar y el índice de COP a los 12 años para 54 países en las últimas cinco décadas. Metodología: Estudio ecológico sobre fuentes secundarias de bases de datos de la OMS, Banco mundial, PubMed/Medline y sitios web de los países seleccionados. Resultados: El porcentaje de decrecimiento entre el primer y último COP reportado por cada país fue: Régimen Social-Demócrata (-86,6%, Régimen Conservador (-81,7%, Régimen Liberal (-79,0%, Régimen de Seguridad Informal A (-55,2%, Régimen de Seguridad Informal B (-46,9%, Régimen de Inseguridad A (-35,9%, Régimen de Inseguridad B (+136,8%. Conclusiones: El descenso de la caries observado en países desarrollados es resultado de medidas de salud pública, las condiciones-estilos de vida y la mejora de prácticas de autocuidado. Se espera que la incidencia de caries incremente en países africanos y asiáticos por el creciente consumo de azúcares e inadecuada exposición a fluoruros. Los retos futuros implican traducir conocimientos y experiencias en la promoción de la salud y prevención de la caries en los programas de acción.

  1. Memoria colectiva, emociones y cultura política: análisis de los actos públicos presentados por el Movimiento Nacional de Víctimas de Crímenes de Estado - MOVICE, capítulo Bogotá

    OpenAIRE

    González Caballero, David Eduardo

    2015-01-01

    Este escrito presenta los resultados de la investigación dedicada al estudio de las actividades adelantadas por el Capítulo Bogotá del Movimiento Nacional de Víctimas de Crímenes de Estado – MOVICE, en particular de los actos públicos mediante los cuales estas víctimas buscan transmitir su memoria colectiva al conjunto de la sociedad. El texto propone repensar el concepto de cultura política como la lucha por el sentido de lo social, para adaptarlo a las necesidades de un trabajo cualita...

  2. Fire regimes and vegetation responses in two Mediterranean-climate regions Regímenes de incendios y respuestas de la vegetación en dos regiones de clima Mediterráneo

    Directory of Open Access Journals (Sweden)

    GLORIA MONTENEGRO

    2004-09-01

    other environmental pressures, such as severe and long summer droughts, herbivory, and volcanism. Although both Mediterranean-type ecosystems have shown to be resilient to anthropogenic fires, increasing fire frequency may be an important factor that needs to be considered as it may result in strong negative effects on plant successional trends and on plant diversityLos incendios forestales originados por tormentas estivales son una característica común en la mayoría de las regiones con clima Mediterráneo, tal como el sur de California, y han jugado un rol importante en la ecología y evolución de su flora. Las regiones con clima Mediterráneo han sido, además, centros importantes para el establecimiento de poblaciones humanas, las que al alterar los regímenes de incendios podrían producir efectos negativos importantes en este tipo de formaciones vegetales. Sin embargo, los efectos antrópicos sobre el régimen de incendios podrían tener impactos distintos en ecosistemas Mediterráneos cuya vegetación ha evolucionado naturalmente con este tipo de perturbación. Así, en este trabajo comparamos los regímenes de incendios y la capacidad de respuesta de la vegetación de dos regiones con clima Mediterráneo que han tenido historias distintas en cuanto a la ocurrencia natural de incendios forestales y de ocupación humana, tales como la zona central de Chile (matorral y el sur de California (chaparral. En Chile, casi todos los incendios forestales son el resultado de actividades antrópicas, mientras que en California los incendios producidos por el hombre se suman a los producidos por tormentas estivales. En ambas regiones, los incendios son más frecuentes en verano debido a la acumulación de biomasa vegetal seca altamente combustible. El hombre ha incrementado significativamente la frecuencia de incendios tanto en el matorral como en el chaparral en las últimas décadas, pero la extensión de los incendios no se ha incrementado en forma importante

  3. Analytic hierarchy process-based approach for selecting a Pareto-optimal solution of a multi-objective, multi-site supply-chain planning problem

    Science.gov (United States)

    Ayadi, Omar; Felfel, Houssem; Masmoudi, Faouzi

    2017-07-01

    The current manufacturing environment has changed from traditional single-plant to multi-site supply chain where multiple plants are serving customer demands. In this article, a tactical multi-objective, multi-period, multi-product, multi-site supply-chain planning problem is proposed. A corresponding optimization model aiming to simultaneously minimize the total cost, maximize product quality and maximize the customer satisfaction demand level is developed. The proposed solution approach yields to a front of Pareto-optimal solutions that represents the trade-offs among the different objectives. Subsequently, the analytic hierarchy process method is applied to select the best Pareto-optimal solution according to the preferences of the decision maker. The robustness of the solutions and the proposed approach are discussed based on a sensitivity analysis and an application to a real case from the textile and apparel industry.

  4. The opportunities and challenges of multi-site evaluations: lessons from the jail diversion and trauma recovery national cross-site evaluation.

    Science.gov (United States)

    Stainbrook, Kristin; Penney, Darby; Elwyn, Laura

    2015-06-01

    Multi-site evaluations, particularly of federally funded service programs, pose a special set of challenges for program evaluation. Not only are there contextual differences related to project location, there are often relatively few programmatic requirements, which results in variations in program models, target populations and services. The Jail Diversion and Trauma Recovery-Priority to Veterans (JDTR) National Cross-Site Evaluation was tasked with conducting a multi-site evaluation of thirteen grantee programs that varied along multiple domains. This article describes the use of a mixed methods evaluation design to understand the jail diversion programs and client outcomes for veterans with trauma, mental health and/or substance use problems. We discuss the challenges encountered in evaluating diverse programs, the benefits of the evaluation in the face of these challenges, and offer lessons learned for other evaluators undertaking this type of evaluation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Replication and Comparison of the Newly Proposed ADOS-2, Module 4 Algorithm in ASD without ID: A Multi-site Study

    OpenAIRE

    Pugliese, Cara E.; Kenworthy, Lauren; Bal, Vanessa Hus; Wallace, Gregory L; Yerys, Benjamin E; Maddox, Brenna B.; White, Susan W.; Popal, Haroon; Armour, Anna Chelsea; Miller, Judith; Herrington, John D.; Schultz, Robert T.; Martin, Alex; Anthony, Laura Gutermuth

    2015-01-01

    Recent updates have been proposed to the Autism Diagnostic Observation Schedule-2 Module 4 diagnostic algorithm. This new algorithm, however, has not yet been validated in an independent sample without intellectual disability (ID). This multi-site study compared the original and revised algorithms in individuals with ASD without ID. The revised algorithm demonstrated increased sensitivity, but lower specificity in the overall sample. Estimates were highest for females, individuals with a verb...

  6. Design and Baseline Findings of a Multi-site Non-randomized Evaluation of the Effect of a Health Programme on Microfinance Clients in India

    OpenAIRE

    Saha, Somen

    2013-01-01

    Microfinance is the provision of financial services for the poor. Health program through microfinance has the potential to address several access barriers to health. We report the design and baseline findings of a multi-site non-randomized evaluation of the effect of a health program on the members of two microfinance organizations from Karnataka and Gujarat states of India. Villages identified for roll-out of health services with microfinance were pair-matched with microfinance only villages...

  7. The value and potential of multisited ethnography for science education research: a review of Jrène Rahm's Science in the Making at the Margin

    Science.gov (United States)

    Beeman-Cadwallader, Nicole

    2012-03-01

    Rahm sought to illuminate how children and youth make meaning of science in three out-of-school time programs, and the identity work that is done through the trajectory of their youth toward their young adulthood. Through using multisited ethnography, she asserts that we can learn more about what the youth say about their science learning and science literacy development in these programs. She has revealed through her rich data the potential value of multisited ethnography for science education research. A similar theme of insider/outsider status to science emerged in each of the three sites. The nature of the data collected in Rahm's multisited ethnography allowed for the unveiling of the similarities in this theme, but also made evident the nuanced ways that this theme presented itself differently across the three sites. The additional potential came through in the varied data Rahm could have delved into and did not. A unique characteristic of ethnographic research, that is not necessarily present in other research methods, is that a wide array of varied data is collected. An analysis of documents, images, and observational field notes, which go beyond interview data, may provide deeper understandings previously untouched in science education.

  8. Risk and direct protective factors for youth violence: results from the Centers for Disease Control and Prevention's Multisite Violence Prevention Project.

    Science.gov (United States)

    Henry, David B; Tolan, Patrick H; Gorman-Smith, Deborah; Schoeny, Michael E

    2012-08-01

    This study was conducted as part of a multisite effort to examine risk and direct protective factors for youth violence. The goal was to identify those factors in the lives of young people that increase or decrease the risk of violence. These analyses fill an important gap in the literature, as few studies have examined risk and direct protective factors for youth violence across multiple studies. Data on 4432 middle-school youth, from the CDC Multisite Violence Prevention Project were used. Evaluations were made of effects of variables coded as risk and direct protective factors in the fall of 6th grade on violence measured in spring of 7th and 8th grades. Factors tested included depression, delinquency, alcohol and drug involvement, involvement in family activities, academic achievement, attitudes toward school, truancy, and peer deviance. Most variables were coded with two sets of dummy variables indicating risk and protective directions of effects. Results showed that higher teacher-rated study skills were associated with lower subsequent violence across genders and ethnic groups. Affiliation with deviant peers was significantly associated with increased subsequent violence among youth reporting their race/ethnicity as white or other, marginally associated with increased violence among African-American youth, and unrelated among Latino youth. This study identified some factors than should be areas of interest for effective prevention programs. Some ethnic differences also should be considered in planning of prevention. The CDC Multisite Violence Prevention Project completed enrollment prior to July 2005. Copyright © 2012. Published by Elsevier Inc.

  9. Multi-site laser Doppler flowmetry for assessing collateral flow in experimental ischemic stroke: Validation of outcome prediction with acute MRI.

    Science.gov (United States)

    Cuccione, Elisa; Versace, Alessandro; Cho, Tae-Hee; Carone, Davide; Berner, Lise-Prune; Ong, Elodie; Rousseau, David; Cai, Ruiyao; Monza, Laura; Ferrarese, Carlo; Sganzerla, Erik P; Berthezène, Yves; Nighoghossian, Norbert; Wiart, Marlène; Beretta, Simone; Chauveau, Fabien

    2017-06-01

    High variability in infarct size is common in experimental stroke models and affects statistical power and validity of neuroprotection trials. The aim of this study was to explore cerebral collateral flow as a stratification factor for the prediction of ischemic outcome. Transient intraluminal occlusion of the middle cerebral artery was induced for 90 min in 18 Wistar rats. Cerebral collateral flow was assessed intra-procedurally using multi-site laser Doppler flowmetry monitoring in both the lateral middle cerebral artery territory and the borderzone territory between middle cerebral artery and anterior cerebral artery. Multi-modal magnetic resonance imaging was used to assess acute ischemic lesion (diffusion-weighted imaging, DWI), acute perfusion deficit (time-to-peak, TTP), and final ischemic lesion at 24 h. Infarct volumes and typology at 24 h (large hemispheric versus basal ganglia infarcts) were predicted by both intra-ischemic collateral perfusion and acute DWI lesion volume. Collateral flow assessed by multi-site laser Doppler flowmetry correlated with the corresponding acute perfusion deficit using TTP maps. Multi-site laser Doppler flowmetry monitoring was able to predict ischemic outcome and perfusion deficit in good agreement with acute MRI. Our results support the additional value of cerebral collateral flow monitoring for outcome prediction in experimental ischemic stroke, especially when acute MRI facilities are not available.

  10. Evidence for the ferromagnetic frustration in a classical spin- 1 / 2 system with multisite interaction in external magnetic field: Exact results

    Science.gov (United States)

    Jurčišinová, E.; Jurčišin, M.

    2017-11-01

    We investigate the influence of the multisite interaction among sites within elementary triangles of the kagome-like recursive lattice on the properties of the classical spin- 1 / 2 ferromagnetic Ising model in the external magnetic field. The exact solution of the model is found and it is shown that the model exhibits a nontrivial structure of the first order as well as second order phase transitions in nonzero external magnetic fields related to the multisite interaction. The equation for the exact determination of the positions of the critical points of the second order phase transitions is derived. The thermodynamic properties of the model are investigated in detail and it is shown that the competition between the ferromagnetic interaction and the multisite interaction leads to the appearance of strong ferromagnetic frustration effects represented by the formation of a nontrivial system of macroscopically degenerated plateau-like and single-point-like ground states. The residual entropies of all ground states are found and the kagome spin-ice-like highly macroscopically degenerated plateau state with nonzero magnetization is identified with the exact residual entropy per site s /kB = ln(4 / 3) / 3 ≈ 0 . 095894. The properties of the specific heat are investigated, its Schottky-type behavior near the single-point ground state values of the magnetic field is identified, the existence of large magnetocaloric effect is discussed, and the existence of the first order phase transitions without the specific heat capacity change is demonstrated.

  11. Webinar Training: an acceptable, feasible and effective approach for multi-site medical record abstraction: the BOWII experience

    Directory of Open Access Journals (Sweden)

    St Charles Meaghan

    2011-10-01

    Full Text Available Abstract Background Abstractor training is a key element in creating valid and reliable data collection procedures. The choice between in-person vs. remote or simultaneous vs. sequential abstractor training has considerable consequences for time and resource utilization. We conducted a web-based (webinar abstractor training session to standardize training across six individual Cancer Research Network (CRN sites for a study of breast cancer treatment effects in older women (BOWII. The goals of this manuscript are to describe the training session, its participants and participants' evaluation of webinar technology for abstraction training. Findings A webinar was held for all six sites with the primary purpose of simultaneously training staff and ensuring consistent abstraction across sites. The training session involved sequential review of over 600 data elements outlined in the coding manual in conjunction with the display of data entry fields in the study's electronic data collection system. Post-training evaluation was conducted via Survey Monkey©. Inter-rater reliability measures for abstractors within each site were conducted three months after the commencement of data collection. Ten of the 16 people who participated in the training completed the online survey. Almost all (90% of the 10 trainees had previous medical record abstraction experience and nearly two-thirds reported over 10 years of experience. Half of the respondents had previously participated in a webinar, among which three had participated in a webinar for training purposes. All rated the knowledge and information delivered through the webinar as useful and reported it adequately prepared them for data collection. Moreover, all participants would recommend this platform for multi-site abstraction training. Consistent with participant-reported training effectiveness, results of data collection inter-rater agreement within sites ranged from 89 to 98%, with a weighted average of

  12. A multi-site resting state fMRI study on the amplitude of low frequency fluctuations in schizophrenia

    Directory of Open Access Journals (Sweden)

    Jessica A Turner

    2013-08-01

    Full Text Available Background. This multi-site study compares resting state fMRI amplitude of low frequency fluctuations (ALFF and fractional ALFF (fALFF between patients with schizophrenia (SZ and healthy controls (HC. Methods. Eyes-closed resting fMRI scans (5:38 minutes; n=306, 146 SZ were collected from 6 Siemens 3T scanners and one GE 3T scanner. Imaging data were pre-processed using an SPM pipeline. Power in the low frequency band (0.01 to 0.08 Hz was calculated both for the original pre-processed data as well as for the pre-processed data after regressing out the six rigid-body motion parameters, mean white matter and CSF signals. Both original and regressed ALFF and fALFF measures were modeled with site, diagnosis, age, and diagnosis × age interactions. Results. Regressing out motion and non-gray matter signals significantly decreased fALFF throughout the brain as well as ALFF in the cortical edge, but significantly increased ALFF in subcortical regions. Regression had little effect on site, age, and diagnosis effects on ALFF, other than to reduce diagnosis effects in subcortical regions. There were significant effects of site across the brain in all the analyses, largely due to vendor differences. HC showed greater ALFF in the occipital, posterior parietal, and superior temporal lobe, while SZ showed smaller clusters of greater ALFF in the frontal and temporal/insular regions as well as in the caudate, putamen, and hippocampus. HC showed greater fALFF compared with SZ in all regions, though subcortical differences were only significant for original fALFF. Conclusions. SZ show greater eyes-closed resting state low frequency power in frontal cortex, and less power in posterior lobes than do HC; fALFF, however, is lower in SZ than HC throughout the cortex. These effects are robust to multi-site variability. Regressing out physiological noise signals significantly affects both total and fractional ALFF measures, but does not affect the pattern of case

  13. Peat humification and climate change: a multi-site comparison from mires in south-east Alaska

    Directory of Open Access Journals (Sweden)

    R.J. Payne

    2008-11-01

    Full Text Available Peatland records of Holocene palaeoclimate have been widely used in Europe. Their potential in western North America remains largely unexploited despite an abundance of candidate sites. Peat humification analysis is a widely used technique for palaeoclimatic inference from peatlands. This study attempts to demonstrate a climatic role in determining peat humification by comparing low-resolution peat humification records from five mires in south-east Alaska. Humification was determined by alkali extraction and colorimetry and records dated by radiocarbon and tephrochronology. Testate amoebae analysis was carried out across a major humification-inferred wet shift in three of the sites. The humification results show variability down the length of the cores but there is only limited agreement between records from different sites. Many general trends in the data appear to be out of phase and periods of proxy 'complacency' are shown. This study does not provide strong evidence for climatic forcing of humification in these sites. Methodological issues including possible problems with the age-depth models and the role of a peat-forming plant species signal in the humification data are discussed. The results support previous studies in suggesting the value of employing a multi-proxy, multi-site, and possibly multi-core approach in peat-based palaeoclimatology.

  14. Patient training in cancer pain management using integrated print and video materials: a multisite randomized controlled trial.

    Science.gov (United States)

    Syrjala, Karen L; Abrams, Janet R; Polissar, Nayak L; Hansberry, Jennifer; Robison, Jeanne; DuPen, Stuart; Stillman, Mark; Fredrickson, Marvin; Rivkin, Saul; Feldman, Eric; Gralow, Julie; Rieke, John W; Raish, Robert J; Lee, Douglas J; Cleeland, Charles S; DuPen, Anna

    2008-03-01

    Standard guidelines for cancer pain treatment routinely recommend training patients to reduce barriers to pain relief, use medications appropriately, and communicate their pain-related needs. Methods are needed to reduce professional time required while achieving sustained intervention effectiveness. In a multisite, randomized controlled trial, this study tested a pain training method versus a nutrition control. At six oncology clinics, physicians (N=22) and nurses (N=23) enrolled patients (N=93) who were over 18 years of age, with cancer diagnoses, pain, and a life expectancy of at least 6 months. Pain training and control interventions were matched for materials and method. Patients watched a video followed by about 20 min of manual-standardized training with an oncology nurse focused on reviewing the printed material and adapted to individual concerns of patients. A follow-up phone call after 72 h addressed individualized treatment content and pain communication. Assessments at baseline, one, three, and 6 months included barriers, the Brief Pain Inventory, opioid use, and physician and nurse ratings of their patients' pain. Trained versus control patients reported reduced barriers to pain relief (P6 on a 0-10 scale) at 1-month outcomes (P=.03). Physician and nurse ratings were closer to patients' ratings of pain for trained versus nutrition groups (P=.04 and print materials, with brief individualized training, effectively improved pain management over time for cancer patients of varying diagnostic and demographic groups.

  15. SPICODYN: A Toolbox for the Analysis of Neuronal Network Dynamics and Connectivity from Multi-Site Spike Signal Recordings.

    Science.gov (United States)

    Pastore, Vito Paolo; Godjoski, Aleksandar; Martinoia, Sergio; Massobrio, Paolo

    2018-01-01

    We implemented an automated and efficient open-source software for the analysis of multi-site neuronal spike signals. The software package, named SPICODYN, has been developed as a standalone windows GUI application, using C# programming language with Microsoft Visual Studio based on .NET framework 4.5 development environment. Accepted input data formats are HDF5, level 5 MAT and text files, containing recorded or generated time series spike signals data. SPICODYN processes such electrophysiological signals focusing on: spiking and bursting dynamics and functional-effective connectivity analysis. In particular, for inferring network connectivity, a new implementation of the transfer entropy method is presented dealing with multiple time delays (temporal extension) and with multiple binary patterns (high order extension). SPICODYN is specifically tailored to process data coming from different Multi-Electrode Arrays setups, guarantying, in those specific cases, automated processing. The optimized implementation of the Delayed Transfer Entropy and the High-Order Transfer Entropy algorithms, allows performing accurate and rapid analysis on multiple spike trains from thousands of electrodes.

  16. Racial and Ethnic Disparities in Parental Refusal of Consent in a Large, Multisite Pediatric Critical Care Clinical Trial.

    Science.gov (United States)

    Natale, Joanne E; Lebet, Ruth; Joseph, Jill G; Ulysse, Christine; Ascenzi, Judith; Wypij, David; Curley, Martha A Q

    2017-05-01

    To evaluate whether race or ethnicity was independently associated with parental refusal of consent for their child's participation in a multisite pediatric critical care clinical trial. We performed a secondary analyses of data from Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE), a 31-center cluster randomized trial of sedation management in critically ill children with acute respiratory failure supported on mechanical ventilation. Multivariable logistic regression modeling estimated associations between patient race and ethnicity and parental refusal of study consent. Among the 3438 children meeting enrollment criteria and approached for consent, 2954 had documented race/ethnicity of non-Hispanic White (White), non-Hispanic Black (Black), or Hispanic of any race. Inability to approach for consent was more common for parents of Black (19.5%) compared with White (11.7%) or Hispanic children (13.2%). Among those offered consent, parents of Black (29.5%) and Hispanic children (25.9%) more frequently refused consent than parents of White children (18.2%, P refuse consent. Parents of children offered participation in the intervention arm were more likely to refuse consent than parents in the control arm (OR 2.15, 95% CI 1.37-3.36, P care clinical trial. Ameliorating this racial disparity may improve the validity and generalizability of study findings. ClinicalTrials.gov: NCT00814099. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Carboxyl-terminal multi-site phosphorylation regulates internalization and desensitization of the human sst2 somatostatin receptor.

    Science.gov (United States)

    Lehmann, Andreas; Kliewer, Andrea; Schütz, Dagmar; Nagel, Falko; Stumm, Ralf; Schulz, Stefan

    2014-04-25

    The somatostatin receptor 2 (sst2) is the pharmacological target of somatostatin analogs that are widely used in the diagnosis and treatment of human neuroendocrine tumors. We have recently shown that the stable somatostatin analogs octreotide and pasireotide (SOM230) stimulate distinct patterns of sst2 receptor phosphorylation and internalization. Like somatostatin, octreotide promotes the phosphorylation of at least six carboxyl-terminal serine and threonine residues namely S341, S343, T353, T354, T356 and T359, which in turn leads to a robust receptor endocytosis. Unlike somatostatin, pasireotide stimulates a selective phosphorylation of S341 and S343 of the human sst2 receptor followed by a partial receptor internalization. Here, we show that exchange of S341 and S343 by alanine is sufficient to block pasireotide-driven internalization, whereas mutation of T353, T354, T356 and T359 to alanine is required to strongly inhibited both octreotide- and somatostatin-induced internalization. Yet, combined mutation of T353, T354, T356 and T359 is not sufficient to prevent somatostatin-driven β-arrestin mobilization and receptor desensitization. Replacement of all fourteen carboxyl-terminal serine and threonine residues by alanine completely abrogates sst2 receptor internalization and β-arrestin mobilization in HEK293 cells. Together, our findings demonstrate for the first time that agonist-selective sst2 receptor internalization is regulated by multi-site phosphorylation of its carboxyl-terminal tail. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. The Impact of Sexual Assault Nurse Examiner Programs on Criminal Justice Case Outcomes: A Multisite Replication Study.

    Science.gov (United States)

    Campbell, Rebecca; Bybee, Deborah; Townsend, Stephanie M; Shaw, Jessica; Karim, Nidal; Markowitz, Jenifer

    2014-05-01

    To address the underreporting and underprosecution of adult sexual assaults, communities throughout the United States have implemented multidisciplinary interventions to improve postassault care for victims and the criminal justice system response. One such model is the Sexual Assault Nurse Examiner (SANE) Program, whereby specially trained nurses provide comprehensive psychological, medical, and forensic services for sexual assault. In this study, we conducted a multisite evaluation of six SANE programs (two rural programs, two serving midsized communities, two urban) to assess how implementation of SANE programs affects adult sexual assault prosecution rates. At each site, most sexual assaults reported to law enforcement were never referred by police to prosecutors or were not charged by the prosecutor's office (80%-89%). Individually, none of the sites had a statistically significant increase in prosecution rates pre-SANE to post-SANE. However, when the data were aggregated across sites, thereby increasing statistical power, there was a significant effect such that cases were more likely to be prosecuted post-SANE as compared with pre-SANE. These findings suggest that the SANE intervention model does have a positive impact on sexual assault case progression in the criminal justice system. Nevertheless, there is still a pressing need for improvement as the vast majority of both pre-SANE and post-SANE resulted in nonreferral/no charges filed. © The Author(s) 2014.

  19. Toward uniform implementation of parametric map Digital Imaging and Communication in Medicine standard in multisite quantitative diffusion imaging studies.

    Science.gov (United States)

    Malyarenko, Dariya; Fedorov, Andriy; Bell, Laura; Prah, Melissa; Hectors, Stefanie; Arlinghaus, Lori; Muzi, Mark; Solaiyappan, Meiyappan; Jacobs, Michael; Fung, Maggie; Shukla-Dave, Amita; McManus, Kevin; Boss, Michael; Taouli, Bachir; Yankeelov, Thomas E; Quarles, Christopher Chad; Schmainda, Kathleen; Chenevert, Thomas L; Newitt, David C

    2018-01-01

    This paper reports on results of a multisite collaborative project launched by the MRI subgroup of Quantitative Imaging Network to assess current capability and provide future guidelines for generating a standard parametric diffusion map Digital Imaging and Communication in Medicine (DICOM) in clinical trials that utilize quantitative diffusion-weighted imaging (DWI). Participating sites used a multivendor DWI DICOM dataset of a single phantom to generate parametric maps (PMs) of the apparent diffusion coefficient (ADC) based on two models. The results were evaluated for numerical consistency among models and true phantom ADC values, as well as for consistency of metadata with attributes required by the DICOM standards. This analysis identified missing metadata descriptive of the sources for detected numerical discrepancies among ADC models. Instead of the DICOM PM object, all sites stored ADC maps as DICOM MR objects, generally lacking designated attributes and coded terms for quantitative DWI modeling. Source-image reference, model parameters, ADC units and scale, deemed important for numerical consistency, were either missing or stored using nonstandard conventions. Guided by the identified limitations, the DICOM PM standard has been amended to include coded terms for the relevant diffusion models. Open-source software has been developed to support conversion of site-specific formats into the standard representation.

  20. Optimizing Travel Time to Outpatient Interventional Radiology Procedures in a Multi-Site Hospital System Using a Google Maps Application.

    Science.gov (United States)

    Mandel, Jacob E; Morel-Ovalle, Louis; Boas, Franz E; Ziv, Etay; Yarmohammadi, Hooman; Deipolyi, Amy; Mohabir, Heeralall R; Erinjeri, Joseph P

    2018-02-20

    The purpose of this study is to determine whether a custom Google Maps application can optimize site selection when scheduling outpatient interventional radiology (IR) procedures within a multi-site hospital system. The Google Maps for Business Application Programming Interface (API) was used to develop an internal web application that uses real-time traffic data to determine estimated travel time (ETT; minutes) and estimated travel distance (ETD; miles) from a patient's home to each a nearby IR facility in our hospital system. Hypothetical patient home addresses based on the 33 cities comprising our institution's catchment area were used to determine the optimal IR site for hypothetical patients traveling from each city based on real-time traffic conditions. For 10/33 (30%) cities, there was discordance between the optimal IR site based on ETT and the optimal IR site based on ETD at non-rush hour time or rush hour time. By choosing to travel to an IR site based on ETT rather than ETD, patients from discordant cities were predicted to save an average of 7.29 min during non-rush hour (p = 0.03), and 28.80 min during rush hour (p travel time when more than one location providing IR procedures is available within the same hospital system.

  1. Crónica de una muerte anunciada: la jurisdicción de los tribunales españoles sobre crímenes internacionales antes y después de la Ley Orgánica 1/2014 relativa a la justicia universal

    Directory of Open Access Journals (Sweden)

    Enrique Carnero Rojo

    2015-09-01

    Full Text Available En marzo de 2014, el Parlamento español reformó la jurisdicción universal de los tribunales nacionales. El presente artículo analiza la evolución legislativa que condujo a esta reforma, sus orígenes políticos y sus consecuencias en la práctica judicial. Tal análisis demuestra que las limitaciones al ejercicio de la jurisdicción española sobre crímenes internacionales cometidos en el extranjero contra víctimas no españolas  comenzaron por vía judicial en el año 2003. Cuando dichas limitaciones fueron declaradas contrarias a la Constitución española, el legislador enmendó la ley en 2009 para establecer límites al ejercicio de la jurisdicción universal por razones económicas y diplomáticas y lo hizo de nuevo en 2014, con la intención aparente de impedir directamente el ejercicio de dicha jurisdicción. Esta última reforma, llevada a cabo de manera unilateral y expedita, impuso estrictas condiciones legales a la jurisdicción universal en España y desnaturalizó por completo su ejercicio. La deficiente calidad jurídica de la reforma no solo ha generado tensiones dentro de los tribunales, al impedirles seguir conociendo de la mayoría de los crímenes internacionales que estaban siendo investigados, sino que también ha dado lugar a una preocupante falta de seguridad jurídica de cara a procesos futuros.

  2. Multisite longitudinal reliability of tract-based spatial statistics in diffusion tensor imaging of healthy elderly subjects.

    Science.gov (United States)

    Jovicich, Jorge; Marizzoni, Moira; Bosch, Beatriz; Bartrés-Faz, David; Arnold, Jennifer; Benninghoff, Jens; Wiltfang, Jens; Roccatagliata, Luca; Picco, Agnese; Nobili, Flavio; Blin, Oliver; Bombois, Stephanie; Lopes, Renaud; Bordet, Régis; Chanoine, Valérie; Ranjeva, Jean-Philippe; Didic, Mira; Gros-Dagnac, Hélène; Payoux, Pierre; Zoccatelli, Giada; Alessandrini, Franco; Beltramello, Alberto; Bargalló, Núria; Ferretti, Antonio; Caulo, Massimo; Aiello, Marco; Ragucci, Monica; Soricelli, Andrea; Salvadori, Nicola; Tarducci, Roberto; Floridi, Piero; Tsolaki, Magda; Constantinidis, Manos; Drevelegas, Antonios; Rossini, Paolo Maria; Marra, Camillo; Otto, Josephin; Reiss-Zimmermann, Martin; Hoffmann, Karl-Titus; Galluzzi, Samantha; Frisoni, Giovanni B

    2014-11-01

    Large-scale longitudinal neuroimaging studies with diffusion imaging techniques are necessary to test and validate models of white matter neurophysiological processes that change in time, both in healthy and diseased brains. The predictive power of such longitudinal models will always be limited by the reproducibility of repeated measures acquired during different sessions. At present, there is limited quantitative knowledge about the across-session reproducibility of standard diffusion metrics in 3T multi-centric studies on subjects in stable conditions, in particular when using tract based spatial statistics and with elderly people. In this study we implemented a multi-site brain diffusion protocol in 10 clinical 3T MRI sites distributed across 4 countries in Europe (Italy, Germany, France and Greece) using vendor provided sequences from Siemens (Allegra, Trio Tim, Verio, Skyra, Biograph mMR), Philips (Achieva) and GE (HDxt) scanners. We acquired DTI data (2 × 2 × 2 mm(3), b = 700 s/mm(2), 5 b0 and 30 diffusion weighted volumes) of a group of healthy stable elderly subjects (5 subjects per site) in two separate sessions at least a week apart. For each subject and session four scalar diffusion metrics were considered: fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD) and axial (AD) diffusivity. The diffusion metrics from multiple subjects and sessions at each site were aligned to their common white matter skeleton using tract-based spatial statistics. The reproducibility at each MRI site was examined by looking at group averages of absolute changes relative to the mean (%) on various parameters: i) reproducibility of the signal-to-noise ratio (SNR) of the b0 images in centrum semiovale, ii) full brain test-retest differences of the diffusion metric maps on the white matter skeleton, iii) reproducibility of the diffusion metrics on atlas-based white matter ROIs on the white matter skeleton. Despite the differences of MRI scanner

  3. Supporting successful inclusive practices for learners with disabilities in high schools: a multisite, mixed method collective case study.

    Science.gov (United States)

    Maciver, Donald; Hunter, Cathleen; Adamson, Amanda; Grayson, Zoe; Forsyth, Kirsty; McLeod, Iona

    2018-07-01

    The increase in the number of individuals with disabilities in general education has led to an increased interest in how to best provide support. Despite an emphasis on inclusion and participation in policy and practice, defining and describing the support provided for these learners is still an important task. This multisite, mixed method collective case study reports on 125 education and other staff from seven schools who took part in interviews and focus groups to reflect on a range of topics related to learners with disabilities in high schools. We focused on what the participants did, what they considered to be successful and what their "best" practices were. Descriptions of practices were rich, nuanced and complex. The analysis identified over 200 "strategies" which were synthesized into two meta-themes and eight subthemes. We discuss the results in the context of an ecological perspective, and the importance of focusing on the full range of influences and outcomes for young people in designing supports. We have drawn on evidence from this study as a basis for professional development activities and identified that focusing on the environment and the role of practitioners has a potential to improve the inclusion outcomes for older learners with disabilities. Implications for Rehabilitation Inclusion is influenced by the physical environment, attitudes, expectations and opportunities, in addition to a learner's skills and abilities. Schools should focus on the environment and teachers' practices, rather than on what an individual learner can or cannot do. The practices discussed in this study reflect those that a range of educators and related services personnel agree are realistic, appropriate and effective. Change may be led by the school management team; however, there are many ways in which all staff can contribute; indeed, approaches will not work effectively unless they are understood and implemented by everyone.

  4. Multisite Thrombus Imaging and Fibrin Content Estimation With a Single Whole-Body PET Scan in Rats.

    Science.gov (United States)

    Blasi, Francesco; Oliveira, Bruno L; Rietz, Tyson A; Rotile, Nicholas J; Naha, Pratap C; Cormode, David P; Izquierdo-Garcia, David; Catana, Ciprian; Caravan, Peter

    2015-10-01

    Thrombosis is a leading cause of morbidity and mortality worldwide. Current diagnostic strategies rely on imaging modalities that are specific for distinct vascular territories, but a thrombus-specific whole-body imaging approach is still missing. Moreover, imaging techniques to assess thrombus composition are underdeveloped, although therapeutic strategies may benefit from such technology. Therefore, our goal was to test whether positron emission tomography (PET) with the fibrin-binding probe (64)Cu-FBP8 allows multisite thrombus detection and fibrin content estimation. Thrombosis was induced in Sprague-Dawley rats (n=32) by ferric chloride application on both carotid artery and femoral vein. (64)Cu-FBP8-PET/CT imaging was performed 1, 3, or 7 days after thrombosis to detect thrombus location and to evaluate age-dependent changes in target uptake. Ex vivo biodistribution, autoradiography, and histopathology were performed to validate imaging results. Arterial and venous thrombi were localized on fused PET/CT images with high accuracy (97.6%; 95% confidence interval, 92-100). A single whole-body PET/MR imaging session was sufficient to reveal the location of both arterial and venous thrombi after (64)Cu-FBP8 administration. PET imaging showed that probe uptake was greater in younger clots than in older ones for both arterial and venous thrombosis (P<0.0001). Quantitative histopathology revealed an age-dependent reduction of thrombus fibrin content (P<0.001), consistent with PET results. Biodistribution and autoradiography further confirmed the imaging findings. We demonstrated that (64)Cu-FBP8-PET is a feasible approach for whole-body thrombus detection and that molecular imaging of fibrin can provide, noninvasively, insight into clot composition. © 2015 American Heart Association, Inc.

  5. Development of the Sydney Falls Risk Screening Tool in brain injury rehabilitation: A multisite prospective cohort study.

    Science.gov (United States)

    McKechnie, Duncan; Fisher, Murray J; Pryor, Julie; Bonser, Melissa; Jesus, Jhoven De

    2018-03-01

    To develop a falls risk screening tool (FRST) sensitive to the traumatic brain injury rehabilitation population. Falls are the most frequently recorded patient safety incident within the hospital context. The inpatient traumatic brain injury rehabilitation population is one particular population that has been identified as at high risk of falls. However, no FRST has been developed for this patient population. Consequently in the traumatic brain injury rehabilitation population, there is the real possibility that nurses are using falls risk screening tools that have a poor clinical utility. Multisite prospective cohort study. Univariate and multiple logistic regression modelling techniques (backward elimination, elastic net and hierarchical) were used to examine each variable's association with patients who fell. The resulting FRST's clinical validity was examined. Of the 140 patients in the study, 41 (29%) fell. Through multiple logistic regression modelling, 11 variables were identified as predictors for falls. Using hierarchical logistic regression, five of these were identified for inclusion in the resulting falls risk screening tool: prescribed mobility aid (such as, wheelchair or frame), a fall since admission to hospital, impulsive behaviour, impaired orientation and bladder and/or bowel incontinence. The resulting FRST has good clinical validity (sensitivity = 0.9; specificity = 0.62; area under the curve = 0.87; Youden index = 0.54). The tool was significantly more accurate (p = .037 on DeLong test) in discriminating fallers from nonfallers than the Ontario Modified STRATIFY FRST. A FRST has been developed using a comprehensive statistical framework, and evidence has been provided of this tool's clinical validity. The developed tool, the Sydney Falls Risk Screening Tool, should be considered for use in brain injury rehabilitation populations. © 2017 John Wiley & Sons Ltd.

  6. Effect of peer support on prevention of postnatal depression among high risk women: multisite randomised controlled trial.

    Science.gov (United States)

    Dennis, C-L; Hodnett, E; Kenton, L; Weston, J; Zupancic, J; Stewart, D E; Kiss, A

    2009-01-15

    To evaluate the effectiveness of telephone based peer support in the prevention of postnatal depression. Multisite randomised controlled trial. Seven health regions across Ontario, Canada. 701 women in the first two weeks postpartum identified as high risk for postnatal depression with the Edinburgh postnatal depression scale and randomised with an internet based randomisation service. Proactive individualised telephone based peer (mother to mother) support, initiated within 48-72 hours of randomisation, provided by a volunteer recruited from the community who had previously experienced and recovered from self reported postnatal depression and attended a four hour training session. Edinburgh postnatal depression scale, structured clinical interview-depression, state-trait anxiety inventory, UCLA loneliness scale, and use of health services. After web based screening of 21 470 women, 701 (72%) eligible mothers were recruited. A blinded research nurse followed up more than 85% by telephone, including 613 at 12 weeks and 600 at 24 weeks postpartum. At 12 weeks, 14% (40/297) of women in the intervention group and 25% (78/315) in the control group had an Edinburgh postnatal depression scale score >12 (chi(2)=12.5, P<0.001; number need to treat 8.8, 95% confidence interval 5.9 to 19.6; relative risk reduction 0.46, 95% confidence interval 0.24 to 0.62). There was a positive trend in favour of the intervention group for maternal anxiety but not loneliness or use of health services. For ethical reasons, participants identified with clinical depression at 12 weeks were referred for treatment, resulting in no differences between groups at 24 weeks. Of the 221 women in the intervention group who received and evaluated their experience of peer support, over 80% were satisfied and would recommend this support to a friend. Telephone based peer support can be effective in preventing postnatal depression among women at high risk. ISRCTN 68337727.

  7. Criminal victimisation in people with severe mental illness: a multi-site prevalence and incidence survey in the Netherlands.

    Directory of Open Access Journals (Sweden)

    Astrid M Kamperman

    Full Text Available BACKGROUND: Although crime victimisation is as prevalent in psychiatric patients as crime perpetration (and possibly more so, few European figures for it are available. We therefore assessed its one-year prevalence and incident rates in Dutch severely mentally ill outpatients, and compared the results with victimisation rates in the general population. METHOD: This multisite epidemiological survey included a random sample of 956 adult severely mentally ill outpatients. Data on victimisation were obtained using the victimisation scale of the Dutch Crime and Victimisation Survey, which assesses crime victimisation over the preceding 12 months. Comparison data were derived from the nationwide survey on safety and victimisation in the Netherlands. Prevalence and incident rates were weighted for sex, age, ethnicity and socioeconomic status, and compared with a general population sample matched by region (N = 38,227. RESULTS: In the past year, almost half of the severely mentally ill outpatients (47% had been victim of a crime. After control for demographic differences, prevalence rates of overall and specific victimisation measures were significantly higher in severely mentally ill outpatients than in the general population. The relative rates were especially high for personal crimes such as violent threats (RR = 2.12, 95% CI: 1.72-2.61, physical assaults (RR = 4.85, 95% CI: 3.69-6.39 and sexual harassment and assaults (RR = 3.94, 95% CI: 3.05-5.09. In concordance, severely mentally ill outpatients reported almost 14 times more personal crime incidents than persons from the general population (IRR = 13.68, 95% CI: 12.85-14.56. CONCLUSION: Crime victimisation is a serious problem in Dutch severely mentally ill outpatients. Mental-healthcare institutions and clinicians should become aware of their patients' victimisation risk, and should implement structural measures to detect and prevent (re-victimisation.

  8. Novel Magnetic Microprobe with Benzoboroxole-Modified Flexible Multisite Arm for High-Efficiency cis-Diol Biomolecule Detection.

    Science.gov (United States)

    Chen, Guosheng; Huang, Siming; Kou, Xiaoxue; Zhang, Jin'ge; Wang, Fuxin; Zhu, Fang; Ouyang, Gangfeng

    2018-03-06

    With regard to regulating a variety of biological events, including molecular recognition, signal transduction, cell adhesion, and immune response, cis-diol biomolecules, such as saccharides and glycoproteins, play vital roles. However, saccharides and glycoproteins in living systems usually exist in very low abundance, along with abundant interfering components. High-efficiency detection of saccharides and glycoproteins is a challenging yet highly impactful area of research. Herein, we reported a novel magnetic microprobe with a benzoboroxole-modified flexible multisite arm (PEG 2000-grafted PAMAM dendrimers; the microprobe was denoted as BFMA-MNP) for high-efficiency saccharides detection. The extraction capacity was significantly improved by ∼2 orders of magnitude, because of the integration of the enhanced hydrophilicity and multivalency effects in benzoboroxoles and the enhanced accessibility of the binding sites within the PEG 2000-grafted PAMAM dendrimers. As a result, the proposed approach possessed several advantages, compared with previous boronic acid-based methods, including ultrahigh sensitivity (limit of detection was <1 ng/mL), wide linear range (ranged from 0.5 μM to 2000 μM), and applicable in physiological pH condition. Furthermore, we established a general BFMA-MNP/glycoproteins/AuNPs sandwich assay to realize the visual glycoprotein qualitative screening for the first time. The unique sandwich assay possessed the dual nature of the magnetic separation by BFMA-MNPs and specific coloration by citrate-coated AuNPs. This visual sandwich assay enabled fast differentiation of the existence of glycoproteins in complicated samples without any advanced instruments. We believe the proposed BFMA-MNP microprobe herein will advance the ideas to detect and identify trace saccharides and glycoproteins in important fields such as glycomics and glycoproteomics.

