WorldWideScience

Sample records for system petis evidence

  1. Transfer function analysis of positron-emitting tracer imaging system (PETIS) data

    International Nuclear Information System (INIS)

    Keutgen, N.; Matsuhashi, S.; Mizuniwa, C.; Ito, T.; Fujimura, T.; Ishioka, N.S.; Watanabe, S.; Sekine, T.; Uchida, H.; Hashimoto, S.

    2002-01-01

    Quantitative analysis of the two-dimensional image data obtained with the positron-emitting tracer imaging system (PETIS) for plant physiology has been carried out using a transfer function analysis method. While a cut leaf base of Chinese chive (Allium tuberosum Rottler) or a cut stem of soybean (Glycine max L.) was immersed in an aqueous solution containing the [ 18 F] F - ion or [ 13 N]NO 3 - ion, tracer images of the leaf of Chinese chive and the trifoliate of soybean were recorded with PETIS. From the time sequence of images, the tracer transfer function was estimated from which the speed of tracer transport and the fraction moved between specified image positions were deduced

  2. A preliminary study of an Al effect on 15O-labeled water uptake in a soybean plant by PETIS (Positron Emitting Tracer Imaging System)

    International Nuclear Information System (INIS)

    Nakanishi, Tomoko M.; Yokota, Harumi; Furukawa, Jun

    2002-01-01

    Analysis of biological activity in intact cells or tissues is essential to understand many life processes. Techniques for these in vivo measurements have not been well developed. We present here a nondestructive method to image real-time water movement in living plants by PETIS (Positron Emitting Tracer Imaging System), using a positron emitting nuclide, 15 O (half-life: 2 min.). 15 O-labeled water was produced by a cyclotron through 14 N(d, n) 15 O reaction and the gamma-rays emitted from the sample was measured by a pair of BGO counters. Then the labeled water was supplied to the plant and the radioactivity from the plant was accumulated every 15 sec until 20 min. The water uptake speed in the plant was very slow and most of the labeled water was found to be transferred only to the lowest internode, between a root and the first leaves, even after 20 min. There was not any change of water uptake manner when Al (400 μ M) was supplied to the solution after 8 min of the measurement. However, when the root was cut off and the water was supplied from the bottom part of the stem, inhibition of water uptake was observed by addition of Al. Aluminum accumulation in the stem was doubled when the Al solution was supplied from the bottom part of the stem, compared to that supplied form the root, suggesting inhibition activity of Al for water uptake. (author)

  3. Light activates H{sub 2.}{sup 15}0 flow in rice: Detailed monitoring using a positron-emitting tracer imaging system (PETIS)

    Energy Technology Data Exchange (ETDEWEB)

    Kiyomiya, S.; Nakanishi, H.; Mori, S. [The Univ. of Tokyo, Dept. of Applied Biological Chemistry, Tokyo (Japan); Uchida, H.; Nishiyama, S.; Tsukada, H.; Tsuji, A. [Central Res. Lab. Hamamatsu Photonics KK, Shizuoka (Japan); Ishioka, N.S.; Watanabe, S.; Osa, A.; Mizuniwa, C.; Ito, T.; Matsuhashi, S.; Hashimoto, S.; Sekine, T. [Japan Atomic Energy Res. Inst., Takasaki Radation Chemistry Res. Establishment, Gunma (Japan)

    2001-07-01

    Water (H{sub 2}{sup 15}O) translocation from the roots to the top of rice plants (Oryza saliva L. cv. Nipponbare) was visualized over time by a positron-emitting tracer imaging system (PETIS). H{sub 2}{sup 15}O flow was activated 8 min after plants were exposed to bright light (1500 {mu}mol m{sup -2} s{sup -1}). When the light was subsequently removed, the flow gradually slowed and completely stopped after 12 min. In plants exposed to low light (500 {mu}mol m{sup -2} s{sup -1}), H{sub 2}{sup 15}O flow was activated more slowly, and a higher translocation rate of H{sub 2}{sup 15}O was observed in the same low light at the end of the next dark period. NaCl (80 mM) and methylmercury (1 mM) directly suppressed absorption of H{sub 2}{sup 15}O by the roots, while methionine sulfoximine (1 mM), abscisic acid (10 {mu}M) and carbonyl cyanide m-chlorophenylhydrazone (10 mM) were transported to the leaves and enhanced stomatal closure, reducing H{sub 2}{sup 15}O translocation. (au)

  4. Out of the Autoclave Fabrication of LaRC[TradeMark] PETI-9 Polyimide Laminates

    Science.gov (United States)

    Cano, Robert J.; Jensen, Brian J.

    2013-01-01

    The NASA Langley Research Center developed polyimide system, LaRC PETI-9, has successfully been processed into composites by high temperature vacuum assisted resin transfer molding (HT-VARTM). To extend the application of this high use temperature material to other out-of-autoclave (OOA) processing techniques, the fabrication of PETI- 9 laminates was evaluated using only a vacuum bag and oven cure. A LaRC PETI-9 polyimide solution in NMP was prepared and successfully utilized to fabricate unidirectional IM7 carbon fiber prepreg that was subsequently processed into composites with a vacuum bag and oven cure OOA process. Composite panels of good quality were successfully fabricated and mechanically tested. Processing characteristics, composite panel quality and mechanical properties are presented in this work. The resultant properties are compared to previously developed LaRC material systems processed by both autoclave and OOA techniques including the well characterized, autoclave processed LaRC PETI-5.

  5. Usulan Perbaikan Sistem Handling Cargodoring Di Pelabuhan Peti Kemas Untuk Meminimalkan Biaya Distribusi Logistik

    Directory of Open Access Journals (Sweden)

    Dwi Indah Maryanie

    2012-08-01

    Full Text Available Sistem handling pelabuhan peti kemas merupakan masalah krusial karena berkaitan dengan waktu, biaya, dan kepuasan konsumen. Sistem handling yang baik terlihat dari waktu melakukan bongkar muat. Apabila waktu yang dihabiskan relatif singkat, maka sistem handling tergolong baik. Tiga tahapan umum dalam sistem handling, yaitu (1 Stevedoring, (2 Cargodoring dan (3 Receiving. Dari keseluruhan tahapan tersebut, proses cargodoring merupakan proses yang paling banyak menghabiskan waktu bongkar muat, sehingga biaya logistik di Indonesia menjadi tinggi. Fokus penelitian untuk memberi solusi sistem handling cargodoring yang baik pada pelabuhan di Indonesia. Selain itu, akan dibahas pula pelabuhan logistik lain yakni Pelabuhan Fremantle, Australia sebagai pembanding agar diperoleh gambaran mengenai sistem handling cargodoring yang digunakan di sana. Metode benchmarking digunakan dalam pengambilan solusi perbaikan, serta kajian Container Management, Reverse Logistic, dan Layout Study untuk membantu menemukan solusi perbaikan. Hasil penelitian diketahui bahwa pelabuhan di Indonesia masih menggunakan head truck dalam proses cargodoring, sedangkan di Fremantle telah menggunakan kereta api, akibatnya waktu bongkar menjadi terlalu lama. Hasil penelitian ini adalah berupa gagasan perbaikan sistem handling cargodoring yakni dengan menggunakan kereta api seperti di Fremantle, tetapi dikembangkan menggunakan kereta semi otomatis tanpa kepala, yang memanfaatkan tenaga air laut dan sistem conveyor sebagai alat bantu pendorong peti kemas. Kata kunci: biaya distribusi logistik, cargodoring, peningkatan kinerja, pelabuhan peti kemas     Handling system at the container port is a crucial issue because it is related to time, logistics cost, and customer satisfaction. A good handling system can be seen from its time for loading and unloading. If the process takes short time, then this handling system is quite good. There are three general phases in the handling system

  6. PETI-298 Prepared by Microwave Synthesis: Neat Resin and Composite Properties

    Science.gov (United States)

    Smith, Joseph G.; Connell, John W.; Li, Chao-Jun; Wu, Wei; Criss, Jim M., Jr.

    2004-01-01

    PETI-298 is a high temperature/high performance matrix resin that is processable into composites by resin transfer molding (RTM), resin infusion and vacuum assisted RTM techniques. It is typically synthesized in a polar aprotic solvent from the reaction of an aromatic anhydride and a combination of diamines and endcapped with phenylethynylphthalic anhydride. Microwave synthesis of PETI-298 was investigated as a means to eliminate solvent and decrease reaction time. The monomers were manually mixed and placed in a microwave oven for various times to determine optimum reaction conditions. The synthetic process was subsequently scaled-up to 330g. Three batches were synthesized and combined to give 1 kg of material that was characterized for thermal and rheological properties and compared to PETI-298 prepared by the classic solution based synthetic method. The microwave synthesized PETI-298 was subsequently used to fabricate flat laminates on T650 carbon fabric by RTM. The composite panels were analyzed and mechanical properties determined and compared with those fabricated from PETI-298 prepared by the classic solution method. The microwave synthesis process and characterization of neat resin and carbon fiber reinforced composites fabricated by RTM will be presented. KEY WORDS: Resin Transfer Molding, High Temperature Polymers, Phenylethynyl Terminated Imides, Microwave Synthesis

  7. High Temperature Transfer Molding Resins: Preliminary Composite Properties of PETI-375

    Science.gov (United States)

    Connell, J. W.; Smith, J. G., Jr.; Hergenrother, P. M.; Criss, J. M., Jr.

    2004-01-01

    As part of an ongoing effort to develop materials for resin transfer molding (RTM) of high performance/high temperature composites, a new phenylethynyl containing imide designated as PETI-375 has been under evaluation. PETI-375 was prepared using 2,3,3 ,4 - biphenyltetracarboxylic dianhydride (a-BPDA), 1,3-bis(4-aminophenoxy)benzene and 2,2 - bis(trifluoromethyl)benzidine and endcapped with 4-phenylethynylphthalic anhydride. This material exhibited a stable melt viscosity of 0.1-0.4 Pa sec at 280 C. High quality, void-free laminates were fabricated by high temperature RTM using unsized T-650 carbon fabric and evaluated. After curing for 1 hour at 371 C, the laminates exhibited a glass transition temperature of approx. 375 C by thermomechanical analysis. The laminates were essentially void and microcrack free as evidenced by optical microscopic examination. The chemistry, physical, and composite properties of PETI-375 will be discussed.

  8. Potentialities and limits of the child labour eradication program (PETI in the sisal /Brazil territory

    Directory of Open Access Journals (Sweden)

    Aline dos Santos Lima

    2009-07-01

    Full Text Available Child work was considered to be a natural practice for a long time in Brazil, both as a part of the child socialization process and a way of preventing crime and idleness. During the last decades of the 20th century, however, these ideas started to be controlled by a network in Brazil, through the Program for the Eradication of Child Work (PETI - public policy proposed to combat child work by placing the children and teenagers in full-time school. Our goal is to analyze the social and family changes caused by this program, indicating its potentialities and limits. For that, program beneficiaries - parents, coordinators, teachers, tutors and students - were interviewed either through focus groups or questionnaires. Key-words: Child work; Public policies; Sisal

  9. What is Happening in the Petišovci Fields? An Edited Conversation with an Activist of the Initiative “Stop the Fracking in Slovenia”

    Directory of Open Access Journals (Sweden)

    Danijela Tamše

    2015-12-01

    Full Text Available The article is an edited conversation with an activist of an initiative “Stop the fracking in Slovenia”. In order to start the process of fracking for natural gas extraction in the Prekmurje region, companies still have to obtain some environmental permits from the government environmental agency, which seems to have taken the companies’ side. The initiative is struggling to stop this. The conversation was focused on the developments in the Petišovci fields, formal procedures connected to obtaining permits, and the companies involved. The article also contains the explanation of what fracking is.

  10. STRATEGI KOMUNIKASI PEMASARAN USAHA SKALA MIKRO (MICRO ENTERPRISE KUB BAJRAH GUNAH KLAMPIS BANGKALAN PADA PRODUK TERASI, PETIS DAN KERUPUK IKAN

    Directory of Open Access Journals (Sweden)

    Dwi Ratna Hidayati

    2006-04-01

    Full Text Available Potensi lestari sumber daya ikan (SDI laut Indonesia sekitar 6,4 juta ton per tahun. Seiring dengan hal tersebut, potensi bahan baku perikanan yang sedemikian besar mendorong tumbuhnya usaha-usaha pengolahan makanan berbahan dasar ikan terutama usaha skala mikro kecil menengah, khususnya di wilayah-wilayah sentra penghasil perikanan seperti di kecamatan Klampis. Salah satu Kelompok Usaha Bersama (KUB skala mikro yang mengusahakan produk berbasis hasil perikanan adalah KUB “Bajrah Gunah” yang berlokasi di Kecamatan Klampis Kabupaten Bangkalan yang memproduksi petis, terasi dan kerupuk ikan. Namun demikian,usaha skala mikro (micro enterprise seringkali terkendala berbagai permasalahan terutama dibidang pemasaran, apalagi dalam kondisi harus bersaing dengan perusahaan skala menengah ataupun industri skala besar lainnya. Komunikasi pemasaran merupakan kata kunci strategis untuk memainkan peran produk lokal agar bisa berkembang oleh karena itu penelitian ini dilakukan untuk mengetahui strategi komunikasi pemasaran yang dilakukan oleh usaha skala mikro KUB Bajrah Gunah. Metode analisis yang digunakan adalah SWOT analysis yang datanya diperoleh hasil Focus Group Discussion. Hasil penelitian menunjukkan bahwa strategi komunikasi pemasaran yang harus dilakukan adalah perbaikan label sebagai sarana komunikasi dan promosi terhadap pelanggan, Perluasan jejaring, model serta saluran komunikasi pemasaran untuk membidik target konsumen yang lebih luas melalui penambahan media komunikasi pemasaran selain handphone, seperti web dan blog, serta pembuatan sarana promosi lainnya seperti leaflet, banner serta ikut serta dalam jejaring pameran yang lebih luas, branding yang kuat dengan label yang lebih marketable, perbaikan kemasan yang sesuai bagi seluruh produk yang ada, pelatihan secara kontinu  serta berjenjang dari pihak terkait serta plang papan nama KUB di dekat jalan utama untuk menginformasikan keberadaaan KUB Bajrah Gunah.

  11. Health systems integration: state of the evidence.

    Science.gov (United States)

    Armitage, Gail D; Suter, Esther; Oelke, Nelly D; Adair, Carol E

    2009-06-17

    Integrated health systems are considered a solution to the challenge of maintaining the accessibility and integrity of healthcare in numerous jurisdictions worldwide. However, decision makers in a Canadian health region indicated they were challenged to find evidence-based information to assist with the planning and implementation of integrated healthcare systems. A systematic literature review of peer-reviewed literature from health sciences and business databases, and targeted grey literature sources. Despite the large number of articles discussing integration, significant gaps in the research literature exist. There was a lack of high quality, empirical studies providing evidence on how health systems can improve service delivery and population health. No universal definition or concept of integration was found and multiple integration models from both the healthcare and business literature were proposed in the literature. The review also revealed a lack of standardized, validated tools that have been systematically used to evaluate integration outcomes. This makes measuring and comparing the impact of integration on system, provider and patient level challenging. Healthcare is likely too complex for a one-size-fits-all integration solution. It is important for decision makers and planners to choose a set of complementary models, structures and processes to create an integrated health system that fits the needs of the population across the continuum of care. However, in order to have evidence available, decision makers and planners should include evaluation for accountability purposes and to ensure a better understanding of the effectiveness and impact of health systems integration.

  12. Health systems integration: state of the evidence

    Directory of Open Access Journals (Sweden)

    Gail D. Armitage

    2009-06-01

    Full Text Available Introduction: Integrated health systems are considered a solution to the challenge of maintaining the accessibility and integrity of healthcare in numerous jurisdictions worldwide. However, decision makers in a Canadian health region indicated they were challenged to find evidence-based information to assist with the planning and implementation of integrated healthcare systems. Methods: A systematic literature review of peer-reviewed literature from health sciences and business databases, and targeted grey literature sources. Results: Despite the large number of articles discussing integration, significant gaps in the research literature exist. There was a lack of high quality, empirical studies providing evidence on how health systems can improve service delivery and population health. No universal definition or concept of integration was found and multiple integration models from both the healthcare and business literature were proposed in the literature. The review also revealed a lack of standardized, validated tools that have been systematically used to evaluate integration outcomes. This makes measuring and comparing the impact of integration on system, provider and patient level challenging. Discussion and conclusion: Healthcare is likely too complex for a one-size-fits-all integration solution. It is important for decision makers and planners to choose a set of complementary models, structures and processes to create an integrated health system that fits the needs of the population across the continuum of care. However, in order to have evidence available, decision makers and planners should include evaluation for accountability purposes and to ensure a better understanding of the effectiveness and impact of health systems integration.

  13. Limited evidence for existing caries assessment systems.

    Science.gov (United States)

    Carson, Susan J

    2013-03-01

    Data were sourced from the Cochrane Oral Health Groups Specialised Register, Cochrane Central Register of Controlled Trails, Medline, bibliographic references of identified systematic reviews, prospective cohort studies and clinical trials, textbooks and review articles. The studies included presented validating criteria for caries incidence/ increment and were limited to those with human subjects and natural carious lesions. Only studies published in peer reviewed journals were included. Excluded were studies which gave an incomplete description of sample selection, or of outcome, or had a small sample size. Studies which did not meet the Oxford Centre for Evidence Based Medicine prognosis category criteria for best evidence were also excluded. Data were extracted by the first review author and were independently checked by a second author. The criteria reported in the ADA Clinical Recommendations Handbook(1) were used to assess the quality of the studies. Adjustments made for potential confounders were considered as a means to evaluate the internal validity of each study. One hundred and thirty-seven study reports remained for review following systematic strategic search and title review. Of these, six studies of existing caries risk assessment models were selected for inclusion. Of the six studies reviewed four were deemed 'fair' by the ADA criteria and two 'poor'. The authors found variation in the parameters used for caries risk assessment and the population groups studied. No study found the risk assessment systems to have reliable prediction utility in children. One prospective study found Cariogram to give good to moderate caries prediction in elderly adults and one retrospective study found the CAMBRA assessment to provide prediction for cavitated lesions, but only between low risk and extreme risk individuals over the age of six. This systematic review suggests that evidence available on the validity of a number of existing systems for caries risk

  14. Perbaikan Tanah Dasar Menggunakan Pre-Fabricated Vertical Drain Dengan Variasi Kedalaman Dan Perkuatan Lereng Dengan Turap Studi Kasus : Lapangan Penumpukan Peti Kemas, Pelabuhan Trisakti, Banjarmasin, Kalimantan Selatan

    Directory of Open Access Journals (Sweden)

    Dofran Winner

    2017-03-01

    Full Text Available Metode perbaikan tanah dasar menggunakan preloading yang dikombinasikan dengan Pre-fabricated Vertical Drain (PVD dipilih untuk proyek pengembangan lapangan penumpukan peti kemas di Pelabuhan Trisakti, Banjarmasin, Kalimantan Selatan. Selama masa preloading, ternyata kelongsoran selebar 37 meter terjadi di area penumpukan. Diketahui bahwa kelongsoran terjadi saat preloading setinggi 4,0 meter. Agar lapangan penumpukan dapat beroperasi kembali, diperlukan perencanaan untuk perkuatan lereng dan untuk menghilangkan pemampatan tanah dasar di area lapangan penumpukan. Perbaikan tanah dasar menggunakan preloading yang dikombinasikan dengan Pre-fabricated Vertical Drain (PVD digunakan untuk Zona 3, 4, dan 5, dan perkuatan lereng dengan turap digunakan untuk Zona-1 dan Zona-2 yang merupakan bagian lereng dari lapangan penumpukan. Direncanakan PVD dipasang pada kedalaman yang berbeda: 1/3H, 2/3H, dan H (H adalah ketebalan lapisan tanah lunak untuk melihat kondisi yang menghasilkan biaya paling murah. Dari hasil perencanaan yang dilakukan, diketahui bahwa turap yang digunakan adalah Corrugated Concrete sheet pile type W-600 A1000. Turap dipasang sedalam 18 meter di Zona-1 dan sedalam 22 meter di Zona-2; selain itu, angker dipasang pada turap untuk meningkatkan kekakuan turap. Hasil perencanaan juga menunjukkan bahwa biaya yang paling ekonomis adalah PVD dipasang sampai 2/3H di Zona-3, dan tanpa PVD di Zona-4 dan Zona-5. Total biaya konstruksi adalah sebesar Rp 843.106.053,00 untuk Zona-1 dan Zona-2; Rp 9.446.530.597,00 untuk Zona-3; Rp 1.869.613.200,00 untuk Zona 4; dan Rp 3.577.392.000,00 untuk Zona 5.

  15. Strengthening health systems through linking research evidence to ...

    African Journals Online (AJOL)

    informed policies. Accordingly, a critical way of addressing these challenges facing health systems in the region is through the linking of health research findings to policy. Keywords: Evidence; Sub-Saharan Africa; Health Policy; Health Systems ...

  16. Evidence for mirror systems in emotions

    Science.gov (United States)

    Bastiaansen, J. A. C. J.; Thioux, M.; Keysers, C.

    2009-01-01

    Why do we feel tears well up when we see a loved one cry? Why do we wince when we see other people hurt themselves? This review addresses these questions from the perspective of embodied simulation: observing the actions and tactile sensations of others activates premotor, posterior parietal and somatosensory regions in the brain of the observer which are also active when performing similar movements and feeling similar sensations. We will show that seeing the emotions of others also recruits regions involved in experiencing similar emotions, although there does not seem to be a reliable mapping of particular emotions onto particular brain regions. Instead, emotion simulation seems to involve a mosaic of affective, motor and somatosensory components. The relative contributions of these components to a particular emotion and their interrelationship are largely unknown, although recent experimental evidence suggests that motor simulation may be a trigger for the simulation of associated feeling states. This mosaic of simulations may be necessary for generating the compelling insights we have into the feelings of others. Through their integration with, and modulation by, higher cognitive functions, they could be at the core of important social functions, including empathy, mind reading and social learning. PMID:19620110

  17. Use of Research Evidence and Implementation of Evidence-Based Practices in Youth-Serving Systems.

    Science.gov (United States)

    Palinkas, Lawrence A; Saldana, Lisa; Chou, Chih-Ping; Chamberlain, Patricia

    2017-09-01

    Although the effectiveness of interventions for prevention and treatment of mental health and behavioral problems in abused and neglected youth is demonstrated through the accumulation of evidence through rigorous and systematic research, it is uncertain whether use of research evidence (URE) by child-serving systems leaders increases the likelihood of evidence- based practice (EBP) implementation and sustainment. Information on URE was collected from 151 directors and senior administrators of child welfare, mental health and juvenile justice systems in 40 California and 11 Ohio counties participating in an RCT of the use of community development teams (CDTs) to scale up implementation of Treatment Foster Care Oregon over a 3 year period (2010-12). Separate multivariate models were used to assess independent effects of evidence acquisition (input), evaluation (process), application (output), and URE in general (SIEU Total) on two measures of EBP implementation, highest stage reached and proportion of activities completed at pre-implementation, implementation and sustainment phases. Stage of implementation and proportion of activities completed in the implementation and sustainment phases were independently associated with acquisition of evidence and URE in general. Participation in CDTs was significantly associated with URE in general and acquisition of research evidence in particular. Implementation of EBPs for treatment of abused and neglected youth does appear to be associated with use of research evidence, especially during the later phases.