  9. A Multi-site, Two-Phase, Prescription Opioid Addiction Treatment Study (POATS): Rationale, Design, and Methodology

    Science.gov (United States)

    Weiss, Roger D.; Potter, Jennifer Sharpe; Provost, Scott E.; Huang, Zhen; Jacobs, Petra; Hasson, Albert; Lindblad, Robert; Connery, Hilary Smith; Prather, Kristi; Ling, Walter

    2010-01-01

    The National Institute on Drug Abuse Clinical Trials Network launched the Prescription Opioid Addiction Treatment Study (POATS) in response to rising rates of prescription opioid dependence and gaps in understanding the optimal course of treatment for this population. POATS employed a multi-site, two-phase adaptive, sequential treatment design to approximate clinical practice. The study took place at 10 community treatment programs around the United States. Participants included men and women age ≥18 who met Diagnostic and Statistical Manual, 4th Edition criteria for dependence upon prescription opioids, with physiologic features; those with a prominent history of heroin use (according to pre-specified criteria) were excluded. All participants received buprenorphine/naloxone (bup/nx). Phase 1 consisted of 4 weeks of bup/nx treatment, including a 14-day dose taper, with 8 weeks of follow-up. Phase 1 participants were monitored for treatment response during these 12 weeks. Those who relapsed to opioid use, as defined by pre-specified criteria, were invited to enter Phase 2; Phase 2 consisted of 12 weeks of bup/nx stabilization treatment, followed by a 4-week taper and 8 weeks of post-treatment follow-up. Participants were randomized at the beginning of Phase 1 to receive bup/nx, paired with either Standard Medical Management (SMM) or Enhanced Medical Management (EMM; defined as SMM plus individual drug counseling). Eligible participants entering Phase 2 were re-randomized to either EMM or SMM. POATS was developed to determine what benefit, if any, EMM offers over SMM in short-term and longer-term treatment paradigm. This paper describes the rationale and design of the study. PMID:20116457

  10. Protective determinants of sickness absence among employees with multisite pain-a 7-year follow-up.

    Science.gov (United States)

    Haukka, Eija; Ojajärvi, Anneli; Kaila-Kangas, Leena; Leino-Arjas, Päivi

    2017-02-01

    We identified factors protective of all-cause sickness absence (SA) among subjects with multisite musculoskeletal pain (MSP). The nationally representative source sample comprised 3420 actively working Finns aged 30 to 55 in year 2000 and alive at follow-up. Pain in 18 body locations was combined into four sites (neck, low back, upper limbs, and lower limbs). The baseline prevalence of MSP (pain in ≥ 2 sites) was 32%. Baseline data on sociodemographic factors, work ability, work, health, and lifestyle were gathered by questionnaire, interview, and clinical examination and linked with national registers on all-cause SA (periods lasting ≥10 workdays) for 2002 to 2008. Based on trajectory analysis, 74% of those with MSP had a low and 26% a high probability of SA. In logistic regression analysis, younger age, male sex, and professional occupational group were inversely associated with SA. Allowing for these, good physician-assessed work ability, physically light work, possibility to adjust workday length, encouraging workplace atmosphere, no problems with working community or mental stress, normal weight, and no sleep disorders were predictive of lower SA rates (odds ratios between 0.47 and 0.70). In a final stepwise model adjusted for age, sex, and occupational group, no exposure to lifting (odds ratio 0.58, 95% confidence interval 0.39-0.85) and to repetitive hand movements (0.57, 0.39-0.83), possibility to adjust workday length (0.73, 0.53-0.99), and normal weight (0.59, 0.40-0.87) were inversely associated with SA. In conclusion, several modifiable factors related to work and lifestyle were found as predictive of lower rates of longer SA among occupationally active subjects with MSP.

  11. Chronic multisite brain recordings from a totally implantable bidirectional neural interface: experience in 5 patients with Parkinson's disease.

    Science.gov (United States)

    Swann, Nicole C; de Hemptinne, Coralie; Miocinovic, Svjetlana; Qasim, Salman; Ostrem, Jill L; Galifianakis, Nicholas B; Luciano, Marta San; Wang, Sarah S; Ziman, Nathan; Taylor, Robin; Starr, Philip A

    2018-02-01

    OBJECTIVE Dysfunction of distributed neural networks underlies many brain disorders. The development of neuromodulation therapies depends on a better understanding of these networks. Invasive human brain recordings have a favorable temporal and spatial resolution for the analysis of network phenomena but have generally been limited to acute intraoperative recording or short-term recording through temporarily externalized leads. Here, the authors describe their initial experience with an investigational, first-generation, totally implantable, bidirectional neural interface that allows both continuous therapeutic stimulation and recording of field potentials at multiple sites in a neural network. METHODS Under a physician-sponsored US Food and Drug Administration investigational device exemption, 5 patients with Parkinson's disease were implanted with the Activa PC+S system (Medtronic Inc.). The device was attached to a quadripolar lead placed in the subdural space over motor cortex, for electrocorticography potential recordings, and to a quadripolar lead in the subthalamic nucleus (STN), for both therapeutic stimulation and recording of local field potentials. Recordings from the brain of each patient were performed at multiple time points over a 1-year period. RESULTS There were no serious surgical complications or interruptions in deep brain stimulation therapy. Signals in both the cortex and the STN were relatively stable over time, despite a gradual increase in electrode impedance. Canonical movement-related changes in specific frequency bands in the motor cortex were identified in most but not all recordings. CONCLUSIONS The acquisition of chronic multisite field potentials in humans is feasible. The device performance characteristics described here may inform the design of the next generation of totally implantable neural interfaces. This research tool provides a platform for translating discoveries in brain network dynamics to improved neurostimulation

  12. Prevalence of drug use during sex amongst MSM in Europe: Results from a multi-site bio-behavioural survey.

    Science.gov (United States)

    Rosińska, Magdalena; Gios, Lorenzo; Nöstlinger, Christiana; Vanden Berghe, Wim; Marcus, Ulrich; Schink, Susanne; Sherriff, Nigel; Jones, Anna-Marie; Folch, Cinta; Dias, Sonia; Velicko, Inga; Mirandola, Massimo

    2018-05-01

    Substance use has been consistently reported to be more prevalent amongst Men who have Sex with Men (MSM) compared to the general population. Substance use, in particular polydrug use, has been found to be influenced by social and contextual factors and to increase the risk of unprotected intercourse among MSM. The objective of this analysis was to investigate the prevalence and predictors of drug use during a sexual encounter and to identify specific prevention needs. A multi-site bio-behavioural cross-sectional survey was implemented in 13 European cities, targeting MSM and using Time-Location Sampling and Respondent-Driven Sampling methods Multivariable multi-level logistic random-intercept model (random effect of study site) was estimated to identify factors associated with the use of alcohol, cannabis, party drugs, sexual performance enhancement drugs and chemsex drugs. Overall, 1261 (30.0%) participants reported drug use, and 436 of 3706 (11.8%) reported the use of two or more drugs during their last sexual encounter. By drug class, 966 (23.0%) reported using sexual performance enhancement drugs, 353 (8.4%) - party drugs, and 142 (3.4%) the use of chemsex drugs. Respondents who reported drug use were more frequently diagnosed with HIV (10.5% vs. 3.9%) before and with other STIs during the 12 months prior to the study (16.7% vs. 9.2%). The use of all the analysed substances was significantly associated with sexual encounter with more than one partner. Substance and polydrug use during sexual encounters occurred amongst sampled MSM across Europe although varying greatly between study sites. Different local social norms within MSM communities may be important contextual drivers of drug use, highlighting the need for innovative and multi-faceted prevention measures to reduce HIV/STI risk in the context of drug use. Copyright © 2018 Elsevier B.V. All rights reserved.

  13. Multisite musculoskeletal pain in adolescence as a predictor of medical and social welfare benefits in young adulthood: The Norwegian Arctic Adolescent Health Cohort Study.

    Science.gov (United States)

    Eckhoff, C; Straume, B; Kvernmo, S

    2017-11-01

    Pain in adolescence is associated with mental health problems, the main reason for work disability in young adults. This study explores the relationship between multisite musculoskeletal pain in adolescence and later medical (sickness and medical rehabilitation benefits) and social welfare benefits, adjusted for sociodemographic, adolescent psychosocial and mental health problems. Data were obtained by linkage between the National Insurance Registry (2003-11) and the Norwegian Arctic Adolescent Health Study, a school-based survey in North Norway (2003-05), accepted by 3987 fifteen- to sixteen-year-olds (68% of the total population). The start of the follow-up time was July 1st of the corresponding year the participants responded to the health study. Musculoskeletal pain was measured by the number of musculoskeletal pain sites. We found a positive linear relationship between adolescent musculoskeletal pain sites and the occurrence of medical and social welfare benefits in young adulthood (p ≤ 0.001). Adolescent musculoskeletal pain was a significant predictor of sickness (p adolescent psychosocial and mental health problems. The most important adolescent psychosocial predictors were externalizing problems, less parental involvement and adverse life events. Adolescent multisite musculoskeletal pain was found to be an important predictor of later sickness and social welfare benefit receipt from adolescence to young adulthood. Adolescents with multisite musculoskeletal pain are at substantially increased risk of health and social difficulties into young adulthood. Identification and interventions for these adolescent problems could alleviate this risk and be a sound socioeconomic investment. © 2017 European Pain Federation - EFIC®.

  14. Applying probabilistic temporal and multisite data quality control methods to a public health mortality registry in Spain: a systematic approach to quality control of repositories.

    Science.gov (United States)

    Sáez, Carlos; Zurriaga, Oscar; Pérez-Panadés, Jordi; Melchor, Inma; Robles, Montserrat; García-Gómez, Juan M

    2016-11-01

    To assess the variability in data distributions among data sources and over time through a case study of a large multisite repository as a systematic approach to data quality (DQ). Novel probabilistic DQ control methods based on information theory and geometry are applied to the Public Health Mortality Registry of the Region of Valencia, Spain, with 512 143 entries from 2000 to 2012, disaggregated into 24 health departments. The methods provide DQ metrics and exploratory visualizations for (1) assessing the variability among multiple sources and (2) monitoring and exploring changes with time. The methods are suited to big data and multitype, multivariate, and multimodal data. The repository was partitioned into 2 probabilistically separated temporal subgroups following a change in the Spanish National Death Certificate in 2009. Punctual temporal anomalies were noticed due to a punctual increment in the missing data, along with outlying and clustered health departments due to differences in populations or in practices. Changes in protocols, differences in populations, biased practices, or other systematic DQ problems affected data variability. Even if semantic and integration aspects are addressed in data sharing infrastructures, probabilistic variability may still be present. Solutions include fixing or excluding data and analyzing different sites or time periods separately. A systematic approach to assessing temporal and multisite variability is proposed. Multisite and temporal variability in data distributions affects DQ, hindering data reuse, and an assessment of such variability should be a part of systematic DQ procedures. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. Multi-site Study of Diffusion Metric Variability: Characterizing the Effects of Site, Vendor, Field Strength, and Echo Time using the Histogram Distance

    Science.gov (United States)

    Helmer, K. G.; Chou, M-C.; Preciado, R. I.; Gimi, B.; Rollins, N. K.; Song, A.; Turner, J.; Mori, S.

    2016-01-01

    MRI-based multi-site trials now routinely include some form of diffusion-weighted imaging (DWI) in their protocol. These studies can include data originating from scanners built by different vendors, each with their own set of unique protocol restrictions, including restrictions on the number of available gradient directions, whether an externally-generated list of gradient directions can be used, and restrictions on the echo time (TE). One challenge of multi-site studies is to create a common imaging protocol that will result in a reliable and accurate set of diffusion metrics. The present study describes the effect of site, scanner vendor, field strength, and TE on two common metrics: the first moment of the diffusion tensor field (mean diffusivity, MD), and the fractional anisotropy (FA). We have shown in earlier work that ROI metrics and the mean of MD and FA histograms are not sufficiently sensitive for use in site characterization. Here we use the distance between whole brain histograms of FA and MD to investigate within- and between-site effects. We concluded that the variability of DTI metrics due to site, vendor, field strength, and echo time could influence the results in multi-center trials and that histogram distance is sensitive metrics for each of these variables. PMID:27350723

  16. Ensuring treatment fidelity in a multi-site behavioral intervention study: implementing NIH Behavior Change Consortium recommendations in the SMART trial.

    Science.gov (United States)

    Robb, Sheri L; Burns, Debra S; Docherty, Sharron L; Haase, Joan E

    2011-11-01

    The Stories and Music for Adolescent/Young Adult Resilience during Transplant (SMART) study (R01NR008583; U10CA098543; U10CA095861) is an ongoing multi-site Children's Oncology Group randomized clinical trial testing the efficacy of a therapeutic music video intervention for adolescents/young adults (11-24 years of age) with cancer undergoing stem cell transplant. Treatment fidelity strategies from our trial are consistent with the National Institutes of Health (NIH) Behavior Change Consortium Treatment Fidelity Workgroup (BCC) recommendations and provide a successful working model for treatment fidelity implementation in a large, multi-site behavioral intervention study. In this paper, we summarize 20 specific treatment fidelity strategies used in the SMART trial and how these strategies correspond with NIH BCC recommendations in five specific areas: (1) study design, (2) training providers, (3) delivery of treatment, (4) receipt of treatment, and (5) enactment of treatment skills. Increased use and reporting of treatment fidelity procedures is essential in advancing the reliability and validity of behavioral intervention research. The SMART trial provides a strong model for the application of fidelity strategies to improve scientific findings and addresses the absence of published literature, illustrating the application of BCC recommendations in behavioral intervention studies. Copyright © 2010 John Wiley & Sons, Ltd.

  17. Lessons Learned in Evaluating a Multisite, Comprehensive Teen Dating Violence Prevention Strategy: Design and Challenges of the Evaluation of Dating Matters: Strategies to Promote Healthy Teen Relationships.

    Science.gov (United States)

    Niolon, Phyllis Holditch; Taylor, Bruce G; Latzman, Natasha E; Vivolo-Kantor, Alana M; Valle, Linda Anne; Tharp, Andra T

    2016-03-01

    This paper describes the multisite, longitudinal cluster randomized controlled trial (RCT) design of the evaluation of the Dating Matters: Strategies to Promote Healthy Relationships initiative, and discusses challenges faced in conducting this evaluation. Health departments in 4 communities are partnering with middle schools in high-risk, urban communities to implement 2 models of teen dating violence (TDV) prevention over 4 years. Schools were randomized to receive either the Dating Matters comprehensive strategy or the "standard of care" strategy (an existing, evidence-based TDV prevention curriculum). Our design permits comparison of the relative effectiveness of the comprehensive and standard of care strategies. Multiple cohorts of students from 46 middle schools are surveyed in middle school and high school, and parents and educators from participating schools are also surveyed. Challenges discussed in conducting a multisite RCT include site variability, separation of implementation and evaluation responsibilities, school retention, parent engagement in research activities, and working within the context of high-risk urban schools and communities. We discuss the strengths and weaknesses of our approaches to these challenges in the hopes of informing future research. Despite multiple challenges, the design of the Dating Matters evaluation remains strong. We hope this paper provides researchers who are conducting complex evaluations of behavioral interventions with thoughtful discussion of the challenges we have faced and potential solutions to such challenges.

  18. Multi-site Study of Diffusion Metric Variability: Characterizing the Effects of Site, Vendor, Field Strength, and Echo Time using the Histogram Distance.

    Science.gov (United States)

    Helmer, K G; Chou, M-C; Preciado, R I; Gimi, B; Rollins, N K; Song, A; Turner, J; Mori, S

    2016-02-27

    MRI-based multi-site trials now routinely include some form of diffusion-weighted imaging (DWI) in their protocol. These studies can include data originating from scanners built by different vendors, each with their own set of unique protocol restrictions, including restrictions on the number of available gradient directions, whether an externally-generated list of gradient directions can be used, and restrictions on the echo time (TE). One challenge of multi-site studies is to create a common imaging protocol that will result in a reliable and accurate set of diffusion metrics. The present study describes the effect of site, scanner vendor, field strength, and TE on two common metrics: the first moment of the diffusion tensor field (mean diffusivity, MD), and the fractional anisotropy (FA). We have shown in earlier work that ROI metrics and the mean of MD and FA histograms are not sufficiently sensitive for use in site characterization. Here we use the distance between whole brain histograms of FA and MD to investigate within- and between-site effects. We concluded that the variability of DTI metrics due to site, vendor, field strength, and echo time could influence the results in multi-center trials and that histogram distance is sensitive metrics for each of these variables.

  19. Multi-site study of diffusion metric variability: effects of site, vendor, field strength, and echo time on regions-of-interest and histogram-bin analyses.

    Science.gov (United States)

    Helmer, K G; Chou, M-C; Preciado, R I; Gimi, B; Rollins, N K; Song, A; Turner, J; Mori, S

    2016-02-27

    It is now common for magnetic-resonance-imaging (MRI) based multi-site trials to include diffusion-weighted imaging (DWI) as part of the protocol. It is also common for these sites to possess MR scanners of different manufacturers, different software and hardware, and different software licenses. These differences mean that scanners may not be able to acquire data with the same number of gradient amplitude values and number of available gradient directions. Variability can also occur in achievable b-values and minimum echo times. The challenge of a multi-site study then, is to create a common protocol by understanding and then minimizing the effects of scanner variability and identifying reliable and accurate diffusion metrics. This study describes the effect of site, scanner vendor, field strength, and TE on two diffusion metrics: the first moment of the diffusion tensor field (mean diffusivity, MD), and the fractional anisotropy (FA) using two common analyses (region-of-interest and mean-bin value of whole brain histograms). The goal of the study was to identify sources of variability in diffusion-sensitized imaging and their influence on commonly reported metrics. The results demonstrate that the site, vendor, field strength, and echo time all contribute to variability in FA and MD, though to different extent. We conclude that characterization of the variability of DTI metrics due to site, vendor, field strength, and echo time is a worthwhile step in the construction of multi-center trials.

  20. Evaluating meteorological data from weather stations, and from satellites and global models for a multi-site epidemiological study.

    Science.gov (United States)

    Colston, Josh M; Ahmed, Tahmeed; Mahopo, Cloupas; Kang, Gagandeep; Kosek, Margaret; de Sousa Junior, Francisco; Shrestha, Prakash Sunder; Svensen, Erling; Turab, Ali; Zaitchik, Benjamin

    2018-04-21

    Longitudinal and time series analyses are needed to characterize the associations between hydrometeorological parameters and health outcomes. Earth Observation (EO) climate data products derived from satellites and global model-based reanalysis have the potential to be used as surrogates in situations and locations where weather-station based observations are inadequate or incomplete. However, these products often lack direct evaluation at specific sites of epidemiological interest. Standard evaluation metrics of correlation, agreement, bias and error were applied to a set of ten hydrometeorological variables extracted from two quasi-global, commonly used climate data products - the Global Land Data Assimilation System (GLDAS) and Climate Hazards Group InfraRed Precipitation with Stations (CHIRPS) - to evaluate their performance relative to weather-station derived estimates at the specific geographic locations of the eight sites in a multi-site cohort study. These metrics were calculated for both daily estimates and 7-day averages and for a rotavirus-peak-season subset. Then the variables from the two sources were each used as predictors in longitudinal regression models to test their association with rotavirus infection in the cohort after adjusting for covariates. The availability and completeness of station-based validation data varied depending on the variable and study site. The performance of the two gridded climate models varied considerably within the same location and for the same variable across locations, according to different evaluation criteria and for the peak-season compared to the full dataset in ways that showed no obvious pattern. They also differed in the statistical significance of their association with the rotavirus outcome. For some variables, the station-based records showed a strong association while the EO-derived estimates showed none, while for others, the opposite was true. Researchers wishing to utilize publicly available climate data

  1. Preliminary results on the fracture analysis of multi-site cracking of lap joints in aircraft skins

    Science.gov (United States)

    Beuth, J. L., Jr.; Hutchinson, John W.

    1992-07-01

    Results of a fracture mechanics analysis relevant to fatigue crack growth at rivets in lap joints of aircraft skins are presented. Multi-site damage (MSD) is receiving increased attention within the context of problems of aging aircraft. Fracture analyses previously carried out include small-scale modeling of rivet/skin interactions, larger-scale two-dimensional models of lap joints similar to that developed here, and full scale three-dimensional models of large portions of the aircraft fuselage. Fatigue testing efforts have included flat coupon specimens, two-dimensional lap joint tests, and full scale tests on specimens designed to closely duplicate aircraft sections. Most of this work is documented in the proceedings of previous symposia on the aging aircraft problem. The effect MSD has on the ability of skin stiffeners to arrest the growth of long skin cracks is a particularly important topic that remains to be addressed. One of the most striking features of MSD observed in joints of some test sections and in the joints of some of the older aircraft fuselages is the relative uniformity of the fatigue cracks from rivet to rivet along an extended row of rivets. This regularity suggests that nucleation of the cracks must not be overly difficult. Moreover, it indicates that there is some mechanism which keeps longer cracks from running away from shorter ones, or, equivalently, a mechanism for shorter cracks to catch-up with longer cracks. This basic mechanism has not been identified, and one of the objectives of the work is to see to what extent the mechanism is revealed by a fracture analysis of the MSD cracks. Another related aim is to present accurate stress intensity factor variations with crack length which can be used to estimate fatigue crack growth lifetimes once cracks have been initiated. Results are presented which illustrate the influence of load shedding from rivets with long cracks to neighboring rivets with shorter cracks. Results are also included

  2. Multi-Site Project Management A Program for Reducing the Cost of Technology Deployment at Department of Energy Sites

    International Nuclear Information System (INIS)

    Davis, N.R.; Selden, E.R.; Little, D.B.; Coleman, M.C.; Bennett, J.T.

    2009-01-01

    Retrieval and processing of High Level Waste (HLW) stored in Department of Energy (DOE) waste tanks is performed to support closure of the tanks as required by site specific regulatory agreements. Currently, there are four sites in the DOE Complex that have HLW tanks and must process and disposition HLW. As such, there is an opportunity to achieve an economy of scale and reduce duplication of efforts. Two or more sites typically have similar technology development and deployment needs. Technology development is already executed at the national level. As the technology is matured, the next step is to commission a design/build project. Typically each site performs this separately due to differences in waste type, tank design, site specific considerations such as proximity to the water table or to the site boundary. The focus of the individual sites tends to be on the differences between sites versus on the similarities thus there is an opportunity to minimize the cost for similar deployments. A team of engineers and project management professionals from the Savannah River Site has evaluated technology needs at the four HLW sites and determined that there is an economy of scale that can be achieved by specific technology deployments in the area of waste retrieval, waste pretreatment and waste disposition. As an example, the Waste on Wheels tank retrieval system (presented in the 2006 Waste Management Symposium) was designed and fabricated in portable modules that could be installed in HLW tanks at Hanford, Savannah River or Idaho. This same concept could be used for modular in-tank cesium removal process and equipment, tank cleaning mechanical equipment, and chemical tank cleaning process and equipment. The purpose of this paper is to present a multi-site project management approach that will reduce deployment costs and be consistent with DOE Order 413.3 project management principles. The approach will describe how projects can be managed by a lead site with

  3. Measuring Variance in Subnational Regimes: Results from an Expert-Based Operationalization of Democracy in the Argentine Provinces Midiendo la variación de los regímenes subnacionales: Resultados de una operacionalización basada en expertos de la democracia en las provincias argentinas

    Directory of Open Access Journals (Sweden)

    Carlos Gervasoni

    2010-01-01

    Política Provincial (EEPP y se realiza un análisis preliminar de sus resultados. Algunos aspectos de los regímenes provinciales aparecen como claramente democráticos, mientras que otros son mixtos o incluso se inclinan hacia el autoritarismo. Además, algunos muestran escasa variación interprovincial, mientras que otros varían considerablemente de provincia a provincia. Un análisis de la tendencia central y la dispersión de los ítems de la encuesta permite una descripción general de los regímenes provinciales argentinos. La dimensión más democrática es la inclusión, mientras que la efectividad de los límites institucionales al poder del Ejecutivo es la más deficiente. La competencia electoral no es en general afectada por formas tradicionales de fraude, pero los oficialismos a menudo gozan de mucho mayores niveles de recursos de campaña y atención mediática que sus oponentes. La represión física es poco habitual, pero los opositores en algunas provincias enfrentan formas más sutiles de castigo. Aunque la encuesta no descubre ningún caso claro de autoritarismo subnacional en sentido estricto, los regímenes provinciales varían significativamente desde los que son básicamente democráticos hasta los claramente híbridos.

  4. Relevância de exames de rotina em pacientes de baixo risco submetidos a cirurgias de pequeno e médio porte Relevancia de los exámenes de rutina en pacientes de bajo riesgo sometidos a cirugías menores Relevance of routine testing in low-risk patients undergoing minor and medium surgical procedures

    Directory of Open Access Journals (Sweden)

    Danielle de Sousa Soares

    2013-04-01

    evaluación preoperatoria tiene el objetivo de disminuir la morbimortalidad del paciente quirúrgico, el coste de la atención perioperatoria y la ansiedad preoperatoria. A partir de la evaluación clínica debemos definir la necesidad de exámenes complementarios y de estrategias para reducir el riesgo anestésico-quirúrgico. El objetivo de este trabajo fue el de evaluar el beneficio de exámenes de rutina preoperatorio de pacientes de bajo riesgo en las cirugías menores. MÉTODOS: Se trata de un estudio descriptivo, transversal con 700 pacientes atendidos en la consulta de evaluación preanestésica del Hospital Santo Antonio, Salvador, BA. Fueron incluidos pacientes de 1 a 45 años, estado físico ASA I, que serían sometidos a cirugías electivas menores. Se evaluaron las alteraciones en el hemograma, el coagulograma, el electrocardiograma, RX de tórax, glucemia, función renal y dosificación de sodio y potasio, y los eventuales cambios de conducta que se suscitaron provenientes de esas alteraciones. RESULTADOS: De los 800 pacientes evaluados un 97,5% realizaron hemograma, 89% coagulograma, 74,1% electrocardiograma, 62% RX de tórax, 68% glucemia en ayunas, 55,7% dosificaciones séricas de urea y creatinina y un 10,1% dosificaciones de sodio y potasio séricos. De esos 800 pacientes, 68 (9,71% tuvieron alteración en los exámenes preoperatorios de rutina y solo 10 (14,7% de los considerados alterados tuvieron una conducta preoperatoria modificada, o sea, una solicitación de nuevos exámenes, interconsulta o la postergación del procedimiento. Ninguna de las cirugías se suspendió. CONCLUSIONES: Observamos que los excesivos exámenes complementarios se solicitaban en el preoperatorio, aunque fuese en los pacientes jóvenes y de bajo riesgo quirúrgico, con poca o ninguna interferencia en el conducta perioperatoria. Los exámenes laboratoriales estándares no son buenos instrumentos de screening de enfermedades y pueden generar gastos elevados e innecesarios

  5. Análise da capacidade diagnóstica dos exames preventivos do câncer de colo uterino Análisis de la capacidad diagnóstica de los exámenes preventivos del cáncer de cuello uterino Analysis of the capacity of preventive diagnostic tests for cervical cancer

    Directory of Open Access Journals (Sweden)

    Thaís Marques Lima

    2012-01-01

    Full Text Available OBJETIVO: Avaliar a capacidade diagnóstica dos exames citológicos, colposcópico e histológico na detecção de lesões pré-malignas. MÉTODOS: Estudo documental, retrospectivo, com abordagem quantitativa, realizado no Instituto de Prevenção do Câncer (IPC, em Fortaleza-CE. A população foi composta por prontuários de 112 mulheres que possuíam o resultado dos três exames. Adotou-se o teste de qui-quadrado e considerou-se estatisticamente significativo quando p OBJETIVO: Evaluar la capacidad diagnóstica de los exámenes citológicos, colposcópico e histológico en la detección de lesiones pre-malignas. MÉTODOS: Estudio documental, retrospectivo, con abordaje cuantitativo, realizado en el Instituto de Prevención del Cáncer (IPC, en Fortaleza-CE. La población estuvo compuesta por historias clínicas de 112 mujeres que poseían el resultado de los tres exámenes. Se adoptó el test de Chi-cuadrado y se consideró estadísticamente significativo cuando p OBJECTIVE: To evaluate the diagnostic capacity of cytological, colposcopic, and histological exams on the detection of premalignant lesions. METHODS: A documentary, retrospective study, with a quantitative approach, conducted in the Cancer Prevention Institute (CPI, in Fortaleza-CE. The population consisted of medical records of 112 women who had the results of these three exams. We adopted the chi-square test and considered it statistically significant when p <0.05. We applied sensitivity and specificity, positive predictive value (PPV and negative predictive value (NPV for cytology and colposcopy. RESULTS: From the comparison between the diagnostic tests, we observed that cytology obtained a sensitivity of 89.8%, a specificity of 35.7%, a PPV of 90.7% and an NPV of 33.3%. Colposcopy achieved a sensitivity of 84.7%, a specificity of 50%, a PPV of 92.2% and an NPV of 31.8%. CONCLUSION: We found that these tests presented sensitivity and specificity that can alternate with one

  6. Commande en boucle fermee sur un profil d'aile deformable dans la soufflerie Price-Paidoussis

    Science.gov (United States)

    Brossard, Jeremy

    The purpose of the ATR-42 project is to apply the concept of morphing wings by fabricating a morphing composite wing model of the Regional Transport Aircraft-42 to reduce drag and improve the aerodynamic performance. A control-command system coupled to an actuator mechanism will morph the wing skin. However, for best results, the control of the deformation must be studied carefully to insure the precision. Thus, a dual digitalexperimental approach is required. The solution proposed in this paper focuses on the controlled deformation of the upper wing of the ATR-42. A composite wing model with morphing capabilities was built and tested in the wind tunnel to evaluate its aerodynamic performance and serve as reference. A deformation mechanism, consisting of two engines and two camshafts, was subsequently designed and integrated within this model to obtain the optimum wing shapes according to the different flight condition. A control loop position was modeled in Matlab / Simulink and implemented experimentally to control the mechanism. Two types of results have been obtained. The first set concerned regulation and the second concerned aerodynamics. The control loop has achieved the desired skin displacement with an accuracy of 5%. Deformations of the upper skin were performed by a actuation system driven by motors, limitations supply were assured by the regulation architecture. For several flight conditions, the pressure measurements, validated with simulation results, have confirmed a reduction of the induced drag, compared to the original ATR-42 airfoil drag reduction.

  7. Strategic planning for waste management: Characterization of chemically and radioactively hazardous waste and treatment, storage, and disposal capabilities for diverse and varied multisite operations

    International Nuclear Information System (INIS)

    Jolley, R.L.; Rivera, A.L.; Fox, E.C.; Hyfantis, G.J.; McBrayer, J.F.

    1988-01-01

    Information about current and projected waste generation as well as available treatment, storage, and disposal (TSD) capabilities and needs is crucial for effective, efficient, and safe waste management. This is especially true for large corporations that are responsible for multisite operations involving diverse and complex industrial processes. Such information is necessary not only for day-to-day operations, but also for strategic planning to ensure safe future performance. This paper reports on some methods developed and successfully applied to obtain requisite information and to assist waste management planning at the corporate level in a nationwide system of laboratories and industries. Waste generation and TSD capabilities at selected US Department of Energy (DOE) sites were studied. 1 ref., 2 tabs

  8. A Phase 3 Placebo-Controlled, Double Blind, Multi-Site Trial of the alpha-2-adrenergic Agonist, Lofexidine, for Opioid Withdrawal

    Science.gov (United States)

    Yu, Elmer; Miotto, Karen; Akerele, Evaristo; Montgomery, Ann; Elkashef, Ahmed; Walsh, Robert; Montoya, Ivan; Fischman, Marian W.; Collins, Joseph; McSherry, Frances; Boardman, Kathy; Davies, David K.; O’Brien, Charles P.; Ling, Walter; Kleber, Herbert; Herman, Barbara H.

    2008-01-01

    Context Lofexidine is an alpha-2-A noradrenergic receptor agonist that is approved in the United Kingdom for the treatment of opioid withdrawal symptoms. Lofexidine has been reported to have more significant effects on decreasing opioid withdrawal symptoms with less hypotension than clonidine. Objective To demonstrate that lofexidine is well tolerated and effective in the alleviation of observationally-defined opioid withdrawal symptoms in opioid dependent individuals undergoing medically supervised opioid detoxification as compared to placebo. Design An inpatient, Phase 3, placebo-controlled, double blind, randomized multi-site trial with three phases: (1) Opioid Agonist Stabilization Phase (days 1–3), (2) Detoxification/Medication or Placebo Phase (days 4–8), and (3) Post Detoxification/Medication Phase (days 9–11). Subjects Sixty-eight opioid dependent subjects were enrolled at three sites with 35 randomized to lofexidine and 33 to placebo. Main Outcome Measure Modified Himmelsbach Opiate Withdrawal Scale (MHOWS) on study day 5 (2nd opioid detoxification treatment day). Results Due to significant findings, the study was terminated early. On the study day 5 MHOWS, subjects treated with lofexidine had significantly lower scores (equating to fewer/less severe withdrawal symptoms) than placebo subjects (Least squares means 19.5 ± 2.1 versus 30.9 ± 2.7; p=0.0019). Lofexidine subjects had significantly better retention in treatment than placebo subjects (38.2% versus 15.2%; Log rank test p=0.01). Conclusions Lofexidine is well tolerated and more efficacious than placebo for reducing opioid withdrawal symptoms in inpatients undergoing medically supervised opioid detoxification. Trial Registration trial registry name A Phase 3 Placebo-Controlled, Double-Blind Multi-Site Trial of Lofexidine for Opiate Withdrawal, registration number NCT00032942, URL for the registry http://clinicaltrials.gov/ct/show/NCT00032942?order=4. PMID:18508207

  9. Validation of mismatch negativity and P3a for use in multi-site studies of schizophrenia: characterization of demographic, clinical, cognitive, and functional correlates in COGS-2.

    Science.gov (United States)

    Light, Gregory A; Swerdlow, Neal R; Thomas, Michael L; Calkins, Monica E; Green, Michael F; Greenwood, Tiffany A; Gur, Raquel E; Gur, Ruben C; Lazzeroni, Laura C; Nuechterlein, Keith H; Pela, Marlena; Radant, Allen D; Seidman, Larry J; Sharp, Richard F; Siever, Larry J; Silverman, Jeremy M; Sprock, Joyce; Stone, William S; Sugar, Catherine A; Tsuang, Debby W; Tsuang, Ming T; Braff, David L; Turetsky, Bruce I

    2015-04-01

    Mismatch negativity (MMN) and P3a are auditory event-related potential (ERP) components that show robust deficits in schizophrenia (SZ) patients and exhibit qualities of endophenotypes, including substantial heritability, test-retest reliability, and trait-like stability. These measures also fulfill criteria for use as cognition and function-linked biomarkers in outcome studies, but have not yet been validated for use in large-scale multi-site clinical studies. This study tested the feasibility of adding MMN and P3a to the ongoing Consortium on the Genetics of Schizophrenia (COGS) study. The extent to which demographic, clinical, cognitive, and functional characteristics contribute to variability in MMN and P3a amplitudes was also examined. Participants (HCS n=824, SZ n=966) underwent testing at 5 geographically distributed COGS laboratories. Valid ERP recordings were obtained from 91% of HCS and 91% of SZ patients. Highly significant MMN (d=0.96) and P3a (d=0.93) amplitude reductions were observed in SZ patients, comparable in magnitude to those observed in single-lab studies with no appreciable differences across laboratories. Demographic characteristics accounted for 26% and 18% of the variance in MMN and P3a amplitudes, respectively. Significant relationships were observed among demographically-adjusted MMN and P3a measures and medication status as well as several clinical, cognitive, and functional characteristics of the SZ patients. This study demonstrates that MMN and P3a ERP biomarkers can be feasibly used in multi-site clinical studies. As with many clinical tests of brain function, demographic factors contribute to MMN and P3a amplitudes and should be carefully considered in future biomarker-informed clinical studies. Published by Elsevier B.V.

  10. Emociones y cultura política: análisis de las galerías de la memoria presentadas por el Capítulo Bogotá del Movimiento Nacional de Víctimas de Crímenes de Estado (Movice

    Directory of Open Access Journals (Sweden)

    David Eduardo González Caballero

    2016-01-01

    Full Text Available El texto propone repensar el concepto de cultura política como la lucha por elsentido de lo social, para adaptarlo a las necesidades de un trabajo cualitativo y deperspectiva microsocial, mediante la inclusión de insumos teóricos y metodológicosprovenientes de las sociologías de los movimientos sociales y de las emociones.Una vez planteada esta concepción renovada de dicho concepto, el texto se ocupadel análisis de las galerías de la memoria desplegadas por el Capítulo Bogotá delMovimiento Nacional de Víctimas de Crímenes de Estado (Movice, argumentandoque el principal objetivo de estos actos públicos de memoria es la transformaciónde la cultura política de quienes los observan, en un proceso de resocializacióncognitiva, emocional y moral dirigido contra los significados, reglas emocionalesy principios morales que dan soporte a determinadas estructuras y relaciones dedominación en el ámbito macrosocial.

  11. Emociones y cultura política. Análisis de las galerías de la memoria presentadas por el Capítulo Bogotá del Movimiento Nacional de Víctimas de Crímenes de Estado (Movice

    Directory of Open Access Journals (Sweden)

    David Eduardo González Caballero

    Full Text Available El texto propone repensar el concepto de cultura política como la lucha por el sentido de lo social, para adaptarlo a las necesidades de un trabajo cualitativo y de perspectiva microsocial, mediante la inclusión de insumos teóricos y metodológicos provenientes de las sociologías de los movimientos sociales y de las emociones. Una vez planteada esta concepción renovada de dicho concepto, el texto se ocupa del análisis de las galerías de la memoria desplegadas por el Capítulo Bogotá del Movimiento Nacional de Víctimas de Crímenes de Estado (Movice, argumentando que el principal objetivo de estos actos públicos de memoria es la transformación de la cultura política de quienes los observan, en un proceso de resocialización cognitiva, emocional y moral dirigido contra los significados, reglas emocionales y principios morales que dan soporte a determinadas estructuras y relaciones de dominación en el ámbito macrosocial.

  12. What is the benefit of driving a hydrological model with data from a multi-site weather generator compared to data from a simple delta change approach?"

    Science.gov (United States)

    Rössler, Ole; Keller, Denise; Fischer, Andreas

    2016-04-01

    . Recently, a multi-site weather generator was developed and tested for downscaling purposes over Switzerland. The weather generator is of type Richardson, that is run with spatially correlated random number streams to ensure spatial consistency. As a downside, multi-site weather generators are much more complex to develop, but they are a very promising alternative downscaling technique. A new multi-site-weather generator was developed for Switzerland in a previous study (Keller et al. 2014). In this study, we tested this new multi-site-weather generator against the "standard" delta change derived data in a hydrological impact assessment study that focused on runoff in the meso-scale catchment of the river Thur catchment. Two hydrological models of different complexity were run with the data sets under present (1980-2009) and under future conditions (2070-2099), assuming the SRES A1B emission2070-2100 scenario conditions. Eight meteorological stations were used to interpolate a meteorological field that served as input to calibrate and validate the two hydrological models against runoff. The downscaling intercomparison was done for We applied 10 GCM-RCM combinations simulations of the ENSEMBLES. In case of the weather generator, that allows for multiple synthetic realizations, we generated for which change factors for each station (delta change approach) were available and generated 25 realizations of multi-site weather. with each climate model projection. Results show that the delta change driven data constitutes only one appropriate representation compared to theof a bandwidth of runoff projections yielded by the multi-site weather generator data. Especially oOn average, differences between both the two approaches are small. Low and high runoff Runoff values to both extremes are however better reproduced with the weather generator driven data set. The stochastic representation of multiday rainfall events are considered as the main reason. Hence, tThere is a clear yet small

  13. CHERISH (collaboration for hospitalised elders reducing the impact of stays in hospital): protocol for a multi-site improvement program to reduce geriatric syndromes in older inpatients.

    Science.gov (United States)

    Mudge, Alison M; Banks, Merrilyn D; Barnett, Adrian G; Blackberry, Irene; Graves, Nicholas; Green, Theresa; Harvey, Gillian; Hubbard, Ruth E; Inouye, Sharon K; Kurrle, Sue; Lim, Kwang; McRae, Prue; Peel, Nancye M; Suna, Jessica; Young, Adrienne M

    2017-01-09

    Older inpatients are at risk of hospital-associated geriatric syndromes including delirium, functional decline, incontinence, falls and pressure injuries. These contribute to longer hospital stays, loss of independence, and death. Effective interventions to reduce geriatric syndromes remain poorly implemented due to their complexity, and require an organised approach to change care practices and systems. Eat Walk Engage is a complex multi-component intervention with structured implementation, which has shown reduced geriatric syndromes and length of stay in pilot studies at one hospital. This study will test effectiveness of implementing Eat Walk Engage using a multi-site cluster randomised trial to inform transferability of this intervention. A hybrid study design will evaluate the effectiveness and implementation strategy of Eat Walk Engage in a real-world setting. A multisite cluster randomised study will be conducted in 8 medical and surgical wards in 4 hospitals, with one ward in each site randomised to implement Eat Walk Engage (intervention) and one to continue usual care (control). Intervention wards will be supported to develop and implement locally tailored strategies to enhance early mobility, nutrition, and meaningful activities. Resources will include a trained, mentored facilitator, audit support, a trained healthcare assistant, and support by an expert facilitator team using the i-PARIHS implementation framework. Patient outcomes and process measures before and after intervention will be compared between intervention and control wards. Primary outcomes are any hospital-associated geriatric syndrome (delirium, functional decline, falls, pressure injuries, new incontinence) and length of stay. Secondary outcomes include discharge destination; 30-day mortality, function and quality of life; 6 month readmissions; and cost-effectiveness. Process measures including patient interviews, activity mapping and mealtime audits will inform interventions in each

  14. Evaluating climate change impacts on streamflow variability based on a multisite multivariate GCM downscaling method in the Jing River of China

    Science.gov (United States)

    Li, Zhi; Jin, Jiming

    2017-11-01

    Projected hydrological variability is important for future resource and hazard management of water supplies because changes in hydrological variability can cause more disasters than changes in the mean state. However, climate change scenarios downscaled from Earth System Models (ESMs) at single sites cannot meet the requirements of distributed hydrologic models for simulating hydrological variability. This study developed multisite multivariate climate change scenarios via three steps: (i) spatial downscaling of ESMs using a transfer function method, (ii) temporal downscaling of ESMs using a single-site weather generator, and (iii) reconstruction of spatiotemporal correlations using a distribution-free shuffle procedure. Multisite precipitation and temperature change scenarios for 2011-2040 were generated from five ESMs under four representative concentration pathways to project changes in streamflow variability using the Soil and Water Assessment Tool (SWAT) for the Jing River, China. The correlation reconstruction method performed realistically for intersite and intervariable correlation reproduction and hydrological modeling. The SWAT model was found to be well calibrated with monthly streamflow with a model efficiency coefficient of 0.78. It was projected that the annual mean precipitation would not change, while the mean maximum and minimum temperatures would increase significantly by 1.6 ± 0.3 and 1.3 ± 0.2 °C; the variance ratios of 2011-2040 to 1961-2005 were 1.15 ± 0.13 for precipitation, 1.15 ± 0.14 for mean maximum temperature, and 1.04 ± 0.10 for mean minimum temperature. A warmer climate was predicted for the flood season, while the dry season was projected to become wetter and warmer; the findings indicated that the intra-annual and interannual variations in the future climate would be greater than in the current climate. The total annual streamflow was found to change insignificantly but its variance ratios of 2011-2040 to 1961-2005 increased

  15. Evaluating climate change impacts on streamflow variability based on a multisite multivariate GCM downscaling method in the Jing River of China

    Directory of Open Access Journals (Sweden)

    Z. Li

    2017-11-01

    Full Text Available Projected hydrological variability is important for future resource and hazard management of water supplies because changes in hydrological variability can cause more disasters than changes in the mean state. However, climate change scenarios downscaled from Earth System Models (ESMs at single sites cannot meet the requirements of distributed hydrologic models for simulating hydrological variability. This study developed multisite multivariate climate change scenarios via three steps: (i spatial downscaling of ESMs using a transfer function method, (ii temporal downscaling of ESMs using a single-site weather generator, and (iii reconstruction of spatiotemporal correlations using a distribution-free shuffle procedure. Multisite precipitation and temperature change scenarios for 2011–2040 were generated from five ESMs under four representative concentration pathways to project changes in streamflow variability using the Soil and Water Assessment Tool (SWAT for the Jing River, China. The correlation reconstruction method performed realistically for intersite and intervariable correlation reproduction and hydrological modeling. The SWAT model was found to be well calibrated with monthly streamflow with a model efficiency coefficient of 0.78. It was projected that the annual mean precipitation would not change, while the mean maximum and minimum temperatures would increase significantly by 1.6 ± 0.3 and 1.3 ± 0.2 °C; the variance ratios of 2011–2040 to 1961–2005 were 1.15 ± 0.13 for precipitation, 1.15 ± 0.14 for mean maximum temperature, and 1.04 ± 0.10 for mean minimum temperature. A warmer climate was predicted for the flood season, while the dry season was projected to become wetter and warmer; the findings indicated that the intra-annual and interannual variations in the future climate would be greater than in the current climate. The total annual streamflow was found to change insignificantly but its

  16. Activities and interim outcomes of a multi-site development project to promote cognitive support technology use and employment success among postsecondary students with traumatic brain injuries.

    Science.gov (United States)

    Hendricks, Deborah J; Sampson, Elaine; Rumrill, Phillip; Leopold, Anne; Elias, Eileen; Jacobs, Karen; Nardone, Amanda; Scherer, Marcia; Stauffer, Callista

    2015-01-01

    This article describes the activities and interim outcomes of a multi-site development project called Project Career, designed to promote cognitive support technology (CST) use and employment success for college and university students with traumatic brain injuries (TBIs). To obtain early intervention results from participants in Project Career's first 18 months of operation. Fifty-six students with TBI have participated to date across three implementation sites in Massachusetts, Ohio, and West Virginia, with 25 of these participants being military veterans. Descriptive analyses provide information regarding the participants, the barriers they face due to their TBI in obtaining a post-secondary education, and the impact services provided by Project Career have had to date in ameliorating those difficulties. Inferential statistical analyses provide preliminary results regarding program effectiveness. Preliminary results indicate the program is encouraging students to use CST strategies in the form of iPads and cognitive enhancement applications (also known as 'apps'). Significant results indicate participants are more positive, independent, and social; participants have a more positive attitude toward technology after six months in the program; and participants reported significantly improved experiences with technology during their first six months in the program. Participating students are actively preparing for their careers after graduation through a wide range of intensive vocational supports provided by project staff members.

  17. Brain white matter changes associated with urological chronic pelvic pain syndrome: Multi-site neuroimaging from a MAPP case-control study

    Science.gov (United States)

    Huang, Lejian; Kutch, Jason J.; Ellingson, Benjamin M.; Martucci, Katherine T.; Harris, Richard E.; Clauw, Daniel J.; Mackey, Sean; Mayer, Emeran A.; Schaeffer, Anthony J.; Apkarian, A. Vania; Farmer, Melissa A.

    2016-01-01

    Clinical phenotyping of urological chronic pelvic pain syndromes (UCPPS) in men and women has focused on end-organ abnormalities to identify putative clinical subtypes. Initial evidence of abnormal brain function and structure in male pelvic pain has necessitated large-scale, multi-site investigations into potential UCPPS brain biomarkers. We present the first evidence of regional white matter (axonal) abnormalities in men and women with UCPPS, compared to positive (irritable bowel syndrome, IBS) and healthy controls. Epidemiological and neuroimaging data was collected from participants with UCPPS (n=52), IBS (n=39), and healthy, sex- and age-matched controls (n=61). White matter microstructure, measured as fractional anisotropy (FA), was examined with diffusion tensor imaging (DTI). Group differences in regional FA positively correlated with pain severity, including segments of the right corticospinal tract and right anterior thalamic radiation. Increased corticospinal FA was specific and sensitive to UCPPS, positively correlated with pain severity, and reflected sensory (not affective) features of pain. Reduced anterior thalamic radiation FA distinguished IBS from UCPPS patients and controls, suggesting greater microstructural divergence from normal tract organization. Findings confirm that regional white matter abnormalities characterize UCPPS and can distinguish between visceral diagnoses, suggesting that regional axonal microstructure is either altered with ongoing pain or predisposes its development. PMID:27842046

  18. Journey Toward High Reliability: A Comprehensive Safety Program to Improve Quality of Care and Safety Culture in a Large, Multisite Radiation Oncology Department.

    Science.gov (United States)

    Woodhouse, Kristina Demas; Volz, Edna; Maity, Amit; Gabriel, Peter E; Solberg, Timothy D; Bergendahl, Howard W; Hahn, Stephen M

    2016-05-01

    High-reliability organizations (HROs) focus on continuous identification and improvement of safety issues. We sought to advance a large, multisite radiation oncology department toward high reliability through the implementation of a comprehensive safety culture (SC) program at the University of Pennsylvania Department of Radiation Oncology. In 2011, with guidance from safety literature and experts in HROs, we designed an SC framework to reduce radiation errors. All state-reported medical events (SRMEs) from 2009 to 2016 were retrospectively reviewed and plotted on a control chart. Changes in SC grade were assessed using the Agency for Healthcare Research and Quality Hospital Survey. Outcomes measured included the number of radiation treatment fractions and days between SRMEs, as well as SC grade. Multifaceted safety initiatives were implemented at our main academic center and across all network sites. Postintervention results demonstrate increased staff fundamental safety knowledge, enhanced peer review with an electronic system, and special cause variation of SRMEs on control chart analysis. From 2009 to 2016, the number of days and fractions between SRMEs significantly increased, from a mean of 174 to 541 days (P safety framework. Our multifaceted initiatives, focusing on culture and system changes, can be successfully implemented in a large academic radiation oncology department to yield measurable improvements in SC and outcomes. Copyright © 2016 by American Society of Clinical Oncology.

  19. Validity Evidence and Scoring Guidelines for Standardized Patient Encounters and Patient Notes From a Multisite Study of Clinical Performance Examinations in Seven Medical Schools.

    Science.gov (United States)

    Park, Yoon Soo; Hyderi, Abbas; Heine, Nancy; May, Win; Nevins, Andrew; Lee, Ming; Bordage, Georges; Yudkowsky, Rachel

    2017-11-01

    To examine validity evidence of local graduation competency examination scores from seven medical schools using shared cases and to provide rater training protocols and guidelines for scoring patient notes (PNs). Between May and August 2016, clinical cases were developed, shared, and administered across seven medical schools (990 students participated). Raters were calibrated using training protocols, and guidelines were developed collaboratively across sites to standardize scoring. Data included scores from standardized patient encounters for history taking, physical examination, and PNs. Descriptive statistics were used to examine scores from the different assessment components. Generalizability studies (G-studies) using variance components were conducted to estimate reliability for composite scores. Validity evidence was collected for response process (rater perception), internal structure (variance components, reliability), relations to other variables (interassessment correlations), and consequences (composite score). Student performance varied by case and task. In the PNs, justification of differential diagnosis was the most discriminating task. G-studies showed that schools accounted for less than 1% of total variance; however, for the PNs, there were differences in scores for varying cases and tasks across schools, indicating a school effect. Composite score reliability was maximized when the PN was weighted between 30% and 40%. Raters preferred using case-specific scoring guidelines with clear point-scoring systems. This multisite study presents validity evidence for PN scores based on scoring rubric and case-specific scoring guidelines that offer rigor and feedback for learners. Variability in PN scores across participating sites may signal different approaches to teaching clinical reasoning among medical schools.

  20. Monitoring compliance with the International Code of Marketing of Breastmilk Substitutes in west Africa: multisite cross sectional survey in Togo and Burkina Faso.

    Science.gov (United States)

    Aguayo, Victor M; Ross, Jay S; Kanon, Souleyman; Ouedraogo, Andre N

    2003-01-18

    To monitor compliance with the International Code of Marketing of Breastmilk Substitutes in health systems, sales outlets, distribution points, and the news media in Togo and Burkina Faso, west Africa. Multisite cross sectional survey. Staff at 43 health facilities and 66 sales outlets and distribution points, 186 health providers, and 105 mothers of infants aged market commercial breast milk substitutes were found in 29 (44%) sales and distribution points. Forty commercial breast milk substitutes violated the labelling standards of the code: 21 were manufactured by Danone, 11 by Nestlé, and eight by other national and international manufacturers. Most (148, 90%) health providers had never heard of the code, and 66 mothers (63%) had never received any counselling on breast feeding by their health providers. In west Africa manufacturers are violating the code of marketing of breast milk substitutes. Comparable levels of code violations are observed with (Burkina Faso) or without (Togo) regulating legislation. Legislation must be accompanied by effective information, training, and monitoring systems to ensure that healthcare providers and manufacturers comply with evidence based practice and the code.

  1. Effect of decision aid for breast cancer prevention on decisional conflict in women with a BRCA1 or BRCA2 mutation: a multisite, randomized, controlled trial.

    Science.gov (United States)

    Metcalfe, Kelly A; Dennis, Cindy-Lee; Poll, Aletta; Armel, Susan; Demsky, Rochelle; Carlsson, Lindsay; Nanda, Sonia; Kiss, Alexander; Narod, Steven A

    2017-03-01

    Women with a BRCA1 or BRCA2 mutation are at high risk for breast cancer and must make important decisions about breast cancer prevention and screening. In the current study, we report a multisite, randomized, controlled trial evaluating the effectiveness of a decision aid for breast cancer prevention in women with a BRCA mutation with no previous diagnosis of cancer. Within 1 month of receiving a positive BRCA result, women were randomized to receive either usual care (control group) or decision aid (intervention group). Participants were followed at 3, 6, and 12 months; were asked about preventive measures; and completed standardized questionnaires assessing decision making and psychosocial functioning. One hundred fifty women were randomized. Mean cancer-related distress scores were significantly lower in the intervention group compared with the control group at 6 months (P = 0.01) and at 12 months postrandomization (P = 0.05). Decisional conflict scores declined over time for both groups and at no time were there statistical differences between the two groups. The decision aid for breast cancer prevention in women with a BRCA1 or BRCA2 mutation is effective in significantly decreasing cancer-related distress within the year following receipt of positive genetic test results.Genet Med 19 3, 330-336.

  2. Ground-based search for the brightest transiting planets with the Multi-site All-Sky CAmeRA: MASCARA

    Science.gov (United States)

    Snellen, Ignas A. G.; Stuik, Remko; Navarro, Ramon; Bettonvil, Felix; Kenworthy, Matthew; de Mooij, Ernst; Otten, Gilles; ter Horst, Rik; le Poole, Rudolf

    2012-09-01

    The Multi-site All-sky CAmeRA MASCARA is an instrument concept consisting of several stations across the globe, with each station containing a battery of low-cost cameras to monitor the near-entire sky at each location. Once all stations have been installed, MASCARA will be able to provide a nearly 24-hr coverage of the complete dark sky, down to magnitude 8, at sub-minute cadence. Its purpose is to find the brightest transiting exoplanet systems, expected in the V=4-8 magnitude range - currently not probed by space- or ground-based surveys. The bright/nearby transiting planet systems, which MASCARA will discover, will be the key targets for detailed planet atmosphere observations. We present studies on the initial design of a MASCARA station, including the camera housing, domes, and computer equipment, and on the photometric stability of low-cost cameras showing that a precision of 0.3-1% per hour can be readily achieved. We plan to roll out the first MASCARA station before the end of 2013. A 5-station MASCARA can within two years discover up to a dozen of the brightest transiting planet systems in the sky.

  3. The avoidance of activities due to fear of falling contributes to sedentary behavior among community-dwelling older adults with chronic musculoskeletal pain: a multisite observational study.

    Science.gov (United States)

    Stubbs, Brendon; Patchay, Sandhi; Soundy, Andy; Schofield, Pat

    2014-11-01

    Physical inactivity and sedentary behavior (SB) are leading causes of mortality. We investigated if older adults with chronic musculoskeletal pain (CMP) are more sedentary than a group of similar age and sex without CMP and possible contributory factors to this. In this multisite observational study, 285 community-dwelling older adults (response rate 71%) took part. One hundred forty-four had CMP (78.4 years, 65.9% female), and 141 formed the comparison group without CMP. Details regarding falls were collected, and all participants completed the brief pain inventory (BPI), modified version of the survey of activities and fear of falling in elderly scale (mSAFFE), and the International Physical Activity Questionnaire (IPAQ) to measure SB. Data were analyzed with hierarchical regression analysis. Older adults with CMP spent approximately 3 1/2 hours a day more being sedentary than the comparison group (11.5 hours vs 7.9, Psedentary than those of a similar sex and age without CMP. It appears that the avoidance of activities due to fear of falling is a significant contributory factor to SB in older adults with CMP. Wiley Periodicals, Inc.

  4. An introduction to the composition of the Multi-Site University Study of Identity and Culture (MUSIC): a collaborative approach to research and mentorship.

    Science.gov (United States)

    Weisskirch, Robert S; Zamboanga, Byron L; Ravert, Russell D; Whitbourne, Susan Krauss; Park, Irene J K; Lee, Richard M; Schwartz, Seth J

    2013-04-01

    The Multi-Site University Study of Identity and Culture (MUSIC) is the product of a research collaboration among faculty members from 30 colleges and universities from across the United States. Using Katz and Martin's (1997, p. 7) definition, the MUSIC research collaboration is "the working together of researchers to achieve the common goals of producing new scientific knowledge." The collaboration involved more than just coauthorship; it served "as a strategy to insert more energy, optimism, creativity and hope into the work of [researchers]" (Conoley & Conoley, 2010, p. 77). The philosophy underlying the MUSIC collaborative was intended to foster natural collaborations among researchers, to provide opportunities for scholarship and mentorship for early career and established researchers, and to support exploration of identity, cultural, and ethnic/racial research ideas by tapping the expertise and interests of the broad MUSIC network of collaborators. In this issue, five research articles present innovative findings from the MUSIC datasets. There are two themes across the articles. Research is emerging about broadening the constructs and measures of acculturation and ethnic identity and their relation to health risk behaviors and psychosocial and mental health outcomes. The second theme is about the relationship of perceived discrimination on behavioral and mental health outcomes among immigrant populations.

  5. Reklamesemiotik mellem mening og virkning – komposition, kategorier og kognition

    Directory of Open Access Journals (Sweden)

    Christian Andersen

    2004-09-01

    Full Text Available På baggrund af kognitionspsykologi og peirceansk tegnteori fremsætter artiklen et reklamesemiotisk bud på sammenhængen mellem annoncers komposition og deres virkning. Artiklen har til formål at belyse, hvorledes den trykte annonces forskellige æstetikker og kompositioner udløser for- skellige emotionelle og kognitive effekter i receptionen. Der indkredses tre receptionsmodi, der hver svarer til en bestemt annoncekompositorisk kategori. Artiklen er en videreudvikling af reklamesemiotikken, som i Dan- mark især er blevet funderet på et semiologisk grundlag. Der argumente- res for, at den semiologiske tilgang kun er delvis fyldestgørende, efter- som man her læser reklamens illustration med verbalsproget som model og derved implicit antager, at verbalsproglige og visuelle tegnsystemer har samme organisation. I modsætning til sproget mangler billedet imid- lertid den dobbelte artikulation. Artiklen forsøger at indfange disse forskel- le mellem tegnsystemer for derigennem at oparbejde et mere nuanceret blik for, i hvilket omfang forskellige reklameæstetikker faktisk udløser bestemte kognitive effekter i receptionen. Ved ’kognitive effekter’ forstås primært emotionsdannelse og inferensprocesser.

  6. Børn som skabere af betydning og mening

    DEFF Research Database (Denmark)

    Balle, Søren Hattesen; Olsen, Merete; Svendsen Pedersen, Michael

    2017-01-01

    One of the main issue of teaching English to young learners is whether language learning is different for young learners as opposed to adult learners. Researchers have adopted two different approaches to this question: one is a psychological developmental approach inspired by Piaget, the other...

  7. Børn som skabere af betydning og mening

    DEFF Research Database (Denmark)

    Hattesen Balle, Søren; Olsen, Merete; Pedersen, Michael Svendsen

    2018-01-01

    One of the main issues of teaching English to young learners is whether language learning is different for young learners as opposed to adult learners. Researchers have adopted two different approaches to this question: one is a psychological developmental approach inspired by Piaget, the other...

  8. Forvandling, fortælling og handling med mening

    DEFF Research Database (Denmark)

    Dupont, Søren

    2015-01-01

    Artiklen fokuserer på en række begreber og udviklinger hos Jerome Bruner og diskuterer de forskellige grundlag, som Jerome Bruner gennem tiderne har haft fokus på uden at noget grundlag på noget tidspunkt entydigt har været bestemmende. Jerome Bruner har bevæget sig fra at være orienteret mod...

  9. Social mening og viden på sociale video sites

    DEFF Research Database (Denmark)

    Rasmussen, Tove Arendt

    2011-01-01

    . De sociale medier som Facebook, YouTube o.l. er blevet prototype for det dialogiske aspekt, der egentlig ligger indbygget fra starten i de digitale netværksmedier. Modtageren, læseren, seeren og tilhøreren deltager i den medierede kommunikation med kommentar, dialog eller egne produkter. Brugeren er...... også producent og distributør adf viden i de sociale mediers brugerfællesskaber. Brugeren er ikke kun ’user’, men ’produser’ (sammentrækning af user og producer), skriver den amerikanske medieforsker Axel Bruns, som både Tove Arendt Rasmussen og hans Jørn Nielsen citerer i deres artikler”....

  10. El valor predictivo de los exámenes de Estado frente al rendimiento académico universitario O valor preditivo dos testes de Estado frente ao desempenho acadêmico na universidade The Value of State Exams in Predicting College Academic Performance

    Directory of Open Access Journals (Sweden)

    Catherine Pereira

    2011-04-01

    Full Text Available Se presenta una medición y un análisis correlacional entre los resultados del examen para el ingreso a la educación superior y el examen de calidad de la misma. Este es un estudio piloto, que utiliza una base de datos con 2.888 estudiantes de programas de Administración, entre el 2000 y el 2005. Utilizando modelos multivariados, se encontraron correlaciones predictivas débiles entre los dos exámenes obligatorios asociados a la educación superior en Colombia. Se encontró una relación lineal débil entre todos los componentes de conocimiento evaluados y el promedio general de la Universidad.O artigo apresenta la medição e a análise de correlação entre os resultados do exame de admissão para o ensino superior e o exame de qualidade do ensino superior. Este estudo piloto utiliza um banco de dados de 2.888 estudantes de programas de administração entre 2000 e 2005. Usando modelos multivariados, uma fraca houve correlação preditiva entre os dois exames obrigatórios relativos ao ensino superior na Colômbia. Além disso, houve uma fraca relação linear entre os componentes do conhecimento avaliados e a média da universidade.The article offers a measurement and correlational analysis of the results of the State College Entrance Exam and the Higher Education Quality Exam. It is a pilot study that employs a database with 2,888 students who were majoring in business administration between 2000 and 2005. Using multivariate models, the study found weak predictive correlations between the two mandatory exams associated with higher education in Colombia. It also found a weak linear relationship between all the evaluated components of knowledge and the general grade point average in college.

  11. Psychiatric patients' return for HIV/STI test results in mental health centers Devolución de los resultados de exámenes serológicos de VIH/ITS entre pacientes psiquiátricos en los servicios de salud mental Devolução dos resultados de exames sorológicos de HIV/IST entre pacientes psiquiátricos nos serviços de saúde mental

    Directory of Open Access Journals (Sweden)

    Ana Paula Souto Melo

    2012-04-01

    Full Text Available OBJECTIVE: To assess individual and/or health service factors associated with patients returning for results of HIV or sexually transmitted infection (STI tests in mental health centers. METHODS: Cross-sectional national multicenter study among 2,080 patients randomly selected from 26 Brazilian mental health centers in 2007. Multilevel logistic regression was used to assess the effect of individual (level 1 and mental health service characteristics (level 2 on receipt of test results. RESULTS: The rate of returning HIV/STI test results was 79.6%. Among health service characteristics examined, only condom distribution was associated with receiving HIV/STI test results, whereas several individual characteristics were independently associated including living in the same city where treatment centers are; being single; not having heard of AIDS; and not having been previously HIV tested. CONCLUSIONS: It is urgent to expand HIV/STI testing in health services which provide care for patients with potentially increased vulnerability to these conditions, and to promote better integration between mental health and health services.OBJETIVO: Analizar factores asociados a la recepción de resultados de exámenes serológicos para VIH y otras infecciones de transmisión sexual (ITS entre pacientes psiquiátricos. MÉTODOS: Estudio de corte transversal multicéntrico nacional de 2.080 participantes seleccionados aleatoriamente entre 26 instituciones brasileñas de salud mental en 2007. El efecto del individuo (nivel 1 y de los servicios de salud mental (nivel 2 en la recepción de los resultados de los exámenes fue evaluado utilizándose regresión logística multinivel. RESULTADOS: La proporción de retorno de los resultados de exámenes VIH/ITS fue 79,6%. Entre las características individuales, hubo asociación del desenlace con: vivir en la misma ciudad donde se encontraban los servicios, ser soltero, no haber escuchado hablar sobre el sida, y no haber

  12. MULTI-SITE OBSERVATIONS OF PULSATION IN THE ACCRETING WHITE DWARF SDSS J161033.64-010223.3 (V386 Ser)

    International Nuclear Information System (INIS)

    Mukadam, Anjum S.; Szkody, P.; Townsley, D. M.; Gaensicke, B. T.; Marsh, T. R.; Aungwerojwit, A.; Southworth, J.; Robinson, E. L.; For, B.-Q.; Bildsten, L.; Schreiber, M. R.; Schwope, A.; Tovmassian, G.; Zharikov, S. V.; Hidas, M. G.; Baliber, N.; Brown, T.; Woudt, P. A.; Warner, B.; O'Donoghue, D.

    2010-01-01

    Non-radial pulsations in the primary white dwarfs of cataclysmic variables can now potentially allow us to explore the stellar interior of these accretors using stellar seismology. In this context, we conducted a multi-site campaign on the accreting pulsator SDSS J161033.64-010223.3 (V386 Ser) using seven observatories located around the world in 2007 May over a duration of 11 days. We report the best-fit periodicities here, which were also previously observed in 2004, suggesting their underlying stability. Although we did not uncover a sufficient number of independent pulsation modes for a unique seismological fit, our campaign revealed that the dominant pulsation mode at 609 s is an evenly spaced triplet. The even nature of the triplet is suggestive of rotational splitting, implying an enigmatic rotation period of about 4.8 days. There are two viable alternatives assuming the triplet is real: either the period of 4.8 days is representative of the rotation period of the entire star with implications for the angular momentum evolution of these systems, or it is perhaps an indication of differential rotation with a fast rotating exterior and slow rotation deeper in the star. Investigating the possibility that a changing period could mimic a triplet suggests that this scenario is improbable, but not impossible. Using time-series spectra acquired in 2009 May, we determine the orbital period of SDSS J161033.64-010223.3 to be 83.8 ± 2.9 minutes. Three of the observed photometric frequencies from our 2007 May campaign appear to be linear combinations of the 609 s pulsation mode with the first harmonic of the orbital period at 41.5 minutes. This is the first discovery of a linear combination between non-radial pulsation and orbital motion for a variable white dwarf.

  13. Quantification of iopamidol multi-site chemical exchange properties for ratiometric chemical exchange saturation transfer (CEST) imaging of pH

    International Nuclear Information System (INIS)

    Sun, Phillip Zhe; Longo, Dario Livio; Hu, Wei; Xiao, Gang; Wu, Renhua

    2014-01-01

    pH-sensitive chemical exchange saturation transfer (CEST) MRI holds great promise for in vivo applications. However, the CEST effect depends on not only exchange rate and hence pH, but also on the contrast agent concentration, which must be determined independently for pH quantification. Ratiometric CEST MRI normalizes the concentration effect by comparing CEST measurements of multiple labile protons to simplify pH determination. Iopamidol, a commonly used x-ray contrast agent, has been explored as a ratiometric CEST agent for imaging pH. However, iopamidol CEST properties have not been solved, determination of which is important for optimization and quantification of iopamidol pH imaging. Our study numerically solved iopamidol multi-site pH-dependent chemical exchange properties. We found that iopamidol CEST MRI is suitable for measuring pH between 6 and 7.5 despite that T 1 and T 2 measurements varied substantially with pH and concentration. The pH MRI precision decreased with pH and concentration. The standard deviation of pH determined from MRI was 0.2 and 0.4 pH unit for 40 and 20 mM iopamidol solution of pH 6, and it improved to be less than 0.1 unit for pH above 7. Moreover, we determined base-catalyzed chemical exchange for 2-hydrooxypropanamido (k sw = 1.2*10 pH−4.1 ) and amide (k sw = 1.2*10 pH−4.6 ) protons that are statistically different from each other (P < 0.01, ANCOVA), understanding of which should help guide in vivo translation of iopamidol pH imaging. (paper)

  14. Does 'Time Together' increase quality of interaction and decrease stress? A study protocol of a multisite nursing intervention in psychiatric inpatient care, using a mixed method approach.

    Science.gov (United States)

    Molin, Jenny; Lindgren, Britt-Marie; Graneheim, Ulla Hällgren; Ringnér, Anders

    2017-08-28

    Despite the long-known significance of the nurse-patient relationship, research in psychiatric inpatient care still reports unfulfilled expectations of, and difficulties in, interactions and relationships between patients and staff. Interventions that create structures to allow quality interactions between patients and staff are needed to solve these problems. The aim of this project is to test effects of the nursing intervention Time Together and to evaluate the intervention process. This is a multisite study with a single-system experimental design using frequent measures. The primary outcomes are quality interactions for patients and perceived stress for staff. Secondary outcomes are levels of symptoms of anxiety and depression for patients and stress of conscience for staff. A process evaluation is performed to describe contextual factors and experiences. Data are collected using questionnaires, participant observations and semistructured interviews. For analysis of quantitative data, both visual and statistical methods will be used. Qualitative data will be analysed using qualitative content analysis. Ethical approval was granted by the Ethical Review Board in the region (Dnr 2016/339-31). The findings will contribute to the development of nursing interventions in general, but more specifically to the development of the intervention. This is relevant both nationally and internationally as similar interventions are needed but sparse. The findings will be disseminated through conference presentations and peer-reviewed publications. NCT02981563. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: a multi-site focus group study.

    Science.gov (United States)

    Palepu, Anita; Hubley, Anita M; Russell, Lara B; Gadermann, Anne M; Chinni, Mary

    2012-08-15

    The aim of this study was to identify what is most important to the quality of life (QoL) of those who experience homelessness by directly soliciting the views of homeless and hard-to-house Canadians themselves. These individuals live within a unique social context that differs considerably from that of the general population. To understand the life areas that are most important to them, it is critical to have direct input from target populations of homeless and hard-to-house persons. Focus groups were conducted with 140 individuals aged 15 to 73 years who were homeless or hard-to-house to explore the circumstances in which they were living and to capture what they find to be important and relevant domains of QoL. Participants were recruited in Toronto, Ottawa, Montreal, and Vancouver. Content analysis was used to analyze the data. Six major content themes emerged: Health/health care; Living conditions; Financial situation; Employment situation; Relationships; and Recreational and leisure activities. These themes were linked to broader concepts that included having choices, stability, respect, and the same rights as other members of society. These findings not only aid our understanding of QoL in this group, but may be used to develop measures that capture QoL in this population and help programs and policies become more effective in improving the life situation for persons who are homeless and hard-to-house. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study.

  16. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study

    Directory of Open Access Journals (Sweden)

    Palepu Anita

    2012-08-01

    Full Text Available Abstract Background The aim of this study was to identify what is most important to the quality of life (QoL of those who experience homelessness by directly soliciting the views of homeless and hard-to-house Canadians themselves. These individuals live within a unique social context that differs considerably from that of the general population. To understand the life areas that are most important to them, it is critical to have direct input from target populations of homeless and hard-to-house persons. Methods Focus groups were conducted with 140 individuals aged 15 to 73 years who were homeless or hard-to-house to explore the circumstances in which they were living and to capture what they find to be important and relevant domains of QoL. Participants were recruited in Toronto, Ottawa, Montreal, and Vancouver. Content analysis was used to analyze the data. Results Six major content themes emerged: Health/health care; Living conditions; Financial situation; Employment situation; Relationships; and Recreational and leisure activities. These themes were linked to broader concepts that included having choices, stability, respect, and the same rights as other members of society. Conclusions These findings not only aid our understanding of QoL in this group, but may be used to develop measures that capture QoL in this population and help programs and policies become more effective in improving the life situation for persons who are homeless and hard-to-house. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study.

  17. Multi-Site Clinical Assessment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (MCAM): Design and Implementation of a Prospective/Retrospective Rolling Cohort Study.

    Science.gov (United States)

    Unger, Elizabeth R; Lin, Jin-Mann S; Tian, Hao; Natelson, Benjamin H; Lange, Gudrun; Vu, Diana; Blate, Michelle; Klimas, Nancy G; Balbin, Elizabeth G; Bateman, Lucinda; Allen, Ali; Lapp, Charles W; Springs, Wendy; Kogelnik, Andreas M; Phan, Catrina C; Danver, Joan; Podell, Richard N; Fitzpatrick, Trisha; Peterson, Daniel L; Gottschalk, C Gunnar; Rajeevan, Mangalathu S

    2017-04-15

    In the Multi-Site Clinical Assessment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (MCAM), we relied on expert clinician diagnoses to enroll patients from 7 specialty clinics in the United States in order to perform a systematic collection of data on measures of myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS). Healthy persons and those with other illnesses that share some features with ME/CFS were enrolled in comparison groups. The major objectives were to: 1) use standardized questionnaires to measure illness domains of ME/CFS and to evaluate patient heterogeneity overall and between clinics; 2) describe the course of illness, identify the measures that best correlate with meaningful clinical differences, and assess the performances of questionnaires as patient/person-reported outcome measures; 3) describe prescribed medications, orders for laboratory and other tests, and management tools used by expert clinicians to care for persons with ME/CFS; 4) collect biospecimens for future hypothesis testing and for evaluation of morning cortisol profiles; and 5) identify measures that best distinguish persons with ME/CFS from those in the comparison groups and detect subgroups of persons with ME/CFS who may have different underlying causes. Enrollment began in 2012 and is planned to continue in multiple stages through 2017. We present the MCAM methods in detail, along with an initial description of the 471 patients with ME/CFS who were enrolled in stage 1. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  18. MO-F-CAMPUS-T-04: Implementation of a Standardized Monthly Quality Check for Linac Output Management in a Large Multi-Site Clinic

    Energy Technology Data Exchange (ETDEWEB)

    Xu, H; Yi, B; Prado, K [Univ. of Maryland School Of Medicine, Baltimore, MD (United States)

    2015-06-15

    Purpose: This work is to investigate the feasibility of a standardized monthly quality check (QC) of LINAC output determination in a multi-site, multi-LINAC institution. The QC was developed to determine individual LINAC output using the same optimized measurement setup and a constant calibration factor for all machines across the institution. Methods: The QA data over 4 years of 7 Varian machines over four sites, were analyzed. The monthly output constancy checks were performed using a fixed source-to-chamber-distance (SCD), with no couch position adjustment throughout the measurement cycle for all the photon energies: 6 and 18MV, and electron energies: 6, 9, 12, 16 and 20 MeV. The constant monthly output calibration factor (Nconst) was determined by averaging the machines’ output data, acquired with the same monthly ion chamber. If a different monthly ion chamber was used, Nconst was then re-normalized to consider its different NDW,Co-60. Here, the possible changes of Nconst over 4 years have been tracked, and the precision of output results based on this standardized monthly QA program relative to the TG-51 calibration for each machine was calculated. Any outlier of the group was investigated. Results: The possible changes of Nconst varied between 0–0.9% over 4 years. The normalization of absorbed-dose-to-water calibration factors corrects for up to 3.3% variations of different monthly QA chambers. The LINAC output precision based on this standardized monthly QC relative to the TG-51 output calibration is within 1% for 6MV photon energy and 2% for 18MV and all the electron energies. A human error in one TG-51 report was found through a close scrutiny of outlier data. Conclusion: This standardized QC allows for a reasonably simplified, precise and robust monthly LINAC output constancy check, with the increased sensitivity needed to detect possible human errors and machine problems.

  19. Prefrontal rTMS for treating depression: location and intensity results from the OPT-TMS multi-site clinical trial.

    Science.gov (United States)

    Johnson, Kevin A; Baig, Mirza; Ramsey, Dave; Lisanby, Sarah H; Avery, David; McDonald, William M; Li, Xingbao; Bernhardt, Elisabeth R; Haynor, David R; Holtzheimer, Paul E; Sackeim, Harold A; George, Mark S; Nahas, Ziad

    2013-03-01

    Motor cortex localization and motor threshold determination often guide Transcranial Magnetic Stimulation (TMS) placement and intensity settings for non-motor brain stimulation. However, anatomic variability results in variability of placement and effective intensity. Post-study analysis of the OPT-TMS Study reviewed both the final positioning and the effective intensity of stimulation (accounting for relative prefrontal scalp-cortex distances). We acquired MRI scans of 185 patients in a multi-site trial of left prefrontal TMS for depression. Scans had marked motor sites (localized with TMS) and marked prefrontal sites (5 cm anterior of motor cortex by the "5 cm rule"). Based on a visual determination made before the first treatment, TMS therapy occurred either at the 5 cm location or was adjusted 1 cm forward. Stimulation intensity was 120% of resting motor threshold. The "5 cm rule" would have placed stimulation in premotor cortex for 9% of patients, which was reduced to 4% with adjustments. We did not find a statistically significant effect of positioning on remission, but no patients with premotor stimulation achieved remission (0/7). Effective stimulation ranged from 93 to 156% of motor threshold, and no seizures were induced across this range. Patients experienced remission with effective stimulation intensity ranging from 93 to 146% of motor threshold, and we did not find a significant effect of effective intensity on remission. Our data indicates that individualized positioning methods are useful to reduce variability in placement. Stimulation at 120% of motor threshold, unadjusted for scalp-cortex distances, appears safe for a broad range of patients. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Comparative efficacy of the Cognitive Behavioral Analysis System of Psychotherapy versus Supportive Psychotherapy for early onset chronic depression: design and rationale of a multisite randomized controlled trial

    Science.gov (United States)

    2011-01-01

    Background Effective treatment strategies for chronic depression are urgently needed since it is not only a common and particularly disabling disorder, but is also considered treatment resistant by most clinicians. There are only a few studies on chronic depression indicating that traditional psycho- and pharmacological interventions are not as effective as in acute, episodic depression. Current medications are no more effective than those introduced 50 years ago whereas the only psychotherapy developed specifically for the subgroup of chronic depression, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP), faired well in one large trial. However, CBASP has never been directly compared to a non-specific control treatment. Methods/Design The present article describes the study protocol of a multisite parallel-group randomized controlled trial in Germany. The purpose of the study is to estimate the efficacy of CBASP compared to supportive psychotherapy in 268 non-medicated early-onset chronically depressed outpatients. The intervention includes 20 weeks of acute treatment with 24 individual sessions followed by 28 weeks of continuation treatment with another 8 sessions. Depressive symptoms are evaluated 20 weeks after randomisation by means of the 24-item Hamilton Rating Scale of Depression (HRSD). Secondary endpoints are depressive symptoms after 12 and 48 weeks, and remission after 12, 20, and 48 weeks. Primary outcome will be analysed using analysis of covariance (ANCOVA) controlled for pre-treatment scores and site. Analyses of continuous secondary variables will be performed using linear mixed models. For remission rates, chi-squared tests and logistic regression will be applied. Discussion The study evaluates the comparative effects of a disorder-specific psychotherapy and a well designed non-specific psychological approach in the acute and continuation treatment phase in a large sample of early-onset chronically depressed patients. Trial

  1. Power of national economy, disease control and employment status in patients with RA-an analytical multi-site ecological study.

    Science.gov (United States)

    Pieringer, Herwig; Puchner, Rudolf; Pohanka, Erich; Danninger, Kathrin

    2016-02-01

    In rheumatology, sufficient disease control is a central part of the treatment concept. However, modern treatment strategies are associated with a substantial economic burden for health care systems. Ecological studies offer the unique opportunity to analyse differences between groups as well as group level effects. In the present analytical multi-site ecological study, we investigated whether more powerful national economies as measured by the gross domestic product per capita (GDPpc) are associated with better disease control in RA patients as measured by the disease activity score 28 (DAS28). We used aggregated data on RA patients from the recently published COMORA study as well as the World Health Organization database. There was a strong negative correlation between DAS28 and GDPpc (r = -0.815; p = 0.0002). Adjustment for sex, smoking status, disease duration or current employment status did not significantly change this association. There was a strong, negative correlation between DAS28 and age (r = -0.870; p < 0.001) and a strong, positive correlation between GDPpc and age (r = 0.737; p = 0.002). Adjustment for age reduced the regression coefficient (DAS28/GDPpc) to -0.000018 (p = 0.054). There was a negative correlation between DAS28 and current employment status (r = -0.642; p = 0.008) and a positive correlation between GDPpc and employment status (r = 0.722; p = 0.002). In conclusion, there is evidence of an association between disease control and GDPpc. This association is alleviated after adjustment for age. Of note, in countries with higher GDPpc, a higher proportion of RA patients are currently employed. This is true despite the fact that RA patients in countries with higher GDPpc are also older.

  2. Structural and reliability analysis of a patient satisfaction with cancer-related care measure: a multisite patient navigation research program study.

    Science.gov (United States)

    Jean-Pierre, Pascal; Fiscella, Kevin; Freund, Karen M; Clark, Jack; Darnell, Julie; Holden, Alan; Post, Douglas; Patierno, Steven R; Winters, Paul C

    2011-02-15

    Patient satisfaction is an important outcome measure of quality of cancer care and 1 of the 4 core study outcomes of the National Cancer Institute (NCI)-sponsored Patient Navigation Research Program to reduce race/ethnicity-based disparities in cancer care. There is no existing patient satisfaction measure that spans the spectrum of cancer-related care. The objective of this study was to develop a Patient Satisfaction With Cancer Care measure that is relevant to patients receiving diagnostic/therapeutic cancer-related care. The authors developed a conceptual framework, an operational definition of Patient Satisfaction With Cancer Care, and an item pool based on literature review, expert feedback, group discussion, and consensus. The 35-item Patient Satisfaction With Cancer Care measure was administered to 891 participants from the multisite NCI-sponsored Patient Navigation Research Program. Principal components analysis (PCA) was conducted for latent structure analysis. Internal consistency was assessed using Cronbach coefficient alpha (α). Divergent analysis was performed using correlation analyses between the Patient Satisfaction With Cancer Care, the Communication and Attitudinal Self-Efficacy-Cancer, and demographic variables. The PCA revealed a 1-dimensional measure with items forming a coherent set explaining 62% of the variance in patient satisfaction. Reliability assessment revealed high internal consistency (α ranging from 0.95 to 0.96). The Patient Satisfaction With Cancer Care demonstrated good face validity, convergent validity, and divergent validity, as indicated by moderate correlations with subscales of the Communication and Attitudinal Self-Efficacy-Cancer (all P .05). The Patient Satisfaction With Cancer Care is a valid tool for assessing satisfaction with cancer-related care for this sample. Copyright © 2010 American Cancer Society.

  3. Treatment of chronically depressed patients: A multisite randomized controlled trial testing the effectiveness of 'Cognitive Behavioral Analysis System of Psychotherapy' (CBASP for chronic depressions versus usual secondary care

    Directory of Open Access Journals (Sweden)

    Penninx Brenda WJH

    2008-03-01

    Full Text Available Abstract Background 'Cognitive Behavioral Analysis System of Psychotherapy' (CBASP is a form of psychotherapy specifically developed for patients with chronic depression. In a study in the U.S., remarkable favorable effects of CBASP have been demonstrated. However, no other studies have as yet replicated these findings and CBASP has not been tested outside the United States. This protocol describes a randomized controlled trial on the effectiveness of CBASP in the Netherlands. Methods/Design The purpose of the present paper is to report the study protocol of a multisite randomized controlled trial testing the effectiveness of 'Cognitive Behavioral Analysis System of Psychotherapy' (CBASP for chronic depression in the Netherlands. In this study, CBASP in combination with medication, will be tested versus usual secondary care in combination with medication. The aim is to recruit 160 patients from three mental health care organizations. Depressive symptoms will be assessed at baseline, after 8 weeks, 16 weeks, 32 weeks and 52 weeks, using the 28-item Inventory for Depressive Symptomatology (IDS. Effect modification by co morbid anxiety, alcohol consumption, general and social functioning and working alliance will be tested. GEE analyses of covariance, controlling for baseline value and center will be used to estimate the overall treatment effectiveness (difference in IDS score at post-treatment and follow up. The primary analysis will be by 'intention to treat' using double sided tests. An economic analysis will compare the two groups in terms of mean costs and cost-effectiveness from a societal perspective. Discussion The study will provide an answer to the question whether the favorable effects of CBASP can be replicated outside the US. Trial Registration The Dutch Cochrane Center, NTR1090.

  4. Low prevalence of work disability in early inflammatory arthritis (EIA) and early rheumatoid arthritis at enrollment into a multi-site registry: results from the catch cohort.

    Science.gov (United States)

    Mussen, Lauren; Boyd, Tristan; Bykerk, Vivian; de Leon, Faye; Li, Lihua; Boire, Gilles; Hitchon, Carol; Haraoui, Boulos; Thorne, J Carter; Pope, Janet

    2013-02-01

    We determined the prevalence of work disability in early rheumatoid arthritis (ERA) and undifferentiated early inflammatory arthritis (EIA) patients at first enrollment into the Canadian Early Arthritis Cohort (CATCH) who met the 2010 ACR criteria versus those not meeting criteria, to determine the impact of meeting new criteria on work disability status. Data at first visit into the cohort were analyzed. Descriptive statistics and logistic regression analyses were performed to investigate the association of other variables in our database with work disability. 1,487 patients were enrolled in the CATCH study, a multi-site observational, prospective cohort of patients with EIA. 934 patients were excluded (505 based on missing criteria for ACR 2010 classification, as anti-CCP was absent, and 429 were not working for other reasons). Of the 553 patients included, 71 % were female with mean disease duration of 6.4 months. 524 (94.8 %) were employed while 29 (5.2 %) reported work disability at first visit. There were no differences between those meeting 2010 ACR criteria versus those who did not. Baseline characteristics associated with work disability were male gender, age, education, income, HAQ, and positive RF status. The mean HAQ score in work disabled patients was 1.4 versus 0.9 in those who were working (p 50 years; p = 0.3), lower education (p = 0.3) or RF positivity (p = 0.6). We found rates of work disability to be low at entry into this EIA cohort compared to previous studies. There may be potential for intervention in ERA to prevent the development of work disability.

  5. Repeated tumor pO2 measurements by multi-site EPR oximetry as a prognostic marker for enhanced therapeutic efficacy of fractionated radiotherapy

    International Nuclear Information System (INIS)

    Hou Huagang; Lariviere, Jean P.; Demidenko, Eugene; Gladstone, David; Swartz, Harold; Khan, Nadeem

    2009-01-01

    Purpose: To investigate the temporal effects of single or fractionated radiotherapy on subcutaneous RIF-1 tumor pO 2 and to determine the therapeutic outcomes when the timing of fractionations is guided by tumor pO 2 . Methods: The time-course of the tumor pO 2 changes was followed by multi-site electron paramagnetic resonance (EPR) oximetry. The tumors were treated with single 10, 20, and 10 Gy x 2 doses, and the tumor pO 2 was measured repeatedly for six consecutive days. In the 10 Gy x 2 group, the second dose of 10 Gy was delivered at a time when the tumors were either relatively oxygenated or hypoxic. The changes in tumor volumes were followed for nine days to determine the therapeutic outcomes. Results: A significant increase in tumor pO 2 was observed at 24 h post 10 Gy, while 20 Gy resulted in a significant increase in tumor pO 2 at 72-120 h post irradiation. The tumors irradiated with a second dose of 10 Gy at 24 h, when the tumors were oxygenated, had a significant increase in tumor doubling times (DTs), as compared to tumors treated at 48 h when they were hypoxic (p 2 repeatedly during fractionated schemes to optimize radiotherapeutic outcome. This technique could also be used to identify responsive and non-responsive tumors, which will facilitate the design of other therapeutic approaches for non-responsive tumors at early time points during the course of therapy.

  6. Physical workload, leisure-time physical activity, obesity and smoking as predictors of multisite musculoskeletal pain. A 2-year prospective study of kitchen workers.

    Science.gov (United States)

    Haukka, Eija; Ojajärvi, Anneli; Takala, Esa-Pekka; Viikari-Juntura, Eira; Leino-Arjas, Päivi

    2012-07-01

    The aim of this prospective study was to examine the role of physical workload, leisure-time physical activity, obesity and smoking in predicting the occurrence and course of multisite musculoskeletal pain (MSP). Data on physical and psychosocial workload, lifestyle factors and MSP were based on questionnaire surveys of 385 Finnish female kitchen workers. MSP (defined as pain at three or more of seven sites) during the past 3 months was measured repeatedly at 3-month intervals over 2 years. Four different patterns (trajectories) in the course of MSP were identified. The authors analysed whether the determinants at baseline predicted the occurrence of MSP (1) at the 2-year follow-up and (2) over the total of nine measurements during the 2 years by exploiting the MSP trajectories. Logistic regression was used. High physical workload at baseline was an independent predictor of MSP at the 2-year follow-up (OR 3.8, 95% CI 1.7 to 8.5) in a model allowing for age, psychosocial factors at work and lifestyle. High physical workload (OR 2.0, 95% CI 1.0 to 4.0) and moderate (OR 2.4, 95% CI 1.2 to 4.9) or low (OR 2.3, 95% CI 1.1 to 4.7) physical activity predicted persistent MSP. Obesity (OR 2.8, 95% CI 1.0 to 7.8) predicted an increased, and not being obese (OR 3.7, 95% CI 1.1 to 12.7) a decreased, prevalence of MSP in models similarly including all covariates. Smoking had no effect. The results emphasise the importance of high physical workload, low to moderate physical activity and obesity as potential modifiable risk factors for the occurrence and course of MSP over time.