  18. Corruption in the health care system: the circumstantial evidence.

    Science.gov (United States)

    Ibrahim, Joseph; Majoor, Jennifer

    2002-01-01

    Health care systems are under intense scrutiny, and there is an increasing emphasis on patient safety and quality of care in general. Evidence continues to emerge demonstrating that health systems are performing at sub-optimal levels. The evidence includes the under-use, over-use and mis-use of health care services; new standards asking for respect, dignity, honesty and transparency; the corporatization of health; and the existing inequalities in power and health outcomes. Recommendations for improving health care often refer to increasing the level of collaboration and consultation. These strategies are unlikely to remedy the root causes of our ailing health systems if we accept the circumstantial evidence that suggests the system is rotten.

  19. Health Information Systems From evidence to action | IDRC ...

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

    2013-03-28

    Mar 28, 2013 ... Equitable health policies demand timely and reliable evidence on what is needed, what works, and who is being left out. A combination of research and training supported by IDRC is strengthening health information systems in low- and middle- income countries to meet peoples' real health needs.

  20. Nigeria Evidence-based Health System Initiative (NEHSI ...

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

    Population weighted raster maps can communicate findings of social audits : examples from three continents. Download PDF. Journal articles. Male responsibility and maternal morbidity: a cross-sectional study in two Nigerian states. Download PDF. Studies. Impact of the Nigeria evidence-based health system initiative in ...

  1. Health Information Systems From evidence to action | CRDI - Centre ...

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

    28 mars 2013 ... Equitable health policies demand timely and reliable evidence on what is needed, what works, and who is being left out. A combination of research and training supported by IDRC is strengthening health information systems in low- and middle- income countries to meet peoples' real health needs.

  2. Evidence-based treatment of systemic lupus erythematosus and its ...

    African Journals Online (AJOL)

    Outcomes for patients with systemic lupus erythematosus (SLE) have improved during the last two decades as our understanding of the disease expands. In particular, the importance of antimalarial therapy for addressing and preventing a host of complications in SLE has emerged. Furthermore, evidence is mounting that ...

  3. Changing tides: increasing evidence to embrace a patient classification system.

    Science.gov (United States)

    Malloch, Kathy

    2012-01-01

    The effective use of a patient classification system (PCS) in a way that provides value to all health care organizations has yet to be realized given the challenging developmental pathway of these systems. As the science and technology of workforce management emerges along with evidence to support the relationships between nurse work and patient care needs, it is no longer appropriate to rely on systems that provide aggregated and minimal data to address the need for safer patient care and retention of nurses. Specificity about patient care needs in a valid and reliable PCS is essential on our pathway to improved resource utilization, improved decision making, integration of nurse cognitive and knowledge work, and management of variances from planned resource use. Advancements with technology, the ability to create and monitor equitable nurse-patient assignments, conceptual clarity, evidence, regulatory requirements, and professional role development point to a new receptiveness for PCSs.

  4. Evident?

    DEFF Research Database (Denmark)

    Plant, Peter

    2012-01-01

    Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind......Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind...

  5. Granular biodurable nanomaterials: No convincing evidence for systemic toxicity.

    Science.gov (United States)

    Moreno-Horn, Marcus; Gebel, Thomas

    2014-11-01

    Nanomaterials are usually defined by primary particle diameters ranging from 1 to 100 nm. The scope of this review is an evaluation of experimental animal studies dealing with the systemic levels and putative systemic effects induced by nanoparticles which can be characterized as being granular biodurable particles without known specific toxicity (GBP). Relevant examples of such materials comprise nanosized titanium dioxide (TiO2) and carbon black. The question was raised whether GBP nanomaterials systemically accumulate and may possess a relevant systemic toxicity. With few exceptions, the 56 publications reviewed were not performed using established standard protocols, for example, OECD guidelines but used non-standard study designs. The studies including kinetic investigations indicated that GBP nanomaterials were absorbed and systemically distributed to rather low portions only. There was no valid indication that GPB nanomaterials possess novel toxicological hazard properties. In addition, no convincing evidence for a relevant specific systemic toxicity of GBP nanomaterials could be identified. The minority of the papers reviewed (15/56) investigated both nanosized and microsized GBP materials in parallel. A relevant different translocation of GBP nanomaterials in contrast to GBP micromaterials was not observed in these studies. There was no evidence that GPB nanomaterials possess toxicological properties other than their micromaterial counterparts.

  6. Complex systems dynamics in aging: new evidence, continuing questions.

    Science.gov (United States)

    Cohen, Alan A

    2016-02-01

    There have long been suggestions that aging is tightly linked to the complex dynamics of the physiological systems that maintain homeostasis, and in particular to dysregulation of regulatory networks of molecules. This review synthesizes recent work that is starting to provide evidence for the importance of such complex systems dynamics in aging. There is now clear evidence that physiological dysregulation--the gradual breakdown in the capacity of complex regulatory networks to maintain homeostasis--is an emergent property of these regulatory networks, and that it plays an important role in aging. It can be measured simply using small numbers of biomarkers. Additionally, there are indications of the importance during aging of emergent physiological processes, functional processes that cannot be easily understood through clear metabolic pathways, but can nonetheless be precisely quantified and studied. The overall role of such complex systems dynamics in aging remains an important open question, and to understand it future studies will need to distinguish and integrate related aspects of aging research, including multi-factorial theories of aging, systems biology, bioinformatics, network approaches, robustness, and loss of complexity.

  7. Catchment systems science and management: from evidence to resilient landscapes

    Science.gov (United States)

    Quinn, Paul

    2014-05-01

    There is an urgent need to reassess both the scientific understanding and the policy making approaches taken to manage flooding, water scarcity and pollution in intensively utilised catchments. Many European catchments have been heavily modified and natural systems have largely disappeared. However, working with natural processes must still be at the core of any future management strategy. Many catchments have greatly reduced infiltration rates and buffering capacity and this process needs to be reversed. An interventionist and holistic approach to managing water quantity and quality at the catchment scale is urgently required through the active manipulation of natural flow processes. Both quantitative (field experiments and modelling) and qualitative evidence (local knowledge) is required to demonstrate that catchment have become 'unhealthy'. For example, dense networks of low cost instrumentation could provide this multiscale evidence and, coupled with stakeholder knowledge, build a comprehensive understanding of whole system function. Proactive Catchment System Management is an interventionist approach to altering the catchment scale runoff regime through the manipulation of landscape scale hydrological flow pathways. Many of the changes to hydrological processes cannot be detected at the catchment scale as the primary causes of flooding and pollution. Evidence shows it is the land cover and the soil that are paramount to any change. Local evidence shows us that intense agricultural practices reduce the infiltration capacity through soil degradation. The intrinsic buffering capacity has also been lost across the landscape. The emerging hydrological process is one in which the whole system responds too quickly (driven by near surface and overland flow processes). The bulk of the soil matrix is bypassed during storm events and there is little or no buffering capacity in the riparian areas or in headwater catchments. The prospect of lower intensity farming rates is

  8. Evidence for consciousness-related anomalies in random physical systems

    Science.gov (United States)

    Radin, Dean I.; Nelson, Roger D.

    1989-12-01

    Speculations about the role of consciousness in physical systems are frequently observed in the literature concerned with the interpretation of quantum mechanics. While only three experimental investigations can be found on this topic in physics journals, more than 800 relevant experiments have been reported in the literature of parapsychology. A well-defined body of empirical evidence from this domain was reviewed using meta-analytic techniques to assess methodological quality and overall effect size. Results showed effects conforming to chance expectation in control conditions and unequivocal non-chance effects in experimental conditions. This quantitative literature review agrees with the findings of two earlier reviews, suggesting the existence of some form of consciousness-related anomaly in random physical systems.

  9. Combination of evidence in recommendation systems characterized by distance functions

    Energy Technology Data Exchange (ETDEWEB)

    Rocha, L. M. (Luis Mateus)

    2002-01-01

    Recommendation systems for different Document Networks (DN) such as the World Wide Web (WWW), Digitnl Libarries, or Scientific Databases, often make use of distance functions extracted from relationships among documents and between documents and semantic tags. For instance, documents In the WWW are related via a hyperlink network, while documents in bibliographic databases are related by citation and collaboration networks.Furthermore, documents can be related to semantic tags such as keywords used to describe their content, The distance functions computed from these relations establish associative networks among items of the DN, and allow recommendation systems to identify relevant associations for iudividoal users. The process of recommendation can be improved by integrating associative data from different sources. Thus we are presented with a problem of combining evidence (about assochaons between items) from different sonrces characterized by distance functions. In this paper we summarize our work on (1) inferring associations from semi-metric distance functions and (2) combining evidence from different (distance) associative DN.

  10. The global stock of research evidence relevant to health systems policymaking

    OpenAIRE

    Wilson, Michael G; Moat, Kaelan A; Lavis, John N

    2013-01-01

    Background: Policymakers and stakeholders need immediate access to many types of research evidence to make informed decisions about the full range of questions that may arise regarding health systems. Methods: We examined all types of research evidence about governance, financial and delivery arrangements, and implementation strategies within health systems contained in Health Systems Evidence (HSE) (http://www.healthsystemsevidence.org). The research evidence types include evidence briefs fo...

  11. 76 FR 27355 - Law Enforcement Vehicular Digital Multimedia Evidence Recording System Selection and Application...

    Science.gov (United States)

    2011-05-11

    ... of Justice Programs Law Enforcement Vehicular Digital Multimedia Evidence Recording System Selection... public, the ``Law Enforcement Vehicular Digital Multimedia Evidence Recording System Selection and Application Guide.'' The opportunity to provide comments on these documents is open to industry technical...

  12. Participatory health system priority setting: Evidence from a budget experiment.

    Science.gov (United States)

    Costa-Font, Joan; Forns, Joan Rovira; Sato, Azusa

    2015-12-01

    Budget experiments can provide additional guidance to health system reform requiring the identification of a subset of programs and services that accrue the highest social value to 'communities'. Such experiments simulate a realistic budget resource allocation assessment among competitive programs, and position citizens as decision makers responsible for making 'collective sacrifices'. This paper explores the use of a participatory budget experiment (with 88 participants clustered in social groups) to model public health care reform, drawing from a set of realistic scenarios for potential health care users. We measure preferences by employing a contingent ranking alongside a budget allocation exercise (termed 'willingness to assign') before and after program cost information is revealed. Evidence suggests that the budget experiment method tested is cognitively feasible and incentive compatible. The main downside is the existence of ex-ante "cost estimation" bias. Additionally, we find that participants appeared to underestimate the net social gain of redistributive programs. Relative social value estimates can serve as a guide to aid priority setting at a health system level. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Evidence to Practice Commentary: The Evidence Alert Traffic Light Grading System

    Science.gov (United States)

    Novak, Iona

    2012-01-01

    The purpose of the "Evidence to Practice" commentary is to highlight an issue or research finding in selected articles, emphasizing the relevance to practice. This article introduces a new tool designed to summarize the most up-to-date evidence in an easily readable format, in order to provide clinically useful answers within minutes for assisting…

  14. Novel Evidence-Based Systemic Lupus Erythematosus Responder Index

    Science.gov (United States)

    Furie, Richard A.; Petri, Michelle A.; Wallace, Daniel J.; Ginzler, Ellen M.; Merrill, Joan T.; Stohl, William; Chatham, W. Winn; Strand, Vibeke; Weinstein, Arthur; Chevrier, Marc R.; Zhong, John; Freimuth, William W.

    2009-01-01

    Objective To describe a new systemic lupus erythematosus (SLE) Responder Index (SRI) based on the belimumab phase II SLE trial and demonstrate its potential utility in SLE clinical trials. Methods Data from a 449-patient randomized, double-blind, placebo-controlled study of 3 doses of belimumab (1, 4, 10 mg/kg) or placebo plus standard of care therapy (SOC) over a 56-week period were analyzed. SELENA-SLEDAI and BILAG SLE disease activity instruments, SF-36 Health Survey, and biomarker analyses were used to create a novel SRI. Response to treatment in a subset of SLE patients (n=321) who were serologically active (ANA ≥1:80 and/or anti-dsDNA antibody ≥30 IU) at baseline was retrospectively evaluated using the SRI. Results SRI response is defined as: 1) ≥4-point reduction in SELENA-SLEDAI score; 2) no new BILAG A or no more than 1 new BILAG B domain score; and 3) no deterioration from baseline in the Physician’s Global Assessment (PGA) by ≥0.3 points. In serologically active patients, addition of belimumab to SOC resulted in a response in 46% of patients at week 52 compared with 29% for the placebo patients (P=0.006). SRI responses were independent of baseline autoantibody subtype. Conclusion Evidence-based evaluation of a large randomized, placebo-controlled trial in SLE resulted in the ability to define a robust responder index based on improvement in disease activity without worsening of the overall condition or the development of significant disease activity in new organ systems. PMID:19714615

  15. Evidence-based treatment of systemic lupus erythematosus and its ...

    African Journals Online (AJOL)

    . Antiphospholipid syndrome. Antiphospholipid antibodies are commonly encountered in. SLE patients and are associated with a 50% risk of thrombo embolism.[12] Despite the lack of evidence for primary prevention of thombosis and ...

  16. Evidence-based management of ambulatory electronic health record system implementation: an assessment of conceptual support and qualitative evidence.

    Science.gov (United States)

    McAlearney, Ann Scheck; Hefner, Jennifer L; Sieck, Cynthia; Rizer, Milisa; Huerta, Timothy R

    2014-07-01

    While electronic health record (EHR) systems have potential to drive improvements in healthcare, a majority of EHR implementations fall short of expectations. Shortcomings in implementations are often due to organizational issues around the implementation process rather than technological problems. Evidence from both the information technology and healthcare management literature can be applied to improve the likelihood of implementation success, but the translation of this evidence into practice has not been widespread. Our objective was to comprehensively study and synthesize best practices for managing ambulatory EHR system implementation in healthcare organizations, highlighting applicable management theories and successful strategies. We held 45 interviews with key informants in six U.S. healthcare organizations purposively selected based on reported success with ambulatory EHR implementation. We also conducted six focus groups comprised of 37 physicians. Interview and focus group transcripts were analyzed using both deductive and inductive methods to answer research questions and explore emergent themes. We suggest that successful management of ambulatory EHR implementation can be guided by the Plan-Do-Study-Act (PDSA) quality improvement (QI) model. While participants did not acknowledge nor emphasize use of this model, we found evidence that successful implementation practices could be framed using the PDSA model. Additionally, successful sites had three strategies in common: 1) use of evidence from published health information technology (HIT) literature emphasizing implementation facilitators; 2) focusing on workflow; and 3) incorporating critical management factors that facilitate implementation. Organizations seeking to improve ambulatory EHR implementation processes can use frameworks such as the PDSA QI model to guide efforts and provide a means to formally accommodate new evidence over time. Implementing formal management strategies and incorporating

  17. Event Highlight: Nigeria Evidence-based Health System Initiative

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

    From 14. May to 1 June 2012 in Calabar, Cross River State. (Nigeria), the academic non-governmental organisation CIET Trust ran the third module of an intensive degree program in epidemiology and evidence-based planning. Most course participants. (eight women and 12 men) were planners from state ministries of ...

  18. 75 FR 78269 - Vehicular Digital Multimedia Evidence Recording System (VDMERS) Standard for Law Enforcement

    Science.gov (United States)

    2010-12-15

    ... of Justice Programs Vehicular Digital Multimedia Evidence Recording System (VDMERS) Standard for Law... the general public the draft ``Vehicular Digital Multimedia Evidence Recording System Standard for Law Enforcement.'' The opportunity to provide comments on this voluntary standard is open to industry technical...

  19. Empirical Evidence and Policy Implications from National Systems of ...

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

    Earlier efforts to understand national innovation systems in developing countries have focused on the elements of the system (firms, universities, public research organizations, etc.), with little emphasis on the relationships and knowledge flows between them. These relationships are important as they may induce positive ...

  20. Pleomorphic lobular carcinomain situ: Current evidence and a systemic review.

    Science.gov (United States)

    Wazir, Umar; Wazir, Ali; Wells, Clive; Mokbel, Kefah

    2016-12-01

    Pleomorphic lobular carcinoma in situ (PLCIS) has only recently been identified as a distinct pathological entity within classic lobular carcinoma in situ (CLCIS). As such, there is currently no consensus among clinicians regarding the optimal treatment of this disease. The present study determined the risk of concomitant invasive disease and ductal carcinoma in situ (DCIS) if PLCIS is observed on core needle biopsy (CNB) and collated the evidence regarding the risk of recurrence in relation to surgical margins and adjuvant therapy. In addition, the pertinent literature available through MedLine, PubMed, the WHO Clinical Trials Registry Platform and Google Scholar using appropriate keywords was reviewed. The pooled results of studies in the literature demonstrated a concomitant presence of invasive disease of 40%, and 15% for DCIS. The studies that examined recurrence rates indicated that the risk is reduced with ample resection margins (>2 mm) and adjuvant radiotherapy. However, recent studies raise concerns regarding breast conservation when pursuing clear margins. No level 1 evidence from prospective studies, randomized controlled trials (RCTs), or meta-analyses based on such RCTs was identified. This is a clinical issue that warrants investigation in appropriately powered well designed prospective studies for a satisfactory resolution of all concerns.

  1. Direct evidence for T violation in the neutral kaon system

    CERN Document Server

    Adler, R; Angelopoulos, Angelos; Aspostolakis, A; Aslanides, Elie; Backenstoss, Gerhard; Bee, C P; Behnke, O; Benelli, A; Bertin, V; Blanc, F; Bloch, P; Bula, C; Carlson, P J; Carroll, M; Carvalho, J; Cawley, E; Charalambous, S; Chardalas, M; Chardin, G; Chertok, M B; Cody, A; Danielsson, M; Dedoussis, S; Dejardin, M; Derré, J; Duclos, J; Ealet, A; Eckart, B; Eleftheriadis, C; Evangelou, I; Faravel, L; Fassnacht, P; Faure, J L; Felder, C; Ferreira-Marques, R; Fetscher, W; Fidecaro, Maria; Filipcic, A; Francis, D; Fry, J; Gabathuler, Erwin; Gamet, R; Garreta, D; Gerber, H J; Go, A; Guyot, C; Haselden, A; Hayman, P J; Henry-Coüannier, F; Hollander, R W; Hubert, E; Jon-And, K; Kettle, P R; Kochowski, Claude; Kokkas, P; Kreuger, R; Le Gac, R; Leimgruber, F; Liolios, A; Machado, E; Mandic, I; Manthos, N; Marel, Gérard; Mikuz, M; Miller, J; Montanet, François; Nakada, Tatsuya; Onofre, A; Pagels, B; Papadopoulos, I M; Pavlopoulos, P; Pinto da Cunha, J; Policarpo, Armando; Polivka, G; Rickenbach, R; Roberts, B L; Rozaki, E; Ruf, T; Sakelliou, L; Sanders, P; Santoni, C; Sarigiannis, K; Schäfer, M; Schaller, L A; Schopper, A; Schune, P; Soares, A; Tauscher, Ludwig; Thibault, C; Touchard, F; Touramanis, C; Triantis, F A; Van Beveren, E; van Eijk, C W E; Varner, G S; Vlachos, S; Weber, P; Wigger, O; Wolter, M; Yéche, C; Zavrtanik, D; Zimmerman, D

    1995-01-01

    We present the first direct observation of T violation in the neutral kaon system, showing a positive signal with a significance of more than two standard deviations. The result does not rely on the validity of the CPT theorem.

  2. The endocannabinoid system and schizophrenia: integration of evidence.

    Science.gov (United States)

    Zamberletti, Erica; Rubino, Tiziana; Parolaro, Daniela

    2012-01-01

    Cannabis derivatives produce their CNS effect through activation of the endocannabinoid system, a recently discovered signalling system comprising specific receptors, their intrinsic lipid ligands and the associated enzymatic machinery (transporters, biosynthetic and degradative enzymes). This review provides the latest preclinical and clinical breakthroughs on the endocannabinoid system's role in psychotic disorders such as schizophrenia. Data reported so far clearly indicate the presence of a dysregulation in the endocannabinoid system (both in term of cannabinoid receptors and endocannabinoid ligands) in animal models of psychosis as well as in schizophrenic patients. Based on these observations, the pharmacological modulation of the endocannabinoid system has been taken into account as a new therapeutic possibility for psychotic disorders. However, preclinical studies have not provided straightforward results, with both agonists and antagonists exhibiting positive, negative or even no effect. At human level, only cannabidiol, a non psychotropic phytocannabinoid, and the antagonist/inverse agonist rimonabant were tested, however additional controlled trials are required to confirm the therapeutic exploitation of these compounds. Another important aspect in studying the relationship between the endocannabinoid system and schizophrenia is the impact of Cannabis consumption on psychotic disorders, especially when this occurs at vulnerable ages such as adolescence. In fact literature from animal models support adolescence as a highly vulnerable age for the consequences of cannabis exposure on different domains (such as cognition and social behaviour) that are altered in psychotic disorders.

  3. Systems Thinking Evidence from Colleges of Business and Their Universities

    Science.gov (United States)

    Seiler, John H.; Kowalsky, Michelle

    2011-01-01

    This study investigated instances of the term "systems thinking" among the websites of the Top 25 business schools as ranked by "U. S. News and World Report" in 2010. Since a greater number of instances of the term and its variants in a university's web documents may indicate an increased interest of the institution in the…

  4. Social capital and systems of care: some contrasting evidence ...

    African Journals Online (AJOL)

    No abstract available for this article... Keywords: social capital, systems. Research Review Supplement 16 (2004: 1-15). AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL · News.

  5. Using Evidence to Strengthen Health Systems in Africa and the ...

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

    The project is timely for Lebanon, a country that is working to strengthen its primary health care system to respond to current priorities such as the emerging crisis of Syrian refugees. Timely access to information The project will strengthen institutional and individual abilities to conduct and use systematic and rapid reviews to ...

  6. Multiple Systems of Spatial Memory: Evidence from Described Scenes

    Science.gov (United States)

    Avraamides, Marios N.; Kelly, Jonathan W.

    2010-01-01

    Recent models in spatial cognition posit that distinct memory systems are responsible for maintaining transient and enduring spatial relations. The authors used perspective-taking performance to assess the presence of these enduring and transient spatial memories for locations encoded through verbal descriptions. Across 3 experiments, spatial…

  7. The number processing and calculation system: evidence from cognitive neuropsychology.

    Science.gov (United States)

    Salguero-Alcañiz, M P; Alameda-Bailén, J R

    2015-04-01

    Cognitive neuropsychology focuses on the concepts of dissociation and double dissociation. The performance of number processing and calculation tasks by patients with acquired brain injury can be used to characterise the way in which the healthy cognitive system manipulates number symbols and quantities. The objective of this study is to determine the components of the numerical processing and calculation system. Participants consisted of 6 patients with acquired brain injuries in different cerebral localisations. We used Batería de evaluación del procesamiento numérico y el cálculo, a battery assessing number processing and calculation. Data was analysed using the difference in proportions test. Quantitative numerical knowledge is independent from number transcoding, qualitative numerical knowledge, and calculation. Recodification is independent from qualitative numerical knowledge and calculation. Quantitative numerical knowledge and calculation are also independent functions. The number processing and calculation system comprises at least 4 components that operate independently: quantitative numerical knowledge, number transcoding, qualitative numerical knowledge, and calculation. Therefore, each one may be damaged selectively without affecting the functioning of another. According to the main models of number processing and calculation, each component has different characteristics and cerebral localisations. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  8. A system for rating the stability and strength of medical evidence

    Directory of Open Access Journals (Sweden)

    Reston James T

    2006-10-01

    Full Text Available Abstract Background Methods for describing one's confidence in the available evidence are useful for end-users of evidence reviews. Analysts inevitably make judgments about the quality, quantity consistency, robustness, and magnitude of effects observed in the studies identified. The subjectivity of these judgments in several areas underscores the need for transparency in judgments. Discussion This paper introduces a new system for rating medical evidence. The system requires explicit judgments and provides explicit rules for balancing these judgments. Unlike other systems for rating the strength of evidence, our system draws a distinction between two types of conclusions: quantitative and qualitative. A quantitative conclusion addresses the question, "How well does it work?", whereas a qualitative conclusion addresses the question, "Does it work?" In our system, quantitative conclusions are tied to stability ratings, and qualitative conclusions are tied to strength ratings. Our system emphasizes extensive a priori criteria for judgments to reduce the potential for bias. Further, the system makes explicit the impact of heterogeneity testing, meta-analysis, and sensitivity analyses on evidence ratings. This article provides details of our system, including graphical depictions of how the numerous judgments that an analyst makes can be combined. We also describe two worked examples of how the system can be applied to both interventional and diagnostic technologies. Summary Although explicit judgments and formal combination rules are two important steps on the path to a comprehensive system for rating medical evidence, many additional steps must also be taken. Foremost among these are the distinction between quantitative and qualitative conclusions, an extensive set of a priori criteria for making judgments, and the direct impact of analytic results on evidence ratings. These attributes form the basis for a logically consistent system that can

  9. Evidence for compact binary systems around Kepler red giants

    DEFF Research Database (Denmark)

    Colman, Isabel L.; Huber, Daniel; Bedding, Timothy R.

    2017-01-01

    We present an analysis of 168 oscillating red giants from NASA's Kepler mission that exhibit anomalous peaks in their Fourier amplitude spectra. These peaks result from ellipsoidal variations that are indicative of binary star systems, at frequencies such that the orbit of any stellar companion...... in the sample as chance alignments using a combination of pixel Fourier analysis and difference imaging. We find that in the remaining 81 cases, the anomalous peaks are indistinguishable from the target star to within 4 arcsec, suggesting a physical association. We examine a GALAXIA model of the Kepler field...

  10. [GRADE system: classification of quality of evidence and strength of recommendation].

    Science.gov (United States)

    Aguayo-Albasini, José Luis; Flores-Pastor, Benito; Soria-Aledo, Víctor

    2014-02-01

    The acquisition and classification of scientific evidence, and subsequent formulation of recommendations constitute the basis for the development of clinical practice guidelines. There are several systems for the classification of evidence and strength of recommendations; the most commonly used nowadays is the Grading of Recommendations, Assessment, Development and Evaluation system (GRADE). The GRADE system initially classifies the evidence into high or low, coming from experimental or observational studies; subsequently and following a series of considerations, the evidence is classified into high, moderate, low or very low. The strength of recommendations is based not only on the quality of the evidence, but also on a series of factors such as the risk/benefit balance, values and preferences of the patients and professionals, and the use of resources or costs. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

  11. [Scientific evidence and the cost of innovations in the health-care system].

    Science.gov (United States)

    Porzsolt, Franz; Schreyögg, Jonas

    2009-08-01

    When depicting the relationship between evidence and the cost of an innovation in the health-care system, the overall risks of assessment, the redistribution of risks in a regulated market, and the ethical consequences must first be taken into account. There are also evidence-based criteria and economic considerations which are relevant when calculating the cost of an innovation. These topics can indicate, but not exhaustively deal with the complicated relationship between scientific evidence and calculating the cost of an innovation in the health-care system. The following three statements summarize the current considerations in the continuing discussion of this topic: *Scientific evidence undoubtedly exists which should be taken into consideration when calculating the cost of an innovation in the health-care system. *The existing scientific evidence is, however, not sufficient to reach such a decision. Additional information about the benefit perceived by the patient is required. *No standardized method exists to measure this additional information. Therefore, a definition problem also exists in the health-care system when setting a price according to scientific evidence.

  12. Health Professionals' Use of Online Information Retrieval Systems and Online Evidence.

    Science.gov (United States)

    Lialiou, Paschalina; Pavlopoulou, Ioanna; Mantas, John

    2016-01-01

    Across-sectional survey was designed to determine health professionals' awareness and usage of online evidence retrieval systems in clinical practice. A questionnaire was used to measure professionals' behavior and utilization of online evidences, as well as, reasons and barriers on information retrieval. 439 nurses and physicians from public and private hospitals in Greece formulate the study's sample. The two most common reasons that individuals are using online information systems were for writing scientific manuscripts or filling a knowledge gap. A positive correlation was found between participants with postgraduate studies and information system usage. The majority of them (90,6%) believe that online information systems improves patient care and 67,6% of them had their own experiences on this. More support is needed to nurses and physicians in order to use the online evidence and as a result to improve the provided care and practices.

  13. Scientific evidence-based effects of hydrotherapy on various systems of the body.

    Science.gov (United States)

    Mooventhan, A; Nivethitha, L

    2014-05-01

    The use of water for various treatments (hydrotherapy) is probably as old as mankind. Hydrotherapy is one of the basic methods of treatment widely used in the system of natural medicine, which is also called as water therapy, aquatic therapy, pool therapy, and balneotherapy. Use of water in various forms and in various temperatures can produce different effects on different system of the body. Many studies/reviews reported the effects of hydrotherapy only on very few systems and there is lack of studies/reviews in reporting the evidence-based effects of hydrotherapy on various systems. We performed PubMed and PubMed central search to review relevant articles in English literature based on "effects of hydrotherapy/balneotherapy" on various systems of the body. Based on the available literature this review suggests that the hydrotherapy has a scientific evidence-based effect on various systems of the body.

  14. Development and implementation of the Ontario Stroke System: the use of evidence

    Directory of Open Access Journals (Sweden)

    Jill I. Cameron

    2007-08-01

    Full Text Available Introduction The Ontario Stroke System was developed to enhance the quality and continuity of stroke care provided across the care continuum. Research Objective To identify the role evidence played in the development and implementation of the Ontario Stroke System. Methods This study employed a qualitative case study design. In-depth interviews were conducted with six members of the Ontario Stroke System provincial steering committee. Nine focus groups were conducted with: Regional Program Managers, Regional Education Coordinators, and seven acute care teams. To supplement these findings interviews were conducted with eight individuals knowledgeable about national and international models of integrated service delivery. Results Our analyses identified six themes. The first four themes highlight the use of evidence to support the process of system development and implementation including: 1 informing system development; 2 mobilizing governmental support; 3 getting the system up and running; and 4 integrating services across the continuum of care. The final two themes describe the foundation required to support this process: 1 human capacity and 2 mechanisms to share evidence. Conclusion This study provides guidance to support the development and implementation of evidence-based models of integrated service delivery.

  15. A Framework for Evidence-Based Licensure of Adaptive Autonomous Systems: Technical Areas

    Science.gov (United States)

    2016-03-01

    system (i.e., we assume it already has an anti - lock braking system ). The autonomous system includes additional software modules that implement the...dispatcher and police. We assume the tractor-trailer includes system software for device-level control of the power train, drivetrain, and braking ...I N S T I T U T E F O R D E F E N S E A N A L Y S E S A Framework for Evidence-Based Licensure of Adaptive Autonomous Systems : Technical Areas

  16. CDS, UX, and System Redesign - Promising Techniques and Tools to Bridge the Evidence Gap.

    Science.gov (United States)

    McGinn, Thomas

    2015-01-01

    In this special issue of eGEMs, we explore the struggles related to bringing evidence into day-to-day practice, what I define as the "evidence gap." We are all aware of high quality evidence in the form of guidelines, randomized clinical trials for treatments and diagnostic tests, and clinical prediction rules, which are all readily available online. We also know that electronic health records (EHRs) are now ubiquitous in health care and in most practices across the country. How we marry this high quality evidence and the practice of medicine through effective decision support is a major challenge. All of the articles in this issue explore, in some fashion, CDS systems and how we can best bring providers and their work environment to the evidence. We are at the very early stages of the science of usability. Much more research and funding is needed in this area if we hope to improve the dissemination and implementation of evidence in practice. While the featured examples, techniques, and tools in the special issue are a promising start to improving usability and CDS, many of the papers highlight current gaps in knowledge and a great need for generalizable approaches. The great promise is for "learning" approaches to generate new evidence and to integrate this evidence in reliable, patient-centered ways at scale using new technology. Closing the evidence gap is a real possibility, but only if the community works together to innovate and invest in research on the best ways to disseminate, communicate, and implement evidence in practice.

  17. A Regional PD Strategy for EPR Systems: Evidence-Based IT Development

    DEFF Research Database (Denmark)

    Simonsen, Jesper; Hertzum, Morten

    2006-01-01

    One of the five regions in Denmark has initiated a remark-able and alternative strategy for the development of Elec-tronic Patient Record (EPR) systems. This strategy is driven by Participatory Design (PD) experiments and based on evidence of positive effects on the clinical practice when using EPR...... systems. We present this PD strategy and our related research on evidence-based IT development. We report from a newly completed PD experiment with EPR in the region conducted through a close collaboration compris-ing a neurological stroke unit, the region’s EPR unit, the vendor, as well as the authors....

  18. Enhancing requirements engineering for patient registry software systems with evidence-based components.

    Science.gov (United States)

    Lindoerfer, Doris; Mansmann, Ulrich

    2017-07-01

    Patient registries are instrumental for medical research. Often their structures are complex and their implementations use composite software systems to meet the wide spectrum of challenges. Commercial and open-source systems are available for registry implementation, but many research groups develop their own systems. Methodological approaches in the selection of software as well as the construction of proprietary systems are needed. We propose an evidence-based checklist, summarizing essential items for patient registry software systems (CIPROS), to accelerate the requirements engineering process. Requirements engineering activities for software systems follow traditional software requirements elicitation methods, general software requirements specification (SRS) templates, and standards. We performed a multistep procedure to develop a specific evidence-based CIPROS checklist: (1) A systematic literature review to build a comprehensive collection of technical concepts, (2) a qualitative content analysis to define a catalogue of relevant criteria, and (3) a checklist to construct a minimal appraisal standard. CIPROS is based on 64 publications and covers twelve sections with a total of 72 items. CIPROS also defines software requirements. Comparing CIPROS with traditional software requirements elicitation methods, SRS templates and standards show a broad consensus but differences in issues regarding registry-specific aspects. Using an evidence-based approach to requirements engineering for registry software adds aspects to the traditional methods and accelerates the software engineering process for registry software. The method we used to construct CIPROS serves as a potential template for creating evidence-based checklists in other fields. The CIPROS list supports developers in assessing requirements for existing systems and formulating requirements for their own systems, while strengthening the reporting of patient registry software system descriptions. It may be

  19. The validation of forensic DNA extraction systems to utilize soil contaminated biological evidence.

    Science.gov (United States)

    Kasu, Mohaimin; Shires, Karen

    2015-07-01

    The production of full DNA profiles from biological evidence found in soil has a high failure rate due largely to the inhibitory substance humic acid (HA). Abundant in various natural soils, HA co-extracts with DNA during extraction and inhibits DNA profiling by binding to the molecular components of the genotyping assay. To successfully utilize traces of soil contaminated evidence, such as that found at many murder and rape crime scenes in South Africa, a reliable HA removal extraction system would often be selected based on previous validation studies. However, for many standard forensic DNA extraction systems, peer-reviewed publications detailing the efficacy on soil evidence is either lacking or is incomplete. Consequently, these sample types are often not collected or fail to yield suitable DNA material due to the use of unsuitable methodology. The aim of this study was to validate the common forensic DNA collection and extraction systems used in South Africa, namely DNA IQ, FTA elute and Nucleosave for processing blood and saliva contaminated with HA. A forensic appropriate volume of biological evidence was spiked with HA (0, 0.5, 1.5 and 2.5 mg/ml) and processed through each extraction protocol for the evaluation of HA removal using QPCR and STR-genotyping. The DNA IQ magnetic bead system effectively removed HA from highly contaminated blood and saliva, and generated consistently acceptable STR profiles from both artificially spiked samples and crude soil samples. This system is highly recommended for use on soil-contaminated evidence over the cellulose card-based systems currently being preferentially used for DNA sample collection. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. On-farm impact of the System of Rice Intensification (SRI): Evidence and knowledge gaps

    NARCIS (Netherlands)

    Berkhout, E.D.; Glover, D.B.A.; Kuyvenhoven, A.

    2015-01-01

    The System of Rice Intensification (SRI) is being promoted worldwide, but relatively little is yet known about its impacts at farm level. This article reviews available evidence on the impact of SRI practices in terms of yield and productivity. Adoption of SRI practices necessarily changes the mix

  1. Bank Systemic Risk-Taking and Loan Pricing : Evidence from Syndicated Loans

    NARCIS (Netherlands)

    Gong, D.

    2014-01-01

    In this paper we document evidence of systemic risk taking from syndicated loan pricing. Using U.S. syndicated loan data, we find that the borrower's idiosyncratic risk is positively priced whereas systematic risk is negatively related to loan spreads, controlling for firm, loan and bank specific

  2. Forensic Evidence Identification and Modeling for Attacks against a Simulated Online Business Information System

    Directory of Open Access Journals (Sweden)

    Manghui Tu

    2012-12-01

    Full Text Available Forensic readiness can support future forensics investigation or auditing on external/internal attacks, internal sabotage and espionage, and business frauds. To establish forensics readiness, it is essential for an organization to identify what evidences are relevant and where they can be found, to determine whether they are logged in a forensic sound way and whether all the needed evidences are available to reconstruct the events successfully.  Our goal of this research is to ensure evidence availability. First, both external and internal attacks are molded as augmented attack trees/graphs based on the system vulnerabilities. Second, modeled attacks are conducted against a honeynet simulating an online business information system, and each honeypot's hard drive is forensic sound imaged for each individual attack. Third, an evidence tree/graph will be built after forensics examination on the disk images for each attack. The evidence trees/graphs are expected to be used for automatic crime scene reconstruction and automatic attack/fraud detection in the future.

  3. Designing AAC systems for children with autism: evidence from eye tracking research.

    Science.gov (United States)

    Gillespie-Smith, Karri; Fletcher-Watson, Sue

    2014-06-01

    Autism is associated with a range of language difficulties that impact communication, behaviour management, and education. Consequently, a variety of augmentative and alternative communication (AAC) strategies may be employed to support people with autism to communicate. There is a growing body of evidence concerning the visual attention of individuals with autism, which may be relevant to AAC interventions. This review draws on evidence from eye tracking research specifically to inform the design of AAC systems for people with autism. In addition, we discuss the future of AAC for individuals with autism in light of relevant technological developments, and raise questions for future research.

  4. Large-scale adverse effects related to treatment evidence standardization (LAERTES): an open scalable system for linking pharmacovigilance evidence sources with clinical data.

    Science.gov (United States)

    2017-03-07

    Integrating multiple sources of pharmacovigilance evidence has the potential to advance the science of safety signal detection and evaluation. In this regard, there is a need for more research on how to integrate multiple disparate evidence sources while making the evidence computable from a knowledge representation perspective (i.e., semantic enrichment). Existing frameworks suggest well-promising outcomes for such integration but employ a rather limited number of sources. In particular, none have been specifically designed to support both regulatory and clinical use cases, nor have any been designed to add new resources and use cases through an open architecture. This paper discusses the architecture and functionality of a system called Large-scale Adverse Effects Related to Treatment Evidence Standardization (LAERTES) that aims to address these shortcomings. LAERTES provides a standardized, open, and scalable architecture for linking evidence sources relevant to the association of drugs with health outcomes of interest (HOIs). Standard terminologies are used to represent different entities. For example, drugs and HOIs are represented in RxNorm and Systematized Nomenclature of Medicine -- Clinical Terms respectively. At the time of this writing, six evidence sources have been loaded into the LAERTES evidence base and are accessible through prototype evidence exploration user interface and a set of Web application programming interface services. This system operates within a larger software stack provided by the Observational Health Data Sciences and Informatics clinical research framework, including the relational Common Data Model for observational patient data created by the Observational Medical Outcomes Partnership. Elements of the Linked Data paradigm facilitate the systematic and scalable integration of relevant evidence sources. The prototype LAERTES system provides useful functionality while creating opportunities for further research. Future work will

  5. Periodontal disease and systemic illness: will the evidence ever be enough?

    Science.gov (United States)

    Cullinan, Mary P; Seymour, Gregory J

    2013-06-01

    The concept of focal infection or systemic disease arising from infection of the teeth was generally accepted until the mid-20th century when it was dismissed because of lack of evidence. Subsequently, a largely silo approach was taken by the dental and medical professions. Over the past 20 years, however, a plethora of epidemiological, mechanistic and treatment studies have highlighted that this silo approach to oral and systemic diseases can no longer be sustained. While a number of systemic diseases have been linked to oral diseases, the weight of evidence from numerous studies conducted over this period, together with several systematic reviews and meta-analyses, supports an association between periodontitis and cardiovascular disease, and between periodontitis and diabetes. The association has also been supported by a number of biologically plausible mechanisms, including direct infection, systemic inflammation and molecular mimicry. Treatment studies have shown that periodontal treatment may have a small, but significant, systemic effect both on endothelial function and on glycemic control. Despite this, however, there is no direct evidence that periodontal treatment affects either cardiovascular or diabetic events. Nevertheless, over the past 20 years we have learnt that the mouth is an integral part of the body and that the medical and dental professions need to work more closely together in the provision of overall health care for all patients. © 2013 John Wiley & Sons A/S.

  6. Effects of System Characteristics on Adopting Web-Based Advanced Traveller Information System: Evidence from Taiwan

    Directory of Open Access Journals (Sweden)

    Ting-Wei Lin

    2014-02-01

    Full Text Available This study proposes a behavioural intention model that integrates information quality, response time, and system accessibility into the original technology acceptance model (TAM to investigate whether system characteristics affect the adoption of Web-based advanced traveller information systems (ATIS. This study empirically tests the proposed model using data collected from an online survey of Web-based advanced traveller information system users. Con­firmatory factor analysis (CFA was performed to examine the reliability and validity of the measurement model, and structural equation modelling (SEM was used to evaluate the structural model. The results indicate that three system characteristics had indirect effects on the intention to use through perceived usefulness, perceived ease of use, and attitude toward using. Information quality was the most im­portant system characteristic factor, followed by response time and system accessibility. This study presents implica­tions for practitioners and researchers, and suggests direc­tions for future research.

  7. What is evidence-based dentistry, and do oral infections increase systemic morbidity or mortality?

    Science.gov (United States)

    Niederman, Richard; Richards, Derek

    2011-11-01

    From Celsus' first reports of rubor, calor, dolor, tumor, and functio laesa, has come an understanding of inflammation's manifestations at the organ, tissue, vascular, cellular, genetic, and molecular levels. Molecular medicine now raises the opposite question: can local oral infections and their inflammatory mediators increase systemic morbidity or mortality? From these perspectives we examine the clinical evidence relating caries, periodontal disease, and pericoronitis to systemic disease. Widespread affirmation of an oral-systemic linkage remains elusive, raising sobering cautions. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. PENERAPAN ACTIVITY BASED COSTING SYSTEM DALAM PERHITUNGAN PROFITABILITAS PRODUK PADA UD. NIAGA BAKTI

    Directory of Open Access Journals (Sweden)

    Fena Ulfa Aulia

    2015-06-01

    Full Text Available The Charge imposition of factory overhead based on traditional systems often cause distorted costs. One of efforts to overcome these distortions fees is with charging the costs  factory overhead  by the activity based costing. The use of activity based costing can also help companies that produce many products  in determining the level of profitability. Profitability indicates whether an enterprise has good prospects in the future for the company's survival. This research is a quantitative descriptive research conducted at UD NIAGA BAKTI engaged in the processing of tuna fish PETIS in Pamekasan located in the village of Konang, Subdistrict of Galis, Regency of Pamekasan. The type of data  used in this research is quantitative data obtained by direct observation and Interview. This techniques of research analysis calculates and compares the products profitability of PETIS by using traditional cost systems and costing system based activity. The results of this research indicates that there are differences in the principal cost of production and profitability UD NIAGA BAKTI by using activity based costing compared  Traditional Cost Systems.