  7. Behavior of the reference tariffs of three frequently requested laboratory test in three institutions in Colombia, 1990-2003 Comportamiento de las tarifas de referencia de los tres exámenes de laboratorio clínico más solicitados en Medellín, Colombia. 1990-2003

    Directory of Open Access Journals (Sweden)

    Samuel Andrés Arias Valencia

    2003-02-01

    Full Text Available PURPOSE: To describe the tendency of reference tariffs in recent years in three colombian institutions (Sociedad Colombiana de Patología Clínica —SCPC—, Instituto de Seguros Sociales —ISS— and Ministry of Health, for the three laboratory tests with greater demand, namely: glucose test, urine analysis and blood count. Methodology: The tariffs for these tests in the aforementioned institutions were analyzed since first available until 2003. Tariffs of the SCPC are adjusted according to official price indexes and the minimum salary. A comparison year after year was carried out. Results: The proposed tariffs of the SCPC were very closely similar to the adjustments by economic indicators. Prices of the glucose test were on the average 61,3% lower in the ISS and 45,2% lower in the Ministry of Health as compared with the SCPC. Prices of the urine analysis were on the average 58,9% lower in the ISS and 49,4% lower in the Ministry of Health than in the SCPC. Prices for the blood count were on the average 36,5% lower in the ISS and 31,8% lower in the Ministry of Health than in the SCPC. Conclusion: Tariffs for the three evaluated tests are lower in the ISS and the Ministry of Health and the gap with those of the SCPC becomes wider every year. Objetivo: Describir el comportamiento en los últimos años de las tarifas de referencia de la Sociedad Colombiana de Patología Clínica (SCPC, el Instituto de Seguros Sociales (ISS y el Ministerio de Salud (MS, de los tres exámenes de mayor demanda en el laboratorio clínico: la glicemia, el citoquímico de orina y el hemograma. Metodología: Se tomó la tarifa propuesta para las tres pruebas por las tres instituciones desde su inicio hasta el 2003. Las de la SCPC fueron ajustadas también por el índice de precios al consumidor y el salario mínimo. Se realizó una comparación año a año. Resultados: Las tarifas propuestas por la SCPC fueron muy similares a los ajustes por indicadores económicos. Las

  8. Analysis of host responses to Mycobacterium tuberculosis antigens in a multi-site study of subjects with different TB and HIV infection states in sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Jayne S Sutherland

    Full Text Available Tuberculosis (TB remains a global health threat with 9 million new cases and 1.4 million deaths per year. In order to develop a protective vaccine, we need to define the antigens expressed by Mycobacterium tuberculosis (Mtb, which are relevant to protective immunity in high-endemic areas.We analysed responses to 23 Mtb antigens in a total of 1247 subjects with different HIV and TB status across 5 geographically diverse sites in Africa (South Africa, The Gambia, Ethiopia, Malawi and Uganda. We used a 7-day whole blood assay followed by IFN-γ ELISA on the supernatants. Antigens included PPD, ESAT-6 and Ag85B (dominant antigens together with novel resuscitation-promoting factors (rpf, reactivation proteins, latency (Mtb DosR regulon-encoded antigens, starvation-induced antigens and secreted antigens.There was variation between sites in responses to the antigens, presumably due to underlying genetic and environmental differences. When results from all sites were combined, HIV- subjects with active TB showed significantly lower responses compared to both TST(- and TST(+ contacts to latency antigens (Rv0569, Rv1733, Rv1735, Rv1737 and the rpf Rv0867; whilst responses to ESAT-6/CFP-10 fusion protein (EC, PPD, Rv2029, TB10.3, and TB10.4 were significantly higher in TST(+ contacts (LTBI compared to TB and TST(- contacts fewer differences were seen in subjects with HIV co-infection, with responses to the mitogen PHA significantly lower in subjects with active TB compared to those with LTBI and no difference with any antigen.Our multi-site study design for testing novel Mtb antigens revealed promising antigens for future vaccine development. The IFN-γ ELISA is a cheap and useful tool for screening potential antigenicity in subjects with different ethnic backgrounds and across a spectrum of TB and HIV infection states. Analysis of cytokines other than IFN-γ is currently on-going to determine correlates of protection, which may be useful for vaccine

  9. Energy Contents of Frequently Ordered Restaurant Meals and Comparison with Human Energy Requirements and US Department of Agriculture Database Information: A Multisite Randomized Study

    Science.gov (United States)

    Urban, Lorien E.; Weber, Judith L.; Heyman, Melvin B.; Schichtl, Rachel L.; Verstraete, Sofia; Lowery, Nina S.; Das, Sai Krupa; Schleicher, Molly M.; Rogers, Gail; Economos, Christina; Masters, William A.; Roberts, Susan B.

    2017-01-01

    Background Excess energy intake from meals consumed away from home is implicated as a major contributor to obesity, and ~50% of US restaurants are individual or small-chain (non–chain) establishments that do not provide nutrition information. Objective To measure the energy content of frequently ordered meals in non–chain restaurants in three US locations, and compare with the energy content of meals from large-chain restaurants, energy requirements, and food database information. Design A multisite random-sampling protocol was used to measure the energy contents of the most frequently ordered meals from the most popular cuisines in non–chain restaurants, together with equivalent meals from large-chain restaurants. Setting Meals were obtained from restaurants in San Francisco, CA; Boston, MA; and Little Rock, AR, between 2011 and 2014. Main outcome measures Meal energy content determined by bomb calorimetry. Statistical analysis performed Regional and cuisine differences were assessed using a mixed model with restaurant nested within region×cuisine as the random factor. Paired t tests were used to evaluate differences between non–chain and chain meals, human energy requirements, and food database values. Results Meals from non–chain restaurants contained 1,205±465 kcal/meal, amounts that were not significantly different from equivalent meals from large-chain restaurants (+5.1%; P=0.41). There was a significant effect of cuisine on non–chain meal energy, and three of the four most popular cuisines (American, Italian, and Chinese) had the highest mean energy (1,495 kcal/meal). Ninety-two percent of meals exceeded typical energy requirements for a single eating occasion. Conclusions Non–chain restaurants lacking nutrition information serve amounts of energy that are typically far in excess of human energy requirements for single eating occasions, and are equivalent to amounts served by the large-chain restaurants that have previously been criticized

  10. Energy Contents of Frequently Ordered Restaurant Meals and Comparison with Human Energy Requirements and U.S. Department of Agriculture Database Information: A Multisite Randomized Study.

    Science.gov (United States)

    Urban, Lorien E; Weber, Judith L; Heyman, Melvin B; Schichtl, Rachel L; Verstraete, Sofia; Lowery, Nina S; Das, Sai Krupa; Schleicher, Molly M; Rogers, Gail; Economos, Christina; Masters, William A; Roberts, Susan B

    2016-04-01

    Excess energy intake from meals consumed away from home is implicated as a major contributor to obesity, and ∼50% of US restaurants are individual or small-chain (non-chain) establishments that do not provide nutrition information. To measure the energy content of frequently ordered meals in non-chain restaurants in three US locations, and compare with the energy content of meals from large-chain restaurants, energy requirements, and food database information. A multisite random-sampling protocol was used to measure the energy contents of the most frequently ordered meals from the most popular cuisines in non-chain restaurants, together with equivalent meals from large-chain restaurants. Meals were obtained from restaurants in San Francisco, CA; Boston, MA; and Little Rock, AR, between 2011 and 2014. Meal energy content determined by bomb calorimetry. Regional and cuisine differences were assessed using a mixed model with restaurant nested within region×cuisine as the random factor. Paired t tests were used to evaluate differences between non-chain and chain meals, human energy requirements, and food database values. Meals from non-chain restaurants contained 1,205±465 kcal/meal, amounts that were not significantly different from equivalent meals from large-chain restaurants (+5.1%; P=0.41). There was a significant effect of cuisine on non-chain meal energy, and three of the four most popular cuisines (American, Italian, and Chinese) had the highest mean energy (1,495 kcal/meal). Ninety-two percent of meals exceeded typical energy requirements for a single eating occasion. Non-chain restaurants lacking nutrition information serve amounts of energy that are typically far in excess of human energy requirements for single eating occasions, and are equivalent to amounts served by the large-chain restaurants that have previously been criticized for providing excess energy. Restaurants in general, rather than specific categories of restaurant, expose patrons to

  11. Reasons for unmet need for family planning, with attention to the measurement of fertility preferences: protocol for a multi-site cohort study.

    Science.gov (United States)

    Machiyama, Kazuyo; Casterline, John B; Mumah, Joyce N; Huda, Fauzia Akhter; Obare, Francis; Odwe, George; Kabiru, Caroline W; Yeasmin, Sharifa; Cleland, John

    2017-02-09

    Unmet need for family planning points to the gap between women's reproductive desire to avoid pregnancy and contraceptive behaviour. An estimated 222 million women in low- and middle-income countries have unmet need for modern contraception. Despite its prevalence, there has been little rigorous research during the past fifteen years on reasons for this widespread failure to implement childbearing desires in contraceptive practice. There is demographic survey data on women's self-reported reasons for non-use, but these data provide limited insight on the full set of possible obstacles to use, and one may doubt the meaningfulness of explanations provided by non-users alone. To rectify this evidence gap, this study will gather extensive information on women's perceptions of contraception (generic and method-specific) and their past contraceptive experience, and it will allow for more complexity in fertility preferences than is standard in demographic surveys. A multi-site cohort study will be conducted in urban Kenya, rural Kenya, and rural Bangladesh. In each setting trained fieldworkers will recruit and interview 2600 women, with participants re-interviewed at 12 and 18 months. Data will be collected using a questionnaire whose development was informed by a review of existing literature and instruments from past studies in both developed and developing countries. Dozens of experts in the field were consulted as the instrument was developed. The questionnaire has three main components: a sub-set of Demographic and Health Survey items measuring socio-demographic characteristics, reproductive history, and sexual activity; additional questions on prospective and retrospective fertility preferences designed to capture ambivalence and uncertainty; and two large blocks of items on (i) generic concerns about contraception and (ii) method-specific attributes. The method-specific items encompass eight modern and traditional methods. Policy and programmes intended to reduce

  12. The Importance of Medical Students' Attitudes Regarding Cognitive Competence for Teaching Applied Statistics: Multi-Site Study and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Natasa M Milic

    Full Text Available The scientific community increasingly is recognizing the need to bolster standards of data analysis given the widespread concern that basic mistakes in data analysis are contributing to the irreproducibility of many published research findings. The aim of this study was to investigate students' attitudes towards statistics within a multi-site medical educational context, monitor their changes and impact on student achievement. In addition, we performed a systematic review to better support our future pedagogical decisions in teaching applied statistics to medical students.A validated Serbian Survey of Attitudes Towards Statistics (SATS-36 questionnaire was administered to medical students attending obligatory introductory courses in biostatistics from three medical universities in the Western Balkans. A systematic review of peer-reviewed publications was performed through searches of Scopus, Web of Science, Science Direct, Medline, and APA databases through 1994. A meta-analysis was performed for the correlation coefficients between SATS component scores and statistics achievement. Pooled estimates were calculated using random effects models.SATS-36 was completed by 461 medical students. Most of the students held positive attitudes towards statistics. Ability in mathematics and grade point average were associated in a multivariate regression model with the Cognitive Competence score, after adjusting for age, gender and computer ability. The results of 90 paired data showed that Affect, Cognitive Competence, and Effort scores demonstrated significant positive changes. The Cognitive Competence score showed the largest increase (M = 0.48, SD = 0.95. The positive correlation found between the Cognitive Competence score and students' achievement (r = 0.41; p<0.001, was also shown in the meta-analysis (r = 0.37; 95% CI 0.32-0.41.Students' subjective attitudes regarding Cognitive Competence at the beginning of the biostatistics course, which were

  13. The Importance of Medical Students' Attitudes Regarding Cognitive Competence for Teaching Applied Statistics: Multi-Site Study and Meta-Analysis.

    Science.gov (United States)

    Milic, Natasa M; Masic, Srdjan; Milin-Lazovic, Jelena; Trajkovic, Goran; Bukumiric, Zoran; Savic, Marko; Milic, Nikola V; Cirkovic, Andja; Gajic, Milan; Kostic, Mirjana; Ilic, Aleksandra; Stanisavljevic, Dejana

    2016-01-01

    The scientific community increasingly is recognizing the need to bolster standards of data analysis given the widespread concern that basic mistakes in data analysis are contributing to the irreproducibility of many published research findings. The aim of this study was to investigate students' attitudes towards statistics within a multi-site medical educational context, monitor their changes and impact on student achievement. In addition, we performed a systematic review to better support our future pedagogical decisions in teaching applied statistics to medical students. A validated Serbian Survey of Attitudes Towards Statistics (SATS-36) questionnaire was administered to medical students attending obligatory introductory courses in biostatistics from three medical universities in the Western Balkans. A systematic review of peer-reviewed publications was performed through searches of Scopus, Web of Science, Science Direct, Medline, and APA databases through 1994. A meta-analysis was performed for the correlation coefficients between SATS component scores and statistics achievement. Pooled estimates were calculated using random effects models. SATS-36 was completed by 461 medical students. Most of the students held positive attitudes towards statistics. Ability in mathematics and grade point average were associated in a multivariate regression model with the Cognitive Competence score, after adjusting for age, gender and computer ability. The results of 90 paired data showed that Affect, Cognitive Competence, and Effort scores demonstrated significant positive changes. The Cognitive Competence score showed the largest increase (M = 0.48, SD = 0.95). The positive correlation found between the Cognitive Competence score and students' achievement (r = 0.41; p<0.001), was also shown in the meta-analysis (r = 0.37; 95% CI 0.32-0.41). Students' subjective attitudes regarding Cognitive Competence at the beginning of the biostatistics course, which were directly linked to

  14. Orthopaedic resident preparedness for closed reduction and pinning of pediatric supracondylar fractures is improved by e-learning: a multisite randomized controlled study.

    Science.gov (United States)

    Hearty, Thomas; Maizels, Max; Pring, Maya; Mazur, John; Liu, Raymond; Sarwark, John; Janicki, Joseph

    2013-09-04

    There is a need to provide more efficient surgical training methods for orthopaedic residents. E-learning could possibly increase resident surgical preparedness, confidence, and comfort for surgery. Using closed reduction and pinning of pediatric supracondylar humeral fractures as the index case, we hypothesized that e-learning could increase resident knowledge acquisition for case preparation in the operating room. An e-learning surgical training module was created on the Computer Enhanced Visual Learning platform. The module provides a detailed and focused road map of the procedure utilizing a multimedia format. A multisite prospective randomized controlled study design compared residents who used a textbook for case preparation (control group) with residents who used the same textbook plus completed the e-learning module (test group). All subjects completed a sixty-question test on the theory and methods of the case. After completion of the test, the control group then completed the module as well. All subjects were surveyed on their opinion regarding the effectiveness of the module after performing an actual surgical case. Twenty-eight subjects with no previous experience in this surgery were enrolled at four academic centers. Subjects were randomized into two equal groups. The test group scored significantly better (p < 0.001) and demonstrated competence on the test compared with the control group; the mean correct test score (and standard deviation) was 90.9% ± 6.8% for the test group and 73.5% ± 6.4% for the control group. All residents surveyed (n = 27) agreed that the module is a useful supplement to traditional methods for case preparation and twenty-two of twenty-seven residents agreed that it reduced their anxiety during the case and improved their attention to surgical detail. E-learning using the Computer Enhanced Visual Learning platform significantly improved preparedness, confidence, and comfort with percutaneous closed reduction and pinning of a

  15. Monitoring compliance with the International Code of Marketing of Breastmilk Substitutes in west Africa: multisite cross sectional survey in Togo and Burkina Faso

    Science.gov (United States)

    Aguayo, Victor M; Ross, Jay S; Kanon, Souleyman; Ouedraogo, Andre N

    2003-01-01

    Objectives To monitor compliance with the International Code of Marketing of Breastmilk Substitutes in health systems, sales outlets, distribution points, and the news media in Togo and Burkina Faso, west Africa. Design Multisite cross sectional survey. Participants Staff at 43 health facilities and 66 sales outlets and distribution points, 186 health providers, and 105 mothers of infants aged ⩽5 months in 16 cities. Results Six (14%) health facilities had received donations of breast milk substitutes. All donations were being given to mothers free of charge. Health providers in five (12%) health facilities had received free samples of breast milk substitutes for purposes other than professional research or evaluation. Health professionals in five (12%) health facilities had received promotional gifts from manufacturers. Promotional materials of commercial breast milk substitutes were found in seven (16%) health facilities. Special displays to market commercial breast milk substitutes were found in 29 (44%) sales and distribution points. Forty commercial breast milk substitutes violated the labelling standards of the code: 21 were manufactured by Danone, 11 by Nestlé, and eight by other national and international manufacturers. Most (148, 90%) health providers had never heard of the code, and 66 mothers (63%) had never received any counselling on breast feeding by their health providers. Conclusion In west Africa manufacturers are violating the code of marketing of breast milk substitutes. Comparable levels of code violations are observed with (Burkina Faso) or without (Togo) regulating legislation. Legislation must be accompanied by effective information, training, and monitoring systems to ensure that healthcare providers and manufacturers comply with evidence based practice and the code. What is already known on this topicAll member states of the World Health Assembly have reaffirmed their support for the International Code of Marketing of Breastmilk

  16. Challenges and opportunities in establishing a collaborative multisite observational study of chronic diseases and lifestyle factors among adults in Puerto Rico

    Directory of Open Access Journals (Sweden)

    Josiemer Mattei

    2017-01-01

    Full Text Available Abstract Background Prevalence of chronic diseases and unhealthy lifestyle behaviors among the adult population of Puerto Rico (PR is high; however, few epidemiological studies have been conducted to address these. We aimed to document the methods and operation of establishing a multisite cross-sectional study of chronic diseases and risk factors in PR, in partnership with academic, community, clinical, and research institutions. Methods The Puerto Rico Assessment of Diet, Lifestyle and Diseases (PRADLAD documented lifestyle and health characteristics of adults living in PR, with the goal of informing future epidemiological and intervention projects, as well as public health, policy, and clinical efforts to help improve the population’s health. The study was conducted in three primary care clinics in the San Juan, PR metropolitan area. Eligible volunteers were 30–75y, living in PR for at least 10 months of the previous year, and able to answer interviewer-administered questionnaires without assistance. Questions were recorded electronically by trained interviewers, and included socio-demographic characteristics, lifestyle behaviors, self-reported medically-diagnosed diseases, and psychosocial factors. Waist and hip circumferences were measured following standardized protocols. A subset of participants answered a validated food frequency questionnaire, a legumes questionnaire, and had medical record data abstracted. Process and outcome evaluation indicators were assessed. Results The study screened 403 participants in 5 months. Of these, 396 (98% were eligible and 380 (94% had reliable and complete information. A subset of 242 participants had valid dietary data, and 236 had medical record data. The mean time to complete an interview was 1.5 h. Participants were generally cooperative and research collaborators were fully engaged. Having multiple sites helped enhance recruitment and sociodemographic representation. Diagnosed conditions were

  17. Use of information and communication technologies to support effective work practice innovation in the health sector: a multi-site study

    Directory of Open Access Journals (Sweden)

    Georgiou Andrew

    2009-11-01

    Full Text Available Abstract Background Widespread adoption of information and communication technologies (ICT is a key strategy to meet the challenges facing health systems internationally of increasing demands, rising costs, limited resources and workforce shortages. Despite the rapid increase in ICT investment, uptake and acceptance has been slow and the benefits fewer than expected. Absent from the research literature has been a multi-site investigation of how ICT can support and drive innovative work practice. This Australian-based project will assess the factors that allow health service organisations to harness ICT, and the extent to which such systems drive the creation of new sustainable models of service delivery which increase capacity and provide rapid, safe, effective, affordable and sustainable health care. Design A multi-method approach will measure current ICT impact on workforce practices and develop and test new models of ICT use which support innovations in work practice. The research will focus on three large-scale commercial ICT systems being adopted in Australia and other countries: computerised ordering systems, ambulatory electronic medical record systems, and emergency medicine information systems. We will measure and analyse each system's role in supporting five key attributes of work practice innovation: changes in professionals' roles and responsibilities; integration of best practice into routine care; safe care practices; team-based care delivery; and active involvement of consumers in care. Discussion A socio-technical approach to the use of ICT will be adopted to examine and interpret the workforce and organisational complexities of the health sector. The project will also focus on ICT as a potentially disruptive innovation that challenges the way in which health care is delivered and consequently leads some health professionals to view it as a threat to traditional roles and responsibilities and a risk to existing models of care

  18. Use of information and communication technologies to support effective work practice innovation in the health sector: a multi-site study.

    Science.gov (United States)

    Westbrook, Johanna I; Braithwaite, Jeffrey; Gibson, Kathryn; Paoloni, Richard; Callen, Joanne; Georgiou, Andrew; Creswick, Nerida; Robertson, Louise

    2009-11-08

    Widespread adoption of information and communication technologies (ICT) is a key strategy to meet the challenges facing health systems internationally of increasing demands, rising costs, limited resources and workforce shortages. Despite the rapid increase in ICT investment, uptake and acceptance has been slow and the benefits fewer than expected. Absent from the research literature has been a multi-site investigation of how ICT can support and drive innovative work practice. This Australian-based project will assess the factors that allow health service organisations to harness ICT, and the extent to which such systems drive the creation of new sustainable models of service delivery which increase capacity and provide rapid, safe, effective, affordable and sustainable health care. A multi-method approach will measure current ICT impact on workforce practices and develop and test new models of ICT use which support innovations in work practice. The research will focus on three large-scale commercial ICT systems being adopted in Australia and other countries: computerised ordering systems, ambulatory electronic medical record systems, and emergency medicine information systems. We will measure and analyse each system's role in supporting five key attributes of work practice innovation: changes in professionals' roles and responsibilities; integration of best practice into routine care; safe care practices; team-based care delivery; and active involvement of consumers in care. A socio-technical approach to the use of ICT will be adopted to examine and interpret the workforce and organisational complexities of the health sector. The project will also focus on ICT as a potentially disruptive innovation that challenges the way in which health care is delivered and consequently leads some health professionals to view it as a threat to traditional roles and responsibilities and a risk to existing models of care delivery. Such views have stifled debate as well as wider

  19. Connecting Smartphone and Wearable Fitness Tracker Data with a Nationally Used Electronic Health Record System for Diabetes Education to Facilitate Behavioral Goal Monitoring in Diabetes Care: Protocol for a Pragmatic Multi-Site Randomized Trial.

    Science.gov (United States)

    Wang, Jing; Coleman, Deidra Carroll; Kanter, Justin; Ummer, Brad; Siminerio, Linda

    2018-04-02

    Mobile and wearable technology have been shown to be effective in improving diabetes self-management; however, integrating data from these technologies into clinical diabetes care to facilitate behavioral goal monitoring has not been explored. The objective of this paper is to report on a study protocol for a pragmatic multi-site trial along with the intervention components, including the detailed connected health interface. This interface was developed to integrate patient self-monitoring data collected from a wearable fitness tracker and its companion smartphone app to an electronic health record system for diabetes self-management education and support (DSMES) to facilitate behavioral goal monitoring. A 3-month multi-site pragmatic clinical trial was conducted with eligible patients with diabetes mellitus from DSMES programs. The Chronicle Diabetes system is currently freely available to diabetes educators through American Diabetes Association-recognized DSMES programs to set patient nutrition and physical activity goals. To integrate the goal-setting and self-monitoring intervention into the DSMES process, a connected interface in the Chronicle Diabetes system was developed. With the connected interface, patient self-monitoring information collected from smartphones and wearable fitness trackers can facilitate educators' monitoring of patients' adherence to their goals. Feasibility outcomes of the 3-month trial included hemoglobin A 1c levels, weight, and the usability of the connected system. An interface designed to connect data from a wearable fitness tracker with a companion smartphone app for nutrition and physical activity self-monitoring into a diabetes education electronic health record system was successfully developed to enable diabetes educators to facilitate goal setting and monitoring. A total of 60 eligible patients with type 2 diabetes mellitus were randomized into either group 1) standard diabetes education or 2) standard education enhanced with

  20. A Web-Based Data Collection Platform for Multisite Randomized Behavioral Intervention Trials: Development, Key Software Features, and Results of a User Survey.

    Science.gov (United States)

    Modi, Riddhi A; Mugavero, Michael J; Amico, Rivet K; Keruly, Jeanne; Quinlivan, Evelyn Byrd; Crane, Heidi M; Guzman, Alfredo; Zinski, Anne; Montue, Solange; Roytburd, Katya; Church, Anna; Willig, James H

    2017-06-16

    Meticulous tracking of study data must begin early in the study recruitment phase and must account for regulatory compliance, minimize missing data, and provide high information integrity and/or reduction of errors. In behavioral intervention trials, participants typically complete several study procedures at different time points. Among HIV-infected patients, behavioral interventions can favorably affect health outcomes. In order to empower newly diagnosed HIV positive individuals to learn skills to enhance retention in HIV care, we developed the behavioral health intervention Integrating ENGagement and Adherence Goals upon Entry (iENGAGE) funded by the National Institute of Allergy and Infectious Diseases (NIAID), where we deployed an in-clinic behavioral health intervention in 4 urban HIV outpatient clinics in the United States. To scale our intervention strategy homogenously across sites, we developed software that would function as a behavioral sciences research platform. This manuscript aimed to: (1) describe the design and implementation of a Web-based software application to facilitate deployment of a multisite behavioral science intervention; and (2) report on results of a survey to capture end-user perspectives of the impact of this platform on the conduct of a behavioral intervention trial. In order to support the implementation of the NIAID-funded trial iENGAGE, we developed software to deploy a 4-site behavioral intervention for new clinic patients with HIV/AIDS. We integrated the study coordinator into the informatics team to participate in the software development process. Here, we report the key software features and the results of the 25-item survey to evaluate user perspectives on research and intervention activities specific to the iENGAGE trial (N=13). The key features addressed are study enrollment, participant randomization, real-time data collection, facilitation of longitudinal workflow, reporting, and reusability. We found 100% user

  1. Realistic multisite lattice-gas modeling and KMC simulation of catalytic surface reactions: Kinetics and multiscale spatial behavior for CO-oxidation on metal (1 0 0) surfaces

    Science.gov (United States)

    Liu, Da-Jiang; Evans, James W.

    2013-12-01

    A realistic molecular-level description of catalytic reactions on single-crystal metal surfaces can be provided by stochastic multisite lattice-gas (msLG) models. This approach has general applicability, although in this report, we will focus on the example of CO-oxidation on the unreconstructed fcc metal (1 0 0) or M(1 0 0) surfaces of common catalyst metals M = Pd, Rh, Pt and Ir (i.e., avoiding regimes where Pt and Ir reconstruct). These models can capture the thermodynamics and kinetics of adsorbed layers for the individual reactants species, such as CO/M(1 0 0) and O/M(1 0 0), as well as the interaction and reaction between different reactant species in mixed adlayers, such as (CO + O)/M(1 0 0). The msLG models allow population of any of hollow, bridge, and top sites. This enables a more flexible and realistic description of adsorption and adlayer ordering, as well as of reaction configurations and configuration-dependent barriers. Adspecies adsorption and interaction energies, as well as barriers for various processes, constitute key model input. The choice of these energies is guided by experimental observations, as well as by extensive Density Functional Theory analysis. Model behavior is assessed via Kinetic Monte Carlo (KMC) simulation. We also address the simulation challenges and theoretical ramifications associated with very rapid diffusion and local equilibration of reactant adspecies such as CO. These msLG models are applied to describe adsorption, ordering, and temperature programmed desorption (TPD) for individual CO/M(1 0 0) and O/M(1 0 0) reactant adlayers. In addition, they are also applied to predict mixed (CO + O)/M(1 0 0) adlayer structure on the nanoscale, the complete bifurcation diagram for reactive steady-states under continuous flow conditions, temperature programmed reaction (TPR) spectra, and titration reactions for the CO-oxidation reaction. Extensive and reasonably successful comparison of model predictions is made with experimental

  2. Enhancing mHealth Technology in the Patient-Centered Medical Home Environment to Activate Patients With Type 2 Diabetes: A Multisite Feasibility Study Protocol.

    Science.gov (United States)

    Gimbel, Ronald; Shi, Lu; Williams, Joel E; Dye, Cheryl J; Chen, Liwei; Crawford, Paul; Shry, Eric A; Griffin, Sarah F; Jones, Karyn O; Sherrill, Windsor W; Truong, Khoa; Little, Jeanette R; Edwards, Karen W; Hing, Marie; Moss, Jennie B

    2017-03-06

    The potential of mHealth technologies in the care of patients with diabetes and other chronic conditions has captured the attention of clinicians and researchers. Efforts to date have incorporated a variety of tools and techniques, including Web-based portals, short message service (SMS) text messaging, remote collection of biometric data, electronic coaching, electronic-based health education, secure email communication between visits, and electronic collection of lifestyle and quality-of-life surveys. Each of these tools, used alone or in combination, have demonstrated varying degrees of effectiveness. Some of the more promising results have been demonstrated using regular collection of biometric devices, SMS text messaging, secure email communication with clinical teams, and regular reporting of quality-of-life variables. In this study, we seek to incorporate several of the most promising mHealth capabilities in a patient-centered medical home (PCMH) workflow. We aim to address underlying technology needs and gaps related to the use of mHealth technology and the activation of patients living with type 2 diabetes. Stated differently, we enable supporting technologies while seeking to influence patient activation and self-care activities. This is a multisite phased study, conducted within the US Military Health System, that includes a user-centered design phase and a PCMH-based feasibility trial. In phase 1, we will assess both patient and provider preferences regarding the enhancement of the enabling technology capabilities for type 2 diabetes chronic care management. Phase 2 research will be a single-blinded 12-month feasibility study that incorporates randomization principles. Phase 2 research will seek to improve patient activation and self-care activities through the use of the Mobile Health Care Environment with tailored behavioral messaging. The primary outcome measure is the Patient Activation Measure scores. Secondary outcome measures are Summary of

  3. Synthesis of Tetrasubstituted Thieno[3,2-b]pyridin-5(4H)-one Derivatives as a Heterocyclic Scaffold for Multisite-specific Fluorous Fluorescent Tagging and Fluorous Solid-Phase Extraction

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Moon-Kook; Yi, Su-Jin [Korea Research Institute of Chemical Technology, Daejeon (Korea, Republic of); Son, Seung Uk [Sungkyunkwan University, Suwon (Korea, Republic of)

    2016-08-15

    Tetrasubstituted thieno[3,2-b]pyridin-5(4H)-one derivatives were selected as a highly functionalized heterocyclic scaffold for a multisite-specific tagging process utilizing a previously devised fluorous fluorescent tag system. A suitable synthetic method was established for the 7-alkoxy-2,4,6-risubstituted-thieno[3,2-b] pyridin-5(4H)-one derivatives, and incorporating t-butoxycarbonyl-functionalized building blocks into the reaction sequence produced precursors that could be used in the tagging process. Fluorous solid-phase extraction facilitated the purification of the tagged target compounds after a series of reactions, including t-Bu deprotection/N-hydroxysuccinimidyl ester formation/amidation.

  4. Processes for design, construction and utilisation of arrays of light-emitting diodes and light-emitting diode-coupled optical fibres for multi-site brain light delivery.

    Science.gov (United States)

    Bernstein, Jacob G; Allen, Brian D; Guerra, Alexander A; Boyden, Edward S

    2015-05-01

    Optogenetics enables light to be used to control the activity of genetically targeted cells in the living brain. Optical fibers can be used to deliver light to deep targets, and LEDs can be spatially arranged to enable patterned light delivery. In combination, arrays of LED-coupled optical fibers can enable patterned light delivery to deep targets in the brain. Here we describe the process flow for making LED arrays and LED-coupled optical fiber arrays, explaining key optical, electrical, thermal, and mechanical design principles to enable the manufacturing, assembly, and testing of such multi-site targetable optical devices. We also explore accessory strategies such as surgical automation approaches as well as innovations to enable low-noise concurrent electrophysiology.

  5. Synthesis of Tetrasubstituted Thieno[3,2-b]pyridin-5(4H)-one Derivatives as a Heterocyclic Scaffold for Multisite-specific Fluorous Fluorescent Tagging and Fluorous Solid-Phase Extraction

    International Nuclear Information System (INIS)

    Jeon, Moon-Kook; Yi, Su-Jin; Son, Seung Uk

    2016-01-01

    Tetrasubstituted thieno[3,2-b]pyridin-5(4H)-one derivatives were selected as a highly functionalized heterocyclic scaffold for a multisite-specific tagging process utilizing a previously devised fluorous fluorescent tag system. A suitable synthetic method was established for the 7-alkoxy-2,4,6-risubstituted-thieno[3,2-b] pyridin-5(4H)-one derivatives, and incorporating t-butoxycarbonyl-functionalized building blocks into the reaction sequence produced precursors that could be used in the tagging process. Fluorous solid-phase extraction facilitated the purification of the tagged target compounds after a series of reactions, including t-Bu deprotection/N-hydroxysuccinimidyl ester formation/amidation.

  6. Repeated assessment of orthotopic glioma pO2 by multi-site EPR oximetry: A technique with the potential to guide therapeutic optimization by repeated measurements of oxygen

    Science.gov (United States)

    Khan, Nadeem; Mupparaju, Sriram; Hou, Huagang; Williams, Benjamin B.; Swartz, Harold

    2011-01-01

    Tumor hypoxia plays a vital role in therapeutic resistance. Consequently, measurements of tumor pO2 could be used to optimize the outcome of oxygen-dependent therapies, such as, chemoradiation. However, the potential optimizations are restricted by the lack of methods to repeatedly and quantitatively assess tumor pO2 during therapies, particularly in gliomas. We describe the procedures for repeated measurements of orthotopic glioma pO2 by multi-site electron paramagnetic resonance (EPR) oximetry. This oximetry approach provides simultaneous measurements of pO2 at more than one site in the glioma and contralateral cerebral tissue. The pO2 of intracerebral 9L, C6, F98 and U251 tumors, as well as contralateral brain, were measured repeatedly for five consecutive days. The 9L glioma was well oxygenated with pO2 of 27 - 36 mm Hg, while C6, F98 and U251 glioma were hypoxic with pO2 of 7 - 12 mm Hg. The potential of multi-site EPR oximetry to assess temporal changes in tissue pO2 was investigated in rats breathing 100% O2. A significant increase in F98 tumor and contralateral brain pO2 was observed on day 1 and day 2, however, glioma oxygenation declined on subsequent days. In conclusion, EPR oximetry provides the capability to repeatedly assess temporal changes in orthotopic glioma pO2. This information could be used to test and optimize the methods being developed to modulate tumor hypoxia. Furthermore, EPR oximetry could be potentially used to enhance the outcome of chemoradiation by scheduling treatments at times of increase in glioma pO2. PMID:22079559

  7. Multi-site evaluation of a computer aided detection (CAD) algorithm for small acute intra-cranial hemorrhage and development of a stand-alone CAD system ready for deployment in a clinical environment

    Science.gov (United States)

    Deshpande, Ruchi R.; Fernandez, James; Lee, Joon K.; Chan, Tao; Liu, Brent J.; Huang, H. K.

    2010-03-01

    Timely detection of Acute Intra-cranial Hemorrhage (AIH) in an emergency environment is essential for the triage of patients suffering from Traumatic Brain Injury. Moreover, the small size of lesions and lack of experience on the reader's part could lead to difficulties in the detection of AIH. A CT based CAD algorithm for the detection of AIH has been developed in order to improve upon the current standard of identification and treatment of AIH. A retrospective analysis of the algorithm has already been carried out with 135 AIH CT studies with 135 matched normal head CT studies from the Los Angeles County General Hospital/ University of Southern California Hospital System (LAC/USC). In the next step, AIH studies have been collected from Walter Reed Army Medical Center, and are currently being processed using the AIH CAD system as part of implementing a multi-site assessment and evaluation of the performance of the algorithm. The sensitivity and specificity numbers from the Walter Reed study will be compared with the numbers from the LAC/USC study to determine if there are differences in the presentation and detection due to the difference in the nature of trauma between the two sites. Simultaneously, a stand-alone system with a user friendly GUI has been developed to facilitate implementation in a clinical setting.

  8. Design and challenges for a randomized, multi-site clinical trial comparing the use of service dogs and emotional support dogs in Veterans with post-traumatic stress disorder (PTSD).

    Science.gov (United States)

    Saunders, Gabrielle H; Biswas, Kousick; Serpi, Tracey; McGovern, Stephanie; Groer, Shirley; Stock, Eileen M; Magruder, Kathryn M; Storzbach, Daniel; Skelton, Kelly; Abrams, Thad; McCranie, Mark; Richerson, Joan; Dorn, Patricia A; Huang, Grant D; Fallon, Michael T

    2017-11-01

    Posttraumatic stress disorder (PTSD) is a leading cause of impairments in quality of life and functioning among Veterans. Service dogs have been promoted as an effective adjunctive intervention for PTSD, however published research is limited and design and implementation flaws in published studies limit validated conclusions. This paper describes the rationale for the study design, a detailed methodological description, and implementation challenges of a multisite randomized clinical trial examining the impact of service dogs on the on the functioning and quality of life of Veterans with PTSD. Trial design considerations prioritized participant and intervention (dog) safety, selection of an intervention comparison group that would optimize enrollment in all treatment arms, pragmatic methods to ensure healthy well-trained dogs, and the selection of outcomes for achieving scientific and clinical validity in a Veteran PTSD population. Since there is no blueprint for conducting a randomized clinical trial examining the impact of dogs on PTSD of this size and scope, it is our primary intent that the successful completion of this trial will set a benchmark for future trial design and scientific rigor, as well as guiding researchers aiming to better understand the role that dogs can have in the management of Veterans experiencing mental health conditions such as PTSD. Published by Elsevier Inc.

  9. The Influence of Self-Efficacy, Fear-Avoidance Belief, and Coping Styles on Quality of Life for Chinese Patients with Chronic Nonspecific Low Back Pain: A Multisite Cross-Sectional Study.

    Science.gov (United States)

    Du, Shizheng; Hu, Lingli; Bai, Yamei; Dong, Jianshu; Jin, Shengji; Zhang, Heng; Zhu, Ying

    2017-11-23

    As a bio-psycho-social issue, chronic low back pain (CLBP) has been a significant topic in health management, and patients' quality of life (QOL) is gaining extensive attention. Self-efficacy, pain fear-avoidance belief (FAB), and coping styles play important roles in the QOL of CLBP patients. However, it remains unclear how self-efficacy and FAB influence QOL through specific coping styles. This study aimed to explore the influencing paths of self-efficacy, FAB, and coping styles on the QOL of patients with CLBP. This study relies on a multisite, cross-sectional design involving 221 CLBP patients. Stepwise multiple regression and structural equation modeling were employed. CLBP patients lived with a poor global QOL. Self-efficacy played a direct, positive role in predicting QOL for patients with CLBP (β = 0.35), and it also played an indirect, positive role in predicting QOL (β = 0.19) through active coping styles (β = 0.31). FAB played a direct, negative role in predicting QOL (β = -0.33), and it also played an indirect, negative role in predicting QOL (β = -0.32) through passive coping styles (β = 0.32). Self-efficacy and FAB are both directly and indirectly related to global QOL, and coping styles are important mediating variables. Self-efficacy and active coping are protective factors for the QOL of CLBP patients, while FAB and passive coping are risk factors. Health education strategies are recommended by medical personnel to enhance CLBP patients' pain self-efficacy, decrease pain FAB, and modify pain coping styles, so that their global QOL can be improved. © 2017 World Institute of Pain.

  10. An Event-Level Analysis of Condomless Anal Intercourse with a HIV-Discordant or HIV Status-Unknown Partner Among Black Men Who Have Sex with Men from a Multi-site Study.

    Science.gov (United States)

    Yang, Cui; Latkin, Carl; Tobin, Karin; Seal, David; Koblin, Beryl; Chander, Geetanjali; Siconolfi, Daniel; Flores, Stephen; Spikes, Pilgrim

    2018-05-19

    Despite the high HIV incidence and prevalence among black men who have sex with men (BMSM), little research has examined partner characteristics, partner seeking venue, sexual position, substance use, and sexual risk behavior at the sex event-level among BMSM. Using the baseline data from a multi-site study of 807 BMSM stratified by their HIV status, the goal of this study was to conduct a detailed event-level analysis of 1577 male anal sex events to assess the factors associated with condomless anal intercourse (CLAI) with a HIV-discordant or HIV status-unknown partner. We found CLAI with an HIV-discordant or unknown HIV status partner among HIV-negative BMSM was negatively associated with having sex with a main partner, and was positively associated with taking both receptive and insertive sexual positions during sex. As compared to a sex partner met at bar, night club or dance club, HIV-positive BMSM were less likely to engage in CLAI with HIV-discordant and unknown HIV status partner met at party or friend's house or at community organizations. HIV-positive BMSM had lower odds of engaging in CLAI with HIV-discordant and unknown HIV status partner if they had insertive sexual position or both receptive and insertive sexual positions. These results underscore the importance of delineating unique sex event-level factors associated with sexual risk behavior depending on individuals' HIV status. Our findings suggest event-level partner characteristics, sexual position, and partner seeking venues may contribute to disparities in HIV incidence.

  11. A pragmatic, phase III, multisite, double-blind, placebo-controlled, parallel-arm, dose increment randomised trial of regular, low-dose extended-release morphine for chronic breathlessness: Breathlessness, Exertion And Morphine Sulfate (BEAMS) study protocol.

    Science.gov (United States)

    Currow, David; Watts, Gareth John; Johnson, Miriam; McDonald, Christine F; Miners, John O; Somogyi, Andrew A; Denehy, Linda; McCaffrey, Nicola; Eckert, Danny J; McCloud, Philip; Louw, Sandra; Lam, Lawrence; Greene, Aine; Fazekas, Belinda; Clark, Katherine C; Fong, Kwun; Agar, Meera R; Joshi, Rohit; Kilbreath, Sharon; Ferreira, Diana; Ekström, Magnus

    2017-07-17

    Chronic breathlessness is highly prevalent and distressing to patients and families. No medication is registered for its symptomatic reduction. The strongest evidence is for regular, low-dose, extended- release (ER) oral morphine. A recent large phase III study suggests the subgroup most likely to benefit have chronic obstructive pulmonary disease (COPD) and modified Medical Research Council breathlessness scores of 3 or 4. This protocol is for an adequately powered, parallel-arm, placebo-controlled, multisite, factorial, block-randomised study evaluating regular ER morphine for chronic breathlessness in people with COPD. The primary question is what effect regular ER morphine has on worst breathlessness, measured daily on a 0-10 numerical rating scale. Uniquely, the coprimary outcome will use a FitBit to measure habitual physical activity. Secondary questions include safety and, whether upward titration after initial benefit delivers greater net symptom reduction. Substudies include longitudinal driving simulation, sleep, caregiver, health economic and pharmacogenetic studies. Seventeen centres will recruit 171 participants from respiratory and palliative care. The study has five phases including three randomisation phases to increasing doses of ER morphine. All participants will receive placebo or active laxatives as appropriate. Appropriate statistical analysis of primary and secondary outcomes will be used. Ethics approval has been obtained. Results of the study will be submitted for publication in peer-reviewed journals, findings presented at relevant conferences and potentially used to inform registration of ER morphine for chronic breathlessness. NCT02720822; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Testing the effectiveness of a motivational interviewing-based brief intervention for substance use as an adjunct to usual care in community-based AIDS service organizations: study protocol for a multisite randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Bryan R. Garner

    2017-11-01

    Full Text Available Abstract Background In 2010, the first comprehensive National HIV/AIDS Strategy for the United States was released and included three goals: (1 reducing the number of people who become infected with HIV, (2 increasing access to care and improving health outcomes for people living with HIV, and (3 reducing HIV-related health disparities and health inequities. In 2013, as part of its effort to help address the National HIV/AIDS Strategy, the National Institute on Drug Abuse (NIDA funded a type 2 effectiveness-implementation hybrid trial titled the Substance Abuse Treatment to HIV Care (SAT2HIV Project. Aim 1 of the SAT2HIV Project tests the effectiveness of a motivational interviewing-based brief intervention (MIBI for substance use as an adjunct to usual care within AIDS Service Organizations (ASOs as part of its MIBI Experiment. Aim 2 of the SAT2HIV Project tests the effectiveness of implementation and sustainment facilitation (ISF as an adjunct to the Addiction Technology Transfer Center (ATTC model for training staff in motivational interviewing as part of its ISF Experiment. The current paper describes the study protocol for the ISF Experiment. Methods As part of a multisite randomized controlled trial, individuals with comorbid HIV/AIDS and problematic substance use are randomized to receive either the ASOs’ usual care (control condition or usual care plus a MIBI for substance use (experimental condition delivered by trained ASO case-management staff. Primary outcome measures are reductions in days of primary substance use, number of substance-related problems, times engaging in risky behaviors, days of non-adherence to HIV medications, and increases in substance use treatment. As part of this paper, we describe the trial protocol in accordance with the Standard Protocol Items: Recommendations for Interventional Trials guidelines. Discussion If successfully able to implement MIBI as an effective adjunct to usual care, the current trial may

  13. Navigating high-risk surgery: protocol for a multisite, stepped wedge, cluster-randomised trial of a question prompt list intervention to empower older adults to ask questions that inform treatment decisions.