  9. The global stock of research evidence relevant to health systems policymaking.

    Science.gov (United States)

    Wilson, Michael G; Moat, Kaelan A; Lavis, John N

    2013-09-04

    Policymakers and stakeholders need immediate access to many types of research evidence to make informed decisions about the full range of questions that may arise regarding health systems. We examined all types of research evidence about governance, financial and delivery arrangements, and implementation strategies within health systems contained in Health Systems Evidence (HSE) (http://www.healthsystemsevidence.org). The research evidence types include evidence briefs for policy, overviews of systematic reviews, systematic reviews of effects, systematic reviews addressing other questions, systematic reviews in progress, systematic reviews being planned, economic evaluations, and health reform and health system descriptions. Specifically, we describe their distribution across health system topics and domains, trends in their production over time, availability of supplemental content in various languages, and the extent to which they focus on low- and middle-income countries (LMICs), as well as (for systematic reviews) their methodological quality and the availability of user-friendly summaries. As of July 2013, HSE contained 2,629 systematic reviews of effects (of which 501 are Cochrane reviews), 614 systematic reviews addressing other questions, 283 systematic reviews in progress, 186 systematic reviews being planned, 140 review-derived products (evidence briefs and overviews of systematic reviews), 1,669 economic evaluations, 1,092 health reform descriptions, and 209 health system descriptions. Most systematic reviews address topics related to delivery arrangements (n = 2,663) or implementation strategies (n = 1,653) with far fewer addressing financial (n = 241) or governance arrangements (n = 231). In addition, 2,928 systematic reviews have been quality appraised with moderate AMSTAR ratings found for reviews addressing governance (5.6/11), financial (5.9/11), and delivery (6.3/11) arrangements and implementation strategies (6.5/11); 1,075 systematic reviews

  10. Insight and Evidence Motivating the Simplification of Dual-Analysis Hybrid Systems into Single-Analysis Hybrid Systems

    Science.gov (United States)

    Todling, Ricardo; Diniz, F. L. R.; Takacs, L. L.; Suarez, M. J.

    2018-01-01

    Many hybrid data assimilation systems currently used for NWP employ some form of dual-analysis system approach. Typically a hybrid variational analysis is responsible for creating initial conditions for high-resolution forecasts, and an ensemble analysis system is responsible for creating sample perturbations used to form the flow-dependent part of the background error covariance required in the hybrid analysis component. In many of these, the two analysis components employ different methodologies, e.g., variational and ensemble Kalman filter. In such cases, it is not uncommon to have observations treated rather differently between the two analyses components; recentering of the ensemble analysis around the hybrid analysis is used to compensated for such differences. Furthermore, in many cases, the hybrid variational high-resolution system implements some type of four-dimensional approach, whereas the underlying ensemble system relies on a three-dimensional approach, which again introduces discrepancies in the overall system. Connected to these is the expectation that one can reliably estimate observation impact on forecasts issued from hybrid analyses by using an ensemble approach based on the underlying ensemble strategy of dual-analysis systems. Just the realization that the ensemble analysis makes substantially different use of observations as compared to their hybrid counterpart should serve as enough evidence of the implausibility of such expectation. This presentation assembles numerous anecdotal evidence to illustrate the fact that hybrid dual-analysis systems must, at the very minimum, strive for consistent use of the observations in both analysis sub-components. Simpler than that, this work suggests that hybrid systems can reliably be constructed without the need to employ a dual-analysis approach. In practice, the idea of relying on a single analysis system is appealing from a cost-maintenance perspective. More generally, single-analysis systems avoid

  11. Socio-contextual Determinants of Research Evidence Use in Public-Youth Systems of Care.

    Science.gov (United States)

    Garcia, Antonio R; Kim, Minseop; Palinkas, Lawrence A; Snowden, Lonnie; Landsverk, John

    2016-07-01

    Recent efforts have been devoted to understanding the conditions by which research evidence use (REU) is facilitated from the perspective of system leaders in the context of implementing evidence-based child mental health interventions. However, we have limited understanding of the extent to which outer contextual factors influence REU. Outer contextual factors for 37 counties in California were gathered from public records in 2008; and child welfare, juvenile justice, and mental health system leaders' perceptions of their REU were measured via a web-based survey from 2010 to 2012. Results showed that leaders with higher educational attainment and in counties with lower expenditures on inpatient mental health services were significantly associated with higher REU. Positive relationships between gathering research evidence and racial minority concentration and poverty at the county level were also detected. Results underscore the need to identify the organizational and socio-political factors by which mental health services and resources meet client demands that influence REU, and to recruit and retain providers with a graduate degree to negotiate work demands and interpret research evidence.

  12. Brain MRI screening showing evidences of early central nervous system involvement in patients with systemic sclerosis.

    Science.gov (United States)

    Mohammed, Reem Hamdy A; Sabry, Yousriah Y; Nasef, Amr A

    2011-05-01

    Systemic sclerosis is a multisystem autoimmune collagen disease where structural and functional abnormalities of small blood vessels prevail. Transient ischemic attacks, ischemic stroke, and hemorrhage have been reported as primary consequence of vascular central nervous system affection in systemic sclerosis. Magnetic resonance imaging is considered to be the most sensitive diagnostic technique for detecting symptomatic and asymptomatic lesions in the brain in cases of multifocal diseases. The objective of this study is to detect subclinical as well as clinically manifest cerebral vasculopathy in patients with systemic sclerosis using magnetic resonance imaging. As much as 30 female patients with systemic sclerosis aged 27-61 years old, with disease duration of 1-9 years and with no history of other systemic disease or cerebrovascular accidents, were enrolled. Age-matched female control group of 30 clinically normal subjects, underwent brain magnetic resonance examination. Central nervous system (CNS) involvement in the form of white matter hyperintense foci of variable sizes were found in significantly abundant forms in systemic sclerosis patients on magnetic resonance evaluation than in age-related control group, signifying a form of CNS vasculopathy. Such foci showed significant correlation to clinical features of organic CNS lesion including headaches, fainting attacks and organic depression as well as to the severity of peripheral vascular disease with insignificant correlation with disease duration. In conclusion, subclinical as well as clinically manifest CNS ischemic vasculopathy is not uncommon in systemic sclerosis patients and magnetic resonance imaging is considered a sensitive noninvasive screening tool for early detection of CNS involvement in patients with systemic sclerosis.

  13. Dizzy-Beats: a Bayesian evidence analysis tool for systems biology.

    Science.gov (United States)

    Aitken, Stuart; Kilpatrick, Alastair M; Akman, Ozgur E

    2015-06-01

    Model selection and parameter inference are complex problems of long-standing interest in systems biology. Selecting between competing models arises commonly as underlying biochemical mechanisms are often not fully known, hence alternative models must be considered. Parameter inference yields important information on the extent to which the data and the model constrain parameter values. We report Dizzy-Beats, a graphical Java Bayesian evidence analysis tool implementing nested sampling - an algorithm yielding an estimate of the log of the Bayesian evidence Z and the moments of model parameters, thus addressing two outstanding challenges in systems modelling. A likelihood function based on the L1-norm is adopted as it is generically applicable to replicated time series data. http://sourceforge.net/p/bayesevidence/home/Home/. © The Author 2015. Published by Oxford University Press.

  14. Non-Traditional Systemic Treatments for Diabetic Retinopathy: An
Evidence-Based Review

    Science.gov (United States)

    Simó, Rafael; Ballarini, Stefania; Cunha-Vaz, José; Ji, Linong; Haller, Hermann; Zimmet, Paul; Wong, Tien Y.

    2015-01-01

    The rapid escalation in the global prevalence diabetes, with more than 30% being afflicted with diabetic retinopathy (DR), means it is likely that associated vision-threatening conditions will also rise substantially. This means that new therapeutic approaches need to be found that go beyond the current standards of diabetic care, and which are effective in the early stages of the disease. In recent decades several new pharmacological agents have been investigated for their effectiveness in preventing the appearance and progression of DR or in reversing DR; some with limited success while others appear promising. This up-to-date critical review of non-traditional systemic treatments for DR is based on the published evidence in MEDLINE spanning 1980-December 2014. It discusses a number of therapeutic options, paying particular attention to the mechanisms of action and the clinical evidence for the use of renin-angiotensin system blockade, fenofibrate and calcium dobesilate monohydrate in DR. PMID:25989912

  15. Reflections from the Jury Box: Improving Evidence Based Practice through a Comparison with Our Legal System

    Directory of Open Access Journals (Sweden)

    Valerie Coppenrath

    2017-08-01

    Full Text Available Background: An experience serving jury duty prompted reflection on the parallels between evidenced based medicine and our legal system. Findings: The steps of the legal system can be tied to each step of the practice of evidenced based medicine. Implications: Patients should be included in evidence based decisions. Pharmacists can act as resources for other providers practicing evidenced based medicine. Educators can use this analogy to teach evidence based medicine. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received, employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties.   Type: Commentary

  16. What is the role of health systems in responding to domestic violence? An evidence review.

    Science.gov (United States)

    Spangaro, Jo

    2017-12-01

    Objective The aim of the present study was to review and analyse academic literature and program evaluations to identify promising evidence for health system responses to domestic violence in Australia and internationally. Methods English-language literature published between January 2005 and March 2016 was retrieved from search results using the terms 'domestic violence' or 'intimate partner violence' in different combinations with other relevant terms, resulting in 1671 documents, of which 59 were systematic reviews. Electronic databases (Medline (Ovid), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psycinfo, Social work Abstracts, Informit, Violence and Abuse Abstracts, Family Studies Abstracts, Cochrane Library of Systematic Reviews and EMBASE) were searched and narrative analysis undertaken. Results This review details the evidence base for the following interventions by health services responding to domestic violence: first-line responses, routine screening, risk assessment and safety planning, counselling with women, mother-child interventions, responses to perpetrators, child protection notifications, training and system-level responses. Conclusions There is growing evidence for the effectiveness of health service interventions to reduce the extent of harm caused by domestic violence. What is known about the topic? Domestic violence is a significant problem globally with enormous human, social and economic costs. Although women who have experienced abuse make extensive use of healthcare services, health services have lagged behind the policing, criminal justice and other human service domains in responding to domestic violence. What does this paper add? The present comprehensive review identifies best-practice health system responses to domestic violence. What are the implications for practitioners? Health systems can play a key role in identifying and responding to domestic violence for women who often do not access other services

  17. Transformational leadership and staff retention: an evidence review with implications for healthcare systems.

    Science.gov (United States)

    Weberg, Dan

    2010-01-01

    A significant amount of burnout and attrition of nurses occurs in healthcare systems. Nursing leadership has a significant impact on these factors. The purpose of this article is to present an evidence review to determine the impact of transformational leadership on staff satisfaction and burnout. It was found that transformational leadership is significantly related to increased satisfaction, increased staff well-being, decreased burnout, and decreased overall stress in staff nurses.

  18. A Framework for Evidence-Based Licensure of Adaptive Autonomous Systems

    Science.gov (United States)

    2016-03-01

    purposes. The constraints on the activity are an important part of the license— motorcycles or buses require separate licenses from two-axle vehicles...and a basic license does not permit operating a commercial limo service . Licenses are typically based on established evidence that gives the licensing...refer to a mechanism for assessing the desirability of a particular observed system behavior as a normative oracle. A normative oracle provides a process

  19. Critical periods of vulnerability for the developing nervous system: evidence from humans and animal models.

    OpenAIRE

    Rice, D; Barone, S

    2000-01-01

    Vulnerable periods during the development of the nervous system are sensitive to environmental insults because they are dependent on the temporal and regional emergence of critical developmental processes (i.e., proliferation, migration, differentiation, synaptogenesis, myelination, and apoptosis). Evidence from numerous sources demonstrates that neural development extends from the embryonic period through adolescence. In general, the sequence of events is comparable among species, although t...

  20. Areca nut chewing and systemic inflammation: evidence of a common pathway for systemic diseases

    Directory of Open Access Journals (Sweden)

    Shafique Kashif

    2012-06-01

    Full Text Available Abstract Background Areca nut, the seed of fruit of an oriental palm, known as Areca catechu, is commonly chewed in many countries. Diabetes, hypertension, cardiovascular diseases, oropharyngeal and oesophageal cancers have been associated with areca nut chewing and the mechanism by which areca nut chewing increases the risk of systemic diseases remains elusive. We hypothesize that systemic inflammation may be elevated among areca nut users, which is linked with many systemic diseases. Therefore, this present study was conducted to examine the systemic inflammation among areca nut chewers and healthy controls. Methods This was an observational cross sectional study carried out on areca nut chewers and healthy individuals in Karachi, Pakistan. Participants were selected from a region of the city by invitation request sent from door to door. Information was collected regarding the socio-demographic profile and the pattern of use, and a blood sample was obtained to measure the level of C-reactive protein (CRP. We carried out multiple logistic regressions to investigate the association between socio-demographic profile, areca nut chewing and CRP levels. Results We carried out final analysis on 1112 individuals of which 556 were areca nut chewers and 556 were the age, gender and area matched controls. Areca nut chewers had a significantly higher proportion of men (15.1%, n = 84 who had an elevated CRP (>10 mg/dl as compared to controls (5.2%, n = 29. Multivariate analyses showed that areca nut chewers had significantly higher odds of an elevated CRP (OR = 3.23, 95% CI 2.08-5.02, p value Conclusions Areca nut chewing has a significant association with systemic inflammation. Further work is required to confirm that systemic inflammation is the main pathway by which areca nut use increases the risk of systemic diseases.

  1. Diabetes mellitus disease management in a safety net hospital system: translating evidence into practice.

    Science.gov (United States)

    Butler, Michael K; Kaiser, Michael; Johnson, Jolene; Besse, Jay; Horswell, Ronald

    2010-12-01

    The Louisiana State University Health Care Services Division system assessed the effectiveness of implementing a multisite disease management program targeting diabetes mellitus in an indigent patient population. A population-based disease management program centered on evidence-based clinical care guidelines was applied from the system level. Specific clinic modifications and models were used, as well as ancillary services such as medication assistance and equipment subsidies. Marked improvement in process goals led to improved clinical outcomes. From 2001 to 2008, the percentage of patients with a hemoglobin A1c management programs can be successfully implemented and achieve statistically significant results.

  2. Systemic hypertension and the right-sided cardiovascular system: a review of the available evidence.

    Science.gov (United States)

    Pedrinelli, Roberto; Dell'Omo, Giulia; Talini, Enrica; Canale, Maria Laura; Di Bello, Vitantonio

    2009-02-01

    Abnormal vasoconstriction of the lesser circulation characterizes a subset of patients with essential hypertension, a possible effect of mechanisms, such as enhanced sympathetic tone, increased delivery of blood-borne vasoconstrictor substances or abnormal local release of vasoactive factors, acting on both sides of the circulation or to backward transmission of increased pressure due to stiffer left ventricles with more advanced diastolic dysfunction. Elevated systemic pressure also associates with thickening of the right ventricle, a central element of the low-pressure system. Right ventricular remodelling develops in parallel with a similar process occurring at the left side, likely as a result of ventricular interdependence under the influence of trophic factors targeting both ventricles, though other mechanisms, including increased pulmonary afterload, may also be operative. By and large independent of the extent of structural remodelling of both ventricles, systemic hypertension also conditions an impaired filling rate of the right ventricle that accompanies a similar phenomenon at the left side. Thus, quite in contrast with the common and simplistic assumption of a separate behaviour of the two ventricles, the right-sided cardiovascular system is not immune to the effect of systemic hypertension, a concept whose clinical and pathophysiological implications require further studies.

  3. Motivating medical information system performance by system quality, service quality, and job satisfaction for evidence-based practice.

    Science.gov (United States)

    Chang, Ching-Sheng; Chen, Su-Yueh; Lan, Yi-Ting

    2012-11-21

    No previous studies have addressed the integrated relationships among system quality, service quality, job satisfaction, and system performance; this study attempts to bridge such a gap with evidence-based practice study. The convenience sampling method was applied to the information system users of three hospitals in southern Taiwan. A total of 500 copies of questionnaires were distributed, and 283 returned copies were valid, suggesting a valid response rate of 56.6%. SPSS 17.0 and AMOS 17.0 (structural equation modeling) statistical software packages were used for data analysis and processing. The findings are as follows: System quality has a positive influence on service quality (γ11= 0.55), job satisfaction (γ21= 0.32), and system performance (γ31= 0.47). Service quality (β31= 0.38) and job satisfaction (β32= 0.46) will positively influence system performance. It is thus recommended that the information office of hospitals and developers take enhancement of service quality and user satisfaction into consideration in addition to placing b on system quality and information quality when designing, developing, or purchasing an information system, in order to improve benefits and gain more achievements generated by hospital information systems.

  4. Sustainability Strategy and Management Control Systems in Family Firms. Evidence from a Case Study

    Directory of Open Access Journals (Sweden)

    Fabio Caputo

    2017-06-01

    Full Text Available The aim of this paper is to investigate how the integration of new forms of sustainable control systems (SCSs and traditional management control systems (MCSs, and the use of these control systems affect the integration of sustainability within organizational strategy. A qualitative case study based on a longitudinal investigation of an Italian family firm operating in an environment-sensitive context, the intermodal transport industry, has been used to trace the company’s pathway to sustainability integration based on the Gond et al. framework. The paper enriches the Gond et al. conceptualization providing evidence of the external and internal factors relevant in affecting the organization’s pathway towards sustainability integration. To the best of the authors’ knowledge, the present study is the first analysis that investigates the integration of sustainability into organizational strategy in the context of family firms, from the point of view of performance management systems (PMSs.

  5. Complementary roles of systems representing sensory evidence and systems detecting task difficulty during perceptual decision making

    Directory of Open Access Journals (Sweden)

    Douglas A Ruff

    2010-11-01

    Full Text Available Perceptual decision making is a multi-stage process where incoming sensory information is used to select one option from several alternatives. Researchers typically have adopted one of two conceptual frameworks to define the criteria for determining whether a brain region is involved in decision computations. One framework, building on single unite recordings in monkeys, posits that activity in a region involved in decision making reflects the accumulation of evidence toward a decision threshold, thus showing the lowest level of BOLD signal during the hardest decisions. The other framework instead posits that activity in a decision-making region reflects the difficulty of a decision, thus showing the highest level of BOLD signal during the hardest decisions. We had subjects perform a face detection task on degraded face images while we simultaneously recorded BOLD activity. We searched for brain regions where changes in BOLD activity during this task supported either of these frameworks by calculating the correlation of BOLD activity with reaction time - a measure of task difficulty. We found that the right supplementary eye field, right frontal eye field and right inferior frontal gyrus had increased activity relative to baseline that positively correlated with reaction time, while the left superior frontal sulcus and left middle temporal gyrus had decreased activity relative to baseline that negatively correlated with reaction time. We propose that a simple mechanism that scales a region’s activity based on task demands can explain our results.

  6. Initiatives supporting evidence informed health system policymaking in Cameroon and Uganda: a comparative historical case study.

    Science.gov (United States)

    Ongolo-Zogo, Pierre; Lavis, John N; Tomson, Goran; Sewankambo, Nelson K

    2014-11-29

    There is a scarcity of empirical data on institutions devoted to knowledge brokerage and their influence in Africa. Our objective was to describe two pioneering Knowledge Translation Platforms (KTPs) supporting evidence informed health system policymaking (EIHSP) in Cameroon and Uganda since 2006. This comparative historical case study of Evidence Informed Policy Network (EVIPNet) Cameroon and Regional East African Community Health Policy Initiative (REACH-PI) Uganda using multiple methods comprised (i) a descriptive documentary analysis for a narrative historical account, (ii) an interpretive documentary analysis of the context, profiles, activities and outputs inventories and (iii) an evaluative survey of stakeholders exposed to evidence briefs produced and policy dialogues organized by the KTPs. Both initiatives benefited from the technical and scientific support from the global EVIPNet resource group. EVIPNet Cameroon secretariat operates with a multidisciplinary group of part-time researchers in a teaching hospital closely linked to the ministry of health. REACH-PI Uganda secretariat operates with a smaller team of full time staff in a public university. Financial resources were mobilized from external donors to scale up capacity building, knowledge management, and linkage and exchange activities. Between 2008 and 2012, twelve evidence briefs were produced in Cameroon and three in Uganda. In 2012, six rapid evidence syntheses in response to stakeholders' urgent needs were produced in Cameroon against 73 in Uganda between 2010 and 2012. Ten policy dialogues (seven in Cameroon and three in Uganda) informed by pre-circulated evidence briefs were well received. Both KTPs contributed to developing and testing new resources and tools for EIHSP. A network of local and global experts has created new spaces for evidence informed deliberations on priority health policy issues related to MDGs. This descriptive historical account of two KTPs housed in government

  7. Evidence on existing caries risk assessment systems: are they predictive of future caries?

    Science.gov (United States)

    Tellez, M; Gomez, J; Pretty, I; Ellwood, R; Ismail, A I

    2013-02-01

    To critically appraise evidence for the prediction of caries using four caries risk assessment (CRA) systems/guidelines (Cariogram, Caries Management by Risk Assessment (CAMBRA), American Dental Association (ADA), and American Academy of Pediatric Dentistry (AAPD)). This review focused on prospective cohort studies or randomized controlled trials. A systematic search strategy was developed to locate papers published in Medline Ovid and Cochrane databases. The search identified 539 scientific reports, and after title and abstract review, 137 were selected for full review and 14 met the following inclusion criteria: (i) used as validating criterion caries incidence/increment, (ii) involved human subjects and natural carious lesions, and (iii) published in peer-reviewed journals. In addition, papers were excluded if they met one or more of the following criteria: (i) incomplete description of sample selection, outcomes, or small sample size and (ii) not meeting the criteria for best evidence under the prognosis category of the Oxford Centre for Evidence-Based Medicine. There are wide variations among the systems in terms of definitions of caries risk categories, type and number of risk factors/markers, and disease indicators. The Cariogram combined sensitivity and specificity for predicting caries in permanent dentition ranges from 110 to 139 and is the only system for which prospective studies have been conducted to assess its validity. The Cariogram had limited prediction utility in preschool children, and a moderate to good performance for sorting out elderly individuals into caries risk groups. One retrospective analysis on CAMBRA's CRA reported higher incidence of cavitated lesions among those assessed as extreme-risk patients when compared with those at low risk. The evidence on the validity for existing systems for CRA is limited. It is unknown if the identification of high-risk individuals can lead to more effective long-term patient management that prevents

  8. The role of the endocannabinoid system in eating disorders: neurochemical and behavioural preclinical evidence.

    Science.gov (United States)

    Scherma, Maria; Fattore, Liana; Castelli, Maria Paola; Fratta, Walter; Fadda, Paola

    2014-01-01

    The endocannabinoid system has long been known as a modulator of several physiological functions, among which the homeostatic and hedonic aspects of eating. CB1 receptors are widely expressed in brain regions that control food intake, reward and energy balance. Animal and human studies indicate that CB1 receptor agonists possess orexigenic effects enhancing appetite and increasing the rewarding value of food. Conversely, CB1 antagonists have been shown to inhibit the intake of food. Eating disorders include a range of chronic and disabling related pathological illnesses that are characterized by aberrant patterns of feeding behaviour and weight regulation, and by abnormal attitudes and perceptions toward body shape image. The psychological and biological factors underlying eating disorders are complex and not yet completely understood. However in the last decades, converging evidence have led to hypothesise a link between defects in the endocannabinoid system and eating disorders, including obesity. Here we review the neurochemical and behavioural preclinical evidence supporting the role of the endocannabinoid system in eating disorders to offer the reader an update regarding the state of the art. Despite the recent withdrawal from the market of rimonabant for treating obesity and overweight individuals with metabolic complications due to its psychiatric side effects, preclinical findings support the rationale for the clinical development of drug which modulate the endocannabinoid system in the treatment of eating disorders.

  9. An examination of cross-cultural systems implementing evidence-based assessment and intervention approaches

    Directory of Open Access Journals (Sweden)

    Murray Laura K

    2006-01-01

    Full Text Available Implementation of evidence-based assessment and intervention approaches for youth with behavioral and/or emotional problems is rising to recognition worldwide. Feasibility research is critical to examine what characteristics of systems allow for success or barriers to the implementation of evidence-based practices into real-world settings, especially when working cross-culturally. This paper briefly reviews the experience of 4 international sites to understand how the overall structure and specific site variables directed the implementation of the World Health Organization and the World Psychiatry Association project. Discussion includes a thematic summary of the successes and challenges experienced by the sites, and future directions of feasibility studies.

  10. Administrative data provide vital research evidence for maximizing health-system performance and outcomes.

    Science.gov (United States)

    Roder, David; Buckley, Elizabeth

    2017-06-01

    Although the quality of administrative data is frequently questioned, these data are vital for health-services evaluation and complement data from trials, other research studies and registries for research. Trials generally provide the strongest evidence of outcomes in research settings but results may not apply in many service environments. High-quality observational research has a complementary role where trials are not applicable and for assessing whether trial results apply to groups excluded from trials. Administrative data have a broader system-wide reach, enabling system-wide health-services research and monitoring of performance markers. Where administrative data raise questions about service outcomes, follow-up enquiry may be required to investigate validity and service implications. Greater use should be made of administrative data for system-wide monitoring and for research on service effectiveness and equity. © 2017 John Wiley & Sons Australia, Ltd.

  11. The Governance of Fair Trade System: Evidence from Small Honey Producers in Rio Grande do Sul

    Directory of Open Access Journals (Sweden)

    Luciana Marques Vieira

    2009-10-01

    Full Text Available This paper discusses Fair Trade [FT] certification as a way to include small producers in global value chains, and identifies the main barriers for small honey producers from RS to meet these criteria. A new trading system such as FT has been providing access for food products coming from small farmers from developing countries. The method of this study integrates global value chain analysis and the methodology proposed by Paul (2005 to analyse FT as development projects. This study is three-fold: first to characterise the FT system; then to present the role of governance by third party certifiers such as FLO-CERT and finally to provide empirical evidence of the main difficulties that small producers have to comply with FT, such as export and organisation capacity. Our findings show that large retailers recently became big players in the FT system. The certification costs are high but can provide market access though there is a risk of overspecialisation.

  12. Needles in a Haystack: Screening and Healthcare System Evidence for Homelessness.

    Science.gov (United States)

    Fargo, Jamison D; Montgomery, Ann Elizabeth; Byrne, Thomas; Brignone, Emily; Cusack, Meagan; Gundlapalli, Adi V

    2017-01-01

    Effectiveness of screening for homelessness in a large healthcare system was evaluated in terms of successfully referring and connecting patients with appropriate prevention or intervention services. Screening and healthcare services data from nearly 6 million U.S. military veterans were analyzed. Veterans either screened positive for current or risk of housing instability, or negative for both. Current living situation was used to validate results of screening. Administrative evidence for homelessness-related services was significantly higher among positive-screen veterans who accepted a referral for services compared to those who declined. Screening for current or risk of homelessness led to earlier identification, which led to earlier and more extensive service engagement.

  13. Hinkley Point 'C' power station public inquiry: proof of evidence on system considerations

    International Nuclear Information System (INIS)

    Eunson, E.M.

    1988-09-01

    A public inquiry has been set up to examine the planning application made by the Central Electricity Generating Board (CEGB) for the construction of a 1200 MW Pressurized Water Reactor power station at Hinkley Point (Hinkley Point ''C'') in the United Kingdom. This evidence to the Inquiry describes the CEGB system and the concepts of economy, security and quality of supply which underlie it. Attention is drawn to the present geographical imbalance between generation and demand on the CEGB system which leads to high power transfers at times of peak demand and for long periods at off-peak times. When there is a need to install new generating plant in the mid-1990s, system benefits can be achieved by siting plant in the South rather than in the North. The system benefits which would arise from the siting of a new PWR nuclear power station at Hinkley Point ''C'' rather than elsewhere are identified. The system benefits of other PWR sites and non-fossil options, such as a further link with France, interconnection with Iceland and the Severn Tidal Barrage, are reviewed. System benefits in terms of security and economics would accrue from locating a PWR station at Hinkley Point without the need for new transmission lines. (author)

  14. Sleep system sensitization: evidence for changing roles of etiological factors in insomnia.

    Science.gov (United States)

    Kalmbach, David A; Pillai, Vivek; Arnedt, J Todd; Anderson, Jason R; Drake, Christopher L

    2016-05-01

    To test for sensitization of the sleep system in response to insomnia development and major life stress. In addition, to evaluate the impact on depression and anxiety associated with sleep system sensitization. A longitudinal study with three annual assessments. The community-based sample included 262 adults with no history of insomnia or depression who developed insomnia one year after baseline (67.6% female; 44.0 ± 13.4 yr). Measures included the Ford Insomnia Response to Stress Test to assess sleep reactivity, Quick Inventory of Depressive Symptomatology, and Beck Anxiety Inventory. Insomnia classification was based on DSM-IV criteria. Sleep system sensitization was operationally defined as significant increases in sleep reactivity. Sensitization of the sleep system was observed from baseline to insomnia onset at 1-yr follow-up among insomniacs with low premorbid vulnerability (p insomnia remission (p insomnia onset. The impact of sensitization on depression was stable at 2-yr follow-up (p = 0.01). Evidence supports sensitization of the sleep system as a consequence of insomnia development and major life stress among individuals with low premorbid sleep reactivity. Sleep system sensitization may serve as a mechanism by which insomnia is perpetuated. Harmful effects of the sensitization process may increase risk for insomnia-related depression and anxiety. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Asthma and obesity in children: current evidence and potential systems biology approaches.

    Science.gov (United States)

    Frey, U; Latzin, P; Usemann, J; Maccora, J; Zumsteg, U; Kriemler, S

    2015-01-01

    Both obesity and asthma are highly prevalent, complex diseases modified by multiple factors. Genetic, developmental, lung mechanical, immunological and behavioural factors have all been suggested as playing a causal role between the two entities; however, their complex mechanistic interactions are still poorly understood and evidence of causality in children remains scant. Equally lacking is evidence of effective treatment strategies, despite the fact that imbalances at vulnerable phases in childhood can impact long-term health. This review is targeted at both clinicians frequently faced with the dilemma of how to investigate and treat the obese asthmatic child and researchers interested in the topic. Highlighting the breadth of the spectrum of factors involved, this review collates evidence regarding the investigation and treatment of asthma in obese children, particularly in comparison with current approaches in 'difficult-to-treat' childhood asthma. Finally, the authors propose hypotheses for future research from a systems-based perspective. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Evidence-based clinical guidelines: a new system to better determine true strength of recommendation.

    Science.gov (United States)

    Roddy, Edward; Zhang, Weiya; Doherty, Michael; Arden, Nigel K; Barlow, Julie; Birrell, Fraser; Carr, Alison; Chakravarty, Kuntal; Dickson, John; Hay, Elaine; Hosie, Gillian; Hurley, Michael; Jordan, Kelsey M; McCarthy, Christopher; McMurdo, Marion; Mockett, Simon; O'Reilly, Sheila; Peat, George; Pendleton, Adrian; Richards, Selwyn

    2006-06-01

    Clinical practice guidelines often grade the 'strength' of their recommendations according to the robustness of the supporting research evidence. The existing methodology does not allow the strength of recommendation (SOR) to be upgraded for recommendations for which randomized controlled trials are impractical or unethical. The purpose of this study was to develop a new method of determining SOR, incorporating both research evidence and expert opinion. A Delphi technique was employed to produce 10 recommendations for the role of exercise therapy in the management of osteoarthritis of the hip or knee. The SOR for each recommendation was determined by the traditional method, closely linked to the category of research evidence found on a systematic literature search, and on a visual analogue scale (VAS). Recommendations were grouped A-D according to the traditional SOR allocated and the mean VAS calculated. Difference across the groups was assessed by one-way ANOVA variance analysis. Mean VAS scores for the traditional SOR groups A-D and one proposition which was 'not recommended' showed significant linearity on one-way ANOVA. However, certain recommendations which, for practical reasons, could not assessed in randomized controlled trials and therefore could not be recommended strongly by the traditional methodology, were allocated a strong recommendation by VAS. This new system of grading strength of SOR is less constrained than the traditional methodology and offers the advantage of allowing SOR for procedures which cannot be assessed in RCTs for practical or ethical reasons to be upgraded according to expert opinion.

  17. Evolution of the respiratory system in nonavian theropods: evidence from rib and vertebral morphology.

    Science.gov (United States)

    Schachner, Emma R; Lyson, Tyler R; Dodson, Peter

    2009-09-01

    Recent reports of region-specific vertebral pneumaticity in nonavian theropod dinosaurs have brought attention to the hypothesis that these animals possessed an avian-style respiratory system with flow-through ventilation. This study explores the thoracic rib and vertebral anatomy of Sinraptor, Allosaurus, Tyrannosaurus, and Deinonychus; four nonavian theropods that all show well-preserved thoracic vertebrae and ribs. Comparisons to the osteology and soft tissue anatomy of extant saurians provide new evidence supporting the hypothesis of flow-through ventilation in nonavian theropods. Analyses of diapophyseal and parapophyseal position and thoracic rib morphology suggest that most nonavian theropods possessed lungs that were deeply incised by the adjacent bicapitate thoracic ribs. This functionally constrains the lungs as rigid nonexpansive organs that were likely ventilated by accessory nonvascularized air sacs. The axial anatomy of this group also reveals that a crocodilian-like hepatic-piston lung would be functionally and biomechanically untenable. Taken together with the evidence that avian-like air sacs were present in basal theropods, these data lead us to conclude that an avian-style pulmonary system was likely a universal theropod trait. (c) 2009 Wiley-Liss, Inc.

  18. Interpreting drinking water quality in the distribution system using Dempster-Shafer theory of evidence.

    Science.gov (United States)

    Sadiq, Rehan; Rodriguez, Manuel J

    2005-04-01

    Interpreting water quality data routinely generated for control and monitoring purposes in water distribution systems is a complicated task for utility managers. In fact, data for diverse water quality indicators (physico-chemical and microbiological) are generated at different times and at different locations in the distribution system. To simplify and improve the understanding and the interpretation of water quality, methodologies for aggregation and fusion of data must be developed. In this paper, the Dempster-Shafer theory also called theory of evidence is introduced as a potential methodology for interpreting water quality data. The conceptual basis of this methodology and the process for its implementation are presented by two applications. The first application deals with the interpretation of spatial water quality data fusion, while the second application deals with the development of water quality index based on key monitored indicators. Based on the obtained results, the authors discuss the potential contribution of theory of evidence as a decision-making tool for water quality management.

  19. UCLA, British astronomers discover wake of planet around nearby star. Strong evidence for solar system like ours

    CERN Multimedia

    2002-01-01

    "An international team of astronomers reports the first strong evidence for the existence of massive planets on wide orbits - like those of Saturn, Uranus and Neptune - around many stars. The new research provides some of the strongest evidence so far that solar systems similar to our own, or even larger, are likely to exist: (1 page).

  20. Are clinical findings of systemic titanium dispersion following implantation explained by available in vitro evidence? An evidence-based analysis.

    Science.gov (United States)

    Curtin, Justin Paul; Wang, Minji

    2017-08-01

    Although the presence of titanium wear particles released into tissues is known to induce local inflammation following the therapeutic implantation of titanium devices into humans, the role that titanium ions play in adverse tissue responses has received little attention. Support that ongoing titanium ion release occurs is evidenced by the presence of ionic titanium bound to transferrin in blood, and ongoing excretion in the urine of patients with titanium devices. However, as reports documenting the presence of titanium within tissues do not distinguish between particulate and ionic forms due to technical challenges, the degree to which ionic titanium is released into tissues is unknown. To determine the potential for titanium ion release into tissues, this study evaluates available in vitro evidence relating to the release of ionic titanium under physiological conditions. This is a systematic literature review of studies reporting titanium ion release into solutions from titanium devices under conditions replicating the interstitial pH and constituents. Inclusion and exclusion criteria were defined. Of 452 articles identified, titanium ions were reported in nine media relevant to human biology in seventeen studies. Only one study, using human serum replicated both physiological pH and the concentration of constituents while reporting the presence of titanium ions. While there is insufficient information to explain the factors that contribute to the presence of titanium ions in serum of humans implanted with titanium devices, currently available information suggests that areas of future inquiry include the role of transferrin and organic acids.

  1. Cosmochemical evidence for astrophysical processes during the formation of our solar system.

    Science.gov (United States)

    MacPherson, Glenn J; Boss, Alan

    2011-11-29

    Through the laboratory study of ancient solar system materials such as meteorites and comet dust, we can recognize evidence for the same star-formation processes in our own solar system as those that we can observe now through telescopes in nearby star-forming regions. High temperature grains formed in the innermost region of the solar system ended up much farther out in the solar system, not only the asteroid belt but even in the comet accretion region, suggesting a huge and efficient process of mass transport. Bi-polar outflows, turbulent diffusion, and marginal gravitational instability are the likely mechanisms for this transport. The presence of short-lived radionuclides in the early solar system, especially (60)Fe, (26)Al, and (41)Ca, requires a nearby supernova shortly before our solar system was formed, suggesting that the Sun was formed in a massive star-forming region similar to Orion or Carina. Solar system formation may have been "triggered" by ionizing radiation originating from massive O and B stars at the center of an expanding HII bubble, one of which may have later provided the supernova source for the short-lived radionuclides. Alternatively, a supernova shock wave may have simultaneously triggered the collapse and injected the short-lived radionuclides. Because the Sun formed in a region where many other stars were forming more or less contemporaneously, the bi-polar outflows from all such stars enriched the local region in interstellar silicate and oxide dust. This may explain several observed anomalies in the meteorite record: a near absence of detectable (no extreme isotopic properties) presolar silicate grains and a dichotomy in the isotope record between (26)Al and nucleosynthetic (nonradiogenic) anomalies.

  2. Sleep System Sensitization: Evidence for Changing Roles of Etiological Factors in Insomnia

    Science.gov (United States)

    Kalmbach, David A.; Pillai, Vivek; Arnedt, J. Todd; Anderson, Jason R.; Drake, Christopher L.

    2016-01-01

    Objectives To test for sensitization of the sleep system in response to insomnia development and major life stress. In addition, to evaluate the impact on depression and anxiety associated with sleep system sensitization. Methods A longitudinal study with three annual assessments. The community-based sample included 262 adults with no history of insomnia or depression who developed insomnia 1 year after baseline (67.6% female; 44.0±13.4y). Measures included the Ford Insomnia Response to Stress Test to assess sleep reactivity, Quick Inventory of Depressive Symptomatology, and Beck Anxiety Inventory. Insomnia classification was based on DSM-IV criteria. Sleep system sensitization was operationally defined as significant increases in sleep reactivity. Results Sensitization of the sleep system was observed from baseline to insomnia onset at 1-y follow-up among insomniacs with low premorbid vulnerability (psleep reactive. Major life stress was associated with greater sleep system sensitization (p=.02). Results showed that sleep reactivity at 2-y follow-up remained elevated among those with low premorbid vulnerability, even after insomnia remission (psleep reactivity predicted greater depression (pinsomnia onset. The impact of sensitization on depression was stable at 2-y follow-up (p=.01). Conclusions Evidence supports sensitization of the sleep system as consequence of insomnia development and major life stress among individuals with low premorbid sleep reactivity. Sleep system sensitization may serve as a mechanism by which insomnia is perpetuated. Harmful effects of the sensitization process may increase risk for insomnia-related depression and anxiety. PMID:27448474

  3. Essential evidence for guiding health system priorities and policies: anticipating epidemiological transition in Africa.

    Science.gov (United States)

    Byass, Peter; de Savigny, Don; Lopez, Alan D

    2014-01-01

    Despite indications that infection-related mortality in sub-Saharan Africa may be decreasing and the burden of non-communicable diseases increasing, the overwhelming reality is that health information systems across most of sub-Saharan Africa remain too weak to track epidemiological transition in a meaningful and effective way. We propose a minimum dataset as the basis of a functional health information system in countries where health information is lacking. This would involve continuous monitoring of cause-specific mortality through routine civil registration, regular documentation of exposure to leading risk factors, and monitoring effective coverage of key preventive and curative interventions in the health sector. Consideration must be given as to how these minimum data requirements can be effectively integrated within national health information systems, what methods and tools are needed, and ensuring that ethical and political issues are addressed. A more strategic approach to health information systems in sub-Saharan African countries, along these lines, is essential if epidemiological changes are to be tracked effectively for the benefit of local health planners and policy makers. African countries have a unique opportunity to capitalize on modern information and communications technology in order to achieve this. Methodological standards need to be established and political momentum fostered so that the African continent's health status can be reliably tracked. This will greatly strengthen the evidence base for health policies and facilitate the effective delivery of services.

  4. Essential evidence for guiding health system priorities and policies: anticipating epidemiological transition in Africa

    Directory of Open Access Journals (Sweden)

    Peter Byass

    2014-05-01

    Full Text Available Background: Despite indications that infection-related mortality in sub-Saharan Africa may be decreasing and the burden of non-communicable diseases increasing, the overwhelming reality is that health information systems across most of sub-Saharan Africa remain too weak to track epidemiological transition in a meaningful and effective way. Proposals: We propose a minimum dataset as the basis of a functional health information system in countries where health information is lacking. This would involve continuous monitoring of cause-specific mortality through routine civil registration, regular documentation of exposure to leading risk factors, and monitoring effective coverage of key preventive and curative interventions in the health sector. Consideration must be given as to how these minimum data requirements can be effectively integrated within national health information systems, what methods and tools are needed, and ensuring that ethical and political issues are addressed. A more strategic approach to health information systems in sub-Saharan African countries, along these lines, is essential if epidemiological changes are to be tracked effectively for the benefit of local health planners and policy makers. Conclusion: African countries have a unique opportunity to capitalize on modern information and communications technology in order to achieve this. Methodological standards need to be established and political momentum fostered so that the African continent's health status can be reliably tracked. This will greatly strengthen the evidence base for health policies and facilitate the effective delivery of services.

  5. Molecular evidence for ongoing complementarity and horizontal gene transfer in endosymbiotic systems of mealybugs

    Directory of Open Access Journals (Sweden)

    Sergio eLópez-Madrigal

    2014-08-01

    Full Text Available Intracellular bacterial supply of essential amino acids is common among sap-feeding insects, thus complementing the scarcity of nitrogenous compounds in plant phloem. This is also the role of the two mealybug endosymbiotic systems whose genomes have been sequenced. In the nested endosymbiotic system from Planococcus citri (Pseudococcinae, Candidatus Tremblaya princeps and Candidatus Moranella endobia cooperate to synthesize essential amino acids, while in Phenacoccus avenae (Phenacoccinae this function is performed by its single endosymbiont Candidatus Tremblaya phenacola. However, little is known regarding the evolution of essential amino acid supplementation strategies in other mealybug systems. To address this knowledge gap, we screened for the presence of six selected loci involved in essential amino acid biosynthesis in five additional mealybug species. We found evidence of ongoing complementarity among endosymbionts from insects of subfamily Pseudococcinae, as well as horizontal gene transfer affecting endosymbionts from insects of family Phenacoccinae, providing a more comprehensive picture of the evolutionary history of these endosymbiotic systems. Additionally, we report two diagnostic motifs to help identify invasive mealybug species.

  6. Assessment and improvement of the Italian healthcare system: first evidence from a pilot national performance evaluation system.

    Science.gov (United States)

    Nuti, Sabina; Seghieri, Chiara; Vainieri, Milena; Zett, Silvia

    2012-01-01

    The Italian National Health System (NHS), established in 1978, follows a model similar to the Beveridge model developed by the British NHS (Beveridge 1942; Musgrove 2000). Like the British NHS, healthcare coverage for the Italian population is provided and financed by the government through taxes. Universal coverage provides uniform healthcare access to citizens and is the characteristic usually considered the added value of a welfare system financed by tax revenues. Nonetheless, in Italy the strong policy of decentralization, which has been taking place since the early 1990s, has gradually shifted powers from the state to the 21 Italian regions. Consequently, the state now retains limited supervisory control and continues to have overall responsibility for the NHS in order to ensure uniform and essential levels of health services across the country. In this context, it has become essential, both for the ministry and for regions, to adopt a common performance evaluation system (PES). This article reports the definition, implementation, and first evidences of a pilot PES at a national level. It shows how this PES can be viewed as a strategic tool supporting the Ministry of Health (MoH) in ensuring uniform levels of care for the population and assisting regional managers to evaluate performance in benchmarking. Finally, lessons for other health systems, based on the Italian experience, are provided.