    Science.gov (United States)

    Taylor, Lauren J; Rathouz, Paul J; Berlin, Ana; Brasel, Karen J; Mosenthal, Anne C; Finlayson, Emily; Cooper, Zara; Steffens, Nicole M; Jacobson, Nora; Buffington, Anne; Tucholka, Jennifer L; Zhao, Qianqian; Schwarze, Margaret L

    2017-05-29

    Older patients frequently undergo operations that carry high risk for postoperative complications and death. Poor preoperative communication between patients and surgeons can lead to uninformed decisions and result in unexpected outcomes, conflict between surgeons and patients, and treatment inconsistent with patient preferences. This article describes the protocol for a multisite, cluster-randomised trial that uses a stepped wedge design to test a patient-driven question prompt list (QPL) intervention aimed to improve preoperative decision making and inform postoperative expectations. This Patient-Centered Outcomes Research Institute-funded trial will be conducted at five academic medical centres in the USA. Study participants include surgeons who routinely perform vascular or oncological surgery, their patients and families. We aim to enrol 40 surgeons and 480 patients over 24 months. Patients age 65 or older who see a study-enrolled surgeon to discuss a vascular or oncological problem that could be treated with high-risk surgery will be enrolled at their clinic visit. Together with stakeholders, we developed a QPL intervention addressing preoperative communication needs of patients considering major surgery. Guided by the theories of self-determination and relational autonomy, this intervention is designed to increase patient activation. Patients will receive the QPL brochure and a letter from their surgeon encouraging its use. Using audio recordings of the outpatient surgical consultation, patient and family member questionnaires administered at three time points and retrospective chart review, we will compare the effectiveness of the QPL intervention to usual care with respect to the following primary outcomes: patient engagement in decision making, psychological well-being and post-treatment regret for patients and families, and interpersonal and intrapersonal conflict relating to treatment decisions and treatments received. Approvals have been granted by the

  14. Multisites Coordination in Shared Multicast Trees

    National Research Council Canada - National Science Library

    Dommel, H-P; Garcia-Luna-Aceves, J. J

    1999-01-01

    .... The protocol supports Internet-wide coordination for large and highly interactive groupwork, relying on transmission of coordination directives between group members across a shared end-to-end multicast tree...

  15. Ferromagnetic Potts models with multisite interaction

    Science.gov (United States)

    Schreiber, Nir; Cohen, Reuven; Haber, Simi

    2018-03-01

    We study the q -state Potts model with four-site interaction on a square lattice. Based on the asymptotic behavior of lattice animals, it is argued that when q ≤4 the system exhibits a second-order phase transition and when q >4 the transition is first order. The q =4 model is borderline. We find 1 /lnq to be an upper bound on Tc, the exact critical temperature. Using a low-temperature expansion, we show that 1 /(θ lnq ) , where θ >1 is a q -dependent geometrical term, is an improved upper bound on Tc. In fact, our findings support Tc=1 /(θ lnq ) . This expression is used to estimate the finite correlation length in first-order transition systems. These results can be extended to other lattices. Our theoretical predictions are confirmed numerically by an extensive study of the four-site interaction model using the Wang-Landau entropic sampling method for q =3 ,4 ,5 . In particular, the q =4 model shows an ambiguous finite-size pseudocritical behavior.

  16. Forskningskonference 2018 – et forskningssyn på kompetenceudvikling, uddannelse, kompleksitet og mening

    DEFF Research Database (Denmark)

    Hansen, Magnus Rotvig Perlt; Svejvig, Per

    2018-01-01

    Med en udvidelse af forskningskonferencen til begge symposiets dage fletter vi i år temastrømmene sammen med perspektiver fra landets førende projektledelsesforskere. Her bliver mennesket sat I centrum og relateret til bl.a. agilitet og kompleksitet, handlingsorienteret meningsskabelse, og perspe...

  17. Odpowiedzialność menedżera w zarządzaniu pracownikami wiedzy

    OpenAIRE

    Bednarska-Wnuk, Izabela

    2012-01-01

    his article aims to present the role of manager as responsible individuals shaping the organizational space of their workers, particularly knowledge workers. Due to the limited volume of the article, the focus was only on the aspects of motivation in the context of responsible business. For this purpose formulated firs characterized the essence of corporate social responsibility, environment manager and knowledge workers, and then presents the elements associated with motivating knowledge wor...

  18. ¿Tiene Anaxímenes una teoría del cambio?

    Directory of Open Access Journals (Sweden)

    Daniel Graham

    2013-11-01

    Full Text Available For a long time it has been argued that, amongst the first presocratics, Anaximenes is whom possessed the most detailed theory of change. Indeed, his theory of change was one of his fundamental contributions to history of philosophy. Thirty years ago this opinion was questioned and the argument was recently repeated in a revised edition of Anaximenes. So far, I have no notice that such question has been answered. In the present essay I want to argue that, although there is something erroneous in the traditional interpretation of Anaximenes theory of change, it is not what the objectors say it is: truly, Anaximenes possess an important theory of change, of which we have significant antique evidence.

  19. Vliv pivovarského procesu na profil proteinů ječmene

    Czech Academy of Sciences Publication Activity Database

    Benkovská, Dagmar; Flodrová, Dana; Psota, V.; Bobálová, Janette

    2011-01-01

    Roč. 57, 7-8 (2011), 260-265 ISSN 0023-5830 R&D Projects: GA MŠk 1M0570 Institutional research plan: CEZ:AV0Z40310501 Keywords : barley * proteins * brewing process Subject RIV: CB - Analytical Chemistry, Separation

  20. Definicija uspešnega menedžerja v družinskem podjetju

    Directory of Open Access Journals (Sweden)

    Urška Metelko

    2017-08-01

    Full Text Available Purpose and originality: The purpose of this article is to identify the main characteristics of successful managers of family businesses from different perspectives. Method: We used the method of literature review of existing knowledge on family businesses and their managers, on organisational behaviour and on successful managers in general. Results: The research has highlighted the personality traits of successful managers in general, and specifically successful managers in family businesses. Society: Society will benefit from the research findings by obtaining identification of characteristics and activities of a successful manager of family business. Limitations / further research: This research is limited by the number of existing sources that were used. In the future, it would be suitable to augment the theoretical part with an empirical research on the case of Slovenia or one of its regions. It would also be sensible to add a quantitative research.

  1. Fremlæggelse af vores syn på menings- og undringsdreven innovation

    DEFF Research Database (Denmark)

    Hansen, Finn Thorbjørn; Herholdt-Lomholdt, Sine Maria

    2017-01-01

    I denne artikel ’slås tonen an’ ved at stille ind på den forundring, der oftest går forud for den mere filosofiske undren, og som knytter sig til en æstetisk transcendens-erfaring. Med idéhistorikeren Dorthe Jørgensen (Jørgensen, 2014) nuancerer vi, hvad det kan være for anelsesfulde og indfaldsp...... entreprenørtilgang til ’design-drevne innovation’, som f.eks. den danske innovationsorganisation MindLab trækker på, her eksemplificeret af Liedtka og Ogilvies (Liedtka & Ogilvie, 2011) model for designdreven innovation....

  2. MOVIMIENTOS FICCIONALES Y NO FICCIONALES DE LA VIOLENCIA. CRÍMENES DE MUJERES

    Directory of Open Access Journals (Sweden)

    Nora Domínguez

    2013-04-01

    literatura ha ido a la par de esos datos, proponiéndose como un campo de fuerzas donde la violencia y el terror, sustrato políticode estas ficciones, deviene en exploración literaria. A partir del análisis de “La parte de los crímenes” de 2666 de Roberto Bolaño (2004, El trabajo de Aníbal Jarkowski (2007 y Le viste la cara a Dios de Gabriela Cabezón Cámara (2012, este artículo piensa los cuerpos de mujeres como los disparadores narrativos que modulan las versiones político-literarias en las que el intercambio mafioso, la prostitución como amenaza neoliberal o la trata de personas funcionan como núcleos duros de verdades del presente. Los textos literarios afincados en límites verbales no logran colmar la experiencia desnuda del sufrimiento y el dolor, pero manipulan los signos materiales que pueden evocarlos y otorgarles significado.

  3. Regímenes universales de derechos humanos: la princesa vs. la cenicienta.

    OpenAIRE

    Cárdenas Reyes, Ximena Alejandra

    2012-01-01

    Este trabajo de investigación argumenta que no existe un régimen universal único de derechos humanos, pues en la realidad éste en 1966 se dividió en dos dando lugar: un régimen universal de derechos civiles y políticos y un régimen universal de derechos económicos, sociales y culturales. Además, propone que esta división genera efectos reales en la promoción y la protección de los derechos mencionados, colocando a los derechos económicos, sociales y culturales en una posición subordinada fren...

  4. Sensibilidad y especificidad de los exámenes de anticuerpos antigliadina y antiendomisio

    OpenAIRE

    LOZANO, WINSTON; MéNDEZ, VIRGINIA; FERREIRA, MARíA INéS; GUTIéRREZ, CARMEN

    2002-01-01

    La enfermedad celíaca se presenta con una gran heterogeneidad: formas sintomáticas, silentes y latentes. La determinación de anticuerpos antigliadina y antiendomisio es útil para definir a qué pacientes realizar biopsia de intestino delgado y para el seguimiento de los celíacos ya conocidos. Estas técnicas fueron incorporadas en 1994 en el Centro Hospitalario Pereira Rossell. Objetivo: conocer la sensibilidad y especificidad de los anticuerpos antigliadina (IgG) y antiendomisio (IgA) para el ...

  5. A New Method of Estimating Wind Tunnel Wall Interference in the Unsteady Two-Dimensional Flow (Nouvelle Methode D’Estimation de la Perturbation des Ecoulements Instationnaires par les Parois d’une Soufflerie).

    Science.gov (United States)

    1983-01-01

    disturbance theory . The main feature of the method is the use of measured pressure along lines in the flow direction near the tunnel walls. This method...disturbance theory , then $can be written ( , = qo( , ) .@ (:. S-in(.t + 0.( or s CO (8) Defining cw as co S . ^(9) gives Sin= C, f(4,.) + OCr,z)co.s(0t...AUTHOR (S)/ AUTEUR (S) H. Sawada, visiting scientist 2nd Aerodynamics Division, National Aerospace Laboratory, Japan SERIES/SERIE Aeronautical Note 6

  6. Machine Learning-Augmented Propensity Score-Adjusted Multilevel Mixed Effects Panel Analysis of Hands-On Cooking and Nutrition Education versus Traditional Curriculum for Medical Students as Preventive Cardiology: Multisite Cohort Study of 3,248 Trainees over 5 Years

    Science.gov (United States)

    Dart, Lyn; Vanbeber, Anne; Smith-Barbaro, Peggy; Costilla, Vanessa; Samuel, Charlotte; Terregino, Carol A.; Abali, Emine Ercikan; Dollinger, Beth; Baumgartner, Nicole; Kramer, Nicholas; Seelochan, Alex; Taher, Sabira; Deutchman, Mark; Evans, Meredith; Ellis, Robert B.; Oyola, Sonia; Maker-Clark, Geeta; Budnick, Isadore; Tran, David; DeValle, Nicole; Shepard, Rachel; Chow, Erika; Petrin, Christine; Razavi, Alexander; McGowan, Casey; Grant, Austin; Bird, Mackenzie; Carry, Connor; McGowan, Glynis; McCullough, Colleen; Berman, Casey M.; Dotson, Kerri; Sarris, Leah; Harlan, Timothy S.; Co-investigators, on behalf of the CHOP

    2018-01-01

    Background Cardiovascular disease (CVD) annually claims more lives and costs more dollars than any other disease globally amid widening health disparities, despite the known significant reductions in this burden by low cost dietary changes. The world's first medical school-based teaching kitchen therefore launched CHOP-Medical Students as the largest known multisite cohort study of hands-on cooking and nutrition education versus traditional curriculum for medical students. Methods This analysis provides a novel integration of artificial intelligence-based machine learning (ML) with causal inference statistics. 43 ML automated algorithms were tested, with the top performer compared to triply robust propensity score-adjusted multilevel mixed effects regression panel analysis of longitudinal data. Inverse-variance weighted fixed effects meta-analysis pooled the individual estimates for competencies. Results 3,248 unique medical trainees met study criteria from 20 medical schools nationally from August 1, 2012, to June 26, 2017, generating 4,026 completed validated surveys. ML analysis produced similar results to the causal inference statistics based on root mean squared error and accuracy. Hands-on cooking and nutrition education compared to traditional medical school curriculum significantly improved student competencies (OR 2.14, 95% CI 2.00–2.28, p < 0.001) and MedDiet adherence (OR 1.40, 95% CI 1.07–1.84, p = 0.015), while reducing trainees' soft drink consumption (OR 0.56, 95% CI 0.37–0.85, p = 0.007). Overall improved competencies were demonstrated from the initial study site through the scale-up of the intervention to 10 sites nationally (p < 0.001). Discussion This study provides the first machine learning-augmented causal inference analysis of a multisite cohort showing hands-on cooking and nutrition education for medical trainees improves their competencies counseling patients on nutrition, while improving students' own diets. This study suggests that

  7. Machine Learning-Augmented Propensity Score-Adjusted Multilevel Mixed Effects Panel Analysis of Hands-On Cooking and Nutrition Education versus Traditional Curriculum for Medical Students as Preventive Cardiology: Multisite Cohort Study of 3,248 Trainees over 5 Years.

    Science.gov (United States)

    Monlezun, Dominique J; Dart, Lyn; Vanbeber, Anne; Smith-Barbaro, Peggy; Costilla, Vanessa; Samuel, Charlotte; Terregino, Carol A; Abali, Emine Ercikan; Dollinger, Beth; Baumgartner, Nicole; Kramer, Nicholas; Seelochan, Alex; Taher, Sabira; Deutchman, Mark; Evans, Meredith; Ellis, Robert B; Oyola, Sonia; Maker-Clark, Geeta; Dreibelbis, Tomi; Budnick, Isadore; Tran, David; DeValle, Nicole; Shepard, Rachel; Chow, Erika; Petrin, Christine; Razavi, Alexander; McGowan, Casey; Grant, Austin; Bird, Mackenzie; Carry, Connor; McGowan, Glynis; McCullough, Colleen; Berman, Casey M; Dotson, Kerri; Niu, Tianhua; Sarris, Leah; Harlan, Timothy S; Co-Investigators, On Behalf Of The Chop

    2018-01-01

    Cardiovascular disease (CVD) annually claims more lives and costs more dollars than any other disease globally amid widening health disparities, despite the known significant reductions in this burden by low cost dietary changes. The world's first medical school-based teaching kitchen therefore launched CHOP-Medical Students as the largest known multisite cohort study of hands-on cooking and nutrition education versus traditional curriculum for medical students. This analysis provides a novel integration of artificial intelligence-based machine learning (ML) with causal inference statistics. 43 ML automated algorithms were tested, with the top performer compared to triply robust propensity score-adjusted multilevel mixed effects regression panel analysis of longitudinal data. Inverse-variance weighted fixed effects meta-analysis pooled the individual estimates for competencies. 3,248 unique medical trainees met study criteria from 20 medical schools nationally from August 1, 2012, to June 26, 2017, generating 4,026 completed validated surveys. ML analysis produced similar results to the causal inference statistics based on root mean squared error and accuracy. Hands-on cooking and nutrition education compared to traditional medical school curriculum significantly improved student competencies (OR 2.14, 95% CI 2.00-2.28, p < 0.001) and MedDiet adherence (OR 1.40, 95% CI 1.07-1.84, p = 0.015), while reducing trainees' soft drink consumption (OR 0.56, 95% CI 0.37-0.85, p = 0.007). Overall improved competencies were demonstrated from the initial study site through the scale-up of the intervention to 10 sites nationally ( p < 0.001). This study provides the first machine learning-augmented causal inference analysis of a multisite cohort showing hands-on cooking and nutrition education for medical trainees improves their competencies counseling patients on nutrition, while improving students' own diets. This study suggests that the public health and medical sectors can

  8. Machine Learning-Augmented Propensity Score-Adjusted Multilevel Mixed Effects Panel Analysis of Hands-On Cooking and Nutrition Education versus Traditional Curriculum for Medical Students as Preventive Cardiology: Multisite Cohort Study of 3,248 Trainees over 5 Years

    Directory of Open Access Journals (Sweden)

    Dominique J. Monlezun

    2018-01-01

    Full Text Available Background. Cardiovascular disease (CVD annually claims more lives and costs more dollars than any other disease globally amid widening health disparities, despite the known significant reductions in this burden by low cost dietary changes. The world’s first medical school-based teaching kitchen therefore launched CHOP-Medical Students as the largest known multisite cohort study of hands-on cooking and nutrition education versus traditional curriculum for medical students. Methods. This analysis provides a novel integration of artificial intelligence-based machine learning (ML with causal inference statistics. 43 ML automated algorithms were tested, with the top performer compared to triply robust propensity score-adjusted multilevel mixed effects regression panel analysis of longitudinal data. Inverse-variance weighted fixed effects meta-analysis pooled the individual estimates for competencies. Results. 3,248 unique medical trainees met study criteria from 20 medical schools nationally from August 1, 2012, to June 26, 2017, generating 4,026 completed validated surveys. ML analysis produced similar results to the causal inference statistics based on root mean squared error and accuracy. Hands-on cooking and nutrition education compared to traditional medical school curriculum significantly improved student competencies (OR 2.14, 95% CI 2.00–2.28, p<0.001 and MedDiet adherence (OR 1.40, 95% CI 1.07–1.84, p=0.015, while reducing trainees’ soft drink consumption (OR 0.56, 95% CI 0.37–0.85, p=0.007. Overall improved competencies were demonstrated from the initial study site through the scale-up of the intervention to 10 sites nationally (p<0.001. Discussion. This study provides the first machine learning-augmented causal inference analysis of a multisite cohort showing hands-on cooking and nutrition education for medical trainees improves their competencies counseling patients on nutrition, while improving students’ own diets. This

  9. A CONSIDERATION OF ETHICAL AND LEGAL ISSUES IN MULTI-SITE STUDIES CONSIDERACIÓN DE LOS TEMAS ÉTICOS Y LEGALES EN LOS ESTUDIOS MULTICÉNTRICOS CONSIDERAÇÃO DOS TEMAS ÉTICOS E LEGAIS NOS ESTUDOS MULTICÊNTRICOS

    Directory of Open Access Journals (Sweden)

    Sana Loue

    2004-01-01

    Full Text Available Significant ethical and legal issues may arise in conjunction with the conduct of multi-site studies. For example, different cultures may have varying concepts of personhood. The United States, for instance, places significant emphasis on the autonomy of each individual, while many other societies rely to a greater degree on defining an individual with reference to his or her roles or relationships to others. These differing orientations may have implications for informed consent procedures and for the design of procedures to maintain confidentiality of the data and privacy of the participants. The development of procedures for the maintenance of confidentiality and privacy must also consider any differences in reporting requirements between the sites that relate to sexually transmitted diseases and child abuse. The implications of such differences for the conduct of multi-site studies are examinedEn relación con los estudios multicéntricos pueden surgir aspectos éticos y legales. Por ejemplo, culturas diferentes tienen conceptos distintos sobre las personas. Así, Estados Unidos enfatiza la autonomía del individuo, mientras que otras sociedades definen, en mayor grado, al individuo según sus roles o su relación con los demás. Estas orientaciones diferentes pueden influir en el proceso de obtener consentimiento informado y en el diseño de procedimientos para mantener la confidencialidad de los datos y la privacidad de los participantes. El desarrollo de procedimientos que garanticen la confidencialidad y la privacidad debe considerar, también, cualquiera diferencia entre los centros al informar los requisitos que tengan relación con enfermedades de transmisión sexual y con abuso de niños. Se examinan las inferencias de estas diferencias al realizar estudios multicéntricosNos estudos multicêntricos surgem questões éticas e legais. Por exemplo, culturas diferentes tem conceitos distintos sobre as pessoas. Assim, nos Estados Unidos

  10. Reduction in camera-specific variability in [{sup 123}I]FP-CIT SPECT outcome measures by image reconstruction optimized for multisite settings: impact on age-dependence of the specific binding ratio in the ENC-DAT database of healthy controls

    Energy Technology Data Exchange (ETDEWEB)

    Buchert, Ralph; Lange, Catharina [Charite - Universitaetsmedizin Berlin, Department of Nuclear Medicine, Berlin (Germany); Kluge, Andreas; Bronzel, Marcus [ABX-CRO advanced pharmaceutical services Forschungsgesellschaft m.b.H., Dresden (Germany); Tossici-Bolt, Livia [University Hospital Southampton NHS Foundation Trust, Department of Medical Physics, Southampton (United Kingdom); Dickson, John [University College London Hospital NHS Foundation Trust, Institute of Nuclear Medicine, London (United Kingdom); Asenbaum, Susanne [Medical University of Vienna, Department of Nuclear Medicine, Vienna (Austria); Booij, Jan [University of Amsterdam, Department of Nuclear Medicine, Academic Medical Centre, Amsterdam (Netherlands); Kapucu, L. Oezlem Atay [Gazi University, Department of Nuclear Medicine, Faculty of Medicine, Ankara (Turkey); Svarer, Claus [Rigshospitalet and University of Copenhagen, Neurobiology Research Unit, Copenhagen (Denmark); Koulibaly, Pierre-Malick [University of Nice-Sophia Antipolis, Nuclear Medicine Department, Centre Antoine Lacassagne, Nice (France); Nobili, Flavio [University of Genoa, Department of Neuroscience (DINOGMI), Clinical Neurology Unit, Genoa (Italy); Pagani, Marco [CNR, Institute of Cognitive Sciences and Technologies, Rome (Italy); Karolinska Hospital, Department of Nuclear Medicine, Stockholm (Sweden); Sabri, Osama [University of Leipzig, Department of Nuclear Medicine, Leipzig (Germany); Sera, Terez [University of Szeged, Department of Nuclear Medicine and Euromedic Szeged, Szeged (Hungary); Tatsch, Klaus [Municipal Hospital of Karlsruhe Inc, Department of Nuclear Medicine, Karlsruhe (Germany); Borght, Thierry vander [CHU Namur, IREC, Nuclear Medicine Division, Universite catholique de Louvain, Yvoir (Belgium); Laere, Koen van [University Hospital and K.U. Leuven, Nuclear Medicine, Leuven (Belgium); Varrone, Andrea [Karolinska University Hospital, Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm (Sweden); Iida, Hidehiro [National Cerebral and Cardiovascular Center - Research Institute, Osaka (Japan)

    2016-07-15

    Quantitative estimates of dopamine transporter availability, determined with [{sup 123}I]FP-CIT SPECT, depend on the SPECT equipment, including both hardware and (reconstruction) software, which limits their use in multicentre research and clinical routine. This study tested a dedicated reconstruction algorithm for its ability to reduce camera-specific intersubject variability in [{sup 123}I]FP-CIT SPECT. The secondary aim was to evaluate binding in whole brain (excluding striatum) as a reference for quantitative analysis. Of 73 healthy subjects from the European Normal Control Database of [{sup 123}I]FP-CIT recruited at six centres, 70 aged between 20 and 82 years were included. SPECT images were reconstructed using the QSPECT software package which provides fully automated detection of the outer contour of the head, camera-specific correction for scatter and septal penetration by transmission-dependent convolution subtraction, iterative OSEM reconstruction including attenuation correction, and camera-specific ''to kBq/ml'' calibration. LINK and HERMES reconstruction were used for head-to-head comparison. The specific striatal [{sup 123}I]FP-CIT binding ratio (SBR) was computed using the Southampton method with binding in the whole brain, occipital cortex or cerebellum as the reference. The correlation between SBR and age was used as the primary quality measure. The fraction of SBR variability explained by age was highest (1) with QSPECT, independently of the reference region, and (2) with whole brain as the reference, independently of the reconstruction algorithm. QSPECT reconstruction appears to be useful for reduction of camera-specific intersubject variability of [{sup 123}I]FP-CIT SPECT in multisite and single-site multicamera settings. Whole brain excluding striatal binding as the reference provides more stable quantitative estimates than occipital or cerebellar binding. (orig.)

  11. Metoda menedżerska zarządzania działalnością instytucji publicznych – menedżer jako kierownik skuteczności

    OpenAIRE

    Kasprzak, Sylwester

    2012-01-01

    Technics of the Management Managerial of public organizations in the world today is one of the most important strategies of good company and a viable business. Efforts to develop gives the characteristics of work and task manager - head. In the sequence shown were the criteria requirements for candidates for this job. Manager's job is fairly young, but their number also allowed many women who turn out to be a good sense of organization. A good manager a successful organization,...

  12. Historiens Mening som et Kreativt Produkt - En Analyse av Camille Paglias "The Birth of the Western Eye"

    OpenAIRE

    Kyllingstad, Elisabeth

    2016-01-01

    Dette prosjektet er en metodisk tilnærming til Camille Paglias filosofiske historietekst ”The Birth of the Western Eye”. Sexual Personae – Art and Decadence from Nefertiti to Emily Dickinson (1991) er en revidert versjon av doktorgradsavhendlingen hennes, som hun forsvarte i 1974. Den forteller om det Paglia identifiserer som grunnleggende drivkrefter i det vestlige mennesket, og dets kunstneriske produksjon. På denne måten kan verket leses som en guide gjennom vestlig tenkning så vel som kun...

  13. Metody kształcenia menedżerów na wyższych uczelniach

    OpenAIRE

    Krawczyńska, Aleksandra; Sibińska, Anna

    2004-01-01

    The aims of the article are to contribute to a better understanding of the nature and extent of future managers' skills and abilities and show the role of higher business education in developing these features in graduates. The paper analyses labour market's expectations for business graduates with particular reference to developing them during studies at universities and academies. The article is based on a research project undertaken by the Marketing Department of the University of Lodz in ...

  14. The basic roles of manager in business organization Podstawowe role menedżera w organizacji gospodarczej

    Directory of Open Access Journals (Sweden)

    Katarzyna Cieślińska

    2007-12-01

    Full Text Available The subject of the study is the presentation and analysis of manager’s role as the key person in the business organization. Beginning with defining the term “manager”, the author present the particular typologies of managerial roles, that takes into consideration different criteria. In the paper points out the conditions of managerial roles and probably the most important the leader’s role.

  15. Crímenes de “guerra sucia”: derecho penal internacional y jurisdicciones de la memoria

    Directory of Open Access Journals (Sweden)

    Peter Rush

    2014-07-01

    Full Text Available Argentina es una comunidad asediada por experiencias indescriptibles de sufrimiento e injusticia que no cesan de regresar en fragmentos e imágenes. Es un país poseído por la guerra sucia y sus desaparecidos. Es como si esta comunidad política no hubiese superado su situación traumática; como si dicha comunidad estuviese obligada a enfrentarla como una de sus tareas inmediatas. Este ensayo considera las relaciones entre la memoria del derecho, el crimen y la guerra sucia desde la doble mirada del cine y del derecho. La primera parte reconstruye la memoria narrativa y el contexto socio jurídico de la escena contemporánea de la memoria en Argentina. En este punto, se concentra sobre cómo los procesos judiciales han perfilado las prácticas de reconocimiento de experiencias traumáticas, de injusticia y sufrimiento. La segunda parte está relacionada con la película El secreto de sus ojos, dirigida por Juan José Campanella, filmada en Buenos Aires y que describe la vida del derecho después de la atrocidad. Mi argumento es que esta película ofrece elementos para la reflexión a partir de lo que llamo una “jurisdicción de la memoria”, gracias a que la película conecta el trabajo de la memoria en Argentina al funcionamiento de la jurisdicción penal. Después de reconstruir dos formas de vivir una vida vacía, una vida vivida con el trauma de un caso penal, la coda del ensayo se concentra en los vestigios de una jurisdicción penal de la memoria. Si las decisiones son constitutivas de la justicia penal internacional en tiempos de transición, entonces la jurisdicción penal de la memoria, objeto del presente ensayo, puede ser pensada en sus propios términos: desde sus propios géneros de representación y sus propias taxonomías. Una ética del testimonio y una lógica de la memoria han de permanecer, por lo tanto, vigilantes después de la barbarie generalizada. Por ello es posible afirmar que es este el legado que, hoy por hoy, Argentina tiene para ofrecer a la justicia penal internacional.

  16. RESEÑA DE ALGUNOS REGÍMENES ADUANEROS ESPECIALES USADOS COMO ESTÍMULO A LAS EXPORTACIONES

    OpenAIRE

    Arce Rodríguez, Jorge

    2014-01-01

    Actualmente, la creación de puertos o zonas francas, obedece más bien a razones económicas, ligadas fundamentalmente con la necesidad o conveniencia de promover el desarrollo de una determinada zona del territorio nacional; promover o facilita runa corriente comercial desde el extranjero y con destino a los países vecinos, generalmente medita­rráneos; estimular la creación de complejos industriales o de determinadas industrias y aún, desarrollar industrias manufactu­reras a base de materias ...

  17. Der er én eller anden mening med tingene, hvis man bare tror på det

    DEFF Research Database (Denmark)

    Olsen, Jan Brødslev

    2016-01-01

    udgangspunkt i et kort stykke livsfortælling, fokus på meningsbegrebet i eksistentiel belysning. Det sker indledningsvist ud fra den amerikanske psykolog Jerome Bruner og efterfølgende to centrale skikkelser i eksistenspsykologien, østrigske Viktor Frankl og amerikanske Irvin Yalom. Sigtet er at skabe et bud...

  18. Regímenes de bienestar y roles familiares: un análisis del caso español

    OpenAIRE

    Guillén, Ana M.

    1997-01-01

    El texto plantea la influencia de la incorporación de la mujer al mercado de trabajo y la existencia del estado del bienestar en los roles familiares. The article shows the influence of woman's incorporation into the labour market and the existence of a Welfare State in family roles.

  19. Recursos administrativos: conceptos, elementos y presupuestos. Un estudio comparativo de los regímenes peruano y uruguayo

    Directory of Open Access Journals (Sweden)

    Juan Pablo Cajarville Peluffo

    2011-12-01

    Full Text Available El artículo presenta una comparación de las principales características del recurso administrativo en el Derecho peruano y uruguayo. Teniendo como contexto la comparación de ambos marcos constitucionales y legales, se desarrolla la definición del recurso administrativo como ejercicio del derecho de petición para, posteriormente, realizar el análisis de los elementos esenciales y de los elementos no esenciales del recurso administrativo. Finalmente, el trabajo ofrece una visión cuestionadora de la regulación constitucional uruguaya y permite arribar a algunas conclusiones sobre ambos ordenamientos.

  20. Presoja inovativnosti menedžerjev s kazenskopravnega vidika kot bistvenega kriterija družbene odgovornosti

    OpenAIRE

    Cunk, Zoran

    2016-01-01

    Zgodovinskost človeka je obenem podoba njegove ustvarjalnosti, ki predstavlja izraz človekove specifične lastnosti. Ustvarjalnost pa je potrebno tudi vrednotno ocenjevati (v dobrobit človeštva) v skladu z zakonom zadostne in potrebne celovitosti skozi prizmo njenega doprinosa k doseganju celovite družbene odgovornosti in ne samo njenega enostranskega dela, gospodarjenja. Gospodarjenje je rezultat človekove ustvarjalnosti, hkrati pa predstavlja področje možne (in zahtevane) človekove ustvarjal...

  1. Crímenes de Estado, espacialidad y memorias en la Argentina: el caso del Hospital Posadas, Buenos Aires

    Directory of Open Access Journals (Sweden)

    Emilio Ariel Crenzel

    2016-12-01

    Full Text Available En este artículo se examinarán las transformaciones espaciales operadas en el Hospital Posadas y sus barrios adyacentes durante el ciclo de violencia política y dictadura militar en Argentina y su inscripción en las memorias de sus trabajadores y habitantes. El Hospital Posadas, ubicado en la localidad de Haedo, en la provincia de Buenos Aires, fue epicentro de un proceso de radicalización política hasta el golpe de Estado de 1976. Tras el golpe, funcionó en sus dependencias un centro clandestino de detención donde estuvieron personas cautivas en condición de desaparecidas mientras se seguían desarrollando las prácticas habituales relativas al centro de salud. Simultáneamente, en sus barrios adyacentes se desenvolvió una intensa represión política. Se considera aquí que el espacio constituye uno de los marcos sociales fundamentales de la memoria colectiva y que en sus permanencias y transformaciones se materializan, a la vez, las memorias sociales de los actores que luchan por dotar de sentido el pasado. Se entiende que, por ello, este análisis permitirá historizar y comprender el proceso de violencia política en la zona a partir de los cambios operados en la topografía del Hospital y del barrio y de su impacto en las memorias de sus trabajadores y habitantes. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1701203

  2. Crímenes de Estado y experiencias postraumáticas: Argentina y Colombia en perspectiva

    Directory of Open Access Journals (Sweden)

    Alejandro García

    2009-07-01

    Full Text Available Tras siete años criminalidad institucional en Argentina y veinte de genocidio para-institucional en Colombia se abrieron, en ambos países, procesos judiciales con los que se pretendió esclarecer la verdad, ofreciendo justicia y reparación. La comparación de estas dos experiencias nos remite no solo a la particularidad de sus recorridos históricos sino esencialmente al papel que la violencia jugó en los procesos de modernización y por tanto a los alcances y límites de los procesos postraumáticos puestos en marcha en ambos escenarios.

  3. Regímenes de poder y tecnologías de la imagen. Foucault y los estudios visuales

    OpenAIRE

    León Mantilla, Christian Manuel

    2014-01-01

    Este ensayo analiza los legados del pensamiento de Michel Foucault para el estudio de las prácticas visuales, la mirada y las tecnologías de la imagen. A partir la recepción de Foucault en el campo de los estudios visuales, me interesa reflexionar sobre cómo la imagen y la mirada se inscriben dentro de una red de relaciones, saberes, tecnologías, normativas e instituciones que develan formas de operación del poder y de construcción de los sujetos. Para empezar, pongo en diálogo conceptos como...

  4. Use of hydraulic and aerial mock up to study atmospheric pollution; L'utilisation des maquettes aeriennes et hydrauliques pour l'etude de la pollution atmospherique

    Energy Technology Data Exchange (ETDEWEB)

    Facy, L; Perrin De Brichambaut, C; Doury, A; Le Quinio, R

    1962-07-01

    Fundamental studies on turbulent atmospheric diffusion of finely divided particles, cannot remain on a purely theoretical basis. Further experimental studies must be considered. - In full scale, from accidental and induced releases. - On a reduced scale, in aerodynamic wind tunnels or hydraulic water tunnels. A first set of studies on reduced scale models has been worked out according to a contract between French 'Meteorologie Nationale' and French 'Commissariat a l'Energie Atomique' and with the Collaboration of Saint-Cyr 'Institut Aerotechnique'. Essentially two kinds of results have been obtained: - The mathematical model of SUTTON for the turbulent diffusion in the atmosphere, deduced from the SUTTON theory, generally used by us, has been correctly verified, qualitatively and quantitatively whenever experiments were consistent with the theory conditions. - The quantitative assays of photographic and cinematographic visualization have given precise details on the phenomena inaccessible to calculations, due to the influence of obstacles and release conditions. - Generally, it can be asserted, that the atmospheric pollution studies are worked out by mock up experimentations and that, in some cases these experiments never can be replaced by mathematically pure models. (authors) [French] Les etudes fondamentales portant sur la diffusion turbulente dans l'atmosphere de quantites de matieres finement divisees, ne peuvent se maintenir sur un plan exclusivement theorique. C'est pourquoi des etudes experimentales complementaires doivent etre obligatoirement envisagees: - en vraie grandeur, a partir d'emissions accidentelles ou provoquees; - sur modeles reduits, en soufflerie aerodynamique ou en veine hydraulique. En ce qui concerne les modeles reduits, une premiere serie d'etudes a pu etre menee a bien, dans le cadre d'un contrat passe entre la Meteorologie Nationale et le Commissariat a l'Energie Atomique, et avec la collaboration de l'Institut Aerotechnique de Saint

  5. A multisite interaction expansion of the total energy in metals

    International Nuclear Information System (INIS)

    Sowa, E.C.; Gonis, A.

    1994-01-01

    The local-density approximation provides a proper setting for the decomposition of total energy into many-body (many-atom) contributions. Multiple scattering theory in turn provides a convenient framework for carrying out this process. We illustrate this concept with calculations on a linear chain of atoms in bulk copper

  6. Multisite two-photon imaging of neurons on multielectrode arrays

    Science.gov (United States)

    Potter, Steve M.; Lukina, Natalia; Longmuir, Kenneth J.; Wu, Yan

    2001-04-01

    We wish to understand how neural systems store, recall, and process information. We are using cultured networks of cortical neurons grown on microelectrode arrays as a model system for studying the emergent properties of ensembles of living neurons. We have developed a 2-way communication interface between the cultured network and a computer- generated animal, the Neurally Controlled Animat. Neural activity is used to control the behavior of the Animat, and 2- photon time-lapse imaging is carried out in order to observe the morphological changes that might underlie changes in neural processing. The 2-photon microscope is ideal for repeated imaging over hours or days, with submicron resolution and little photodamage. We have designed a computer-controlled microscope stage that allows imaging several locations in sequence, in order to collect more image data. For the latest progress, see: http://www.caltech.edu/~pinelab/PotterGroup.htm.

  7. Defense strategies for cloud computing multi-site server infrastructures

    Energy Technology Data Exchange (ETDEWEB)

    Rao, Nageswara S. [ORNL; Ma, Chris Y. T. [Hang Seng Management College, Hon Kong; He, Fei [Texas A& M University, Kingsville, TX, USA

    2018-01-01

    We consider cloud computing server infrastructures for big data applications, which consist of multiple server sites connected over a wide-area network. The sites house a number of servers, network elements and local-area connections, and the wide-area network plays a critical, asymmetric role of providing vital connectivity between them. We model this infrastructure as a system of systems, wherein the sites and wide-area network are represented by their cyber and physical components. These components can be disabled by cyber and physical attacks, and also can be protected against them using component reinforcements. The effects of attacks propagate within the systems, and also beyond them via the wide-area network.We characterize these effects using correlations at two levels using: (a) aggregate failure correlation function that specifies the infrastructure failure probability given the failure of an individual site or network, and (b) first-order differential conditions on system survival probabilities that characterize the component-level correlations within individual systems. We formulate a game between an attacker and a provider using utility functions composed of survival probability and cost terms. At Nash Equilibrium, we derive expressions for the expected capacity of the infrastructure given by the number of operational servers connected to the network for sum-form, product-form and composite utility functions.

  8. The Violence Prevention Community Meeting: A Multi-Site Study.

    Science.gov (United States)

    Lanza, Marilyn; Ridenour, Marilyn; Hendricks, Scott; Rierdan, Jill; Zeiss, Robert; Schmidt, Satu; Lovelace, Jeff; Amandus, Harlan

    2016-06-01

    The Violence Prevention Community Meeting (VPCM) is a specialized form of community meeting in which avoiding violence and promoting non-violent problem solving and interpersonal civility are focal points. A nationwide study to assess the VPCM as an effective intervention to reduce workplace violence was undertaken. Seven acute locked psychiatric units of the Veterans Health Administration (VHA) throughout the United States participated in the study. All patients and all staff on the seven in-patient locked psychiatry units participated in the intervention (VPCM) or as a control (treatment as usual). The study was 21weeks at each site. The three time periods were pre-treatment weeks 1-3, treatment weeks 4-18, and post-treatment weeks 19-21. The VPCM was conducted during the treatment weeks. Overall rates of aggression declined by 0.6% (95% CI: -5.6%, 6.5%; nonsignificant) per week in the intervention hospitals and by 5.1% (95% CI: 0.4%, 9.6%; significant) per week for the control hospitals. Aggression decreased for both the intervention and control hospitals which could be due to enrollment in a research study and thus being more aware of their ability to address workplace violence at their site. Published by Elsevier Inc.

  9. Multisite study of particle number concentrations in urban air.

    Science.gov (United States)

    Harrison, Roy M; Jones, Alan M

    2005-08-15

    Particle number concentration data are reported from a total of eight urban site locations in the United Kingdom. Of these, six are central urban background sites, while one is an urban street canyon (Marylebone Road) and another is influenced by both a motorway and a steelworks (Port Talbot). The concentrations are generally of a similar order to those reported in the literature, although higher than those in some of the other studies. Highest concentrations are at the Marylebone Road site and lowest are at the Port Talbot site. The central urban background locations lie somewhere between with concentrations typically around 20 000 cm(-3). A seasonal pattern affects all sites, with highest concentrations in the winter months and lowest concentrations in the summer. Data from all sites show a diurnal variation with a morning rush hour peak typical of an anthropogenic pollutant. When the dilution effects of windspeed are accounted for, the data show little directionality at the central urban background sites indicating the influence of sources from all directions as might be expected if the major source were road traffic. At the London Marylebone Road site there is high directionality driven by the air circulation in the street canyon, and at the Port Talbot site different diurnal patterns are seen for particle number count and PM10 influenced by emissions from road traffic (particle number count) and the steelworks (PM10) and local meteorological factors. Hourly particle number concentrations are generally only weakly correlated to NO(x) and PM10, with the former showing a slightly closer relationship. Correlations between daily average particle number count and PM10 were also weak. Episodes of high PM10 concentration in summer typically show low particle number concentrations consistent with transport of accumulation mode secondary aerosol, while winter episodes are frequently associated with high PM10 and particle number count arising from poor dispersion of local primary emissions.

  10. The dynamic multisite interactions between two intrinsically disordered proteins

    KAUST Repository

    Wu, Shaowen

    2017-05-11

    Protein interactions involving intrinsically disordered proteins (IDPs) comprise a variety of binding modes, from the well characterized folding upon binding to dynamic fuzzy complex. To date, most studies concern the binding of an IDP to a structured protein, while the Interaction between two IDPs is poorly understood. In this study, we combined NMR, smFRET, and molecular dynamics (MD) simulation to characterize the interaction between two IDPs, the C-terminal domain (CTD) of protein 4.1G and the nuclear mitotic apparatus (NuMA) protein. It is revealed that CTD and NuMA form a fuzzy complex with remaining structural disorder. Multiple binding sites on both proteins were identified by MD and mutagenesis studies. Our study provides an atomic scenario in which two IDPs bearing multiple binding sites interact with each other in dynamic equilibrium. The combined approach employed here could be widely applicable for investigating IDPs and their dynamic interactions.

  11. Contextual profiles of young adult Ecstasy users: a multisite study

    Science.gov (United States)

    Ramtekkar, Ujjwal P.; Striley, Catherine W; Cottler, Linda B

    2010-01-01

    These analyses assess contextual profiles of 612 young adult Ecstasy users, 18–30 years of age, from St. Louis (USA), Miami (USA) and Sydney (Australia). Bivariate analyses revealed different contextual factors influencing Ecstasy use. Friends were the most common sources of Ecstasy at all sites and most used with friends. St. Louis and Miami use mostly occurred in residences, whereas in Sydney use was mostly at clubs, bars or restaurants. Ecstasy consumption at public places and in cars, trains or ferries was significantly higher in Miami (89% and 77%) than in St. Louis (67% and 65%) and Sydney (67% and 61%). At all sites, simultaneous use of LSD/mushroom and nitrous oxide with Ecstasy was common; concurrent amphetamines predominated in Sydney and heroin/opiates in St. Louis Contextual factors influencing Ecstasy use among young adults vary by geographic region. Their inclusion may help tailor effective prevention programs to reduce or ameliorate Ecstasy use. PMID:21094585

  12. Multisite Testing of the Discrete Address Beacon System (DABS).

    Science.gov (United States)

    1981-07-01

    discrete address would the new DABS/ATCRBS environment, thus, allow individual interrogation of each allowing for an economical transition aircraft so...Traffic used. These changes were primarily Advisory and Resolution Service ( ATARS ) concerned with ATCRBS performance and function and ATC en route...the zenith cones and potential ATARS list of "assigned" sensors; i.e., those conflicts with the stationary Mizpah being used for redundant surveillance

  13. Financial management of a large multisite randomized clinical trial.

    Science.gov (United States)

    Sheffet, Alice J; Flaxman, Linda; Tom, MeeLee; Hughes, Susan E; Longbottom, Mary E; Howard, Virginia J; Marler, John R; Brott, Thomas G

    2014-08-01

    The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) received five years' funding ($21 112 866) from the National Institutes of Health to compare carotid stenting to surgery for stroke prevention in 2500 randomized participants at 40 sites. Herein we evaluate the change in the CREST budget from a fixed to variable-cost model and recommend strategies for the financial management of large-scale clinical trials. Projections of the original grant's fixed-cost model were compared to the actual costs of the revised variable-cost model. The original grant's fixed-cost budget included salaries, fringe benefits, and other direct and indirect costs. For the variable-cost model, the costs were actual payments to the clinical sites and core centers based upon actual trial enrollment. We compared annual direct and indirect costs and per-patient cost for both the fixed and variable models. Differences between clinical site and core center expenditures were also calculated. Using a variable-cost budget for clinical sites, funding was extended by no-cost extension from five to eight years. Randomizing sites tripled from 34 to 109. Of the 2500 targeted sample size, 138 (5·5%) were randomized during the first five years and 1387 (55·5%) during the no-cost extension. The actual per-patient costs of the variable model were 9% ($13 845) of the projected per-patient costs ($152 992) of the fixed model. Performance-based budgets conserve funding, promote compliance, and allow for additional sites at modest additional cost. Costs of large-scale clinical trials can thus be reduced through effective management without compromising scientific integrity. © 2014 The Authors. International Journal of Stroke © 2014 World Stroke Organization.