  7. Scaling up evidence-based practices for children and families in New York State: toward evidence-based policies on implementation for state mental health systems.

    Science.gov (United States)

    Hoagwood, Kimberly Eaton; Olin, S Serene; Horwitz, Sarah; McKay, Mary; Cleek, Andrew; Gleacher, Alissa; Lewandowski, Eric; Nadeem, Erum; Acri, Mary; Chor, Ka Ho Brian; Kuppinger, Anne; Burton, Geraldine; Weiss, Dara; Frank, Samantha; Finnerty, Molly; Bradbury, Donna M; Woodlock, Kristin M; Hogan, Michael

    2014-01-01

    Dissemination of innovations is widely considered the sine qua non for system improvement. At least two dozen states are rolling out evidence-based mental health practices targeted at children and families using trainings, consultations, webinars, and learning collaboratives to improve quality and outcomes. In New York State (NYS) a group of researchers, policymakers, providers, and family support specialists have worked in partnership since 2002 to redesign and evaluate the children's mental health system. Five system strategies driven by empirically based practices and organized within a state-supported infrastructure have been used in the child and family service system with more than 2,000 providers: (a) business practices, (b) use of health information technologies in quality improvement, (c) specific clinical interventions targeted at common childhood disorders, (d) parent activation, and (e) quality indicator development. The NYS system has provided a laboratory for naturalistic experiments. We describe these initiatives, key findings and challenges, lessons learned for scaling, and implications for creating evidence-based implementation policies in state systems.

  8. Feature engineering and a proposed decision-support system for systematic reviewers of medical evidence.

    Directory of Open Access Journals (Sweden)

    Tanja Bekhuis

    Full Text Available Evidence-based medicine depends on the timely synthesis of research findings. An important source of synthesized evidence resides in systematic reviews. However, a bottleneck in review production involves dual screening of citations with titles and abstracts to find eligible studies. For this research, we tested the effect of various kinds of textual information (features on performance of a machine learning classifier. Based on our findings, we propose an automated system to reduce screeing burden, as well as offer quality assurance.We built a database of citations from 5 systematic reviews that varied with respect to domain, topic, and sponsor. Consensus judgments regarding eligibility were inferred from published reports. We extracted 5 feature sets from citations: alphabetic, alphanumeric(+, indexing, features mapped to concepts in systematic reviews, and topic models. To simulate a two-person team, we divided the data into random halves. We optimized the parameters of a Bayesian classifier, then trained and tested models on alternate data halves. Overall, we conducted 50 independent tests.All tests of summary performance (mean F3 surpassed the corresponding baseline, P<0.0001. The ranks for mean F3, precision, and classification error were statistically different across feature sets averaged over reviews; P-values for Friedman's test were .045, .002, and .002, respectively. Differences in ranks for mean recall were not statistically significant. Alphanumeric(+ features were associated with best performance; mean reduction in screening burden for this feature type ranged from 88% to 98% for the second pass through citations and from 38% to 48% overall.A computer-assisted, decision support system based on our methods could substantially reduce the burden of screening citations for systematic review teams and solo reviewers. Additionally, such a system could deliver quality assurance both by confirming concordant decisions and by naming

  9. The Impact of Three Evidence-Based Programmes Delivered in Public Systems in Birmingham, UK

    Directory of Open Access Journals (Sweden)

    Michael Little

    2012-12-01

    Full Text Available The Birmingham Brighter Futures strategy was informed by epidemiological data on child well-being and evidence on “what works,” and included the implementation and evaluation of three evidence-based programmes in regular children’s services systems, as well as an integrated prospective cost-effectiveness analysis (reported elsewhere. A randomised controlled trial (RCT of the Incredible Years BASIC parenting programme involved 161 children aged three and four at risk of a social-emotional or behavioural disorder. An RCT of the universal PATHS social-emotional learning curriculum involved children aged four–six years in 56 primary schools. An RCT of the Level 4 Group Triple-P parenting programme involved parents of 146 children aged four–nine years with potential social-emotional or behavioural disorders. All three studies used validated standardised measures. Both parenting programme trials used parentcompletedmeasures of child and parenting behaviour. The school-based trial used teacher reports of children’s behaviour, emotions, and social competence.Incredible Years yielded reductions in negative parenting behaviours among parents, reductions in child behaviour problems, and improvements in children’s relationships. In the PATHS trial, modest improvements in emotional health and behavioural development after one year disappeared by the end of year two. There were no effects for Triple-P. Much can be learned from the strengths and limitations of the Birmingham experience.

  10. Patient safety is improved with an incident learning system-Clinical evidence in brachytherapy.

    Science.gov (United States)

    Deufel, Christopher L; McLemore, Luke B; de Los Santos, Luis E Fong; Classic, Kelly L; Park, Sean S; Furutani, Keith M

    2017-10-01

    Health leaders have advocated for incident learning systems (ILSs) to prevent errors, but there is limited evidence demonstrating that ILSs improve cancer patient safety. Herein, we report a long-term retrospective review of ILS reports for the brachytherapy practice at a large academic institution. Over a nine-year period, the brachytherapy practice was encouraged to report all standard operating procedure deviations, including low risk deviations. A multidisciplinary committee assigned root causes and risk scores to all incidents. Evidence based practice changes were made using ILS data, and relevant incidents were communicated to all staff in order to reduce recurrence rates. 5258 brachytherapy procedures were performed and 2238 incidents were reported from 2007 to 2015. A ramp-up period was observed in ILS participation between 2007 (0.12 submissions/procedures) and 2011 (1.55 submissions/procedures). Participation remained stable between 2011 and 2015, and we achieved a 60% (psafety policy and a 70% (ppatient care. Safety improvements have been sustained over several years. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  11. Evidence of tensor correlations in the nuclear many-body system using a modern NN potential

    International Nuclear Information System (INIS)

    Fiase, J.O.; Nkoma, J.S.; Sharmaand, L.K.; Hosaka, A.

    2003-01-01

    In this paper we show evidence of the importance of tensor correlations in the nuclear many-body system by calculating the effective two-body nuclear matrix elements in the frame work of the Lowest-Order Constrained Variational (LOCV) technique with two-body correlation functions using the Reid93 potential. We have achieved this by switching on and off the strength of the tensor correlations, α k . We have found that in order to obtain reasonable agreement with earlier calculations based on the G-matrix theory, we must turn on the strength of the tensor correlations especially in the triplet even (TE) and tensor even (TNE) channels to take the value of approximately, 0.05. As an application, we have estimated the value of the Landau - Migdal parameter, g' NN which we found to be g' NN = 0.65. This compares favorably with the G-matrix calculated value of g' NN = 0.54. (author)

  12. Effects of Withania somnifera on Reproductive System: A Systematic Review of the Available Evidence

    Directory of Open Access Journals (Sweden)

    Ramin Nasimi Doost Azgomi

    2018-01-01

    Full Text Available Introduction. Withania somnifera (WS also known as ashwagandha is a well-known medicinal plant used in traditional medicine in many countries for infertility treatment. The present study was aimed at systemically reviewing therapeutic effects of WS on the reproductive system. Methods. This systematic review study was designed in 2016. Required data were obtained from PubMed, Scopus, Google Scholar, Cochrane Library, Science Direct, Web of Knowledge, Web of Science, and manual search of articles, grey literature, reference checking, and expert contact. Results. WS was found to improve reproductive system function by many ways. WS extract decreased infertility among male subjects, due to the enhancement in semen quality which is proposed due to the enhanced enzymatic activity in seminal plasma and decreasing oxidative stress. Also, WS extract improved luteinizing hormone and follicular stimulating hormone balance leading to folliculogenesis and increased gonadal weight, although some animal studies had concluded that WS had reversible spermicidal and infertilizing effects in male subjects. Conclusion. WS was found to enhance spermatogenesis and sperm related indices in male and sexual behaviors in female. But, according to some available evidences for spermicidal features, further studies should focus on the extract preparation method and also dosage used in their study protocols.

  13. Evidence for two numerical systems that are similar in humans and guppies.

    Directory of Open Access Journals (Sweden)

    Christian Agrillo

    Full Text Available BACKGROUND: Humans and non-human animals share an approximate non-verbal system for representing and comparing numerosities that has no upper limit and for which accuracy is dependent on the numerical ratio. Current evidence indicates that the mechanism for keeping track of individual objects can also be used for numerical purposes; if so, its accuracy will be independent of numerical ratio, but its capacity is limited to the number of items that can be tracked, about four. There is, however, growing controversy as to whether two separate number systems are present in other vertebrate species. METHODOLOGY/PRINCIPAL FINDINGS: In this study, we compared the ability of undergraduate students and guppies to discriminate the same numerical ratios, both within and beyond the small number range. In both students and fish the performance was ratio-independent for the numbers 1-4, while it steadily increased with numerical distance when larger numbers were presented. CONCLUSIONS/SIGNIFICANCE: Our results suggest that two distinct systems underlie quantity discrimination in both humans and fish, implying that the building blocks of uniquely human mathematical abilities may be evolutionarily ancient, dating back to before the divergence of bony fish and tetrapod lineages.

  14. Evidence-based clicker use: Audience Response Systems for rehabilitation nurses.

    Science.gov (United States)

    Miller, Mindi; Hartung, Sheila Q

    2012-01-01

    An Audience Response System (ARS) commonly used in schools and universities was studied for its benefit in rehabilitation. Audience response systems or "clickers" are technological tools for promoting interactive learning. Clickers were studied for their applicability to clinical settings as well. Current literature shows evidence-based research and best practices for clicker use within schools. This study expanded ARS into the rehabilitation milieu and then analyzed learner opinions and outcomes. Qualitative data was obtained from both professional and patient groups. Clickers were used while presenting research findings at conferences, when conducting staff seminars, and during client support groups and subsequent educational sessions. Response graphs and decision trees illustrate the flexibility of ARS for helping educators match presentation content to audience feedback. Clickers narrowed the gap between those with expertise and those with minimal experience, since immediate clarification was given according to clicker results. ARS helped to engage listeners, which is consistent with clicker research conducted in academic environments. With clickers, the knowledge and viewpoints of participants can be instantly graphed and displayed, and pertinent information can be provided in real-time. Examples from rehabilitation scenarios depict benefits of Audience Response Systems beyond academia. © 2012 Association of Rehabilitation Nurses.

  15. A MACROPRUDENTIAL SUPERVISION MODEL. EMPIRICAL EVIDENCE FROM THE CENTRAL AND EASTERN EUROPEAN BANKING SYSTEM

    Directory of Open Access Journals (Sweden)

    Trenca Ioan

    2013-07-01

    Full Text Available One of the positive effects of the financial crises is the increasing concern of the supervisors regarding the financial system’s stability. There is a need to strengthen the links between different financial components of the financial system and the macroeconomic environment. Banking systems that have an adequate capitalization and liquidity level may face easier economic and financial shocks. The purpose of this empirical study is to identify the main determinants of the banking system’s stability and soundness in the Central and Eastern Europe countries. We asses the impact of different macroeconomic variables on the quality of capital and liquidity conditions and examine the behaviour of these financial stability indicators, by analyzing a sample of 10 banking systems during 2000-2011. The availability of banking capital signals the banking system’s resiliency to shocks. Capital adequacy ratio is the main indicator used to assess the banking fragility. One of the causes of the 2008-2009 financial crisis was the lack of liquidity in the banking system which led to the collapse of several banking institutions and macroeconomic imbalances. Given the importance of liquidity for the banking system, we propose several models in order to determine the macroeconomic variables that have a significant influence on the liquid reserves to total assets ratio. We found evidence that GDP growth, inflation, domestic credit to private sector, as well as the money and quasi money aggregate indicator have significant impact on the banking stability. The empirical regression confirms the high level of interdependence of the real sector with the financial-banking sector. Also, they prove the necessity for an effective macro prudential supervision at country level which enables the supervisory authorities to have an adequate control over the macro prudential indicators and to take appropriate decisions at the right time.

  16. Increased Evidence-Based Tobacco Treatment Through Oklahoma Hospital System Changes.

    Science.gov (United States)

    Leuthard, Joy L; Beebe, Laura A; Halstead, LaWanna; Olson, Kimbra D; Roysdon, Jennifer W

    2015-11-01

    Oklahoma hospitals admit approximately 120,000 tobacco users each year, many for diseases resulting from tobacco use. To describe a unique partnership between the Oklahoma Hospital Association and Oklahoma Tobacco Settlement Endowment Trust to reach more tobacco users through the implementation of sustainable health system changes within hospitals and clinics to integrate an evidence-based tobacco treatment protocol for all tobacco-using patients. The Oklahoma Hospital Association tobacco-cessation model included (1) identifying all tobacco-using patients; (2) assessing addiction level and readiness to quit; (3) prescribing medications to manage withdrawal while in hospital; and (4) proactively faxing a referral to the Oklahoma Tobacco Helpline for all patients ready to quit. Helpline registration patterns and characteristics of fax-referred hospitalized patients were tracked for the 4 years of the initiative (2009-2013); data were analyzed in 2013. Twenty-one hospitals and 12 clinics participated in the initiative. Fax referrals to the Helpline increased by > 150% in the first year, from about 600 during the year prior to the implementation of the program (July 2009 to June 2010) to 1,581 from Oklahoma Hospital Association facilities alone in the first year following the launch of the initiative. Nearly 5,600 Oklahoma Hospital Association fax referrals were made during the 4-year study period. About 41% of these referrals resulted in Helpline enrollment (n = 2,289). Sustainable, evidence-based tobacco treatment interventions embedded in hospital systems can successfully identify tobacco users and provide effective treatment, including increased proactive Helpline referrals for quit coaching.

  17. Systemic acquired resistance in moss: further evidence for conserved defense mechanisms in plants.

    Science.gov (United States)

    Winter, Peter S; Bowman, Collin E; Villani, Philip J; Dolan, Thomas E; Hauck, Nathanael R

    2014-01-01

    Vascular plants possess multiple mechanisms for defending themselves against pathogens. One well-characterized defense mechanism is systemic acquired resistance (SAR). In SAR, a plant detects the presence of a pathogen and transmits a signal throughout the plant, inducing changes in the expression of various pathogenesis-related (PR) genes. Once SAR is established, the plant is capable of mounting rapid responses to subsequent pathogen attacks. SAR has been characterized in numerous angiosperm and gymnosperm species; however, despite several pieces of evidence suggesting SAR may also exist in non-vascular plants6-8, its presence in non-vascular plants has not been conclusively demonstrated, in part due to the lack of an appropriate culture system. Here, we describe and use a novel culture system to demonstrate that the moss species Amblystegium serpens does initiate a SAR-like reaction upon inoculation with Pythium irregulare, a common soil-borne oomycete. Infection of A. serpens gametophores by P. irregulare is characterized by localized cytoplasmic shrinkage within 34 h and chlorosis and necrosis within 7 d of inoculation. Within 24 h of a primary inoculation (induction), moss gametophores grown in culture became highly resistant to infection following subsequent inoculation (challenge) by the same pathogen. This increased resistance was a response to the pathogen itself and not to physical wounding. Treatment with β-1,3 glucan, a structural component of oomycete cell walls, was equally effective at triggering SAR. Our results demonstrate, for the first time, that this important defense mechanism exists in a non-vascular plant, and, together with previous studies, suggest that SAR arose prior to the divergence of vascular and non-vascular plants. In addition, this novel moss - pathogen culture system will be valuable for future characterization of the mechanism of SAR in moss, which is necessary for a better understanding of the evolutionary history of SAR in

  18. Systemic acquired resistance in moss: further evidence for conserved defense mechanisms in plants.

    Directory of Open Access Journals (Sweden)

    Peter S Winter

    Full Text Available Vascular plants possess multiple mechanisms for defending themselves against pathogens. One well-characterized defense mechanism is systemic acquired resistance (SAR. In SAR, a plant detects the presence of a pathogen and transmits a signal throughout the plant, inducing changes in the expression of various pathogenesis-related (PR genes. Once SAR is established, the plant is capable of mounting rapid responses to subsequent pathogen attacks. SAR has been characterized in numerous angiosperm and gymnosperm species; however, despite several pieces of evidence suggesting SAR may also exist in non-vascular plants6-8, its presence in non-vascular plants has not been conclusively demonstrated, in part due to the lack of an appropriate culture system. Here, we describe and use a novel culture system to demonstrate that the moss species Amblystegium serpens does initiate a SAR-like reaction upon inoculation with Pythium irregulare, a common soil-borne oomycete. Infection of A. serpens gametophores by P. irregulare is characterized by localized cytoplasmic shrinkage within 34 h and chlorosis and necrosis within 7 d of inoculation. Within 24 h of a primary inoculation (induction, moss gametophores grown in culture became highly resistant to infection following subsequent inoculation (challenge by the same pathogen. This increased resistance was a response to the pathogen itself and not to physical wounding. Treatment with β-1,3 glucan, a structural component of oomycete cell walls, was equally effective at triggering SAR. Our results demonstrate, for the first time, that this important defense mechanism exists in a non-vascular plant, and, together with previous studies, suggest that SAR arose prior to the divergence of vascular and non-vascular plants. In addition, this novel moss - pathogen culture system will be valuable for future characterization of the mechanism of SAR in moss, which is necessary for a better understanding of the evolutionary

  19. Evolution of health coverage in Mexico: evidence of progress and challenges in the Mexican health system.

    Science.gov (United States)

    Urquieta-Salomón, José E; Villarreal, Héctor J

    2016-02-01

    To consolidate an effective and efficient universal health care coverage requires a deep understanding of the challenges faced by the health care system in providing services demanded by population in need. This study analyses the dynamics of health insurance coverage and effective access coverage to some health interventions in Mexico. It examines the evolution of inequalities and heterogeneous performance of the insurance subsystems incorporated under the Mexican health care system. Two types of coverage indicators were selected: health insurance and effective access to preventive health interventions intended for normative population. Data were drawn from National Health and Nutrition Surveys 2006 and 2012. The economic inequality was estimated using the Standardized Concentration Index by household per capita consumption expenditure as socioeconomic-status indicator. Approximately 75% of the population reported being covered by one of the existing insurance schemes, representing a huge step forward from 2006, when as much as 51.62% of the population had no health insurance. About 87% of this growth was attributable to the expansion of Non Contributory Health Insurance whereas 7% emanated from the Social Security subsystem. The results revealed that inequality in access to health insurance was virtually eradicated; however, traces of unequal access persisted in some subpopulations groups. Coverage indicators of effective access showed a slight improvement in the period analysed, but prenatal care and interventions to prevent chronic disease still presented a serious shortage. Furthermore, there was no evidence that inequities in coverage of these interventions have decreased in recent years. The results provided a mixed picture, generalizable to the system as a whole, expansion of insurance status represents one of the most remarkable advances that have not been accompanied by a significant improvement in effective access. In addition, existing inequalities are

  20. Theory and evidence of economies of scale in the development of waste management systems

    International Nuclear Information System (INIS)

    Chang, Shoou-Yuh; Rivera, A.L.

    1989-01-01

    Waste is a cost of doing business. This cost can be considered in terms of the potential adverse health and environmental impacts, or the waste management costs associated with avoiding, minimizing, and controlling those impacts. There is an anticipated increase in the cost of waste management as a result of the increasing requirements for regulatory compliance. To meet the total waste management capacity needs of the organization and the compliance requirements, low-level radioactive, hazardous, and mixed waste management will need demonstrated technologies strategically managed as a technology portfolio. The role of the decision maker is to select the optimum mix of technologies and facilities to provide the waste management capacity needed for the next twenty years. The waste management system resulting from this mix includes multiple small-scale fixed facilities, large-scale centralized facilities, and waste management subcontracts. This study was conducted to examine the theory and evidence of economies of scale in the development of waste management systems as as exploratory research on the economic considerations in the process of technology selection and implementation. 25 refs., 24 figs., 11 tabs

  1. Developing and refining the methods for a 'one-stop shop' for research evidence about health systems.

    Science.gov (United States)

    Lavis, John N; Wilson, Michael G; Moat, Kaelan A; Hammill, Amanda C; Boyko, Jennifer A; Grimshaw, Jeremy M; Flottorp, Signe

    2015-02-25

    Policymakers, stakeholders and researchers have not been able to find research evidence about health systems using an easily understood taxonomy of topics, know when they have conducted a comprehensive search of the many types of research evidence relevant to them, or rapidly identify decision-relevant information in their search results. To address these gaps, we developed an approach to building a 'one-stop shop' for research evidence about health systems. We developed a taxonomy of health system topics and iteratively refined it by drawing on existing categorization schemes and by using it to categorize progressively larger bundles of research evidence. We identified systematic reviews, systematic review protocols, and review-derived products through searches of Medline, hand searches of several databases indexing systematic reviews, hand searches of journals, and continuous scanning of listservs and websites. We developed an approach to providing 'added value' to existing content (e.g., coding systematic reviews according to the countries in which included studies were conducted) and to expanding the types of evidence eligible for inclusion (e.g., economic evaluations and health system descriptions). Lastly, we developed an approach to continuously updating the online one-stop shop in seven supported languages. The taxonomy is organized by governance, financial, and delivery arrangements and by implementation strategies. The 'one-stop shop', called Health Systems Evidence, contains a comprehensive inventory of evidence briefs, overviews of systematic reviews, systematic reviews, systematic review protocols, registered systematic review titles, economic evaluations and costing studies, health reform descriptions and health system descriptions, and many types of added-value coding. It is continuously updated and new content is regularly translated into Arabic, Chinese, English, French, Portuguese, Russian, and Spanish. Policymakers and stakeholders can now easily

  2. Brokerage in commercialised healthcare systems: A conceptual framework and empirical evidence from Uttar Pradesh.

    Science.gov (United States)

    Hunter, Benjamin M

    2018-03-02

    In many contexts there are a range of individuals and organisations offering healthcare services that differ widely in cost, quality and outcomes. This complexity is exacerbated by processes of healthcare commercialisation. Yet reliable information on healthcare provision is often limited, and progress to and through the healthcare system may depend on knowledge drawn from prior experiences, social networks and the providers themselves. It is in these contexts that healthcare brokerage emerges and third-party actors facilitate access to healthcare. This article presents a novel framework for studying brokerage of access to healthcare, and empirical evidence on healthcare brokerage in urban slums in Lucknow, Uttar Pradesh. The framework comprises six areas of interest that have been derived from sociological and political science literature on brokerage. A framework approach was used to group observational and interview data into six framework charts (one for each area of interest) to facilitate close thematic analysis. A cadre of women in Lucknow's urban slums performed healthcare brokerage by encouraging use of particular healthcare services, organising travel, and mediating communications and fee negotiations with providers. The women emphasised their personal role in facilitating access to care and encouraged dependency on their services by withholding information from users. They received commission payments from healthcare programmes, and sometimes from users and hospitals as well, but were blamed for issues beyond their control. Disruption to their ability to facilitate low-cost healthcare meant some women lost their positions as brokers, while others adapted by leveraging old and new relationships with hospital managers. Brokerage analysis reveals how people capitalise on the complexity of healthcare systems by positioning themselves as intermediaries. Commercialised healthcare systems offer a fertile environment for such behaviours, which can undermine

  3. The evidence-base for couple therapy, family therapy and systemic interventions for adult-focused problems

    OpenAIRE

    Carr, Alan

    2014-01-01

    This review updates similar articles published in JFT in 2000 and 2009. It presents evidence from meta-analyses, systematic literature reviews and controlled trials for the effectiveness of couple and family therapy for adults with various relationship and mental health problems. The evidence supports the effectiveness of systemic interventions, either alone or as part of multi-modal programmes, for relationship distress, psychosexual problems, intimate partner violence, anxiety disorders, mo...

  4. ­­Clastic Pipes on Mars: Evidence for a Near Surface Groundwater System

    Science.gov (United States)

    Wheatley, D. F.; Chan, M. A.; Okubo, C. H.

    2017-12-01

    Clastic pipes, a type of vertical, columnar injectite, occur throughout the terrestrial stratigraphic record and are identified across many Martian terrains. Terrestrial pipe analogs can aid in identifying clastic pipes on Mars to understand their formation processes and their implications for a past near-surface groundwater system. On Earth, clastic pipes form through fluidization of overpressurized sediment. Fluidization occurs when the upward frictional (i.e., drag) forces of escaping fluids overpower the downward acting gravitational force. To create the forces necessary for pipe formation requires overpressurization of a body of water-saturated porous media overlain by a low permeability confining layer. As the pressure builds, the confining layer eventually fractures and the escaping fluids fluidize the porous sediment causing the sediment to behave like a fluid. These specific formation conditions record evidence of a violent release of fluid-suspended sediment including brecciation of the host and sealing material, internal outward grading/sorting that results in a coarser-grained commonly better cemented outer rind, traction structures, and a cylindrical geometry. Pipes form self-organized, dispersed spatial relationships due to the efficient diffusion of overpressured zones in the subsurface and the expulsion of sediment under pressure. Martian pipes occur across the northern lowlands, dichotomy boundary, and southern highlands in various forms of erosional relief ranging from newer eruption structures to eroded cylindrical/conical mounds with raised rims to highly eroded mounds/hills. Similar to terrestrial examples, Martian pipes form in evenly-spaced, self-organized arrangements. The pipes are typically internally massive with a raised outer rim (interpreted as a sorted, coarser-grained, better-cemented rim). This evidence indicates that Martian pipes formed through fluidization, which requires a near-surface groundwater system. Pipes create a window

  5. Clinical team functioning and IT innovation: a study of the diffusion of a point-of-care online evidence system.

    Science.gov (United States)

    Gosling, A Sophie; Westbrook, Johanna I; Braithwaite, Jeffrey

    2003-01-01

    To investigate the association between clinical team functioning and diffusion (awareness, use, and impact) of a 24-hour online evidence retrieval system. To examine the relationships between clinical team characteristics and the adoption of the online evidence system. 18 clinical teams, consisting of 180 clinicians from three Australian hospitals, were identified and studied. Teams were categorized as small ( 15). Clinical team functioning was assessed using the Team Climate Inventory (TCI). Awareness, use, and impact of an online evidence retrieval system were measured using a self-administered questionnaire. The relationships between TCI scores and awareness, use, and impact were examined using t-tests and one-way ANOVAs. Chi square analyses were used to examine differences between small and large teams. RESULTS were interpreted within a diffusion of innovations framework. Clinical team functioning was not related to awareness or use of the online evidence retrieval system. However, clinical team functioning was significantly associated with the impact of online evidence in terms of reported experience of improved patient care following system use. Clinicians in small teams ( 15) teams. Team functioning had the greatest impact on the fourth stage of innovation diffusion, the effective use of online evidence for clinical care. This supports Rogers' diffusion of innovation theory, to the effect that different types of communication about an innovation are important at different stages in the diffusion process. Members of small teams were more aware of the system than members of large teams. Team functioning is amenable to improvement through interventions. The findings suggest that the role of team climate in the diffusion of information systems is a promising area for future research.

  6. Evaluation of the Performance of Routine Information System Management (PRISM framework: evidence from Uganda

    Directory of Open Access Journals (Sweden)

    Aqil Anwer

    2010-07-01

    Full Text Available Abstract Background Sound policy, resource allocation and day-to-day management decisions in the health sector require timely information from routine health information systems (RHIS. In most low- and middle-income countries, the RHIS is viewed as being inadequate in providing quality data and continuous information that can be used to help improve health system performance. In addition, there is limited evidence on the effectiveness of RHIS strengthening interventions in improving data quality and use. The purpose of this study is to evaluate the usefulness of the newly developed Performance of Routine Information System Management (PRISM framework, which consists of a conceptual framework and associated data collection and analysis tools to assess, design, strengthen and evaluate RHIS. The specific objectives of the study are: a to assess the reliability and validity of the PRISM instruments and b to assess the validity of the PRISM conceptual framework. Methods Facility- and worker-level data were collected from 110 health care facilities in twelve districts in Uganda in 2004 and 2007 using records reviews, structured interviews and self-administered questionnaires. The analysis procedures include Cronbach's alpha to assess internal consistency of selected instruments, test-retest analysis to assess the reliability and sensitivity of the instruments, and bivariate and multivariate statistical techniques to assess validity of the PRISM instruments and conceptual framework. Results Cronbach's alpha analysis suggests high reliability (0.7 or greater for the indices measuring a promotion of a culture of information, RHIS tasks self-efficacy and motivation. The study results also suggest that a promotion of a culture of information influences RHIS tasks self-efficacy, RHIS tasks competence and motivation, and that self-efficacy and the presence of RHIS staff have a direct influence on the use of RHIS information, a key aspect of RHIS performance

  7. Road traffic related mortality in Vietnam: Evidence for policy from a national sample mortality surveillance system

    Directory of Open Access Journals (Sweden)

    Ngo Anh D

    2012-07-01

    Full Text Available Abstract Background Road traffic injuries (RTIs are among the leading causes of mortality in Vietnam. However, mortality data collection systems in Vietnam in general and for RTIs in particular, remain inconsistent and incomplete. Underlying distributions of external causes and body injuries are not available from routine data collection systems or from studies till date. This paper presents characteristics, user type pattern, seasonal distribution, and causes of 1,061 deaths attributable to road crashes ascertained from a national sample mortality surveillance system in Vietnam over a two-year period (2008 and 2009. Methods A sample mortality surveillance system was designed for Vietnam, comprising 192 communes in 16 provinces, accounting for approximately 3% of the Vietnamese population. Deaths were identified from commune level data sources, and followed up by verbal autopsy (VA based ascertainment of cause of death. Age-standardised mortality rates from RTIs were computed. VA questionnaires were analysed in depth to derive descriptive characteristics of RTI deaths in the sample. Results The age-standardized mortality rates from RTIs were 33.5 and 8.5 per 100,000 for males and females respectively. Majority of deaths were males (79%. Seventy three percent of all deaths were aged from 15 to 49 years and 58% were motorcycle users. As high as 80% of deaths occurred on the day of injury, 42% occurred prior to arrival at hospital, and a further 29% occurred on-site. Direct causes of death were identified for 446 deaths (42% with head injuries being the most common cause attributable to road traffic injuries overall (79% and to motorcycle crashes in particular (78%. Conclusion The VA method can provide a useful data source to analyse RTI mortality. The observed considerable mortality from head injuries among motorcycle users highlights the need to evaluate current practice and effectiveness of motorcycle helmet use in Vietnam. The high number of

  8. Water system hardware and management rehabilitation: Qualitative evidence from Ghana, Kenya, and Zambia.

    Science.gov (United States)

    Klug, Tori; Shields, Katherine F; Cronk, Ryan; Kelly, Emma; Behnke, Nikki; Lee, Kristen; Bartram, Jamie

    2017-05-01

    Sufficient, safe, continuously available drinking water is important for human health and development, yet one in three handpumps in sub-Saharan Africa are non-functional at any given time. Community management, coupled with access to external technical expertise and spare parts, is a widely promoted model for rural water supply management. However, there is limited evidence describing how community management can address common hardware and management failures of rural water systems in sub-Saharan Africa. We identified hardware and management rehabilitation pathways using qualitative data from 267 interviews and 57 focus group discussions in Ghana, Kenya, and Zambia. Study participants were water committee members, community members, and local leaders in 18 communities (six in each study country) with water systems managed by a water committee and supported by World Vision (WV), an international non-governmental organization (NGO). Government, WV or private sector employees engaged in supporting the water systems were also interviewed. Inductive analysis was used to allow for pathways to emerge from the data, based on the perspectives and experiences of study participants. Four hardware rehabilitation pathways were identified, based on the types of support used in rehabilitation. Types of support were differentiated as community or external. External support includes financial and/or technical support from government or WV employees. Community actor understanding of who to contact when a hardware breakdown occurs and easy access to technical experts were consistent reasons for rapid rehabilitation for all hardware rehabilitation pathways. Three management rehabilitation pathways were identified. All require the involvement of community leaders and were best carried out when the action was participatory. The rehabilitation pathways show how available resources can be leveraged to restore hardware breakdowns and management failures for rural water systems in sub

  9. Revisiting the Diego Blood Group System in Amerindians: Evidence for Gene-Culture Comigration.

    Directory of Open Access Journals (Sweden)

    Christophe Bégat

    Full Text Available Six decades ago the DI*A allele of the Diego blood group system was instrumental in proving Native American populations originated from Siberia. Since then, it has received scant attention. The present study was undertaken to reappraise distribution of the DI*A allele in 144 Native American populations based on current knowledge. Using analysis of variance tests, frequency distribution was studied according to geographical, environmental, and cultural parameters. Frequencies were highest in Amazonian populations. In contrast, DI*A was undetectable in subarctic, Fuegian, Panamanian, Chaco and Yanomama populations. Closer study revealed a correlation that this unequal distribution was correlated with language, suggesting that linguistic divergence was a driving force in the expansion of DI*A among Native Americans. The absence of DI*A in circumpolar Eskimo-Aleut and Na-Dene speakers was consistent with a late migratory event confined to North America. Distribution of DI*A in subtropical areas indicated that gene and culture exchanges were more intense within than between ecozones. Bolstering the utility of classical genetic markers in biological anthropology, the present study of the expansion of Diego blood group genetic polymorphism in Native Americans shows strong evidence of gene-culture comigration.

  10. Evidence Report: Risk of Acute and Late Central Nervous System Effects from Radiation Exposure

    Science.gov (United States)

    Nelson, Gregory A.; Simonsen, Lisa; Huff, Janice L.

    2016-01-01

    Possible acute and late risks to the central nervous system (CNS) from galactic cosmic rays (GCR) and solar particle events (SPE) are concerns for human exploration of space. Acute CNS risks may include: altered cognitive function, reduced motor function, and behavioral changes, all of which may affect performance and human health. Late CNS risks may include neurological disorders such as Alzheimer's disease (AD), dementia and premature aging. Although detrimental CNS changes are observed in humans treated with high-dose radiation (e.g., gamma rays and 9 protons) for cancer and are supported by experimental evidence showing neurocognitive and behavioral effects in animal models, the significance of these results on the morbidity to astronauts has not been elucidated. There is a lack of human epidemiology data on which to base CNS risk estimates; therefore, risk projection based on scaling to human data, as done for cancer risk, is not possible for CNS risks. Research specific to the spaceflight environment using animal and cell models must be compiled to quantify the magnitude of CNS changes in order to estimate this risk and to establish validity of the current permissible exposure limits (PELs). In addition, the impact of radiation exposure in combination with individual sensitivity or other space flight factors, as well as assessment of the need for biological/pharmaceutical countermeasures, will be considered after further definition of CNS risk occurs.

  11. Polarimetric Evidence of the First White Dwarf Pulsar: The Binary System AR Scorpii

    Directory of Open Access Journals (Sweden)

    David A.H. Buckley

    2018-01-01

    Full Text Available The binary star AR Scorpii was recently discovered to exhibit high amplitude coherent variability across the electromagnetic spectrum (ultraviolet to radio at two closely spaced ∼2 min periods, attributed to the spin period of a white dwarf and the beat period. There is strong evidence (low X-ray luminosity, lack of flickering and absense of broad emission lines that AR Sco is a detached non-accreting system whose luminosity is dominated by the spin-down power of a white dwarf, due to magnetohydrodynamical (MHD interactions with its M5 companion. Optical polarimetry has revealed highly pulsed linear polarization on the same periods, reaching a maximum of 40%, consistent with a pulsar-like dipole, with the Stokes Q and U variations reminiscent of the Crab pulsar. These observations, coupled with the spectral energy distribution (SED which is dominated by non-thermal emission, characteristic of synchrotron emission, support the notion that a strongly magnetic (∼200 MG white dwarf is behaving like a pulsar, whose magnetic field interacts with the secondary star’s photosphere and magnetosphere. Radio synchrotron emission is produced from the pumping action of the white dwarf’s magnetic field on coronal loops from the M-star companion, while emission at high frequencies (UV/optical/X-ray comes from the particle wind, driven by large electric potential, again reminiscent of processes seen in neutron star pulsars.

  12. The vasopressin system: new insights for patients with kidney diseases: Epidemiological evidence and therapeutic perspectives.

    Science.gov (United States)

    Clark, W F; Devuyst, O; Roussel, R

    2017-10-01

    People with chronic kidney disease (CKD) are at risk of severe outcomes, such as end-stage renal disease or cardiovascular disease, and CKD is a globally increasing health burden with a high personal and economic cost. Despite major progresses in prevention and therapeutics in last decades, research is still needed to reverse this epidemic trend. The regulation of water balance and the state of activation of the vasopressin system have emerged as factors tightly associated with kidney health, in the general population but also in specific conditions; among them, various stages of CKD, diabetes and autosomal dominant polycystic kidney disease (ADPKD). Basic science findings and also epidemiological evidence have justified important efforts towards interventional studies supporting causality, and opening therapeutic avenues. On the basis of recent clinical data, the blockade of V2 vasopressin receptors using tolvaptan in patients with rapidly progressing ADPKD has been granted in several countries, and a long-term randomized trial evaluating the effect of an increase in water intake in patients with CKD is on-going. © 2017 The Association for the Publication of the Journal of Internal Medicine.

  13. Use of Electronic Nicotine Delivery Systems Among Adolescents: Status of the Evidence and Public Health Recommendations.

    Science.gov (United States)

    Kamat, Aarti D; Van Dyke, Alison L

    2017-02-01

    Although the prevalence of tobacco smoking has been declining in recent years, the use of electronic nicotine delivery systems (ENDS) such as of electronic cigarettes, vaporizers, and hookahs has been steadily rising, especially among adolescents. ENDS are not only advertised to children, but their sale via the Internet has made them easily accessible to youth. In general, children perceive ENDS as safe, or at least safer than smoking traditional combustible tobacco products; however, exposure to nicotine may have deleterious effects on the developing brain. Concern also persists that ENDS may be a "starter" drug that may lead to further tobacco, drug, and/or alcohol use. In contrast to this precautionary stance that is associated with calls for legislative oversight of ENDS marketing and sales, harm reductionists claim that the risks posed by ENDS are minor in comparison with those of combustible tobacco products and that ENDS may be used as a means of nicotine replacement for smoking cessation, despite no concrete evidence to support this assertion. Many medical and health-related organizations have produced position statements concerning ENDS use, including among adolescents. This article summarizes the advantages and disadvantages of using ENDS espoused in these position statements, especially as they relate to use among adolescents. [Pediatr Ann. 2017;46(2):e69-e77.]. Copyright 2017, SLACK Incorporated.

  14. Preliminary evidence for a role of the adrenergic nervous system in generalized anxiety disorder.

    Science.gov (United States)

    Zhang, Xiaobin; Norton, Joanna; Carrière, Isabelle; Ritchie, Karen; Chaudieu, Isabelle; Ryan, Joanne; Ancelin, Marie-Laure

    2017-02-15

    Generalized anxiety disorder (GAD) is a common chronic condition that is understudied compared to other psychiatric disorders. An altered adrenergic function has been reported in GAD, however direct evidence for genetic susceptibility is missing. This study evaluated the associations of gene variants in adrenergic receptors (ADRs) with GAD, with the involvement of stressful events. Data were obtained from 844 French community-dwelling elderly aged 65 or over. Anxiety disorders were assessed using the Mini-International Neuropsychiatry Interview, according to DSM-IV criteria. Eight single-nucleotide polymorphisms (SNPs) involved with adrenergic function were genotyped; adrenergic receptors alpha(1A) (ADRA1A), alpha(2A) (ADRA2A), and beta2 (ADRB2) and transcription factor TCF7L2. Questionnaires evaluated recent stressful life events as well as early environment during childhood and adolescence. Using multivariate logistic regression analyses four SNPs were significantly associated with GAD. A 4-fold modified risk was found with ADRA1A rs17426222 and rs573514, and ADRB2 rs1042713 which remained significant after Bonferroni correction. Certain variants may moderate the effect of adverse life events on the risk of GAD. Replication in larger samples is needed due to the small case number. This is the first study showing that ADR variants are susceptibility factors for GAD, further highlighting the critical role of the adrenergic nervous system in this disorder.

  15. Cerebrospinal fluid analysis in fatal thallium poisoning: evidence for delayed distribution into the central nervous system.

    Science.gov (United States)

    Sharma, Adhi N; Nelson, Lewis S; Hoffman, Robert S

    2004-06-01

    The neurologic manifestations of thallium poisoning include a severely painful ascending peripheral neuropathy, autonomic dysfunction, cranial nerve abnormalities, and a toxic encephalopathy. Although thallium has a short half-life, these neurologic manifestations commonly progress, even as the blood concentration of thallium decreases. This suggests either that thallium persists in neuronal tissues or that it initiates an injury cascade that takes time to fully manifest. As the latter mechanism is consistent with many toxin exposures, the concept of a central nervous system reservoir for thallium is often discounted. A recent case provided a unique opportunity to evaluate this possibility. A 48-year-old man was acutely and chronically thallium poisoned by his common-law wife. During his initial exposures, only gastrointestinal symptoms manifested. Following an acute ingestion, hospitalization was required. Over 3 days, his symptoms rapidly progressed from a severely painful neuropathy to slurred speech, ptosis, confusion, coma, respiratory insufficiency, and death. Because of considerations of alternative diagnoses, 2 lumbar punctures were performed, one on admission and another on the day of his death. Serum thallium concentrations obtained from stored blood samples were paired with spinal fluid concentrations from the same days. On day 1, serum and spinal fluid concentrations were 8700 mu/L and 1200 mu/L, respectively. On day 3, although the serum concentration had fallen to 7200 mu/L, the spinal fluid concentration had increased to 2100 mu/L. This case provides evidence to support the hypothesis that thallium distributes into the central nervous system more slowly than the blood compartment, and this may in part account for the progression of neurologic findings in the setting of decreasing serum concentrations.

  16. Human resource information systems in health care: a systematic evidence review.

    Science.gov (United States)

    Tursunbayeva, Aizhan; Bunduchi, Raluca; Franco, Massimo; Pagliari, Claudia

    2017-05-01

    This systematic review aimed to: (1) determine the prevalence and scope of existing research on human resource information systems (HRIS) in health organizations; (2) analyze, classify, and synthesize evidence on the processes and impacts of HRIS development, implementation, and adoption; and (3) generate recommendations for HRIS research, practice, and policy, with reference to the needs of different stakeholders. A structured search strategy was used to interrogate 10 electronic databases indexing research from the health, social, management, technology, and interdisciplinary sciences, alongside gray literature sources and reference lists of qualifying studies. There were no restrictions on language or publication year. Two reviewers screened publications, extracted data, and coded findings according to the innovation stages covered in the studies. The Critical Appraisal Skills Program checklist was adopted to assess study quality. The process of study selection was charted using a Preferred Items for Systematic Reviews and Meta-Analysis (PRISMA) diagram. Of the 6824 publications identified by the search strategy, 68, covering 42 studies, were included for final analysis. Research on HRIS in health was interdisciplinary, often atheoretical, conducted primarily in the hospital sector of high-income economies, and largely focused uncritically on use and realized benefits. While studies of HRIS in health exist, the overall lack of evaluative research raises unanswered questions about their capacity to improve quality and efficiency and enable learning health systems, as well as how sociotechnical complexity influences implementation and effectiveness. We offer this analysis to decision makers and managers considering or currently implementing an HRIS, and make recommendations for further research. International Prospective Register of Systematic Reviews (PROSPERO): CRD42015023581. http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42015023581#.VYu1BPl

  17. Evidence evaluation in fingerprint comparison and automated fingerprint identification systems--Modeling between finger variability.

    Science.gov (United States)

    Egli Anthonioz, N M; Champod, C

    2014-02-01

    In the context of the investigation of the use of automated fingerprint identification systems (AFIS) for the evaluation of fingerprint evidence, the current study presents investigations into the variability of scores from an AFIS system when fingermarks from a known donor are compared to fingerprints that are not from the same source. The ultimate goal is to propose a model, based on likelihood ratios, which allows the evaluation of mark-to-print comparisons. In particular, this model, through its use of AFIS technology, benefits from the possibility of using a large amount of data, as well as from an already built-in proximity measure, the AFIS score. More precisely, the numerator of the LR is obtained from scores issued from comparisons between impressions from the same source and showing the same minutia configuration. The denominator of the LR is obtained by extracting scores from comparisons of the questioned mark with a database of non-matching sources. This paper focuses solely on the assignment of the denominator of the LR. We refer to it by the generic term of between-finger variability. The issues addressed in this paper in relation to between-finger variability are the required sample size, the influence of the finger number and general pattern, as well as that of the number of minutiae included and their configuration on a given finger. Results show that reliable estimation of between-finger variability is feasible with 10,000 scores. These scores should come from the appropriate finger number/general pattern combination as defined by the mark. Furthermore, strategies of obtaining between-finger variability when these elements cannot be conclusively seen on the mark (and its position with respect to other marks for finger number) have been presented. These results immediately allow case-by-case estimation of the between-finger variability in an operational setting. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Credit Risk Determinants in the Vulnerable Economies of Europe: Evidence from the Spanish Banking System

    Directory of Open Access Journals (Sweden)

    Gila-Gourgoura, E.