  14. Nursing teamwork in a health system: A multisite study.

    Science.gov (United States)

    Kaiser, Jennifer A; Westers, Judith B

    2018-01-16

    The aim of this study was to examine how the facets of teamwork exist among nurse-only teams in acute and continuing care settings. The health care 'team' conventionally describes the interdisciplinary team in both literature and practice. Nursing-specific teams are rarely considered in the literature. An examination of this specific professional cohort is important to understand how teamwork exists among those who provide the majority of patient care. This was a descriptive, comparative, cross-sectional study using the Nursing Teamwork Survey to measure teamwork of nursing-based teams among 1414 participants in multiple acute care environments across a large Midwestern health system. The characteristics of nursing teams were analysed. The results from the subscales within the teamwork model showed that nursing teams had a good understanding of the various roles and responsibilities. However, nurse team members held a more individualistic rather than collective team-oriented mindset. Increased teamwork has a positive effect on job satisfaction, staffing efficiencies, retention and care delivery. Nurse leaders can use the information provided in this study to target the aspects of highly functioning teams by improving team orientation, trust and backup behaviours. © 2018 John Wiley & Sons Ltd.

  15. Anismus: a marker of multi-site functional disorders?

    Science.gov (United States)

    Bouchoucha, Michel; Devroede, Ghislain; Arsac, Michel

    2004-07-01

    This study was undertaken to assess the clinical significance of anismus in patients who complain of constipation. Thirty control subjects and 93 consecutive patients complaining of functional constipation took part in the study. Colonic transit time study and anorectal manometry were performed. Questions about depression and urinary and sexual diseases were added to a questionnaire based on the Rome II criteria, and visual analog scales about four items (constipation, diarrhoea, abdominal bloating and abdominal pain). Constipated patients have lower threshold sensation volume, lower constant sensation volume, and lower maximum tolerable volume than controls. Thirty-seven patients (40%) were found to have anismus, based on anorectal manometry. No significant difference was found between constipated patients with anismus and constipated patients without anismus, using anorectal manometry. Constipated patients had longer colorectal transit time than controls, but neither total nor segmental colonic transit time was correlated with the presence or absence of anismus. In patients with anismus, a higher frequency of oesophageal symptoms, dysmotility-like dyspepsia, aerophagia, functional bowel disorders, functional abdominal pain, soiling, and dyschezia was found. In addition, a higher frequency of urinary complaints, sexual complaints, and depression was found. Anismus was associated with increased awareness of constipation, abdominal bloating, and abdominal pain, but not with diarrhoea.

  16. Rent Sharing in Multi-Site Hog Production

    OpenAIRE

    Brian P. Cozzarin; Randall E. Westgren

    2000-01-01

    A firm-level model of three-site hog production is used compare a franchise organizational structure to a three-firm alliance. The results of the simulations imply that the franchise system is better equipped to mitigate underproduction in the nursery and finishing units, the nursery and finishing units lose relatively more profit than they otherwise would in an alliance. The pig-space guatantee does little to offset the financial risk for the nursery and finishing units when underproduction ...

  17. A multi-site approach towards integrating environmental ...

    African Journals Online (AJOL)

    driniev

    and delivering products/services of a high quality standard. Cur- rent South ... ment of an effective Environmental Management Strategy/System. (EMS), i.e. ISO .... clearly indicated other uses of water such as houses/restaurants/ gardens.

  18. A multi-site approach towards integrating environmental ...

    African Journals Online (AJOL)

    Although the system is still in its juvenile stage, it already showed some effluent quality improvements through better wastewater management, better control over chemical stores as well as definite improvement in water management and increase in solid wastes recycling. The latter improvements will definitely entail long ...

  19. Multisite analytical evaluation of the Abbott ARCHITECT cyclosporine assay.

    Science.gov (United States)

    Wallemacq, Pierre; Maine, Gregory T; Berg, Keith; Rosiere, Thomas; Marquet, Pierre; Aimo, Giuseppe; Mengozzi, Giulio; Young, Julianna; Wonigeit, Kurt; Kretschmer, Robert; Wermuth, Bendicht; Schmid, Rainer W

    2010-04-01

    The objective of this study was to evaluate the analytical performance of the Abbott ARCHITECT Cyclosporine (CsA) immunoassay in 7 clinical laboratories in comparison to liquid chromatography/tandem mass spectrometry (LC/MS/MS), Abbott TDx, Cobas Integra 800, and the Dade Dimension Xpand immunoassay. The ARCHITECT assay uses a whole blood specimen, a pretreatment step with organic reagents to precipitate proteins and extract the drug, followed by a 2-step automated immunoassay with magnetic microparticles coated with anti-CsA antibody and an acridinium-CsA tracer. Imprecision testing at the 7 evaluation sites gave a range of total % coefficient of variations of 7.5%-12.2% at 87.5 ng/mL, 6.6%-14.3% at 411 ng/mL, and 5.2%-10.7% at 916 ng/mL. The lower limit of quantification ranged from 12 to 20 ng/mL. Purified CsA metabolites AM1, AM1c, AM4N, AM9, and AM19 were tested in whole blood by the ARCHITECT assay and showed minimal cross-reactivity at all 7 sites. In particular, AM1 and AM9 cross-reactivity in the ARCHITECT assay, ranged from -2.5% to 0.2% and -0.8% to 2.2%, respectively, and was significantly lower than for the TDx assay, in which the values were 3.2% and 16.1%, respectively. Comparable testing of metabolites in the Dade Dimension Xpand assay at 2 evaluation sites showed cross-reactivity to AM4N (6.4% and 6.8%) and AM9 (2.6% and 3.6%) and testing on the Roche Integra 800 showed cross-reactivity to AM1c (2.4%), AM9 (10.7%), and AM19 (2.8%). Cyclosporine International Proficiency Testing Scheme samples, consisting of both pooled specimens from patients receiving CsA therapy as well as whole-blood specimens supplemented with CsA, were tested by the ARCHITECT assay at 6 sites and showed an average bias of -24 to -58 ng/mL versus LC/MSMS CsA and -2 to -37 ng/mL versus AxSYM CsA. Studies were performed with the ARCHITECT CsA assay on patient specimens with the following results: ARCHITECT CsA assay versus LC/MSMS, average bias of 31 ng/mL; ARCHITECT versus the Dade Dimension assay (4 sites), average biases of -7 to -228 ng/mL; ARCHITECT versus AxSYM and TDx, average biases of -4 and -53 ng/mL, respectively. Spearman correlation coefficients were >or=0.89. The ARCHITECT CsA assay has significantly reduced CsA metabolite interference relative to other immunoassays and is a convenient and sensitive semiautomated method to measure CsA in whole blood.

  20. Harmonization of multi-site diffusion tensor imaging data.

    Science.gov (United States)

    Fortin, Jean-Philippe; Parker, Drew; Tunç, Birkan; Watanabe, Takanori; Elliott, Mark A; Ruparel, Kosha; Roalf, David R; Satterthwaite, Theodore D; Gur, Ruben C; Gur, Raquel E; Schultz, Robert T; Verma, Ragini; Shinohara, Russell T

    2017-11-01

    Diffusion tensor imaging (DTI) is a well-established magnetic resonance imaging (MRI) technique used for studying microstructural changes in the white matter. As with many other imaging modalities, DTI images suffer from technical between-scanner variation that hinders comparisons of images across imaging sites, scanners and over time. Using fractional anisotropy (FA) and mean diffusivity (MD) maps of 205 healthy participants acquired on two different scanners, we show that the DTI measurements are highly site-specific, highlighting the need of correcting for site effects before performing downstream statistical analyses. We first show evidence that combining DTI data from multiple sites, without harmonization, may be counter-productive and negatively impacts the inference. Then, we propose and compare several harmonization approaches for DTI data, and show that ComBat, a popular batch-effect correction tool used in genomics, performs best at modeling and removing the unwanted inter-site variability in FA and MD maps. Using age as a biological phenotype of interest, we show that ComBat both preserves biological variability and removes the unwanted variation introduced by site. Finally, we assess the different harmonization methods in the presence of different levels of confounding between site and age, in addition to test robustness to small sample size studies. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. The dynamic multisite interactions between two intrinsically disordered proteins

    KAUST Repository

    Wu, Shaowen; Wang, Dongdong; Liu, Jin; Feng, Yitao; Weng, Jingwei; Li, Yu; Gao, Xin; Liu, Jianwei; Wang, Wenning

    2017-01-01

    Protein interactions involving intrinsically disordered proteins (IDPs) comprise a variety of binding modes, from the well characterized folding upon binding to dynamic fuzzy complex. To date, most studies concern the binding of an IDP to a

  2. Multisite Evaluation of APEX for Water Quality: II. Regional Parameterization.

    Science.gov (United States)

    Nelson, Nathan O; Baffaut, Claire; Lory, John A; Anomaa Senaviratne, G M M M; Bhandari, Ammar B; Udawatta, Ranjith P; Sweeney, Daniel W; Helmers, Matt J; Van Liew, Mike W; Mallarino, Antonio P; Wortmann, Charles S

    2017-11-01

    Phosphorus (P) Index assessment requires independent estimates of long-term average annual P loss from fields, representing multiple climatic scenarios, management practices, and landscape positions. Because currently available measured data are insufficient to evaluate P Index performance, calibrated and validated process-based models have been proposed as tools to generate the required data. The objectives of this research were to develop a regional parameterization for the Agricultural Policy Environmental eXtender (APEX) model to estimate edge-of-field runoff, sediment, and P losses in restricted-layer soils of Missouri and Kansas and to assess the performance of this parameterization using monitoring data from multiple sites in this region. Five site-specific calibrated models (SSCM) from within the region were used to develop a regionally calibrated model (RCM), which was further calibrated and validated with measured data. Performance of the RCM was similar to that of the SSCMs for runoff simulation and had Nash-Sutcliffe efficiency (NSE) > 0.72 and absolute percent bias (|PBIAS|) 90%) and was particularly ineffective at simulating sediment loss from locations with small sediment loads. The RCM had acceptable performance for simulation of total P loss (NSE > 0.74, |PBIAS| < 30%) but underperformed the SSCMs. Total P-loss estimates should be used with caution due to poor simulation of sediment loss. Although we did not attain our goal of a robust regional parameterization of APEX for estimating sediment and total P losses, runoff estimates with the RCM were acceptable for P Index evaluation. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  3. Striatal abnormalities in trichotillomania: A multi-site MRI analysis

    Directory of Open Access Journals (Sweden)

    Masanori Isobe

    2018-01-01

    Full Text Available Trichotillomania (hair-pulling disorder is characterized by the repetitive pulling out of one's own hair, and is classified as an Obsessive-Compulsive Related Disorder. Abnormalities of the ventral and dorsal striatum have been implicated in disease models of trichotillomania, based on translational research, but direct evidence is lacking. The aim of this study was to elucidate subcortical morphometric abnormalities, including localized curvature changes, in trichotillomania. De-identified MRI scans were pooled by contacting authors of previous peer-reviewed studies that examined brain structure in adult patients with trichotillomania, following an extensive literature search. Group differences on subcortical volumes of interest were explored (t-tests and localized differences in subcortical structure morphology were quantified using permutation testing. The pooled sample comprised N = 68 individuals with trichotillomania and N = 41 healthy controls. Groups were well-matched in terms of age, gender, and educational levels. Significant volumetric reductions were found in trichotillomania patients versus controls in right amygdala and left putamen. Localized shape deformities were found in bilateral nucleus accumbens, bilateral amygdala, right caudate and right putamen. Structural abnormalities of subcortical regions involved in affect regulation, inhibitory control, and habit generation, play a key role in the pathophysiology of trichotillomania. Trichotillomania may constitute a useful model through which to better understand other compulsive symptoms. These findings may account for why certain medications appear effective for trichotillomania, namely those modulating subcortical dopamine and glutamatergic function. Future work should study the state versus trait nature of these changes, and the impact of treatment.

  4. Outcomes of Asthma Education: Results of a Multisite Evaluation

    Directory of Open Access Journals (Sweden)

    Wilma M Hopman

    2004-01-01

    Full Text Available BACKGROUND: This observational study compared the effectiveness of a standardized adult asthma education program administered in a variety of sites and practice settings on health care utilization, absenteeism, amount of leisure time missed and quality of life (using the Medical Outcomes Study 36-Item Short Form 1.0 [SF-36].

  5. The Role of Conceptual Frameworks in Collecting Multisite Qualitative Data.

    Science.gov (United States)

    Lotto, Linda S.

    1983-01-01

    Examines the use of conceptual frameworks in collecting qualitative data from multiple sites. Presents strategies for devising frameworks that are flexible and general without sacrificing specificity. (JOW)

  6. Gender differences in suicide attempts: preliminary results of the multisite intervention study on suicidal behavior (SUPRE-MISS from Campinas, Brazil Diferenças entre os sexos nas tentativas de suicídio: resultados iniciais do estudo multicêntrico de intervenção no comportamento suicida (SUPRE-MISS obtidos em Campinas, Brasil

    Directory of Open Access Journals (Sweden)

    Sabrina Stefanello

    2008-06-01

    Full Text Available OBJECTIVE: To identify sociodemographic, psychosocial and clinical differences between men and women who attempted suicide and were seen at a university general hospital. METHOD: This is a non-controlled cross-sectional study, sub-project of the Multisite Intervention Study on Suicidal Behavior by the World Health Organization. A standardized interview that comprised psychometric scales was used. The comparison between genders was made by means of uni and multivariate logistic regression. RESULTS: 210 subjects (68.1% women participated. Women had worse scores on the WHO Well-Being Index (p = 0.005, the Beck Depression Inventory (p = 0.01 and the Psychiatric Disability Assessment Schedule (p = 0.03. In the multivariate logistic regression, men presented more mental disorders due to alcohol and drug use (26.1% vs 7%, p = 0.02 and used alcohol at the suicide attempt more frequently (28.3% vs 16%, p = 0.03. Men reported that most of the time they had been feeling "active and vigorous" (50% vs 22%, p OBJETIVO: Identificar diferenças entre os sexos em variáveis sociodemográficas, psicossociais e clínicas em indivíduos que tentaram o suicídio e foram atendidos em um hospital geral universitário. MÉTODO: Estudo transversal não-controlado, subprojeto do Estudo Multicêntrico de Intervenção no Comportamento Suicida, da Organização Mundial de Saúde. Utilizou-se uma entrevista padronizada, incluindo escalas psicométricas. A comparação entre os sexos foi feita usando-se regressão logística uni e multivariada. RESULTADOS: Dos 210 sujeitos, 143 (68,1% foram do sexo feminino. As mulheres tiveram piores escores no Índice de Bem-Estar OMS (p = 0,005, na escala de Beck de Depressão (p = 0,01 e na escala de Desempenho do Papel Social (p = 0,03. Na regressão logística multivariada, encontraram-se mais problemas por uso de álcool e drogas entre os homens (26,1% vs 7%, p = 0,02. Estes se valeram mais dessas substâncias na tentativa de suic

  7. Identificación de Especímenes de Equus grevyi en el Parque Zoológico Nacional de Cuba

    OpenAIRE

    Irina Fermin-Morales; Alberto Martín-Mora

    2014-01-01

    La cebra de Grevy (Equus grevyi) se ha manejado a través de extracciones y reintroducciones de individuos desde su inclusión en la colección de animales del Parque Zoológico Nacional de Cuba. Para mejorar el manejo de esta especie es necesaria la identificación individual a través de caracteres morfológicos, por esto los que los investigadores se propusieron demostrar las diferencias en el patrón de rayado facial existente entre los individuos y entre ambos lados de un mismo individuo. El mét...

  8. Diseño y desarrollo de exámenes a través de herramientas de web semántica

    Directory of Open Access Journals (Sweden)

    María del Mar Sánchez Vera

    2011-12-01

    Full Text Available La Web Semántica no es una propuesta de futuro. Es una realidad. Frente al crecimiento caótico de recursos y la ausencia de una organización clara de la Web actual, la Web semántica aboga por clasificar, dotar de estructura y anotar los recursos con semántica explícita procesable por máquinas. En este artículo presentamos los resultados de una investigación realizada en la Universidad de Murcia por el grupo TECNOMOD y el GITE, que de manera multidisciplinar hemos abordado la aplicación de un programa semántico denominado OeLE en una asignatura virtual de la Titulación de Pedagogía. Se diseñó un entorno de evaluación en red compuesto por el programa OeLE y un sistema de consulta del feedback que OeLE proporciona con el fin de proponer una metodología referida al diseño y evaluación de situaciones en red con herramientas de Web Semántica.

  9. Evaluación de requerimientos ecológicos para el diseño de regímenes ambientales de caudales fluviales

    Directory of Open Access Journals (Sweden)

    Juan Manuel Diez-Hernández

    2008-11-01

    Full Text Available Las sociedades avanzadas medioambientalmente están reclamando progresivamente una gestión fluvial auténticamente integral, que implemente Planes de Manejo de Cuencas Hidrográficas fundamentados en el paradigma del Régimen Ambiental de Caudales (RAC. Este trabajo sugiere una metodología genérica para establecer RAC confiables, que posibiliten el aprovechamiento hídrico a un coste ecológico admisible. Adicionalmente, plantea los criterios y técnicas preferentes para la evaluación de los requerimientos ecosistémicos de caudal, los cuales componen el RAC mediante el Régimen de Caudales Ecológicos (RCE. La adaptación de estos procedimientos para los ríos de Colombia favorecerá la conservación de su valiosa biodiversidad. / The environmentally advanced societies are claiming progressively an authentically integral fluvial management, that implements Watershed Management Programs based on the paradigm of the Environmental Flows Regime (EFR. This work suggests a generic methodology for the reliable EFR setting, that facilitate the water use with an environmental acceptable cost. Additionally, it outlines the approaches and outstanding techniques for the evaluation of instream flow requirements, which constitute the EFR by means of the Instream Flow Regime (IFR. The adaptation of these approaches to the Colombian rivers will contribute to the conservation of their valuable biodiversity.

  10. Transferencias condicionadas, regímenes de bienestar e igualdad de género: ¿blancos, negros o grises?

    NARCIS (Netherlands)

    K. Voorend (Koen); J.M. Franzoni

    2008-01-01

    textabstractLas transferencias monetarias condicionadas, programas “estrella” de la nueva política latinoamericana, ¿favorecen o atentan contra la igualdad de género? ¿Qué tanto los programas de transferencias condicionadas promueven mayores grados de igualdad como lo argumentan sus defensores? ¿Es

  11. Crímenes que producen castigo: sobre el sentido del jubileo penitenciario en una Administración General del Daño.

    Directory of Open Access Journals (Sweden)

    Daniel Jiménez Franco

    2014-09-01

    Full Text Available El artículo propone una lectura de las respuestas penales proyectadas por ese mismo “legislador ejecutivo” que gobierna el Estado español en nombre de un régimen de acumulación improductiva y administración ampliada de daño social –noción que, junto a la de criminalidad estatal-corporativa, salta hoy irremediablemente al primer plano del análisis. La soberanía se actualiza en nombre de una razón de mercado tecnocrática y en falsa forma de prevención ampliada, a costa de la más liviana noción de constitucionalidad. El reflejo institucional de esa imposición autoritaria que castiga expulsando se plasma en una dramática incompatibilidad entre palabras y cosas, significantes y significados, principios y proyectos… entre dichos y hechos, en definitiva. Una vez la retórica demoliberal es vaciada completamente de sentido, la crisis inducida y sus “ajustes estructurales” desnudan al régimen –otra cuestión es que consigan debilitarlo. Gobernar es operar desde el estado a golpe de crimen y según las exigencias del mercado; mantener el orden público es “pacificar” las consecuencias sociales de una expulsión masiva que nos obliga a revisar el papel del hiperencarcelamiento como centro de las dinámicas punitivas en el fin de ciclo capitalista. Un bando neoliberal ha acabado redefiniendo el vínculo entre deuda y castigo. El abandono gubernamental del derecho –con él, la deportación física y jurídica de la llamada “ciudadanía”- se acompaña de una excepcionalidad antijurídica obsesionada por la “tranquilidad ciudadana” pero poco compatible con la “paz social”. En su acepción menos sutil, la cuestión del poder regresa para desbaratar las ataduras disciplinarias del fascismo postmoderno. De ahí que la madre de todos los problemas políticos vuelva a plasmarse hoy en la tensión Pueblo y población.

  12. Modo de dominación y regímenes de violencia en las dictaduras iberoamericanas. Un esbozo de comparación

    OpenAIRE

    Luciano Alonso

    2007-01-01

    El artículo presenta un ejercicio de reflexión a partir de una operación comparativa sobre las formas fundamentales de la violencia en cuatro dictaduras iberoamericanas: el salazarismo portugués, el franquismo español, el pinochetismo chileno y el “proceso de reorganización nacional” argentino. Se definen esas experiencias autoritarias como dictaduras regresivas, distanciándolas del concepto de fascismo pero al mismo tiempo observando su “parecido de familia” respecto de determinadas ...

  13. LOS REGÍMENES CAMBIARIOS EN COSTA RICA: EVOLUCIÓN HISTÓRICA Y EVALUACIÓN DE ALGUNAS ALTERNATIVAS TEÓRICAS

    Directory of Open Access Journals (Sweden)

    Gabriela Saborio Muñoz

    2011-09-01

    Full Text Available A partir de la década de los cincuenta, la economía costarricense comenzó a orientarse hacia un modelo de sustitución de importaciones, modelo impulsado por la CEPAL en América Latina, y el cual se puso muy de moda entre los países subdesarrollados. Este sistema consistía en otorgarle incentivos a la industria local, con el propósito de que orientara su producción hacia el mercado interno, sobre todo de los bienes que normalmente se importaban. Sin embargo, este modelo tenía como principal problema, la dependencia que generaba de las materias primas traídas del exterior, razón por la cual el sistema lo que varió fue el tipo de importaciones.En sus inicios, este modelo fue sostenible debido a la incorporación del país al Mercado Común Centroamericano y a la gran disposición de recursos, que permitieron la importación de bienes de capital, y la construcción de obras de infraestructura. Con el paso de los años, sin embargo, el mercado centroamericano dejó de funcionar como tal a causa principalmente de los problemas políticos que vivían los países del istmo. A pesar de este deterioro en el comercio regional, durante la década de los setenta, Costa Rica tuvo acceso a una gran cantidad de recursos financieros, producto de los excedentes generados por la producción de petróleo a los países productores , y al aumento vertiginoso en los precios internacionales del café, el cual era su principal producto de exportación; esta afluencia de recursos externos permitió ignorar durante unos años los problemas que existían en el sistema productivo costarricense. Cabe recalcar que durante todo el período el tipo de cambio permaneció prácticamente constante, excepto por algunas pequeñas devaluaciones; lo cual iba muy en línea con lo estipulado por el acuerdo de Bretton Woods.

  14. Adaptación de exámenes de comprensión auditiva en lengua inglesa para personas invidentes.

    OpenAIRE

    RODRÍGUEZ SAURE, PAULA LILIANA

    2012-01-01

    Las instituciones educativas en México necesitan elaborar más material que ayude a los estudiantes invidentes a tener un mejor aprendizaje, este material es prácticamente inexistente en la clase de inglés; sin embargo, el problema se agudiza al momento de la evaluación porque a falta del mismo el profesor debe leer el examen al alumno y éste tiene que estar concentrado en varias cosas a la vez; por ejemplo, en la lectura del examen, las preguntas y en las respuestas. La pronunc...

  15. Infraestructura, regímenes de competencia y costos del transporte aéreo: elementos de juicio de varios países

    OpenAIRE

    Alejandro Micco; Tomas Serebrisky

    2004-01-01

    (Disponible en idioma inglés únicamente) La importancia de los costos del transporte ha venido aumentando a medida que la apertura económica continúa reduciendo las barreras artificiales al comercio internacional. Los países necesitan adoptar políticas que les permitan `acercarse` a los mercados mundiales. ¿Es posible reducir los costos del transporte mediante el mejoramiento de la infraestructura y la normativa? ¿Conviene poner en práctica políticas destinadas a aumentar la competencia en lo...

  16. Overview of CEA research in the field of radionuclides migration; Syntheses des recherches menees par le CEA sur la migration des radionucleides

    Energy Technology Data Exchange (ETDEWEB)

    Poinssot, Ch; Trotignon, L; Tevissen, E

    2006-07-01

    This report presents a synthetic status of the researches conducted within the Nuclear Energy Division (CEA/DEN) in the field of radionuclides migration in three specific areas which have been chosen for their representativeness and potential impact: the migration of RN in PWR reactors, the migration of RN from a deep geological repository and the migration processes in the surface environments. In addition, some status is given about more generic research which is conducted in the field of RN speciation in the aqueous phase and at the interfaces and regarding chemistry / transport couplings. Additional information about the human and technical means involved in these fields of research in CEA/DEN is finally given in the Appendix. (authors)

  17. MODELADO DE DINÁMICA DE FLUIDOS Y TRANSFERENCIA DE CALOR Y MASA EN PROCESOS AGROALIMENTARIOS POR MÉTODO DE VOLÚMENES FINITOS

    Directory of Open Access Journals (Sweden)

    NELSON O. MORAGA

    2011-01-01

    Full Text Available Se describe la transferencia de momento, calor y masa transitorio bi-dimensional en procesos agroalimentarios. Estos procesos son: la pre-cosecha y la deshidratación por aire caliente de frutas. La metodología incluye modelación matemática y simulación computacional para describir la convección y difusión de calor y masa conjugada que resulta de la interacción entre el alimento y el aire. El modelo matemático emplea las ecuaciones diferenciales parciales no lineales acopladas de continuidad, momento lineal, energía y materia. Se considera que las propiedades físicas de las frutas calculadas mediante correlaciones empíricas, varían con la temperatura y la concentración de humedad. El método de volúmenes finitos junto el algoritmo SIMPLE se utiliza para obtener los resultados de la variación en el tiempo de las distribuciones de velocidades (v, temperaturas (T y concentraciones de humedad (C para los procesos en estudio. Las propiedades termofísicas variables de los alimentos se obtuvieron a partir de modelos empíricos. Los resultados obtenidos incluyen distribuciones de las variables dependientes (v, T, C en el tiempo, los cuales se comparan con resultados experimentales y numéricos de la literatura especializada.

  18. Regímenes estático y dinámico en la evolución estructural de microclinas pertíticas

    Directory of Open Access Journals (Sweden)

    Sánchez-Muñoz, L.

    2006-08-01

    Full Text Available Eighty six microclines with perthitic texture from seven granitic pegmatites have been collected and studied by X-ray diffraction (XRD, X-ray fluorescence (XRF and optical microscopy (OM. The statistical distribution of the structural state of the microclines shows a tendency to bimodality and also the coexistence of different triclinicities. Pegmatitic microclines are better described when considered as complex crystals and not as heterogeneous pseudomorphic assemblages after sanidine transformation, because the structural state is organized following structural patterns around the interfase with Na-feldspar veins in macroperthitic texture. This tendency to bimodality allows to distinguish among disordered and ordered microclines linked with static and dynamic genetic regimes of solid state evolution on cooling. The static regime produces limited reequilibration since a surface re-crystallization process of regions with high local Si/Al order occurs along boundaries. The ordering is located next to circulation surfaces because the catalyst aqueous fluids have mainly a channeled motion. The dynamic regime is adaptative and important volumes are re-equilibrated by bulk re-crystallization give rise to an ordered microcline. This behavior can be explained considering that a volumetric flow of catalyst water molecules promote global Si/Al ordering. A transitional regime can be distinguished by partial penetration of water through the structures.

    Se han muestreado y estudiado ochenta y seis microclinas con textura pertítica procedentes de siete pegmatitas graníticas por difracción de rayos-X (DRX, fluorescencia de rayos-X (FRX y microscopía óptica de luz transmitida (MLT. La tendencia hacia la bimodalidad estructural y la coexistencia de multitud de estados estructurales se describe considerando las microclinas pegmatíticas no como pseudomorfos heterogéneos sino como cristales complejos. Según ésta descripción, los estados estructurales no están distribuidos al azar sino que están organizados según patrones estructurales en torno a las interfases con el feldespato sódico en venas macropertíticas. La tendencia a la bimodalidad en el estado estructural permite distinguir entre microclinas desordenadas y ordenadas, cuyo origen se puede correlacionar con una dualidad en su evolución al estado sólido según un régimen genético estático y otro dinámico durante el enfriamiento. El régimen estático produce un re-equilibrado limitado porque la recristalización de regiones con mayor orden Si/Al es superficial. El ordenamiento Si/Al está localizado en las proximidades de las superficies con circulación acanalada de fluidos acuosos catalizadores de las transformaciones estructurales. El régimen dinámico es adaptativo y el re-equilibrado es extenso operando por recristalización global. Este comportamiento se explica por el flujo volumétrico de las moléculas de agua catalizadoras del re-equilibrado. La penetración parcial del agua a través de la estructura produce un régimen transicional entre los dos anteriores.

  19. Exámenes diagnósticos cardiovasculares: ¿diferencias de género en su interpretación?

    Directory of Open Access Journals (Sweden)

    Mónica Acevedo

    2018-01-01

    Full Text Available Resumen: Dado que la enfermedad cardiovascular es la principal causa de muerte en las mujeres, conocer las diferencias de género que existen en su diagnóstico, tratamiento y evolución resulta fundamental para el enfoque de la intervención. El rol de las técnicas no invasivas en la evaluación de las mujeres con sospecha de enfermedad cardiovascular isquémica debe tener en cuenta las diferencias anatómicas, fisiológicas y patológicas, que están directamente relacionadas con las diferencias en sus resultados e interpretación. La prueba de esfuerzo convencional tiene menor sensibilidad y especificidad en las mujeres que en los hombres, mientras que la prueba de perfusión miocárdica con talio tiene una sensibilidad más alta, pero no una especificidad mejor al electrocardiograma de esfuerzo tradicional en mujeres, y el Tc-99 sestamibi SPECT tiene una especificidad del ∼90% en mujeres, la cual es similar a la del hombre. Pruebas como el ecocardiograma de estrés tienen una sensibilidad ligeramente peor en mujeres versus hombres, pero con una especificidad comparable. La resonancia nuclear magnética (RNM y la angioTAC coronaria tienen en la actualidad un papel preponderante en el estudio de la enfermedad isquémica cardiaca. La sospecha clínica de enfermedad cardiovascular en la mujer, sumado a la escogencia de la mejor técnica diagnóstica y la interpretación adecuada, favorece diagnósticos y tratamientos más oportunos. Abstract: Given that cardiovascular disease is the main cause of death in women, awareness of the gender differences in its diagnosis, treatment and development is essential for intervention. The role of non-invasive techniques in the assessment of women with suspected ischemic heart disease should take into account the anatomical, physiological and pathological differences which are directly related to their results and interpretation. Conventional stress tests have less sensitivity and specificity in women than in men, while thallium myocardial perfusion scans have a higher sensitivity, but not a better specificity, than the conventional stress electrocardiogram in women; and the Tc-99 sestamibi SPECT has a ∼90% specificity in women, which is similar to that in men. Tests such as stress echocardiograms have a slightly worse sensitivity in women versus men, with a comparable specificity. Nuclear magnetic resonance (NMR and coronary CT angiography currently have a preponderant role in the study of ischemic heart disease. The clinical suspicion of cardiovascular disease in women, together with the selection of the best diagnostic technique and an adequate interpretation, favors more timely diagnoses and treatments. Palabras clave: Enfermedad cardiovascular, Diagnóstico, Cardiopatía isquémica, Mujer, Keywords: Cardiovascular disease, Diagnosis, Ischemic heart disease, Woman

  20. Sökande efter mening och identitet - upplevelser i samband med pensionering : En explorativ studie med pensionärers egna berättelser som grund.

    OpenAIRE

    Christensson, Jenny

    2015-01-01

    This is a qualitative study aiming to examine peoples’ experiences when retiring. In that purpose a criteria based sample has been used, participants have been asked in that they fulfilled the criteria’s to be a retiree within the age of 65 to 71 years of age. The reason of the age criteria was that the experiences should not be so far away in time. Data has been collected through 11 semi-structured interviews which has been recorded and transcribed ongoing during the collecting of data. Them...

  1. Los Crímenes de la Mano Carmesí. Del Corto al Largometraje

    OpenAIRE

    Ger Nogarol, Sara

    2017-01-01

    La protagonista, la Maya, té malsons tan reals que l'espanten, sobretot perquè estan relacionats amb uns assassinats que s'estan cometent a la seva ciutat. Això podria atribuir-se a la sobtada depressió de la Maya per la mort del seu germà, en Noel. La protagonista decideix investigar sobre la mort d'aquest i sobre els seus somnis premonitoris, però no estarà sola, comptarà amb la peculiar ajuda de la inspectora Hillary Marcuse. La protagonista, Maya, sufre unas pesadillas tan reales que l...

  2. LA SOCIEDAD CANADIENSE EN LA ENCRUCIJADA DE LA GLOBALIZACIÓN: REGÍMENES DE ACUMULACIÓN, CLASES SOCIALES E IDENTIDADES

    Directory of Open Access Journals (Sweden)

    Fred Judson

    2002-01-01

    Full Text Available El autor plantea que la experiencia canadiense de la globalización hasta la fecha no ha sido la de una posmodernidad, sino de una globalidad capitalista que responde a una crisis histórica de acumulación. Para comprender la formación social canadiense, sugiere combinar los marcos analíticos de la tradición de la economía política, la sociología política y la ciencia política. Con este eclecticismo analítico, se examina el régimen de acumulación, la estructura social y el carácter del Estado canadiense. El autor argumenta que la globalización ha tenido un impacto en todas esas facetas de la formación social de Canadá. Concluye que algunas respuestas a los dilemas canadienses, en el contexto de la globalización y de la globalidad, se ubican en la recuperación y la extensión de la democracia.

  3. 1,2,3-Trichloropropane: a multisite carcinogen in rats and mice.

    Science.gov (United States)

    Irwin, R D; Haseman, J K; Eustis, S L

    1995-05-01

    1,2,3-Trichloropropane was evaluated in 2-year toxicology and carcinogenesis studies by the National Toxicology Program. The selection of this chemical for study was based on the potential for human exposure, its positive in vitro genotoxicity, and the carcinogenicity of structurally related chemicals. During the 2-year study 1,2,3-trichloropropane was administered in corn oil by gavage 5 days per week; groups of 60 F344/N rats received 0, 3, 10, or 30 mg/kg, while groups of 60 B6C3F1 mice received 0,6,20, or 60 mg/kg. Because of reduced survival associated with the development of chemical-related neoplasms, rats that received 30 mg/kg were terminated at 65 weeks (females) or 76 weeks (males). Similarly, mice that received 60 mg/kg were terminated at 73 weeks (females) or 79 weeks (males), while groups of mice that received 20 mg/kg were terminated at 88 weeks. 1,2,3-Trichloropropane induced benign and/or malignant neoplasms at multiple sites in both rats and mice; this included increased incidences of benign and malignant neoplasms of the squamous epithelium of the oral mucosa and forestomach of male and female rats, benign neoplasms of the kidney and pancreas and benign or malignant neoplasms of the preputial gland in male rats, malignant neoplasms of the mammary gland, and benign or malignant neoplasms of the clitoral gland in female rats. In mice, 1,2,3-trichloropropane induced a low incidence of malignant neoplasms of the oral mucosa in females, high incidences of benign and malignant neoplasms of the forestomach in males and females, benign neoplasms of the liver and harderian gland of males and females, and uterine neoplasms in females.

  4. Methods and Management of the Healthy Brain Study: A Large Multisite Qualitative Research Project

    Science.gov (United States)

    Laditka, Sarah B.; Corwin, Sara J.; Laditka, James N.; Liu, Rui; Friedman, Daniela B.; Mathews, Anna E.; Wilcox, Sara

    2009-01-01

    Purpose of the study: To describe processes used in the Healthy Brain project to manage data collection, coding, and data distribution in a large qualitative project, conducted by researchers at 9 universities in 9 states. Design and Methods: Project management protocols included: (a) managing audiotapes and surveys to ensure data confidentiality,…

  5. Consequences of Ca multisite occupation for the conducting properties of BaTiO{sub 3}

    Energy Technology Data Exchange (ETDEWEB)

    Zulueta, Y.A., E-mail: yohandysalexis.zuluetaleyva@student.kuleuven.be [Departamento de Física, Facultad de Ciencias Naturales, Universidad de Oriente, CP-90500 Santiago de Cuba (Cuba); Department of Chemistry, KU Leuven, B-3001 Leuven (Belgium); Dawson, J.A. [Department of Engineering, University of Cambridge, Cambridge CB2 1PZ (United Kingdom); Leyet, Y. [Departamento de Engenharia de Materiais, Universidade Federal do Amazonas, Av. General Rodrigo Otávio, 6200 – Coroado I, 69077-000 Manaus (Brazil); Departamento de Física, Universidade Federal do Amazonas, Av. General Rodrigo Otávio, 6200 – Coroado I, 69077-000 Manaus, Amazonas (Brazil); Anglada-Rivera, J. [Instituto Federal de Educação Ciência e Tecnologia do Amazonas, Av. 7de Setembro, 1975, 69020-120 Manaus (Brazil); Guerrero, F. [Departamento de Física, Universidade Federal do Amazonas, Av. General Rodrigo Otávio, 6200 – Coroado I, 69077-000 Manaus, Amazonas (Brazil); Silva, R.S. [Departamento de Física, Universidade Federal de Sergipe, 49100-000 São Cristóvão, SE (Brazil); Nguyen, Minh Tho [Department of Chemistry, KU Leuven, B-3001 Leuven (Belgium)

    2016-11-15

    In combination with the dielectric modulus formalism and theoretical calculations, a newly developed defect incorporation mode, which is a combination of the standard A- and B-site doping mechanisms, is used to explain the conducting properties in 5 mol% Ca-doped BaTiO{sub 3}. Simulation results for Ca solution energies in the BaTiO{sub 3} lattice show that the new oxygen vacancy inducing mixed mode exhibits low defect energies. A reduction in dc conductivity compared with undoped BaTiO{sub 3} is witnessed for the incorporation of Ca. The conducting properties of 5 mol% Ca-doped BaTiO{sub 3} are analyzed using molecular dynamics and impedance spectroscopy. The ionic conductivity activation energies for each incorporation mode are calculated and good agreement with experimental data for oxygen migration is observed. The likely existence of the proposed defect configuration is also analyzed on the basis of these methods. - Graphical abstract: Oxygen vacancy formation as a result of self-compensation in Ca-doped BaTiO{sub 3}.

  6. Multisite evaluation of environmental cleanliness of high-touch surfaces in intensive care unit patient rooms.

    Science.gov (United States)

    Hopman, Joost; Donskey, Curtis J; Boszczowski, Icaro; Alfa, Michelle J

    2018-05-23

    The efficacy of discharge cleaning and disinfection of high-touch surfaces of intensive care unit patient rooms in Brazil, Canada, the Netherlands, and the United States was evaluated and the effect of an educational intervention was determined. Significant site-to-site differences in cleaning regimens and baseline cleanliness levels were observed using ATP levels, colony-forming units, and reflective surface marker removal percent pass rates. An educational intervention that includes rapid feedback of the ATP measurements could significantly improve the quality of the cleaning and disinfection regimens. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

  7. A multi-site controlled trial of a cognitive skills program for mentally disordered offenders.

    Science.gov (United States)

    Rees-Jones, Angharad; Gudjonsson, Gisli; Young, Susan

    2012-05-18

    The effectiveness of offending behaviour programs in forensic mental health settings is not well established. Thus this study aimed to evaluate the Reasoning and Rehabilitation Mental Health program (R&R2 MHP) among a mentally disordered offender (MDO) population. A sample of 121 adult males drawn from 10 forensic mental health sites completed questionnaires at baseline and post-treatment to assess violent attitudes, locus of control, social problem-solving and anger. An informant measure of social and psychological functioning, including disruptive behaviour, was completed by unit staff at the same time. At three month follow-up patients completed again the violent attitudes and locus of control questionnaires. The data of 67 patients who participated in the group condition were compared with 54 waiting-list controls who received treatment as usual. 78% of group participants completed the program. In contrast to controls, significant treatment effects were found at outcome on self-reported measures of violent attitudes, rational problem-solving and anger cognitions. Improvements were endorsed by informant ratings of social and psychological functioning within the establishments. At follow-up significant treatment effects were found for both violent attitudes and locus of control. R&R2 MHP was effective in a sample of MDOs and had a comparatively low drop-out rate. Future research should use a randomized controlled design.

  8. Data acquisition system for steady state experiments at multi-sites

    International Nuclear Information System (INIS)

    Nakanishi, H.; Emoto, M.; Nagayama, Y.

    2010-11-01

    A high-performance data acquisition system (LABCOM system) has been developed for steady state fusion experiments in Large Helical Device (LHD). The most important characteristics of this system are the 110 MB/s high-speed real-time data acquisition capability and also the scalability on its performance by using unlimited number of data acquisition (DAQ) units. It can also acquire experimental data from multiple remote sites through the 1 Gbps fusion-dedicated virtual private network (SNET) in Japan. In LHD steady-state experiments, the DAQ cluster has established the world record of acquired data amount of 90 GB/shot which almost reaches the ITER data estimate. Since all the DAQ, storage, and data clients of LABCOM system are distributed on the local area network (LAN), remote experimental data can be also acquired simply by extending the LAN to the wide-area SNET. The speed lowering problem in long-distance TCP/IP data transfer has been improved by using an optimized congestion control and packet pacing method. Japan-France and Japan-US network bandwidth tests have revealed that this method actually utilize 90% of ideal throughput in both cases. Toward the fusion goal, a common data access platform is indispensable so that detailed physics data can be easily compared between multiple large and small experiments. The demonstrated bilateral collaboration scheme will be analogous to that of ITER and the supporting machines. (author)

  9. Characteristics and Outcomes of Female Infertility Treatment Programs Using Traditional Medicine in Korea: A Multisite Analysis.

    Science.gov (United States)

    Kim, Kyeong Han; Jang, Soobin; Lee, Ju Ah; Go, Ho-Yeon; Jung, Jeeyoun; Park, Sunju; Lee, Myeong Soo; Ko, Seong-Gyu

    2018-03-22

    Infertility has long been recognized as a treatable disease, and complementary and alternative medicine treatments, such as acupuncture and moxibustion, have been used in Korea and China. This study describes female infertility treatment programs that used traditional Korean medicine (TKM) and were conducted by local governments in Korea and evaluates its effectiveness and safety. The authors officially requested related information from the report of the infertility treatment programs and related sources from 2006 to 2016 from the Health & Welfare Ministry of Korea and the Association of Korean Medicine (AKOM). Additional information was obtained from six Korean databases. Data including basic information about the programs, participant information, interventions, and outcomes were abstracted. A total of 9 reports, including multiple years of data from 6 programs (total 13 programs), were identified. In these 13 programs, a total of 1023 female subjects participated, and 205 of the 887 subjects who completed the program reported a successful pregnancy, indicating a 23.1% pregnancy rate. The programs lasted 3-9 months, and interventional elements, such as herbal medicine, acupuncture, fumigation, and massage, were identified. Significant adverse effects were not reported. This study suggests that infertility treatment programs with TKM interventions exhibited a positive effect on pregnancy in females with infertility. Thus, the infertility treatment programs with TKM interventions are expected to be useful and might serve as the primary treatment before assisted reproduction techniques.

  10. A multi-sites analysis on the ozone effects on Gross Primary Production of European forests

    Energy Technology Data Exchange (ETDEWEB)

    Proietti, C. [Department of Environmental Biology, Sapienza University of Rome, Piazzale Aldo Moro, 5, 00185 Rome (Italy); Anav, A. [Italian National Agency for New Technologies, Energy and the Environment (ENEA), C.R. Casaccia, Via Anguillarese 301, 00123 S. Maria di Galeria, Rome (Italy); University of Exeter, College of Engineering, Mathematics and Physical Sciences, Exeter (United Kingdom); De Marco, A. [Italian National Agency for New Technologies, Energy and the Environment (ENEA), C.R. Casaccia, Via Anguillarese 301, 00123 S. Maria di Galeria, Rome (Italy); Sicard, P. [ACRI-HE, 260 route du Pin Montard BP234, 06904 Sophia Antipolis-cedex (France); Vitale, M., E-mail: marcello.vitale@uniroma1.it [Department of Environmental Biology, Sapienza University of Rome, Piazzale Aldo Moro, 5, 00185 Rome (Italy)

    2016-06-15

    Ozone (O{sub 3}) is both a greenhouse gas and a secondary air pollutant causing adverse impacts on forests ecosystems at different scales, from cellular to ecosystem level. Specifically, the phytotoxic nature of O{sub 3} can impair CO{sub 2} assimilation that, in turn affects forest productivity. This study aims to evaluate the effects of tropospheric O{sub 3} on Gross Primary Production (GPP) at 37 European forest sites during the time period 2000–2010. Due to the lack of carbon assimilation data at O{sub 3} monitoring stations (and vice-versa) this study makes a first attempt to combine high resolution MODIS Gross Primary Production (GPP) estimates and O{sub 3} measurement data. Partial Correlations, Anomalies Analysis and the Random Forests Analysis (RFA) were used to quantify the effects of tropospheric O{sub 3} concentration and its uptake on GPP and to evaluate the most important factors affecting inter-annual GPP changes. Our results showed, along a North-West/South-East European transect, a negative impact of O{sub 3} on GPP ranging from 0.4% to 30%, although a key role of meteorological parameters respect to pollutant variables in affecting GPP was found. In particular, meteorological parameters, namely air temperature (T), soil water content (SWC) and relative humidity (RH) are the most important predictors at 81% of test sites. Moreover, it is interesting to highlight a key role of SWC in the Mediterranean areas (Spanish, Italian and French test sites) confirming that, soil moisture and soil water availability affect vegetation growth and photosynthesis especially in arid or semi-arid ecosystems such as the Mediterranean climate regions. Considering the pivotal role of GPP in the global carbon balance and the O{sub 3} ability to reduce primary productivity of the forests, this study can help in assessing the O{sub 3} impacts on ecosystem services, including wood production and carbon sequestration. - Highlights: • Assessment of the surface O{sub 3} effects on Gross Primary Production (GPP) • GPP is negatively related to O{sub 3} concentration and positively to O{sub 3} fluxes • Temperature and relative humidity were the most important factors controlling GPP. • Key role of the Soil Water Content in the Mediterranean regions.

  11. Instructional Management Strategy: A Multi-Sites Study on Science Teaching for Islamic School

    Directory of Open Access Journals (Sweden)

    Abdul Ghofur

    2017-12-01

    Full Text Available This paper describes how management strategies in science learning are done by teachers in Islamic schools. This is motivated by the ranking of Indonesia which 87 percent of the population of Muslims always occupy the lowest position for the ability of science literacy. This research was conducted for four months using descriptive qualitative design with data collection technique of interview, observation and documentation. The subjects of the study were six Islamic schools in Lamongan, East Java. The six Islamic schools were chosen by purposive sampling. The results showed that the learning activities of science more dominated by teachers, students heard more explanation than the practice in verifying the process of science. The majority of teachers use lecture, question and answer methods, and assignments, and occasionally apply discussion and demonstration methods. Science laboratories in schools have not been maximally used, some have limited tools and materials, some of which lack laboratory space and even two schools without a science laboratory. Assessment of student learning progress done through pretest, posttest, daily test, question and answer during lessons, UTS and UAS. Teacher's strategy in managing student learning motivation by using animated video as apperception, integrating science materials with Islamic religious values.

  12. How we Ensured Rigor from a Multi-site, Multi-discipline, Multi-researcher Study

    Directory of Open Access Journals (Sweden)

    H. Ken Crawford

    2000-01-01

    Full Text Available Qualitative research has often been criticised for its lack of rigour. In order to overcome this, measures of trustworthiness, dependability and reliability have been suggested. A study of how pastoralists learn to incorporate sustainable farming systems in the tropical savannas of Australia employed multiple-researchers, working in three States and from a variety of disciplines. To ensure rigour a framework for the study was developed by the researchers prior to commencing interviews. This was followed by regular teleconferences to ensure that the framework was valid and to adjust for any problems encountered along the way. Every interview was analysed independently by all researchers before a workshop was conducted to bring the ideas together. Categories and ideas within the data were synthesised to create an overall understanding of the learning process within the confines of "landcare" in the Tropical Savannas. These processes were undertaken in consultation with the pastoralists and the process has been explicitly documented to enable readers to follow the research process easily. The rigour in this project is shown in the clear documentation of the research process carried out by individual researchers and by the team when it met. The understanding of pastoralists' learning processes is our interpretation; it is up to the reader to decide whether s/he agrees with that interpretation, but from the description of the process it is easy for the reader to see where and why her/his interpretation differs. URN: urn:nbn:de:0114-fqs0001125

  13. Using Protein Dimers to Maximize the Protein Hybridization Efficiency with Multisite DNA Origami Scaffolds.

    Directory of Open Access Journals (Sweden)

    Vikash Verma

    Full Text Available DNA origami provides a versatile platform for conducting 'architecture-function' analysis to determine how the nanoscale organization of multiple copies of a protein component within a multi-protein machine affects its overall function. Such analysis requires that the copy number of protein molecules bound to the origami scaffold exactly matches the desired number, and that it is uniform over an entire scaffold population. This requirement is challenging to satisfy for origami scaffolds with many protein hybridization sites, because it requires the successful completion of multiple, independent hybridization reactions. Here, we show that a cleavable dimerization domain on the hybridizing protein can be used to multiplex hybridization reactions on an origami scaffold. This strategy yields nearly 100% hybridization efficiency on a 6-site scaffold even when using low protein concentration and short incubation time. It can also be developed further to enable reliable patterning of a large number of molecules on DNA origami for architecture-function analysis.

  14. Flexible nine-channel photodetector probe facilitated intraspinal multisite transcutaneous photobiomodulation therapy dosimetry in cadaver dogs

    Science.gov (United States)

    Piao, Daqing; Sypniewski, Lara A.; Bailey, Christian; Dugat, Danielle; Burba, Daniel J.; De Taboada, Luis

    2018-01-01

    Noninvasive photobiomodulation therapy (PBMT) of spinal cord disease remains speculative due to the lack of evidence for whether photobiomodulatory irradiances can be transcutaneously delivered to the spinal cord under a clinically acceptable PBMT surface irradiation protocol. We developed a flexible nine-channel photodetection probe for deployment within the spinal canal of a cadaver dog after hemilaminectomy to measure transcutaneously transmitted PBMT irradiance at nine sites over an eight-cm spinal canal length. The probe was built upon a 6.325-mm tubular stem, to the surface of which nine photodiodes were epoxied at approximately 1 cm apart. The photodiode has a form factor of 4.80 mm×2.10 mm×1.15 mm (length×width×height). Each photodiode was individually calibrated to deliver 1 V per 7.58 μW/cm2 continuous irradiance at 850 nm. The outputs of eight photodiodes were logged concurrently using a data acquisition module interfacing eight channels of differential analog signals, while the output of the ninth photodiode was measured by a precision multimeter. This flexible probe rendered simultaneous intraspinal (nine-site) measurements of transcutaneous PBMT irradiations at 980 nm in a pilot cadaver dog model. At a surface continuous irradiance of 3.14 W/cm2 applied off-contact between L1 and L2, intraspinal irradiances picked up by nine photodiodes had a maximum of 327.48 μW/cm2 without the skin and 5.68 μW/cm2 with the skin.

  15. Architectures and methodologies for future deployment of multi-site Zettabyte-Exascale data handling platforms

    CERN Document Server

    Acín, V; Boccali, T; Cancio, G; Collier, I P; Corney, D; Delaunay, B; Delfino, M; dell'Agnello, L; Flix, J; Fuhrmann, P; Gasthuber, M; Gülzow, V; Heiss, A; Lamanna, G; Macchi, P E; Maggi, M; Matthews, B; Neissner, C; Nief, J Y; Porto, M C; Sansum, A; Schulz, M; Shiers, J

    2015-01-01

    Several scientific fields, including Astrophysics, Astroparticle Physics, Cosmology, Nuclear and Particle Physics, and Research with Photons, are estimating that by the 2020 decade they will require data handling systems with data volumes approaching the Zettabyte distributed amongst as many as 10(18) individually addressable data objects (Zettabyte-Exascale systems). It may be convenient or necessary to deploy such systems using multiple physical sites. This paper describes the findings of a working group composed of experts from several

  16. Does Size really matter? A multisite study of competing diagnostic criteria

    DEFF Research Database (Denmark)

    Hansen, Maj; Hyland, Philip; Karstoft, Karen-Inge

    may result in better fit than the DSM-5 based models. At the same time, there is also a tendency for ICD-11 to produce lower estimated PTSD prevalence rates than the DSM-5 criteria, which may ultimately affect who is offered treatment. Of note, it is important to stress that there is a lack of studies...

  17. A Multisite, Randomized Controlled Clinical Trial of Computerized Cognitive Remediation Therapy for Schizophrenia.

    Science.gov (United States)

    Gomar, Jesús J; Valls, Elia; Radua, Joaquim; Mareca, Celia; Tristany, Josep; del Olmo, Francisco; Rebolleda-Gil, Carlos; Jañez-Álvarez, María; de Álvaro, Francisco J; Ovejero, María R; Llorente, Ana; Teixidó, Cristina; Donaire, Ana M; García-Laredo, Eduardo; Lazcanoiturburu, Andrea; Granell, Luis; Mozo, Cristina de Pablo; Pérez-Hernández, Mónica; Moreno-Alcázar, Ana; Pomarol-Clotet, Edith; McKenna, Peter J

    2015-11-01

    The effectiveness of cognitive remediation therapy (CRT) for the neuropsychological deficits seen in schizophrenia is supported by meta-analysis. However, a recent methodologically rigorous trial had negative findings. In this study, 130 chronic schizophrenic patients were randomly assigned to computerized CRT, an active computerized control condition (CC) or treatment as usual (TAU). Primary outcome measures were 2 ecologically valid batteries of executive function and memory, rated under blind conditions; other executive and memory tests and a measure of overall cognitive function were also employed. Carer ratings of executive and memory failures in daily life were obtained before and after treatment. Computerized CRT was found to produce improvement on the training tasks, but this did not transfer to gains on the primary outcome measures and most other neuropsychological tests in comparison to either CC or TAU conditions. Nor did the intervention result in benefits on carer ratings of daily life cognitive failures. According to this study, computerized CRT is not effective in schizophrenia. The use of both active and passive CCs suggests that nature of the control group is not an important factor influencing results. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.

  18. Substance Abuse Treatment Outcomes: A Multi-Site Study of Male and Female Prison Programs

    Science.gov (United States)

    Pelissier, Bernadette; Motivans, Mark; Rounds-Bryant, Jennifer L.

    2005-01-01

    The present study examined whether there were program differences with respect to post-release outcomes in 20 federal in-prison substance abuse programs which used a cognitive-behavioral treatment approach. Recidivism and post-release drug use were examined for a sample of 1,343 individuals--1,065 men and 278 women. Discrete time proportional…

  19. The impact of prison reentry services on short-term outcomes: evidence from a multisite evaluation.

    Science.gov (United States)

    Lattimore, Pamela K; Visher, Christy A

    2013-01-01

    Renewed interest in prisoner rehabilitation to improve postrelease outcomes occurred in the 1990s, as policy makers reacted to burgeoning prison populations with calls to facilitate community reintegration and reduce recidivism. In 2003, the Federal government funded grants to implement locally designed reentry programs. Adult programs in 12 states were studied to determine the effects of the reentry programs on multiple outcomes. A two-stage matching procedure was used to examine the effectiveness of 12 reentry programs for adult males. In the first stage, "intact group matching" was used to identify comparison populations that were similar to program participants. In the second stage, propensity score matching was used to adjust for remaining differences between groups. Propensity score weighted logistic regression was used to examine the impact of reentry program participation on multiple outcomes measured 3 months after release. The study population was 1,697 adult males released from prisons in 2004-2005. Data consisted of interview data gathered 30 days prior to release and approximately 3 months following release, supplemented by administrative data from state departments of correction and the National Crime Information Center. Results suggest programs increased in-prison service receipt and produced modest positive outcomes across multiple domains (employment, housing, and substance use) 3 months after release. Although program participants reported fewer crimes, differences in postrelease arrest and reincarceration were not statistically significant. Incomplete implementation and service receipt by comparison group members may have resulted in insufficient statistical power to identify stronger treatment effects.

  20. Multi-Site Application of the Geomechanical Approach for Natural Fracture Exploration

    Energy Technology Data Exchange (ETDEWEB)

    R. L. Billingsley; V. Kuuskraa

    2006-03-31

    In order to predict the nature and distribution of natural fracturing, Advanced Resources Inc. (ARI) incorporated concepts of rock mechanics, geologic history, and local geology into a geomechanical approach for natural fracture prediction within mildly deformed, tight (low-permeability) gas reservoirs. Under the auspices of this project, ARI utilized and refined this approach in tight gas reservoir characterization and exploratory activities in three basins: the Piceance, Wind River and the Anadarko. The primary focus of this report is the knowledge gained on natural fractural prediction along with practical applications for enhancing gas recovery and commerciality. Of importance to tight formation gas production are two broad categories of natural fractures: (1) shear related natural fractures and (2) extensional (opening mode) natural fractures. While arising from different origins this natural fracture type differentiation based on morphology is sometimes inter related. Predicting fracture distribution successfully is largely a function of collecting and understanding the available relevant data in conjunction with a methodology appropriate to the fracture origin. Initially ARI envisioned the geomechanical approach to natural fracture prediction as the use of elastic rock mechanics methods to project the nature and distribution of natural fracturing within mildly deformed, tight (low permeability) gas reservoirs. Technical issues and inconsistencies during the project prompted re-evaluation of these initial assumptions. ARI's philosophy for the geomechanical tools was one of heuristic development through field site testing and iterative enhancements to make it a better tool. The technology and underlying concepts were refined considerably during the course of the project. As with any new tool, there was a substantial learning curve. Through a heuristic approach, addressing these discoveries with additional software and concepts resulted in a stronger set of geomechanical tools. Thus, the outcome of this project is a set of predictive tools with broad applicability across low permeability gas basins where natural fractures play an important role in reservoir permeability. Potential uses for these learnings and tools range from rank exploration to field-development portfolio management. Early incorporation of the permeability development concepts presented here can improve basin assessment and direct focus to the high potential areas within basins. Insight into production variability inherent in tight naturally fractured reservoirs leads to improved wellbore evaluation and reduces the incidence of premature exits from high potential plays. A significant conclusion of this project is that natural fractures, while often an important, overlooked aspect of reservoir geology, represent only one aspect of the overall reservoir fabric. A balanced perspective encompassing all aspects of reservoir geology will have the greatest impact on exploration and development in the low permeability gas setting.

  1. Cyberbullying, Depression, and Problem Alcohol Use in Female College Students: A Multisite Study

    Science.gov (United States)

    Kota, Rajitha; Chan, Ya-Fen; Moreno, Megan

    2015-01-01

    Abstract Cyberbullying and its effects have been studied largely in middle and high school students, but less is known about cyberbullying in college students. This cross-sectional study investigated the relationship between involvement in cyberbullying and depression or problem alcohol use among college females. Two hundred and sixty-five female students from four colleges completed online surveys assessing involvement in cyberbullying behaviors. Participants also completed the Patient Health Questionnaire-9 (PHQ-9) to assess depressive symptoms and the Alcohol Use Disorder Identification Test (AUDIT) to assess problem drinking. Logistic regression tested associations between involvement in cyberbullying and either depression or problem drinking. Results indicated that 27% of participants had experienced cyberbullying in college; 17.4% of all participants met the criteria for depression (PHQ-9 score ≥10), and 37.5% met the criteria for problem drinking (AUDIT score ≥8). Participants with any involvement in cyberbullying had increased odds of depression. Those involved in cyberbullying as bullies had increased odds of both depression and problem alcohol use. Bully/victims had increased odds of depression. The four most common cyberbullying behaviors were also associated with increased odds for depression, with the highest odds among those who had experienced unwanted sexual advances online or via text message. Findings indicate that future longitudinal study of cyberbullying and its effects into late adolescence and young adulthood could contribute to the prevention of associated comorbidities in this population. PMID:25684608

  2. Efficacy of a process improvement intervention on delivery of HIV services to offenders: a multisite trial.

    Science.gov (United States)

    Pearson, Frank S; Shafer, Michael S; Dembo, Richard; Del Mar Vega-Debién, Graciela; Pankow, Jennifer; Duvall, Jamieson L; Belenko, Steven; Frisman, Linda K; Visher, Christy A; Pich, Michele; Patterson, Yvonne

    2014-12-01

    We tested a modified Network for the Improvement of Addiction Treatment (NIATx) process improvement model to implement improved HIV services (prevention, testing, and linkage to treatment) for offenders under correctional supervision. As part of the Criminal Justice Drug Abuse Treatment Studies, Phase 2, the HIV Services and Treatment Implementation in Corrections study conducted 14 cluster-randomized trials in 2011 to 2013 at 9 US sites, where one correctional facility received training in HIV services and coaching in a modified NIATx model and the other received only HIV training. The outcome measure was the odds of successful delivery of an HIV service. The results were significant at the .05 level, and the point estimate for the odds ratio was 2.14. Although overall the results were heterogeneous, the experiments that focused on implementing HIV prevention interventions had a 95% confidence interval that exceeded the no-difference point. Our results demonstrate that a modified NIATx process improvement model can effectively implement improved rates of delivery of some types of HIV services in correctional environments.

  3. Agile methods in biomedical software development: a multi-site experience report

    Directory of Open Access Journals (Sweden)

    Kuhlmman Karl F

    2006-05-01

    Full Text Available Abstract Background Agile is an iterative approach to software development that relies on strong collaboration and automation to keep pace with dynamic environments. We have successfully used agile development approaches to create and maintain biomedical software, including software for bioinformatics. This paper reports on a qualitative study of our experiences using these methods. Results We have found that agile methods are well suited to the exploratory and iterative nature of scientific inquiry. They provide a robust framework for reproducing scientific results and for developing clinical support systems. The agile development approach also provides a model for collaboration between software engineers and researchers. We present our experience using agile methodologies in projects at six different biomedical software development organizations. The organizations include academic, commercial and government development teams, and included both bioinformatics and clinical support applications. We found that agile practices were a match for the needs of our biomedical projects and contributed to the success of our organizations. Conclusion We found that the agile development approach was a good fit for our organizations, and that these practices should be applicable and valuable to other biomedical software development efforts. Although we found differences in how agile methods were used, we were also able to identify a set of core practices that were common to all of the groups, and that could be a focus for others seeking to adopt these methods.

  4. Conducting a large, multi-site survey about patients’ views on broad consent: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Maureen E. Smith

    2016-11-01

    Full Text Available Abstract Background As biobanks play an increasing role in the genomic research that will lead to precision medicine, input from diverse and large populations of patients in a variety of health care settings will be important in order to successfully carry out such studies. One important topic is participants’ views towards consent and data sharing, especially since the 2011 Advanced Notice of Proposed Rulemaking (ANPRM, and subsequently the 2015 Notice of Proposed Rulemaking (NPRM were issued by the Department of Health and Human Services (HHS and Office of Science and Technology Policy (OSTP. These notices required that participants consent to research uses of their de-identified tissue samples and most clinical data, and allowing such consent be obtained in a one-time, open-ended or “broad” fashion. Conducting a survey across multiple sites provides clear advantages to either a single site survey or using a large online database, and is a potentially powerful way of understanding the views of diverse populations on this topic. Methods A workgroup of the Electronic Medical Records and Genomics (eMERGE Network, a national consortium of 9 sites (13 separate institutions, 11 clinical centers supported by the National Human Genome Research Institute (NHGRI that combines DNA biorepositories with electronic medical record (EMR systems for large-scale genetic research, conducted a survey to understand patients’ views on consent, sample and data sharing for future research, biobank governance, data protection, and return of research results. Results Working across 9 sites to design and conduct a national survey presented challenges in organization, meeting human subjects guidelines at each institution, and survey development and implementation. The challenges were met through a committee structure to address each aspect of the project with representatives from all sites. Each committee’s output was integrated into the overall survey plan. A number of site-specific issues were successfully managed allowing the survey to be developed and implemented uniformly across 11 clinical centers. Conclusions Conducting a survey across a number of institutions with different cultures and practices is a methodological and logistical challenge. With a clear infrastructure, collaborative attitudes, excellent lines of communication, and the right expertise, this can be accomplished successfully.

  5. Supporting make or buy decision for reconfigurable manufacturing system, in multi-site context

    OpenAIRE

    BENAMA , Youssef; Alix , Thecle; PERRY , Nicolas

    2014-01-01

    Part 1: Knowledge Discovery and Sharing; International audience; The make or buy decision is a strategic issue. When looking for finding out which components or products should be manufactured or externalized then buy, capacity for human and technical resources at the workshop level as well as costs of the externalization are key questions to be answered. In the case of mobile manufacturing systems that are movable between various locations, long term strategic aspects must be considered when...

  6. Recruitment of Yoruba families from Nigeria for genetic research: experience from a multisite keloid study.

    Science.gov (United States)

    Olaitan, Peter B; Odesina, Victoria; Ademola, Samuel; Fadiora, Solomon O; Oluwatosin, Odunayo M; Reichenberger, Ernst J

    2014-09-02

    More involvement of sub-Saharan African countries in biomedical studies, specifically in genetic research, is needed to advance individualized medicine that will benefit non-European populations. Missing infrastructure, cultural and religious beliefs as well as lack of understanding of research benefits can pose a challenge to recruitment. Here we describe recruitment efforts for a large genetic study requiring three-generation pedigrees within the Yoruba homelands of Nigeria. The aim of the study was to identify genes responsible for keloids, a wound healing disorder. We also discuss ethical and logistical considerations that we encountered in preparation for this research endeavor. Protocols for this bi-national intercultural study were approved by the Institutional Review Board (IRB) in the US and the ethics committees of the Nigerian institutions for consideration of cultural differences. Principles of community based participatory research were employed throughout the recruitment process. Keloid patients (patient advisors), community leaders, kings/chiefs and medical directors were engaged to assist the research teams with recruitment strategies. Community meetings, church forums, and media outlets (study flyers, radio and TV announcements) were utilized to promote the study in Nigeria. Recruitment of research participants was conducted by trained staff from the local communities. Pedigree structures were re-analyzed on a regular basis as new family members were recruited and recruitment challenges were documented. Total recruitment surpassed 4200 study participants over a 7-year period including 79 families with complete three-generation pedigrees. In 9 families more than 20 family members participated, however, in 5 of these families, we encountered issues with pedigree structure as members from different branches presented inconsistent family histories. These issues were due to the traditional open family structure amongst the Yoruba and by beliefs in voodoo or in juju. In addition, family members living in other parts of the country or abroad complicated timely and complete family recruitment. Organizational, logistics and ethics challenges can be overcome by additional administrative efforts, good communication, community involvement and education of staff members. However, recruitment challenges due to infrastructural shortcomings or cultural and religious beliefs can lead to significant delays, which may negatively affect study time lines and expectations of funding agencies.

  7. Improving Diabetes Outcomes Using a Web-Based Registry and Interactive Education: A Multisite Collaborative Approach

    Science.gov (United States)

    Morrow, Robert W.; Fletcher, Jason; Kelly, Kim F.; Shea, Laura A.; Spence, Maureen M.; Sullivan, Janet N.; Cerniglia, Joan R.; Yang, YoonJung

    2013-01-01

    Introduction: To support the adoption of guideline concordant care by primary care practices, the New York Diabetes Coalition (NYDC) promoted use of an electronic diabetes registry and developed an interactive educational module on using the registry and improving patient communication. The NYDC hypothesized that use of a registry with immediate…

  8. Efficient multi-site data movement using constraint programming for data hungry science

    Energy Technology Data Exchange (ETDEWEB)

    Zerola, Michal; Sumbera, Michal [Nuclear Physics Institute, Academy of Sciences of the Czech Republic (Czech Republic); Lauret, Jerome [Brookhaven National Laboratory, Upton (United States); Bartak, Roman, E-mail: michal.zerola@ujf.cas.c, E-mail: jlauret@bnl.go, E-mail: roman.bartak@mff.cuni.c, E-mail: sumbera@ujf.cas.c [Faculty of Mathematics and Physics, Charles University (Czech Republic)

    2010-04-01

    For the past decade, HENP experiments have been heading towards a distributed computing model in an effort to concurrently process tasks over enormous data sets that have been increasing in size as a function of time. In order to optimize all available resources (geographically spread) and minimize the processing time, it is necessary to face also the question of efficient data transfers and placements. A key question is whether the time penalty for moving the data to the computational resources is worth the presumed gain. Onward to the truly distributed task scheduling we present the technique using a Constraint Programming (CP) approach. The CP technique schedules data transfers from multiple resources considering all available paths of diverse characteristic (capacity, sharing and storage) having minimum user's waiting time as an objective. We introduce a model for planning data transfers to a single destination (data transfer) as well as its extension for an optimal data set spreading strategy (data placement). Several enhancements for a solver of the CP model will be shown, leading to a faster schedule computation time using symmetry breaking, branch cutting, well studied principles from job-shop scheduling field and several heuristics. Finally, we will present the design and implementation of a corner-stone application aimed at moving datasets according to the schedule. Results will include comparison of performance and trade-off between CP techniques and a Peer-2-Peer model from simulation framework as well as the real case scenario taken from a practical usage of a CP scheduler.

  9. Modelling multi-site transmission of the human papillomavirus and its impact on vaccination effectiveness

    Directory of Open Access Journals (Sweden)

    P. Lemieux-Mellouki

    2017-12-01

    Conclusions: Modelling genital-site only transmission may overestimate vaccination impact if extragenital infections contribute to systemic natural immunity or underestimate vaccination impact if a high proportion of genital infections originate from extragenital infections. Under current understanding of heterosexual HPV transmission and immunity, a substantial bias from using uni-site models in predicting vaccination effectiveness against genital HPV infection is unlikely to occur.

  10. Multisite outbreak of norovirus associated with a franchise restaurant--Kent County, Michigan, May 2005.

    Science.gov (United States)

    2006-04-14

    The majority of cases of foodborne gastroenteritis in the United States are caused by noroviruses. This report summarizes an investigation by the Kent County Health Department (KCHD) in Michigan into three norovirus outbreaks and a cluster of community cases that were associated with a national submarine sandwich franchise restaurant during May 3-9, 2005. The investigation identified a potential source, a food handler who had returned to work within a few hours of having symptoms of gastrointestinal illness while he was still excreting norovirus in his stools. To prevent norovirus outbreaks, food service workers should be educated regarding norovirus transmission and control. In 2005, new guidelines for state health departments regarding norovirus containment were published by the Food and Drug Administration (FDA); guidelines for local health departments in Michigan were issued by the state's Department of Community Health and Department of Agriculture. The new guidelines for Michigan recommend that food service workers with suspected norovirus not return to work until they are asymptomatic for 48-72 hours.

  11. Geographic Information System (GIS) Applications at a Multi-Site Community College.

    Science.gov (United States)

    Pottle, Laura

    This report presents the Front Range Community College (FRCC) (Colorado) Office of Institutional Research's recent expansion of its data analysis and reporting capabilities to include a geographic information system (GIS). Utilizing ArcView GIS software, the college is better able to visualize institutional and environmental data. They have…

  12. Accuracy of stated energy contents of restaurant foods in a multi-site study

    Science.gov (United States)

    Context National recommendations for prevention and treatment of obesity emphasize reducing energy intake. Foods purchased in restaurants provide approximately 35% of daily energy intake, but the accuracy of information on the energy contents of these foods is unknown. Objective To examine the a...

  13. Multisite-multivariable sensitivity analysis of distributed watershed models: enhancing the perceptions from computationally frugal methods

    Science.gov (United States)

    This paper assesses the impact of different likelihood functions in identifying sensitive parameters of the highly parameterized, spatially distributed Soil and Water Assessment Tool (SWAT) watershed model for multiple variables at multiple sites. The global one-factor-at-a-time (OAT) method of Morr...

  14. Subthreshold Psychosis in 22q11.2 Deletion Syndrome: Multisite Naturalistic Study.

    Science.gov (United States)

    Weisman, Omri; Guri, Yael; Gur, Raquel E; McDonald-McGinn, Donna M; Calkins, Monica E; Tang, Sunny X; Emanuel, Beverly; Zackai, Elaine H; Eliez, Stephan; Schneider, Maude; Schaer, Marie; Kates, Wendy R; Antshel, Kevin M; Fremont, Wanda; Shashi, Vandana; Hooper, Stephen R; Armando, Marco; Vicari, Stefano; Pontillo, Maria; Kushan, Leila; Jalbrzikowski, Maria; Bearden, Carrie E; Cubells, Joseph F; Ousley, Opal Y; Walker, Elaine F; Simon, Tony J; Stoddard, Joel; Niendam, Tara A; van den Bree, Marianne B M; Gothelf, Doron

    2017-09-01

    Nearly one-third of individuals with 22q11.2 deletion syndrome (22q11.2DS) develop a psychotic disorder during life, most of them by early adulthood. Importantly, a full-blown psychotic episode is usually preceded by subthreshold symptoms. In the current study, 760 participants (aged 6-55 years) with a confirmed hemizygous 22q11.2 microdeletion have been recruited through 10 medical sites worldwide, as part of an international research consortium. Of them, 692 were nonpsychotic and with complete measurement data. Subthreshold psychotic symptoms were assessed using the Structured Interview for Prodromal Syndromes (SIPS). Nearly one-third of participants met criteria for positive subthreshold psychotic symptoms (32.8%), less than 1% qualified for acute positive subthreshold symptoms, and almost a quarter met criteria for negative/disorganized subthreshold symptoms (21.7%). Adolescents and young adults (13-25 years) showed the highest rates of subthreshold psychotic symptoms. Additionally, higher rates of anxiety disorders and attention deficit/hyperactivity disorder (ADHD) were found among the study participants with subthreshold psychotic symptoms compared to those without. Full-scale IQ, verbal IQ, and global functioning (GAF) scores were negatively associated with participants' subthreshold psychotic symptoms. This study represents the most comprehensive analysis reported to date on subthreshold psychosis in 22q11.2DS. Novel findings include age-related changes in subthreshold psychotic symptoms and evidence that cognitive deficits are associated with subthreshold psychosis in this population. Future studies should longitudinally follow these symptoms to detect whether and how early identification and treatment of these manifestations can improve long-term outcomes in those that eventually develop a psychotic disorder. © The Author 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  15. Domestic Violence Courts: A Multisite Test of Whether and How They Change Offender Outcomes.

    Science.gov (United States)

    Cissner, Amanda B; Labriola, Melissa; Rempel, Michael

    2015-09-01

    Findings are from an investigation of 24 criminal domestic violence courts (DVCs) across New York, testing their effect on recidivism, case processing, and case resolutions. Overall, we found a small positive impact on recidivism among convicted offenders. We further found that the sex of defendants moderated the court impact on case resolutions; that is, among male defendants only, DVCs increased conviction rates and sentences involving jail or prison. In addition, multi-level, multivariate analyses found that court policies specifically designed to increase victim safety, hold offenders accountable, and reduce offender recidivism (through deterrence or rehabilitation) were instrumental in reducing recidivism. © The Author(s) 2015.

  16. The "Process" of Process Use: Methods for Longitudinal Assessment in a Multisite Evaluation

    Science.gov (United States)

    Shaw, Jessica; Campbell, Rebecca

    2014-01-01

    Process use refers to the ways in which stakeholders and/or evaluands change as a function of participating in evaluation activities. Although the concept of process use has been well discussed in the literature, exploration of methodological strategies for the measurement and assessment of process use has been limited. Typically, empirical…

  17. Development of a dynamic quality assurance testing protocol for multisite clinical trial DCE-CT accreditation

    Energy Technology Data Exchange (ETDEWEB)

    Driscoll, B. [Department of Radiation Physics, Princess Margaret Cancer Center, 610 University Avenue, Toronto, Ontario M5G 2M9 (Canada); Keller, H. [Department of Radiation Physics, Princess Margaret Cancer Center, 610 University Avenue, Toronto, Ontario M5G 2M9, Canada and Department of Radiation Oncology, University of Toronto, 150 College Street, Toronto, Ontario M5S 3E2 (Canada); Jaffray, D.; Coolens, C. [Department of Radiation Physics, Princess Margaret Cancer Center, 610 University Avenue, Toronto, Ontario M5G 2M9 (Canada); Department of Radiation Oncology, University of Toronto, 150 College Street, Toronto, Ontario M5S 3E2 (Canada); Techna Institute, University Health Network, 124-100 College Street, Toronto, Ontario M5G 1L5 (Canada)

    2013-08-15

    Purpose: Credentialing can have an impact on whether or not a clinical trial produces useful quality data that is comparable between various institutions and scanners. With the recent increase of dynamic contrast enhanced-computed tomography (DCE-CT) usage as a companion biomarker in clinical trials, effective quality assurance, and control methods are required to ensure there is minimal deviation in the results between different scanners and protocols at various institutions. This paper attempts to address this problem by utilizing a dynamic flow imaging phantom to develop and evaluate a DCE-CT quality assurance (QA) protocol.Methods: A previously designed flow phantom, capable of producing predictable and reproducible time concentration curves from contrast injection was fully validated and then utilized to design a DCE-CT QA protocol. The QA protocol involved a set of quantitative metrics including injected and total mass error, as well as goodness of fit comparison to the known truth concentration curves. An additional region of interest (ROI) sensitivity analysis was also developed to provide additional details on intrascanner variability and determine appropriate ROI sizes for quantitative analysis. Both the QA protocol and ROI sensitivity analysis were utilized to test variations in DCE-CT results using different imaging parameters (tube voltage and current) as well as alternate reconstruction methods and imaging techniques. The developed QA protocol and ROI sensitivity analysis was then applied at three institutions that were part of clinical trial involving DCE-CT and results were compared.Results: The inherent specificity of robustness of the phantom was determined through calculation of the total intraday variability and determined to be less than 2.2 ± 1.1% (total calculated output contrast mass error) with a goodness of fit (R{sup 2}) of greater than 0.99 ± 0.0035 (n= 10). The DCE-CT QA protocol was capable of detecting significant deviations from the expected phantom result when scanning at low mAs and low kVp in terms of quantitative metrics (Injected Mass Error 15.4%), goodness of fit (R{sup 2}) of 0.91, and ROI sensitivity (increase in minimum input function ROI radius by 146 ± 86%). These tests also confirmed that the ASIR reconstruction process was beneficial in reducing noise without substantially increasing partial volume effects and that vendor specific modes (e.g., axial shuttle) did not significantly affect the phantom results. The phantom and QA protocol were finally able to quickly (<90 min) and successfully validate the DCE-CT imaging protocol utilized at the three separate institutions of a multicenter clinical trial; thereby enhancing the confidence in the patient data collected.Conclusions: A DCE QA protocol was developed that, in combination with a dynamic multimodality flow phantom, allows the intrascanner variability to be separated from other sources of variability such as the impact of injection protocol and ROI selection. This provides a valuable resource that can be utilized at various clinical trial institutions to test conformance with imaging protocols and accuracy requirements as well as ensure that the scanners are performing as expected for dynamic scans.

  18. Multi-site evaluation of terrestrial evaporation models using FLUXNET data

    KAUST Repository

    Ershadi, Ali; McCabe, Matthew; Evans, Jason P.; Chaney, Nathaniel W.; Wood, Eric F.

    2014-01-01

    We evaluated the performance of four commonly applied land surface evaporation models using a high-quality dataset of selected FLUXNET towers. The models that were examined include an energy balance approach (Surface Energy Balance System; SEBS), a combination-type technique (single-source Penman-Monteith; PM), a complementary method (advection-aridity; AA) and a radiation based approach (modified Priestley-Taylor; PT-JPL). Twenty FLUXNET towers were selected based upon satisfying stringent forcing data requirements and representing a wide range of biomes. These towers encompassed a number of grassland, cropland, shrubland, evergreen needleleaf forest and deciduous broadleaf forest sites. Based on the mean value of the Nash-Sutcliffe efficiency (NSE) and the root mean squared difference (RMSD), the order of overall performance of the models from best to worst were: ensemble mean of models (0.61, 64), PT-JPL (0.59, 66), SEBS (0.42, 84), PM (0.26, 105) and AA (0.18, 105) [statistics stated as (NSE, RMSD in Wm-2)]. Although PT-JPL uses a relatively simple and largely empirical formulation of the evaporative process, the technique showed improved performance compared to PM, possibly due to its partitioning of total evaporation (canopy transpiration, soil evaporation, wet canopy evaporation) and lower uncertainties in the required forcing data. The SEBS model showed low performance over tall and heterogeneous canopies, which was likely a consequence of the effects of the roughness sub-layer parameterization employed in this scheme. However, SEBS performed well overall. Relative to PT-JPL and SEBS, the PM and AA showed low performance over the majority of sites, due to their sensitivity to the parameterization of resistances. Importantly, it should be noted that no single model was consistently best across all biomes. Indeed, this outcome highlights the need for further evaluation of each model's structure and parameterizations to identify sensitivities and their appropriate application to different surface types and conditions. It is expected that the results of this study can be used to inform decisions regarding model choice for water resources and agricultural management, as well as providing insight into model selection for global flux monitoring efforts. © 2013 Elsevier B.V.

  19. Cyberbullying, depression, and problem alcohol use in female college students: a multisite study.

    Science.gov (United States)

    Selkie, Ellen M; Kota, Rajitha; Chan, Ya-Fen; Moreno, Megan

    2015-02-01

    Cyberbullying and its effects have been studied largely in middle and high school students, but less is known about cyberbullying in college students. This cross-sectional study investigated the relationship between involvement in cyberbullying and depression or problem alcohol use among college females. Two hundred and sixty-five female students from four colleges completed online surveys assessing involvement in cyberbullying behaviors. Participants also completed the Patient Health Questionnaire-9 (PHQ-9) to assess depressive symptoms and the Alcohol Use Disorder Identification Test (AUDIT) to assess problem drinking. Logistic regression tested associations between involvement in cyberbullying and either depression or problem drinking. Results indicated that 27% of participants had experienced cyberbullying in college; 17.4% of all participants met the criteria for depression (PHQ-9 score ≥10), and 37.5% met the criteria for problem drinking (AUDIT score ≥8). Participants with any involvement in cyberbullying had increased odds of depression. Those involved in cyberbullying as bullies had increased odds of both depression and problem alcohol use. Bully/victims had increased odds of depression. The four most common cyberbullying behaviors were also associated with increased odds for depression, with the highest odds among those who had experienced unwanted sexual advances online or via text message. Findings indicate that future longitudinal study of cyberbullying and its effects into late adolescence and young adulthood could contribute to the prevention of associated comorbidities in this population.

  20. Architectures and methodologies for future deployment of multi-site Zettabyte-Exascale data handling platforms

    International Nuclear Information System (INIS)

    Acín, V; Neissner, C; Bird, I; Cancio, G; Boccali, T; Dell'Agnello, L; Maggi, M; Collier, I P; Corney, D; Matthews, B; Delaunay, B; Lamanna, G; Macchi, P-E; Nief, J-Y; Delfino, M; Flix, J; Fuhrmann, P; Gasthuber, M; Gülzow, V; Heiss, A

    2015-01-01

    Several scientific fields, including Astrophysics, Astroparticle Physics, Cosmology, Nuclear and Particle Physics, and Research with Photons, are estimating that by the 2020 decade they will require data handling systems with data volumes approaching the Zettabyte distributed amongst as many as 10 18 individually addressable data objects (Zettabyte-Exascale systems). It may be convenient or necessary to deploy such systems using multiple physical sites. This paper describes the findings of a working group composed of experts from several (paper)

  1. Architectures and methodologies for future deployment of multi-site Zettabyte-Exascale data handling platforms

    Science.gov (United States)

    Acín, V.; Bird, I.; Boccali, T.; Cancio, G.; Collier, I. P.; Corney, D.; Delaunay, B.; Delfino, M.; dell'Agnello, L.; Flix, J.; Fuhrmann, P.; Gasthuber, M.; Gülzow, V.; Heiss, A.; Lamanna, G.; Macchi, P.-E.; Maggi, M.; Matthews, B.; Neissner, C.; Nief, J.-Y.; Porto, M. C.; Sansum, A.; Schulz, M.; Shiers, J.

    2015-12-01

    Several scientific fields, including Astrophysics, Astroparticle Physics, Cosmology, Nuclear and Particle Physics, and Research with Photons, are estimating that by the 2020 decade they will require data handling systems with data volumes approaching the Zettabyte distributed amongst as many as 1018 individually addressable data objects (Zettabyte-Exascale systems). It may be convenient or necessary to deploy such systems using multiple physical sites. This paper describes the findings of a working group composed of experts from several

  2. A multi-site evaluation of innovative approaches to increase tuberculosis case notification: summary results.

    Science.gov (United States)

    Creswell, Jacob; Sahu, Suvanand; Blok, Lucie; Bakker, Mirjam I; Stevens, Robert; Ditiu, Lucica

    2014-01-01

    Globally, TB notifications have stagnated since 2007, and sputum smear positive notifications have been declining despite policies to improve case detection. We evaluate results of 28 interventions focused on improving TB case detection. We measured additional sputum smear positive cases treated, defined as the intervention area's increase in case notification during the project compared to the previous year. Projects were encouraged to select control areas and collect historical notification data. We used time series negative binomial regression for over-dispersed cross-sectional data accounting for fixed and random effects to test the individual projects' effects on TB notification while controlling for trend and control populations. Twenty-eight projects, 19 with control populations, completed at least four quarters of case finding activities, covering a population of 89.2 million. Among all projects sputum smear positive (SS+) TB notifications increased 24.9% and annualized notification rates increased from 69.1 to 86.2/100,000 (p = 0.0209) during interventions. Among the 19 projects with control populations, SS+TB case notifications increased 36.9% increase while in the control populations a 3.6% decrease was observed. Fourteen (74%) of the 19 projects' SS+TB notification rates in intervention areas increased from the baseline to intervention period when controlling for historical trends and notifications in control areas. Interventions were associated with large increases in TB notifications across many settings, using an array of interventions. Many people with TB are not reached using current approaches. Different methods and interventions tailored to local realities are urgently needed.

  3. A multi-site evaluation of innovative approaches to increase tuberculosis case notification: summary results.

    Directory of Open Access Journals (Sweden)

    Jacob Creswell

    Full Text Available BACKGROUND: Globally, TB notifications have stagnated since 2007, and sputum smear positive notifications have been declining despite policies to improve case detection. We evaluate results of 28 interventions focused on improving TB case detection. METHODS: We measured additional sputum smear positive cases treated, defined as the intervention area's increase in case notification during the project compared to the previous year. Projects were encouraged to select control areas and collect historical notification data. We used time series negative binomial regression for over-dispersed cross-sectional data accounting for fixed and random effects to test the individual projects' effects on TB notification while controlling for trend and control populations. RESULTS: Twenty-eight projects, 19 with control populations, completed at least four quarters of case finding activities, covering a population of 89.2 million. Among all projects sputum smear positive (SS+ TB notifications increased 24.9% and annualized notification rates increased from 69.1 to 86.2/100,000 (p = 0.0209 during interventions. Among the 19 projects with control populations, SS+TB case notifications increased 36.9% increase while in the control populations a 3.6% decrease was observed. Fourteen (74% of the 19 projects' SS+TB notification rates in intervention areas increased from the baseline to intervention period when controlling for historical trends and notifications in control areas. CONCLUSIONS: Interventions were associated with large increases in TB notifications across many settings, using an array of interventions. Many people with TB are not reached using current approaches. Different methods and interventions tailored to local realities are urgently needed.

  4. Internet use by patients with bipolar disorder: Results from an international multisite survey.

    Science.gov (United States)

    Bauer, Rita; Conell, Jörn; Glenn, Tasha; Alda, Martin; Ardau, Raffaella; Baune, Bernhard T; Berk, Michael; Bersudsky, Yuly; Bilderbeck, Amy; Bocchetta, Alberto; Bossini, Letizia; Castro, Angela M Paredes; Cheung, Eric Yw; Chillotti, Caterina; Choppin, Sabine; Del Zompo, Maria; Dias, Rodrigo; Dodd, Seetal; Duffy, Anne; Etain, Bruno; Fagiolini, Andrea; Hernandez, Miryam Fernández; Garnham, Julie; Geddes, John; Gildebro, Jonas; Gonzalez-Pinto, Ana; Goodwin, Guy M; Grof, Paul; Harima, Hirohiko; Hassel, Stefanie; Henry, Chantal; Hidalgo-Mazzei, Diego; Kapur, Vaisnvy; Kunigiri, Girish; Lafer, Beny; Larsen, Erik R; Lewitzka, Ute; Licht, Rasmus W; Lund, Anne Hvenegaard; Misiak, Blazej; Monteith, Scott; Munoz, Rodrigo; Nakanotani, Takako; Nielsen, René E; O'Donovan, Claire; Okamura, Yasushi; Osher, Yamima; Piotrowski, Patryk; Reif, Andreas; Ritter, Philipp; Rybakowski, Janusz K; Sagduyu, Kemal; Sawchuk, Brett; Schwartz, Elon; Scippa, Ângela M; Slaney, Claire; Sulaiman, Ahmad H; Suominen, Kirsi; Suwalska, Aleksandra; Tam, Peter; Tatebayashi, Yoshitaka; Tondo, Leonardo; Vieta, Eduard; Vinberg, Maj; Viswanath, Biju; Volkert, Julia; Zetin, Mark; Whybrow, Peter C; Bauer, Michael

    2016-08-30

    There is considerable international interest in online education of patients with bipolar disorder, yet little understanding of how patients use the Internet and other sources to seek information. 1171 patients with a diagnosis of bipolar disorder in 17 countries completed a paper-based, anonymous survey. 81% of the patients used the Internet, a percentage similar to the general public. Older age, less education, and challenges in country telecommunications infrastructure and demographics decreased the odds of using the Internet. About 78% of the Internet users looked online for information on bipolar disorder or 63% of the total sample. More years of education in relation to the country mean, and feeling very confident about managing life decreased the odds of seeking information on bipolar disorder online, while having attended support groups increased the odds. Patients who looked online for information on bipolar disorder consulted medical professionals plus a mean of 2.3 other information sources such as books, physician handouts, and others with bipolar disorder. Patients not using the Internet consulted medical professionals plus a mean of 1.6 other information sources. The percentage of patients with bipolar disorder who use the Internet is about the same as the general public. Other information sources remain important. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. A multisite randomized controlled trial on time to self-support among sickness absence beneficiaries

    DEFF Research Database (Denmark)

    Nielsen, Maj Britt D.; Vinsløv Hansen, Jørgen; Aust, Birgit

    2015-01-01

    BACKGROUND: In 2010, the Danish Government launched the Danish national return-to-work (RTW) programme to reduce sickness absence and promote labour market attainment. Multidisciplinary teams delivered the RTW programme, which comprised a coordinated, tailored and multidisciplinary effort (CTM......) for sickness absence beneficiaries at high risk for exclusion from the labour market. The aim of this article was to evaluate the effectiveness of the RTW programme on self-support. METHODS: Beneficiaries from three municipalities (denoted M1, M2 and M3) participated in a randomized controlled trial. We.......54-0.95). In M1, we found no difference between the two groups (HR = 0.99, 95% CI: 0.84-1.17). CONCLUSION: The effect of the CTM programme on return to self-support differed substantially across the three participating municipalities. Thus, generalizing the study results to other Danish municipalities...

  6. Ethical implications of home telecare for older people: a framework derived from a multisited participative study

    NARCIS (Netherlands)

    Mort, M.; Roberts, C.; Pols, J.; Domenech, M.; Moser, I.

    2013-01-01

    Context Telecare and telehealth developments have recently attracted much attention in research and service development contexts, where their evaluation has predominantly concerned effectiveness and efficiency. Their social and ethical implications, in contrast, have received little scrutiny.

  7. Ethical implications of home telecare for older people: a framework derived from a multisited participative study

    NARCIS (Netherlands)

    Mort, Maggie; Roberts, Celia; Pols, Jeannette; Domenech, Miquel; Moser, Ingunn

    2015-01-01

    Telecare and telehealth developments have recently attracted much attention in research and service development contexts, where their evaluation has predominantly concerned effectiveness and efficiency. Their social and ethical implications, in contrast, have received little scrutiny. To develop an

  8. Communication: Quantitative multi-site frequency maps for amide I vibrational spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Reppert, Mike [Department of Chemistry, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139 (United States); Department of Chemistry, University of Chicago, Chicago, Illinois 60637 (United States); Tokmakoff, Andrei, E-mail: tokmakoff@uchicago.edu [Department of Chemistry, University of Chicago, Chicago, Illinois 60637 (United States)

    2015-08-14

    An accurate method for predicting the amide I vibrational spectrum of a given protein structure has been sought for many years. Significant progress has been made recently by sampling structures from molecular dynamics simulations and mapping local electrostatic variables onto the frequencies of individual amide bonds. Agreement with experiment, however, has remained largely qualitative. Previously, we used dipeptide fragments and isotope-labeled constructs of the protein G mimic NuG2b as experimental standards for developing and testing amide I frequency maps. Here, we combine these datasets to test different frequency-map models and develop a novel method to produce an optimized four-site potential (4P) map based on the CHARMM27 force field. Together with a charge correction for glycine residues, the optimized map accurately describes both experimental datasets, with average frequency errors of 2–3 cm{sup −1}. This 4P map is shown to be convertible to a three-site field map which provides equivalent performance, highlighting the viability of both field- and potential-based maps for amide I spectral modeling. The use of multiple sampling points for local electrostatics is found to be essential for accurate map performance.

  9. Development of catalytic materials for the synthesis of valuable chemical products via multifunctional and multisite reactions

    International Nuclear Information System (INIS)

    Apesteguia, C.R; Padro, C.L; Diez, V.K; Di Cosimo, J.I; Trasarti, A.F; Marchi, A.J

    2004-01-01

    This work reports on the successful development of solid catalytic materials carried out by our working group to obtain fine high yield chemical products. Specifically, a report is made of i) the development of metal/acid bi-functional catalysts to obtain racemic menthol from citral in a one step liquid phase process. This menthol is one of the most important chemical flavouring compounds in industry; ii) The use of acid zeolites containing a balanced concentration of Bronsted and Lewis heavy acid sites, which allow the selective synthesis of o-hydroxy acetophenone from the gas phase acylation of phenol with acetic acid. The o-hydroxy acetophenone is an intermediate compound in the production of 4-hydroxy coumarin and warfarin that are used as anticoagulants drugs; iii) The use of mixed MgAl x O y oxides containing dual acid-basic sites (Mg 2- O 2- and Al 3+ -O 2- ) to synthesize isoforone from acetone in gas phase. The isoforone is an intermediate key in the synthesis of vitamin E (CW)

  10. The engineering of a scalable multi-site communications system utilizing quantum key distribution (QKD)

    Science.gov (United States)

    Tysowski, Piotr K.; Ling, Xinhua; Lütkenhaus, Norbert; Mosca, Michele

    2018-04-01

    Quantum key distribution (QKD) is a means of generating keys between a pair of computing hosts that is theoretically secure against cryptanalysis, even by a quantum computer. Although there is much active research into improving the QKD technology itself, there is still significant work to be done to apply engineering methodology and determine how it can be practically built to scale within an enterprise IT environment. Significant challenges exist in building a practical key management service (KMS) for use in a metropolitan network. QKD is generally a point-to-point technique only and is subject to steep performance constraints. The integration of QKD into enterprise-level computing has been researched, to enable quantum-safe communication. A novel method for constructing a KMS is presented that allows arbitrary computing hosts on one site to establish multiple secure communication sessions with the hosts of another site. A key exchange protocol is proposed where symmetric private keys are granted to hosts while satisfying the scalability needs of an enterprise population of users. The KMS operates within a layered architectural style that is able to interoperate with various underlying QKD implementations. Variable levels of security for the host population are enforced through a policy engine. A network layer provides key generation across a network of nodes connected by quantum links. Scheduling and routing functionality allows quantum key material to be relayed across trusted nodes. Optimizations are performed to match the real-time host demand for key material with the capacity afforded by the infrastructure. The result is a flexible and scalable architecture that is suitable for enterprise use and independent of any specific QKD technology.

  11. A multisite randomized trial of social norms marketing campaigns to reduce college student drinking.

    Science.gov (United States)

    DeJong, William; Schneider, Shari Kessel; Towvim, Laura Gomberg; Murphy, Melissa J; Doerr, Emily E; Simonsen, Neal R; Mason, Karen E; Scribner, Richard A

    2006-11-01

    An 18-site randomized trial was conducted to determine the effectiveness of social norms marketing (SNM) campaigns in reducing college student drinking. The SNM campaigns are intended to correct misperceptions of subjective drinking norms and thereby drive down alcohol consumption. Institutions of higher education were randomly assigned to treatment and control groups. At the treatment group institutions, SNM campaigns delivered school-specific, data-driven messages through a mix of campus media venues. Cross-sectional student surveys were conducted by mail at baseline (n = 2,771) and at posttest 3 years later (n = 2,939). Hierarchical linear modeling was applied to examine multiple drinking outcomes, taking intraclass correlation into account. Controlling for other predictors, having an SNM campaign was significantly associated with lower perceptions of student drinking levels and lower alcohol consumption, as measured by a composite drinking scale, recent maximum consumption, blood alcohol concentration for recent maximum consumption, drinks consumed when partying, and drinks consumed per week. A moderate mediating effect of normative perceptions on student drinking was demonstrated by an attenuation of the Experimental Group x Time interaction, ranging from 16.4% to 39.5% across measures. Additional models that took into account the intensity of SNM campaign activity at the treatment institutions suggested that there was a dose-response relationship. This study is the most rigorous evaluation of SNM campaigns conducted to date. Analysis revealed that students attending institutions that implemented an SNM campaign had a lower relative risk of alcohol consumption than students attending control group institutions.

  12. Metabolite variation in hybrid corn grain from a large-scale multisite study

    Directory of Open Access Journals (Sweden)

    Mingjie Chen

    2016-06-01

    Full Text Available Metabolite composition is strongly affected by genotype, environment, and interactions between genotype and environment, although the extent of variation caused by these factors may depend upon the type of metabolite. To characterize the complexity of genotype, environment, and their interaction in hybrid seeds, 50 genetically diverse non-genetically modified (GM maize hybrids were grown in six geographically diverse locations in North America. Polar metabolites from 553 harvested corn grain samples were isolated and analyzed by gas chromatography–mass spectrometry and 45 metabolites detected in all samples were used to generate a data matrix for statistical analysis. There was moderate variation among biological replicates and across genotypes and test sites. The genotype effects were detected by univariate and Hierarchical clustering analyses (HCA when environmental effects were excluded. Overall, environment exerted larger effects than genotype, and polar metabolite accumulation showed a geographic effect. We conclude that it is possible to increase seed polar metabolite content in hybrid corn by selection of appropriate inbred lines and growing regions.

  13. Crew resource management training in the intensive care unit. A multisite controlled before-after study.

    Science.gov (United States)

    Kemper, Peter F; de Bruijne, Martine; van Dyck, Cathy; So, Ralph L; Tangkau, Peter; Wagner, Cordula

    2016-08-01

    There is a growing awareness today that adverse events in the intensive care unit (ICU) are more often caused by problems related to non-technical skills than by a lack of technical, or clinical, expertise. Team training, such as crew resource management (CRM), aims to improve these non-technical skills. The present study evaluated the effectiveness of CRM in the ICU. Six ICUs participated in a paired controlled trial, with one pretest and two post-test measurements (after 3 and 12 months). Three ICUs received CRM training and were compared with a matched control unit. The 2-day classroom-based training was delivered to multidisciplinary groups (ie, ICU physicians, nurses, managers). All levels of Kirkpatrick's evaluation framework were assessed using a mixed method design, including questionnaires, observations and routinely administered patient outcome data. Level I-reaction: participants were very positive directly after the training. Level II-learning: attitudes towards behaviour aimed at optimising situational awareness were relatively high at baseline and remained stable. Level III-behaviour: self-reported behaviour aimed at optimising situational awareness improved in the intervention group. No changes were found in observed explicit professional oral communication. Level IV-organisation: patient outcomes were unaffected. Error management culture and job satisfaction improved in the intervention group. Patient safety culture improved in both control and intervention units. We can conclude that CRM, as delivered in the present study, does not change behaviour or patient outcomes by itself, yet changes how participants think about errors and risks. This indicates that CRM requires a combination with other initiatives in order to improve clinical outcomes. 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/

  14. Sequential multisite phospho-regulation of KNL1-BUB3 interfaces at mitotic kinetochores

    NARCIS (Netherlands)

    Vleugel, Mathijs; Omerzu, Manja; Groenewold, Vincent; Hadders, Michael A; Lens, Susanne M A; Kops, Geert J P L

    2015-01-01

    Regulated recruitment of the kinase-adaptor complex BUB1/BUB3 to kinetochores is crucial for correcting faulty chromosome-spindle attachments and for spindle assembly checkpoint (SAC) signaling. BUB1/BUB3 localizes to kinetochores by binding phosphorylated MELT motifs (MELpT) in the kinetochore

  15. Agro-Environmental Determinants of Avian Influenza Circulation: A Multisite Study in Thailand, Vietnam and Madagascar

    Science.gov (United States)

    Paul, Mathilde C.; Gilbert, Marius; Desvaux, Stéphanie; Rasamoelina Andriamanivo, Harena; Peyre, Marisa; Khong, Nguyen Viet; Thanapongtharm, Weerapong; Chevalier, Véronique

    2014-01-01

    Outbreaks of highly pathogenic avian influenza have occurred and have been studied in a variety of ecological systems. However, differences in the spatial resolution, geographical extent, units of analysis and risk factors examined in these studies prevent their quantitative comparison. This study aimed to develop a high-resolution, comparative study of a common set of agro-environmental determinants of avian influenza viruses (AIV) in domestic poultry in four different environments: (1) lower-Northern Thailand, where H5N1 circulated in 2004–2005, (2) the Red River Delta in Vietnam, where H5N1 is circulating widely, (3) the Vietnam highlands, where sporadic H5N1 outbreaks have occurred, and (4) the Lake Alaotra region in Madagascar, which features remarkable similarities with Asian agro-ecosystems and where low pathogenic avian influenza viruses have been found. We analyzed H5N1 outbreak data in Thailand in parallel with serological data collected on the H5 subtype in Vietnam and on low pathogenic AIV in Madagascar. Several agro-environmental covariates were examined: poultry densities, landscape dominated by rice cultivation, proximity to a water body or major road, and human population density. Relationships between covariates and AIV circulation were explored using spatial generalized linear models. We found that AIV prevalence was negatively associated with distance to the closest water body in the Red River Delta, Vietnam highlands and Madagascar. We also found a positive association between AIV and duck density in the Vietnam highlands and Thailand, and with rice landscapes in Thailand and Madagascar. Our findings confirm the important role of wetlands-rice-ducks ecosystems in the epidemiology of AI in diverse settings. Variables influencing circulation of the H5 subtype in Southeast Asia played a similar role for low pathogenic AIV in Madagascar, indicating that this area may be at risk if a highly virulent strain is introduced. PMID:25029441

  16. Environmental factors determining spontaneous recovery of industrially mined peat bogs: A multi-site analysis

    Czech Academy of Sciences Publication Activity Database

    Konvalinková, Petra; Prach, Karel

    2014-01-01

    Roč. 69, Aug 2014 (2014), s. 38-45 ISSN 0925-8574 R&D Projects: GA ČR(CZ) GAP505/11/0256 Institutional support: RVO:67985939 Keywords : peatland * restoration * succession Subject RIV: EH - Ecology, Behaviour Impact factor: 2.580, year: 2014

  17. Spontaneous vegetation succession in extracted peatlands: a multi-site study

    Czech Academy of Sciences Publication Activity Database

    Konvalinková, Petra; Prach, Karel

    2010-01-01

    Roč. 82, č. 4 (2010), s. 423-435 ISSN 0032-7786 R&D Projects: GA AV ČR IAA600050702 Institutional research plan: CEZ:AV0Z60050516 Keywords : succession * vascular plants * bryophytes Subject RIV: EF - Botanics Impact factor: 2.792, year: 2010

  18. Comparison of template registration methods for multi-site meta-analysis of brain morphometry

    Science.gov (United States)

    Faskowitz, Joshua; de Zubicaray, Greig I.; McMahon, Katie L.; Wright, Margaret J.; Thompson, Paul M.; Jahanshad, Neda

    2016-03-01

    Neuroimaging consortia such as ENIGMA can significantly improve power to discover factors that affect the human brain by pooling statistical inferences across cohorts to draw generalized conclusions from populations around the world. Voxelwise analyses such as tensor-based morphometry also allow an unbiased search for effects throughout the brain. Even so, such consortium-based analyses are limited by a lack of high-powered methods to harmonize voxelwise information across study populations and scanners. While the simplest approach may be to map all images to a single standard space, the benefits of cohort-specific templates have long been established. Here we studied methods to pool voxel-wise data across sites using templates customized for each cohort but providing a meaningful common space across all studies for voxelwise comparisons. As non-linear 3D MRI registrations represent mappings between images at millimeter resolution, we need to consider the reliability of these mappings. To evaluate these mappings, we calculated test-retest statistics on the volumetric maps of expansion and contraction. Further, we created study-specific brain templates for ten T1-weighted MRI datasets, and a common space from four study-specific templates. We evaluated the efficacy of using a two-step registration framework versus a single standard space. We found that the two-step framework more reliably mapped subjects to a common space.

  19. Patient Experience, Pain, and Quality of Life after Lower Limb Angioplasty: A Multisite Prospective Cohort Study

    Energy Technology Data Exchange (ETDEWEB)

    Culverwell, A. D., E-mail: adamculverwell@doctors.net.uk [Leeds General Infirmary (United Kingdom); Tapping, C. R.; Ettles, D. F. [Hull Royal Infirmary (United Kingdom); Kessel, D. [Leeds General Infirmary (United Kingdom)

    2012-08-15

    Purpose: To explore the experience of patients undergoing endovascular lower limb angioplasty and evaluate the improvements in quality of life and disease-related symptoms after the procedure. Methods: Patients completed a questionnaire before treatment and three questionnaires after the procedure (immediately after the procedure, and again 4 weeks and 3 months later). Anxiety, patient understanding, procedure-related pain, and disease-related pain were assessed by a visual analog score (VAS). Complications, analgesic requirements, and satisfaction were recorded. Changes to quality of life were assessed by the validated SF36 questionnaire. Results: A total of 88 patients (41%) responded. Overall, disease-related pain decreased over 3 months after the procedure. Smokers had more pain both before and after the procedure (P < 0.05). Explanation was considered better if provided by radiologist (P < 0.05). Sixty-nine percent of patients found the procedures less painful (mean VAS 2.5) than they had anticipated (VAS 5.5). Fifty percent of patients experienced adverse effects related to their puncture site, but this was highest among patients who had undergone the procedure before and smokers. The greatest quality-of-life improvements were in emotional and general health. Higher levels of disease-related pain were associated with worse general, emotional, and physical health (P < 0.05). Conclusion: Lower limb angioplasty provides symptomatic and quality-of-life improvements. Implementation of simple measures could improve patient satisfaction-for example, treatment should be explained by the radiologist in advance. Routine prescription of analgesics with particular attention to smokers and those undergoing repeat interventions is suggested.

  20. International multi-site survey on the use of online support groups in bipolar disorder.

    Science.gov (United States)

    Bauer, Rita; Conell, Jörn; Glenn, Tasha; Alda, Martin; Ardau, Raffaella; Baune, Bernhard T; Berk, Michael; Bersudsky, Yuly; Bilderbeck, Amy; Bocchetta, Alberto; Bossini, Letizia; Castro, Angela M Paredes; Cheung, Eric Y W; Chillotti, Caterina; Choppin, Sabine; Zompo, Maria Del; Dias, Rodrigo; Dodd, Seetal; Duffy, Anne; Etain, Bruno; Fagiolini, Andrea; Hernandez, Miryam Fernández; Garnham, Julie; Geddes, John; Gildebro, Jonas; Gonzalez-Pinto, Ana; Goodwin, Guy M; Grof, Paul; Harima, Hirohiko; Hassel, Stefanie; Henry, Chantal; Hidalgo-Mazzei, Diego; Kapur, Vaisnvy; Kunigiri, Girish; Lafer, Beny; Larsen, Erik R; Lewitzka, Ute; Licht, Rasmus W; Hvenegaard Lund, Anne; Misiak, Blazej; Piotrowski, Patryk; Monteith, Scott; Munoz, Rodrigo; Nakanotani, Takako; Nielsen, René E; O'donovan, Claire; Okamura, Yasushi; Osher, Yamima; Reif, Andreas; Ritter, Philipp; Rybakowski, Janusz K; Sagduyu, Kemal; Sawchuk, Brett; Schwartz, Elon; Scippa, Ângela M; Slaney, Claire; Sulaiman, Ahmad H; Suominen, Kirsi; Suwalska, Aleksandra; Tam, Peter; Tatebayashi, Yoshitaka; Tondo, Leonardo; Vieta, Eduard; Vinberg, Maj; Viswanath, Biju; Volkert, Julia; Zetin, Mark; Whybrow, Peter C; Bauer, Michael

    2017-08-01

    Peer support is an established component of recovery from bipolar disorder, and online support groups may offer opportunities to expand the use of peer support at the patient's convenience. Prior research in bipolar disorder has reported value from online support groups. To understand the use of online support groups by patients with bipolar disorder as part of a larger project about information seeking. The results are based on a one-time, paper-based anonymous survey about information seeking by patients with bipolar disorder, which was translated into 12 languages. The survey was completed between March 2014 and January 2016 and included questions on the use of online support groups. All patients were diagnosed by a psychiatrist. Analysis included descriptive statistics and general estimating equations to account for correlated data. The survey was completed by 1222 patients in 17 countries. The patients used the Internet at a percentage similar to the general public. Of the Internet users who looked online for information about bipolar disorder, only 21.0% read or participated in support groups, chats, or forums for bipolar disorder (12.8% of the total sample). Given the benefits reported in prior research, clarification of the role of online support groups in bipolar disorder is needed. With only a minority of patients using online support groups, there are analytical challenges for future studies.

  1. Using Protein Dimers to Maximize the Protein Hybridization Efficiency with Multisite DNA Origami Scaffolds

    Science.gov (United States)

    Verma, Vikash; Mallik, Leena; Hariadi, Rizal F.; Sivaramakrishnan, Sivaraj; Skiniotis, Georgios; Joglekar, Ajit P.

    2015-01-01

    DNA origami provides a versatile platform for conducting ‘architecture-function’ analysis to determine how the nanoscale organization of multiple copies of a protein component within a multi-protein machine affects its overall function. Such analysis requires that the copy number of protein molecules bound to the origami scaffold exactly matches the desired number, and that it is uniform over an entire scaffold population. This requirement is challenging to satisfy for origami scaffolds with many protein hybridization sites, because it requires the successful completion of multiple, independent hybridization reactions. Here, we show that a cleavable dimerization domain on the hybridizing protein can be used to multiplex hybridization reactions on an origami scaffold. This strategy yields nearly 100% hybridization efficiency on a 6-site scaffold even when using low protein concentration and short incubation time. It can also be developed further to enable reliable patterning of a large number of molecules on DNA origami for architecture-function analysis. PMID:26348722

  2. A prospective, multisite, international validation of the Complex Regional Pain Syndrome Severity Score.

    Science.gov (United States)

    Harden, R Norman; Maihofner, Christian; Abousaad, Elias; Vatine, Jean-Jacques; Kirsling, Amy; Perez, Roberto S G M; Kuroda, Maxine; Brunner, Florian; Stanton-Hicks, Michael; Marinus, Johan; van Hilten, Jacobus J; Mackey, Sean; Birklein, Frank; Schlereth, Tanja; Mailis-Gagnon, Angela; Graciosa, Joe; Connoly, Sara B; Dayanim, David; Massey, Michael; Frank, Hadas; Livshitz, Anatoly; Bruehl, Stephen

    2017-08-01

    Clinical diagnosis of complex regional pain syndrome (CRPS) is a dichotomous (yes/no) categorization, a format necessary for clinical decision making. Such dichotomous diagnostic categories do not convey an individual's subtle gradations in the severity of the condition over time and have poor statistical power when used as an outcome measure in research. This prospective, international, multicenter study slightly modified and further evaluated the validity of the CRPS Severity Score (CSS), a continuous index of CRPS severity. Using a prospective design, medical evaluations were conducted in 156 patients with CRPS to compare changes over time in CSS scores between patients initiating a new treatment program and patients on stable treatment regimens. New vs stable categorizations were supported by greater changes in pain and function in the former. Results indicated that CSS values in the stable CRPS treatment group exhibited much less change over time relative to the new treatment group, with intraclass correlations nearly twice as large in the former. A calculated smallest real difference value revealed that a change in the CSS of ≥4.9 scale points would indicate real differences in CRPS symptomatology (with 95% confidence). Across groups, larger changes in CRPS features on the CSS over time were associated in the expected direction with greater changes in pain intensity, fatigue, social functioning, ability to engage in physical roles, and general well-being. The overall pattern of findings further supports the validity of the CSS as a measure of CRPS severity and suggests it may prove useful in clinical monitoring and outcomes research.

  3. Patient Experience, Pain, and Quality of Life after Lower Limb Angioplasty: A Multisite Prospective Cohort Study

    International Nuclear Information System (INIS)

    Culverwell, A. D.; Tapping, C. R.; Ettles, D. F.; Kessel, D.

    2012-01-01

    Purpose: To explore the experience of patients undergoing endovascular lower limb angioplasty and evaluate the improvements in quality of life and disease-related symptoms after the procedure. Methods: Patients completed a questionnaire before treatment and three questionnaires after the procedure (immediately after the procedure, and again 4 weeks and 3 months later). Anxiety, patient understanding, procedure-related pain, and disease-related pain were assessed by a visual analog score (VAS). Complications, analgesic requirements, and satisfaction were recorded. Changes to quality of life were assessed by the validated SF36 questionnaire. Results: A total of 88 patients (41%) responded. Overall, disease-related pain decreased over 3 months after the procedure. Smokers had more pain both before and after the procedure (P < 0.05). Explanation was considered better if provided by radiologist (P < 0.05). Sixty-nine percent of patients found the procedures less painful (mean VAS 2.5) than they had anticipated (VAS 5.5). Fifty percent of patients experienced adverse effects related to their puncture site, but this was highest among patients who had undergone the procedure before and smokers. The greatest quality-of-life improvements were in emotional and general health. Higher levels of disease-related pain were associated with worse general, emotional, and physical health (P < 0.05). Conclusion: Lower limb angioplasty provides symptomatic and quality-of-life improvements. Implementation of simple measures could improve patient satisfaction—for example, treatment should be explained by the radiologist in advance. Routine prescription of analgesics with particular attention to smokers and those undergoing repeat interventions is suggested.

  4. Utility in a Fallible Tool: A Multi-Site Case Study of Automated Writing Evaluation

    Science.gov (United States)

    Grimes, Douglas; Warschauer, Mark

    2010-01-01

    Automated writing evaluation (AWE) software uses artificial intelligence (AI) to score student essays and support revision. We studied how an AWE program called MY Access![R] was used in eight middle schools in Southern California over a three-year period. Although many teachers and students considered automated scoring unreliable, and teachers'…

  5. Resolved multisite OH-attack on aqueous aniline studied by pulse radiolysis

    International Nuclear Information System (INIS)

    Solar, S.; Solar, W.; Getoff, N.

    1986-01-01

    The individual formation and decay kinetics as well as the absorption characteristics of the simultaneously formed primary species by OH attack on aniline in aqueous solution (pH 8-9.6), saturated with N 2 O, have been determined by pulse radiolysis combined with a computer optimization procedure. Further the rate constant of e - sub(aq) with aniline was determined to (3.0+-0.1) x l0 7 dm 3 mol -1 cm -1 . Qualitative analysis of final products were also performed. (author)

  6. Rotavirus Infection and Disease in a Multisite Birth Cohort: Results From the MAL-ED Study.

    Science.gov (United States)

    Mohan, Venkata Raghava; Karthikeyan, Ramanujam; Babji, Sudhir; McGrath, Monica; Shrestha, Sanjaya; Shrestha, Jasmin; Mdumah, Estomih; Amour, Caroline; Samie, Amidou; Nyathi, Emanuel; Haque, Rashidul; Qureshi, Shahida; Yori, Pablo Peñataro; Lima, Aldo A M; Bodhidatta, Ladaporn; Svensen, Erling; Bessong, Pascal; Ahmed, Tahmeed; Seidman, Jessica C; Zaidi, Anita K M; Kosek, Margaret N; Guerrant, Richard L; Gratz, Jean; Platts-Mills, James A; Lang, Dennis R; Gottlieb, Michael; Houpt, Eric R; Kang, Gagandeep

    2017-08-01

    In a multicountry birth cohort study, we describe rotavirus infection in the first 2 years of life in sites with and without rotavirus vaccination programs. Children were recruited by 17 days of age and followed to 24 months with collection of monthly surveillance and diarrheal stools. Data on sociodemographics, feeding, and illness were collected at defined intervals. Stools were tested for rotavirus and sera for antirotavirus immunoglobulins by enzyme immunoassays. A total of 1737 children contributed 22646 surveillance and 7440 diarrheal specimens. Overall, rotavirus was detected in 5.5% (408/7440) of diarrheal stools, and 344 (19.8%) children ever had rotavirus gastroenteritis. Household overcrowding and a high pathogen load were consistent risk factors for infection and disease. Three prior infections conferred 74% (P < .001) protection against subsequent infection in sites not using vaccine. In Peru, incidence of rotavirus disease was relatively higher during the second year of life despite high vaccination coverage. Rotavirus infection and disease were common, but with significant heterogeneity by site. Protection by vaccination may not be sustained in the second year of life in settings with high burdens of transmission and poor response to oral vaccines. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  7. Psychological symptoms among 2032 youth living with HIV: a multisite study.

    Science.gov (United States)

    Brown, Larry K; Whiteley, Laura; Harper, Gary W; Nichols, Sharon; Nieves, Amethys

    2015-04-01

    This study determined the prevalence and patterns of psychological symptoms in adolescents and young adults living with HIV (YLWH) in medical care and relationships between psychological symptoms, route and duration of infection, and antiretroviral treatment (ART). A clinic-based sample of 2032 YLWH (mean age 20.3 years), recruited from 20 adolescent medicine HIV clinics, completed a cross-sectional survey of health behaviors and psychological symptoms using the Brief Symptom Inventory (BSI). Overall, 17.5% of youth reported psychological symptoms greater than the normative threshold on the Global Severity Index. A wide variety of symptoms were reported. The prevalence of clinical symptoms was significantly greater in youth with behaviorally acquired HIV compared to those with perinatally acquired infection (20.6% vs. 10.8%, OR=2.06 in Multiple Logistic Regression (MLR)), and in those not taking ART that had been prescribed (29. 2% vs. 18.8%, OR=1.68 in MLR). Knowing one's HIV status for more than one year and disclosure of HIV status were not associated with fewer symptoms. A large proportion of YLWH have psychological symptoms and the prevalence is greatest among those with behaviorally acquired infection. The high rate of psychological symptoms for youth not taking ART that is prescribed is a cause for concern. Symptoms do not appear to be a transient reaction to diagnosis of HIV.

  8. Midwifery practice and maternity services: A multisite descriptive study in Latin America and the Caribbean.

    Science.gov (United States)

    Binfa, Lorena; Pantoja, Loreto; Ortiz, Jovita; Cavada, Gabriel; Schindler, Peter; Burgos, Rosa Ypania; Maganha E Melo, Célia Regina; da Silva, Lúcia Cristina Florentino Pereira; Lima, Marlise de Oliveira Pimentel; Hernández, Laura Valli; Schlenker Rm, Rosana; Sánchez, Verdún; Rojas, Mirian Solis; Huamán, Betty Cruz; Chauca, Maria Luisa Torres; Cillo, Alicia; Lofeudo, Susana; Zapiola, Sandra; Weeks, Fiona; Foster, Jennifer

    2016-09-01

    over the past three decades there has been a social movement in Latin American countries (LAC) to support humanised, physiologic birth. Rates of caesarean section overall in Latin America are approximately 35%, increasing up to 85% in some cases. There are many factors related to poor outcomes with regard to maternal and newborn/infant health in LAC countries. Maternal and perinatal outcome data within and between countries is scarce and inaccurate. The aims of this study were to: i) describe selected obstetric and neonatal outcomes of women who received midwifery care, ii) identify the level of maternal well-being after experiencing midwifery care in 6 Latin America countries. this was a cross sectional and descriptive study, conducted in selected maternity units in Argentina, Brazil, Chile, the Dominican Republic, Peru, and Uruguay. Quantitative methods were used to measure midwifery processes of care and maternal perceptions of well-being in labour and childbirth through a validated survey of maternal well-being and an adapted version of the American College of Nurse-Midwives (ACNM) standardized antepartum and intrapartum data set. Maternity units from 6 Latin American countries. the final sample was a convenience sample, and the total participants for all sites in the six countries was 3009 low risk women. for the countries reporting, overall, 82% of these low risk women had spontaneous vaginal deliveries. The rate of caesarean section was 16%; the Dominican Republic had the highest rate of Caesarean sections (30%) and Peru had the lowest rate (4%). The use of oxytocin in labour was widely variable, although overall there was a high proportion of women whose labour was augmented or induced. Ambulation was common, with the lowest proportion (48%) of women ambulating in labour in Chile, Uruguay (50%), Peru (65%), Brazil (85%). The presence of continuous support was highest in Uruguay (93%), Chile (75%) and Argentina (55%), and Peru had the lowest (22%). Episiotomies are still prevalent in all countries, the lowest rate was reported in the Dominican Republic (22%), and the highest rates were 52 and 53% (Chile and Peru, respectively). The Optimal Maternal well-being score had a prevalence of 43.5%, adequate score was 30.8%; 25% of the total sample of women rated their well-being during labour and childbirth as poor. despite evidence-based guidelines and recommendations, birth is not managed accordingly in most cases. Women feel that care is adequate, although some women report mistreatment. More research is needed to understand why such high levels of intervention exist and to test the implementation of evidence-based practices in local settings. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. ADC multi-site test based on a pre-test with digital input stimulus

    NARCIS (Netherlands)

    Sheng, Xiaoqin; Metra, C.; Kerkhoff, Hans G.; Zjajo, Amir; Gronthoud, Guido

    2012-01-01

    This paper describes two novel algorithms based on the time-modulo reconstruction method intended for detection of the parametric faults in analogue-to-digital converters (ADC). In both algorithms, a pulse signal, in its slightly adapted form to allow sufficient time for converter settling, is taken

  10. Algorithms for ADC multi-site test with digital input stimulus

    NARCIS (Netherlands)

    Sheng, Xiaoqin; Kerkhoff, Hans G.; Zjajo, Amir; Gronthoud, Guido

    2009-01-01

    This paper reports two novel algorithms based on time-modulo reconstruction method intended for detection of the parametric faults in analogue-to-digital converters (ADC). In both algorithms, a pulse signal, in its slightly adapted form to allow sufficient time for converter settling, is taken as

  11. Peer Influence on Ethnic-Racial Identity Development: A Multi-Site Investigation.

    Science.gov (United States)

    Santos, Carlos E; Kornienko, Olga; Rivas-Drake, Deborah

    2017-05-01

    The peer context features prominently in theory, and increasingly in empirical research, about ethnic-racial identity (ERI) development, but no studies have assessed peer influence on ERI using methods designed to properly assess peer influence. We examined peer influence on ERI centrality, private, and public regard using longitudinal social network analysis. Data were drawn from two sites: a predominantly Latina/o Southwestern (SW) school (N = 1034; Mage = 12.10) and a diverse Midwestern (MW) school (N = 513; Mage = 11.99). Findings showed that peers influenced each other's public regard over time at both sites. However, peer influence on centrality was evident in the SW site, whereas peer influence on private regard was evident in the MW site. Importantly, peer influence was evident after controlling for selection effects. Our integration of developmental, contextual, and social network perspectives offers a fruitful approach to explicate how ERI content may shift in early adolescence as a function of peer influence. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.

  12. Multi-site evaluation of the JULES land surface model using global and local data

    Directory of Open Access Journals (Sweden)

    D. Slevin

    2015-02-01

    Full Text Available This study evaluates the ability of the JULES land surface model (LSM to simulate photosynthesis using local and global data sets at 12 FLUXNET sites. Model parameters include site-specific (local values for each flux tower site and the default parameters used in the Hadley Centre Global Environmental Model (HadGEM climate model. Firstly, gross primary productivity (GPP estimates from driving JULES with data derived from local site measurements were compared to observations from the FLUXNET network. When using local data, the model is biased with total annual GPP underestimated by 16% across all sites compared to observations. Secondly, GPP estimates from driving JULES with data derived from global parameter and atmospheric reanalysis (on scales of 100 km or so were compared to FLUXNET observations. It was found that model performance decreases further, with total annual GPP underestimated by 30% across all sites compared to observations. When JULES was driven using local parameters and global meteorological data, it was shown that global data could be used in place of FLUXNET data with a 7% reduction in total annual simulated GPP. Thirdly, the global meteorological data sets, WFDEI and PRINCETON, were compared to local data to find that the WFDEI data set more closely matches the local meteorological measurements (FLUXNET. Finally, the JULES phenology model was tested by comparing results from simulations using the default phenology model to those forced with the remote sensing product MODIS leaf area index (LAI. Forcing the model with daily satellite LAI results in only small improvements in predicted GPP at a small number of sites, compared to using the default phenology model.

  13. Mto2 multisite phosphorylation inactivates non-spindle microtubule nucleation complexes during mitosis

    Science.gov (United States)

    Borek, Weronika E.; Groocock, Lynda M.; Samejima, Itaru; Zou, Juan; de Lima Alves, Flavia; Rappsilber, Juri; Sawin, Kenneth E.

    2015-01-01

    Microtubule nucleation is highly regulated during the eukaryotic cell cycle, but the underlying molecular mechanisms are largely unknown. During mitosis in fission yeast Schizosaccharomyces pombe, cytoplasmic microtubule nucleation ceases simultaneously with intranuclear mitotic spindle assembly. Cytoplasmic nucleation depends on the Mto1/2 complex, which binds and activates the γ-tubulin complex and also recruits the γ-tubulin complex to both centrosomal (spindle pole body) and non-centrosomal sites. Here we show that the Mto1/2 complex disassembles during mitosis, coincident with hyperphosphorylation of Mto2 protein. By mapping and mutating multiple Mto2 phosphorylation sites, we generate mto2-phosphomutant strains with enhanced Mto1/2 complex stability, interaction with the γ-tubulin complex and microtubule nucleation activity. A mutant with 24 phosphorylation sites mutated to alanine, mto2[24A], retains interphase-like behaviour even in mitotic cells. This provides a molecular-level understanding of how phosphorylation ‘switches off' microtubule nucleation complexes during the cell cycle and, more broadly, illuminates mechanisms regulating non-centrosomal microtubule nucleation. PMID:26243668

  14. The impact of a unique knowledge translation programme implemented in a large multisite paediatric hospital.

    Science.gov (United States)

    Christensen, Catie; Wessells, David; Byars, Michelle; Marrie, James; Coffman, Shaun; Gates, Erin; Selhorst, Mitch

    2017-04-01

    Physical therapists (PTs) display positive attitudes toward evidence-based practice (EBP), and implementing it can improve patient outcomes and reduce costs. However, barriers can lead to inconsistent use of EBP. The objectives of this manuscript are to (i) describe the initiation and revisions to a knowledge translation (KT) programme, (ii) assess staff participation in KT, and (iii) evaluate availability, internal use and external dissemination of evidence-based recommendations and research. The KT programme was implemented in a large paediatric hospital employing 66 PTs who provide services in the inpatient, outpatient developmental and sports and orthopaedics settings in 15 locations. The KT programme was initiated 9 years ago but underwent improvements over the past 3 years. Five key revisions included the subdivision of the EBP and Research Coordinator positions by area of practice, increasing the structure of the KT programme, implementing strategies to encourage use of local recommendations, obtaining leadership support to emphasize KT and providing staff education. With the revisions, staff participation in local recommendation development increased from 16.3-68.2%. Research involvement increased from 4.1-50%. The number of local recommendations increased from 1 to 9, and an overall compliance rate of 79% was achieved for the recommendations presented in an algorithm format. External dissemination increased from 1 to 44 for presentations and 0 to 7 for publications. Revisions to a KT programme improved PT engagement in KT activities, increased the availability of local recommendations, encouraged use of EBP and increased external dissemination of information. © 2016 John Wiley & Sons, Ltd.

  15. Meeting the Challenge: The National Cancer Institute's Central Institutional Review Board for Multi-Site Research.

    Science.gov (United States)

    Massett, Holly A; Hampp, Sharon L; Goldberg, Jacquelyn L; Mooney, Margaret; Parreco, Linda K; Minasian, Lori; Montello, Mike; Mishkin, Grace E; Davis, Catasha; Abrams, Jeffrey S

    2018-03-10

    The National Institutes of Health (NIH) issued a new policy that requires a single institutional review board (IRB) of record be used for all protocols funded by the NIH that are carried out at more than one site in the United States, effective January 2018. This policy affects several hundred clinical trials opened annually across the NIH. Limited data exist to compare the use of a single IRB to that of multiple local IRBs, so some institutions are resistant to or distrustful of single IRBs. Since 2001, the National Cancer Institute (NCI) has funded a central IRB (CIRB) that provides human patient reviews for its extensive national cancer clinical trials program. This paper presents data to show the adoption, efficiencies gained, and satisfaction of the CIRB among NCI trial networks and reviews key lessons gleaned from 16 years of experience that may be informative for others charged with implementation of the new NIH single-IRB policy.

  16. A DOE multi-site approach to safeguards integration with facility operations

    International Nuclear Information System (INIS)

    Ostenak, C.A.

    1987-01-01

    The Accountability Technology Exchange (ATEX) Working Group was established in October 1986 by the US Department of Energy (DOE) to help identify nuclear materials accountability measurement needs within the DOE plutonium community and recommend potential improvements. ATEX Working Group membership represents nuclear materials production, safeguards, nondestructive assay (NDA), and analytical chemistry at a multitude of DOE plutonium sites. Currently, the ATEX Working Group has identified twenty NDA accountability measurement needs that fall into five major classes: NDA standards representing various nuclear materials and matrix compositions; NDA for impure nuclear materials compounds, residues, and wastes; NDA for product-grade nuclear materials; NDA for nuclear materials process holdup and in-process inventory; and NDA for nuclear materials item control and verification. Specific needs within these classes have been evaluated and ranked for individual sites and for the total DOE plutonium community

  17. Escitalopram in the Treatment of Adolescent Depression: A Randomized Placebo-Controlled Multisite Trial

    Science.gov (United States)

    Emslie, Graham J.; Ventura, Daniel; Korotzer, Andrew; Tourkodimitris, Stavros

    2009-01-01

    A randomized, double-blind, placebo-controlled trial that involves 312 male and female patients aged 12-17 reveal the effectiveness of escitalopram in the treatment of depressed adolescents. Eighty-three percent of the participants or 259 participants completed the 8 weeks therapy period.

  18. Project STYLE: a multisite RCT for HIV prevention among youths in mental health treatment.

    Science.gov (United States)

    Brown, Larry K; Hadley, Wendy; Donenberg, Geri R; DiClemente, Ralph J; Lescano, Celia; Lang, Delia M; Crosby, Richard; Barker, David; Oster, Danielle

    2014-03-01

    The study examined the efficacy of family-based and adolescent-only HIV prevention programs in decreasing HIV risk and improving parental monitoring and sexual communication among youths in mental health treatment. A randomized controlled trial (RCT) with 721 adolescents (ages 13-18 years) and their caregivers from mental health settings in three U.S. cities were randomly assigned to one of three theory-based, structured group interventions: family-based HIV prevention, adolescent-only HIV prevention, and adolescent-only health promotion. Interventions were delivered during an all-day workshop. Assessments were completed at baseline and three months postintervention. Compared with those in the health intervention, adolescents in the HIV prevention interventions reported fewer unsafe sex acts (adjusted rate ratio=.49, p=.01), greater condom use (adjusted relative change=59%, p=.01), and greater likelihood of avoiding sex (adjusted odds ratio=1.44, p=.05). They also showed improved HIV knowledge (pprevention interventions reduced sexual risk behavior over three months in a large, diverse sample of youths in mental health treatment and that the family-based intervention improved parental monitoring and communication with teens about sex. These interventions show promise.

  19. Online information seeking by patients with bipolar disorder: results from an international multisite survey.

    Science.gov (United States)