    2017-03-01

    Full Text Available Purpose: The purpose of this paper is to investigate the determinants of non-performing loans in the Spanish banking system over the period 1997Q4–2015Q3. This timeframe includes not only the booming period for the Spanish economy but also an extended post-crises interval which is missing from other studies for Spain. Design/methodology/approach: Using quarterly data from the Central Bank of Spain and from the European Central Bank, the paper employs the ARDL approach to cointegration to identify the existence of a long or short-run relationship between NPLs and a set of macroeconomic, bank-related and country-specific indicators. Findings: Findings from the ARDL model indicate that macroeconomic, bank-specific variables and interest rates are important determinants of non-performing loans in the Spanish banking system. Specifically, the real GDP, the Spanish long-term government bond yield, the return on equity, the total credit granted by the Spanish banks and their capital to assets ratio, explain credit risk in Spain both in the short and the long run. Research limitations/implications: Data on the bank-specific variables are for the whole banking industry, and not for individual banks. If such data were available, a comparison of the credit risk determinants between small/ big banks, private/public or domestic/foreign could be possibly made. Originality/value: These findings provide useful evidence to bank managers and policymakers in dealing with loans' defaults in Spain and in undertaking crucial reforms to stabilize the economy.

  19. There is No Evidence on the Effect of the Attachment System on Implant Survival Rate, Overdenture Maintenance, or Patient Satisfaction.

    Science.gov (United States)

    Alqutaibi, Ahmed Yaseen

    2015-12-01

    Attachment systems for mandibular implant overdentures: a systematic review. Kim HY, Lee JY, Shin SW, Bryant SR.J Advanced Prosthodont 2012;4(4):197-203. Ahmed Yaseen Alqutaibi, BDS, MDSc, PhD(c) To address treatment outcomes depending on attachment systems for two-implant mandibular-supported overdentures in terms of (1) implant survival rate, (2) prosthetic maintenance and complications, and (3) patient satisfaction. Systematic review Level 2: Limited-quality, patient-oriented evidence Grade B: Inconsistent, limited-quality patient-oriented evidence. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Lessons Learned From a System-wide Evidence-Based Practice Program Implementation

    Science.gov (United States)

    2017-04-25

    Evidence-based practice (EBP) is described as incorporating scientific evidence, clinical expertise and the patient’s values and preferences into the...The purpose of the 59 MDW EBP program implementation project is to determine the organization’s cultural readiness for enterprise-wide implementation of EBP by identifying EBP beliefs and behaviors of the nursing staff.

  1. Do you do Damon®? What is the current evidence base underlying the philosophy of this appliance system?

    Science.gov (United States)

    Wright, Natasha; Modarai, Faranak; Cobourne, Martyn T; Dibiase, Andrew T

    2011-09-01

    Self-ligating bracket systems are increasing in popularity amongst orthodontists. This reflects their high quality engineering, improved reliability and relative ease of use. However, it might also be related to claims of superior function made by the manufacturers of these appliances. In particular, the Damon(®) appliance system claims to offer significant advantages to both orthodontist and patient over conventional-ligation and other forms of self-ligated appliances. We have reviewed current literature relating to use of the Damon(®) appliance system. There is some evidence to suggest this appliance may lead to reductions in chairside time for the orthodontist, particularly those experienced with this system, in comparison to conventional-ligation. However, evidence that pain experience is reduced for the patient when using Damon(®) brackets is not conclusive. In the presence of identical archwire sequences, there is no evidence that Damon(®) brackets can align teeth faster or in a qualitatively differently manner, when compared with conventional-ligation. There is no high quality evidence that treatment with the Damon(®) appliance takes place more rapidly or leads to a superior occlusal or aesthetic result. Indeed, the best available evidence would suggest there is no difference in treatment outcome or time, at least in extraction cases. There is no evidence that treatment with the Damon(®) appliance is more stable. Claims relating to improved clinical performance of the Damon(®) appliance system are currently being made to orthodontists and patients that are not substantiated in the scientific literature.

  2. Floristic indicators of tropical landuse systems: Evidence from mining areas in Southwestern Nigeria

    Directory of Open Access Journals (Sweden)

    Sehinde Akinbiola

    2016-07-01

    Full Text Available Most forests in the tropics have not only been reduced in size but have also experienced forest degradation. The delicate balance of the components of the forest ecosystem has been altered largely by the landuse systems which have resulted in the disappearance of some species and the introduction of new ones. In order to understand the influence of human disturbance caused by artisanal mining on plant biodiversity and the physical environment, this study assessed changes in vegetation characteristics using plant functional groups, such as invasive, pioneer and understory species. The study was conducted at two sites in two Southwestern states of Nigeria, Itagunmodi in Atakumosa West Local Government Area of Osun State and Olode in Oluyole Local Government Area of Oyo State. Complete enumerations of woody, non-woody and herbaceous plant species were carried out in 20 m by 20 m plots selected using stratified random sampling as representative of landuse classes: freshly mined (6 months and a control plot (secondary forest. The results showed that the control plot in Itagunmodi had undergone degradation as indicated by the presence of Alchornea laxiflora, Geophilia obvallata, Musa sapientum,Elaeis guineensis and Keetia hispida. However, if left undisturbed, it has the potential of regeneration back to its original state because of its woody tree species composition and lianas (Triclisia gilletii. In addition the forest soils in the mines had been exposed to direct insolation for a long period, and the soil structure and texture have been affected, consequently altering the viability of the seed bank. Poaceae and Papilionoideae were the most common in the freshly mined plots while invasive species were the most common in abandoned mined plots. In conclusion, the floristic composition in the mining sites has been altered and there was no clear evidence that regrowth would bring restoration of the lost ecosystem services.

  3. Multi-Sensor Building Fire Alarm System with Information Fusion Technology Based on D-S Evidence Theory

    Directory of Open Access Journals (Sweden)

    Qian Ding

    2014-10-01

    Full Text Available Multi-sensor and information fusion technology based on Dempster-Shafer evidence theory is applied in the system of a building fire alarm to realize early detecting and alarming. By using a multi-sensor to monitor the parameters of the fire process, such as light, smoke, temperature, gas and moisture, the range of fire monitoring in space and time is expanded compared with a single-sensor system. Then, the D-S evidence theory is applied to fuse the information from the multi-sensor with the specific fire model, and the fire alarm is more accurate and timely. The proposed method can avoid the failure of the monitoring data effectively, deal with the conflicting evidence from the multi-sensor robustly and improve the reliability of fire warning significantly.

  4. Seismic Evidence for Conjugate Slip and Block Rotation Within the San Andreas Fault System, Southern California

    Science.gov (United States)

    Nicholson, Craig; Seeber, Leonardo; Williams, Patrick; Sykes, Lynn R.

    1986-08-01

    The pattern of seismicity in southern California indicates that much of the activity is presently occurring on secondary structures, several of which are oriented nearly orthogonal to the strikes of the major through-going faults. Slip along these secondary transverse features is predominantly left-lateral and is consistent with the reactivation of conjugate faults by the current regional stress field. Near the intersection of the San Jacinto and San Andreas faults, however, these active left-lateral faults appear to define a set of small crustal blocks, which in conjunction with both normal and reverse faulting earthquakes, suggests contemporary clockwise rotation as a result of regional right-lateral shear. Other left-lateral faults representing additional rotating block systems are identified in adjacent areas from geologic and seismologic data. Many of these structures predate the modern San Andreas system and may control the pattern of strain accumulation in southern California. Geodetic and paleomagnetic evidence confirm that block rotation by strike-slip faulting is nearly ubiquitous, particularly in areas where shear is distributed, and that it accommodates both short-term elastic and long-term nonelastic strain. A rotating block model accounts for a number of structural styles characteristic of strike-slip deformation in California, including: variable slip rates and alternating transtensional and transpressional features observed along strike of major wrench faults; domains of evenly-spaced antithetic faults that terminate against major fault boundaries; continued development of bends in faults with large lateral displacements; anomalous focal mechanisms; and differential uplift in areas otherwise expected to experience extension and subsidence. Since block rotation requires a detachment surface at depth to permit rotational movement, low-angle structures like detachments, of either local or regional extent, may be involved in the contemporary strike

  5. Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence.

    Science.gov (United States)

    Javadi, D; Feldhaus, I; Mancuso, A; Ghaffar, A

    2017-01-01

    This paper seeks to review the available evidence to determine whether a systems approach is employed in the implementation and evaluation of task shifting for mental health using lay providers in low- and middle-income countries, and to highlight system-wide effects of task-shifting strategies in order to better inform efforts to strength community mental health systems. Pubmed, CINAHL, and Cochrane Library databases were searched. Articles were screened by two independent reviewers with a third reviewer resolving discrepancies. Two stages of screens were done to ensure sensitivity. Studies were analysed using the World Health Organization's building blocks framework with the addition of a community building block, and systems thinking characteristics to determine the extent to which system-wide effects had been considered. Thirty studies were included. Almost all studies displayed positive findings on mental health using task shifting. One study showed no effect. No studies explicitly employed systems thinking tools, but some demonstrated systems thinking characteristics, such as exploring various stakeholder perspectives, capturing unintended consequences, and looking across sectors for system-wide impact. Twenty-five of the 30 studies captured elements other than the most directly relevant building blocks of service delivery and health workforce. There is a lack of systematic approaches to exploring complexity in the evaluation of task-shifting interventions. Systems thinking tools should support evidence-informed decision making for a more complete understanding of community-based systems strengthening interventions for mental health.

  6. European evidence-based recommendations for diagnosis and treatment of childhood-onset systemic lupus erythematosus : The SHARE initiative

    NARCIS (Netherlands)

    Groot, Noortje; De Graeff, Nienke; Avcin, Tadej; Bader-Meunier, Brigitte; Brogan, Paul A.; Dolezalova, Pavla; Feldman, Brian M.; Kone-Paut, Isabelle; Lahdenne, Pekka; Marks, Stephen D; McCann, Liza J.; Ozen, Seza; Pilkington, Clarissa; Ravelli, Angelo; Royen-Kerkhof, Annet Van; Uziel, Yosef; Vastert, Bas; Wulffraat, Nico; Kamphuis, Sylvia; Beresford, Michael W.

    2017-01-01

    Childhood-onset systemic lupus erythematosus (cSLE) is a rare, multisystem and potentially life-Threatening autoimmune disorder with significant associated morbidity. Evidence-based guidelines are sparse and management is often based on clinical expertise. SHARE (Single Hub and Access point for

  7. Evidence-based Metrics Toolkit for Measuring Safety and Efficiency in Human-Automation Systems

    Data.gov (United States)

    National Aeronautics and Space Administration — APRIL 2016 NOTE: Principal Investigator moved to Rice University in mid-2015. Project continues at Rice with the same title (Evidence-based Metrics Toolkit for...

  8. Lessons Learned from A System-Wide Evidence-Based Practice Program Implementation

    Science.gov (United States)

    2017-04-25

    military nurses that provide a higher quality and safer care for our warfighters and their families. Key words: evidence-based practice, EBP, EBP...Practice Program Implementation presented at/published to 2017 Triservice Nursing Research and Evidence-Based Practice Dissemination Course, Ellicott...S9 MOW CRD Graduate Health Sciences Education (GHSE) (SGS O&M); SGS R&D; Tri-Service Nursing Research Program (TSNRP): Defense Medical Research

  9. What supports do health system organizations have in place to facilitate evidence-informed decision-making? A qualitative study.

    Science.gov (United States)

    Ellen, Moriah E; Léon, Gregory; Bouchard, Gisèle; Lavis, John N; Ouimet, Mathieu; Grimshaw, Jeremy M

    2013-08-06

    Decisions regarding health systems are sometimes made without the input of timely and reliable evidence, leading to less than optimal health outcomes. Healthcare organizations can implement tools and infrastructures to support the use of research evidence to inform decision-making. The purpose of this study was to profile the supports and instruments (i.e., programs, interventions, instruments or tools) that healthcare organizations currently have in place and which ones were perceived to facilitate evidence-informed decision-making. In-depth semi-structured telephone interviews were conducted with individuals in three different types of positions (i.e., a senior management team member, a library manager, and a 'knowledge broker') in three types of healthcare organizations (i.e., regional health authorities, hospitals and primary care practices) in two Canadian provinces (i.e., Ontario and Quebec). The interviews were taped, transcribed, and then analyzed thematically using NVivo 9 qualitative data analysis software. A total of 57 interviews were conducted in 25 organizations in Ontario and Quebec. The main findings suggest that, for the healthcare organizations that participated in this study, the following supports facilitate evidence-informed decision-making: facilitating roles that actively promote research use within the organization; establishing ties to researchers and opinion leaders outside the organization; a technical infrastructure that provides access to research evidence, such as databases; and provision and participation in training programs to enhance staff's capacity building. This study identified the need for having a receptive climate, which laid the foundation for the implementation of other tangible initiatives and supported the use of research in decision-making. This study adds to the literature on organizational efforts that can increase the use of research evidence in decision-making. Some of the identified supports may increase the use of

  10. Molecular evidence for a functional ecdysone signaling system in Brugia malayi.

    Directory of Open Access Journals (Sweden)

    George Tzertzinis

    2010-03-01

    Full Text Available Filarial nematodes, including Brugia malayi, the causative agent of lymphatic filariasis, undergo molting in both arthropod and mammalian hosts to complete their life cycles. An understanding of how these parasites cross developmental checkpoints may reveal potential targets for intervention. Pharmacological evidence suggests that ecdysteroids play a role in parasitic nematode molting and fertility although their specific function remains unknown. In insects, ecdysone triggers molting through the activation of the ecdysone receptor: a heterodimer of EcR (ecdysone receptor and USP (Ultraspiracle.We report the cloning and characterization of a B. malayi EcR homologue (Bma-EcR. Bma-EcR dimerizes with insect and nematode USP/RXRs and binds to DNA encoding a canonical ecdysone response element (EcRE. In support of the existence of an active ecdysone receptor in Brugia we also cloned a Brugia rxr (retinoid X receptor homolog (Bma-RXR and demonstrate that Bma-EcR and Bma-RXR interact to form an active heterodimer using a mammalian two-hybrid activation assay. The Bma-EcR ligand-binding domain (LBD exhibits ligand-dependent transactivation via a GAL4 fusion protein combined with a chimeric RXR in mammalian cells treated with Ponasterone-A or a synthetic ecdysone agonist. Furthermore, we demonstrate specific up-regulation of reporter gene activity in transgenic B. malayi embryos transfected with a luciferase construct controlled by an EcRE engineered in a B. malayi promoter, in the presence of 20-hydroxy-ecdysone.Our study identifies and characterizes the two components (Bma-EcR and Bma-RXR necessary for constituting a functional ecdysteroid receptor in B. malayi. Importantly, the ligand binding domain of BmaEcR is shown to be capable of responding to ecdysteroid ligands, and conversely, ecdysteroids can activate transcription of genes downstream of an EcRE in live B. malayi embryos. These results together confirm that an ecdysone signaling system

  11. Fuzzy Decision-Making Fuser (FDMF for Integrating Human-Machine Autonomous (HMA Systems with Adaptive Evidence Sources

    Directory of Open Access Journals (Sweden)

    Yu-Ting Liu

    2017-06-01

    Full Text Available A brain-computer interface (BCI creates a direct communication pathway between the human brain and an external device or system. In contrast to patient-oriented BCIs, which are intended to restore inoperative or malfunctioning aspects of the nervous system, a growing number of BCI studies focus on designing auxiliary systems that are intended for everyday use. The goal of building these BCIs is to provide capabilities that augment existing intact physical and mental capabilities. However, a key challenge to BCI research is human variability; factors such as fatigue, inattention, and stress vary both across different individuals and for the same individual over time. If these issues are addressed, autonomous systems may provide additional benefits that enhance system performance and prevent problems introduced by individual human variability. This study proposes a human-machine autonomous (HMA system that simultaneously aggregates human and machine knowledge to recognize targets in a rapid serial visual presentation (RSVP task. The HMA focuses on integrating an RSVP BCI with computer vision techniques in an image-labeling domain. A fuzzy decision-making fuser (FDMF is then applied in the HMA system to provide a natural adaptive framework for evidence-based inference by incorporating an integrated summary of the available evidence (i.e., human and machine decisions and associated uncertainty. Consequently, the HMA system dynamically aggregates decisions involving uncertainties from both human and autonomous agents. The collaborative decisions made by an HMA system can achieve and maintain superior performance more efficiently than either the human or autonomous agents can achieve independently. The experimental results shown in this study suggest that the proposed HMA system with the FDMF can effectively fuse decisions from human brain activities and the computer vision techniques to improve overall performance on the RSVP recognition task. This

  12. Interactions between hare and brent goose in a salt marsh system : evidence for food competition?

    NARCIS (Netherlands)

    van der Wal, R; Kunst, P; Drent, R

    1998-01-01

    In this study we accumulate evidence that brown hare competes with brent goose for food resources in a temperate salt marsh. We show that both species overlap in habitat use and share food plants. The two herbivores mainly used the common habitat at different times of the day, with hares active in

  13. Ancient coastal transportation system along the Western Saurashtra coast: Evidence from Navibandar

    Digital Repository Service at National Institute of Oceanography (India)

    Gaur, A; Sundaresh; Tripati, S.

    . Navibandar is situated on the eastern bank of the River Bhadar which joins the Arabian Sea about half a kilometre west of the village. The evidence recorded suggests that Navibandar played an auxiliary role to Porbandar port in maritime activities during...

  14. Physical, psychological, sexual, and systemic abuse of children with disabilities in East Africa: Mapping the evidence.

    Directory of Open Access Journals (Sweden)

    Niall Winters

    Full Text Available Children with disabilities (CWDs are at a higher risk of being maltreated than are typical children. The evidence base on the abuse of children with disabilities living in low- and middle-income countries is extremely limited but the problem is particularly acute in East Africa. We don't know the types of evidence that exist on this topic. This problem is compounded by the fact that key indicators of disability, such as reliable prevalence rates, are not available currently. This paper addresses this serious problem by mapping the existing evidence-base to document the coverage, patterns, and gaps in existing research on the abuse of children with disabilities in East Africa. An evidence map, following systematic review guidelines, was conducted and included a systematic search, transparent and structured data extraction, and critical appraisal. Health and social science databases (Medline, EMBASE, PsychInfo, Taylor&Francis, Web of Science, and SAGE were systematically searched for relevant studies. A substantive grey literature search was also conducted. All empirical research on the abuse of CWDs in East Africa was eligible for inclusion: Data on abuse was systematically extracted and the research evidence, following critical appraisal, mapped according to the type of abuse and disability condition, highlighting gaps and patterns in the evidence-base. 6005 studies were identified and screened, of which 177 received a full-text assessment. Of these, 41 studies matched the inclusion criteria. By mapping the available data and reports and systematically assessing their trustworthiness and relevance, we highlight significant gaps in the available evidence base. Clear patterns emerge that show a major data gap and lack of research on sexual abuse of children with disabilities and an identifiable lack of methodological quality in many relevant studies. These make the development of a concerted and targeted research effort to tackle the abuse of

  15. A Novel Evaluation Model for Hybrid Power System Based on Vague Set and Dempster-Shafer Evidence Theory

    Directory of Open Access Journals (Sweden)

    Dongxiao Niu

    2012-01-01

    Full Text Available Because clean energy and traditional energy have different advantages and disadvantages, it is of great significance to evaluate comprehensive benefits for hybrid power systems. Based on thorough analysis of important characters on hybrid power systems, an index system including security, economic benefit, environmental benefit, and social benefit is established in this paper. Due to advantages of processing abundant uncertain and fuzzy information, vague set is used to determine the decision matrix. Convert vague decision matrix to real one by vague combination ruleand determine uncertain degrees of different indexes by grey incidence analysis, then the mass functions of different comment set in different indexes are obtained. Information can be fused in accordance with Dempster-Shafer (D-S combination rule and the evaluation result is got by vague set and D-S evidence theory. A simulation of hybrid power system including thermal power, wind power, and photovoltaic power in China is provided to demonstrate the effectiveness and potential of the proposed design scheme. It can be clearly seen that the uncertainties in decision making can be dramatically decreased compared with existing methods in the literature. The actual implementation results illustrate that the proposed index system and evaluation model based on vague set and D-S evidence theory are effective and practical to evaluate comprehensive benefit of hybrid power system.

  16. Applying systems engineering to implement an evidence-based intervention at a community health center.

    Science.gov (United States)

    Tu, Shin-Ping; Feng, Sherry; Storch, Richard; Yip, Mei-Po; Sohng, HeeYon; Fu, Mingang; Chun, Alan

    2012-11-01

    Impressive results in patient care and cost reduction have increased the demand for systems-engineering methodologies in large health care systems. This Report from the Field describes the feasibility of applying systems-engineering techniques at a community health center currently lacking the dedicated expertise and resources to perform these activities.

  17. Systemic Risk-Taking at Banks: Evidence from the Pricing of Syndicated Loans

    NARCIS (Netherlands)

    D. Gong (Di); W.B. Wagner (Wolf)

    2016-01-01

    textabstractPublic guarantees extended during systemic crises can affect the relative pricing of risks in the financial system. Studying the market for syndicated loans, we find that banks require lower compensation for aggregate risk than for idiosyncratic risk, consistent with systemic risk-taking

  18. Policy issues for Australia's education systems: Evidence from international and Australian research

    OpenAIRE

    Gary N. Marks; Julie McMillan; John Ainley

    2004-01-01

    Our purpose here is to discuss education policy issues in the context of empirical evidence. We note that many commonly held beliefs about Australian education such as, the relative performance and participation levels of Australian students; the importance of socioeconomic background on educational outcomes both relative to other countries and changes over-time; gender differences in mathematics and science; and the labour market situation of early school leavers; are not supported by empiri...

  19. Chitosan solutions as injectable systems for dermal filler applications: Rheological characterization and biological evidence.

    Science.gov (United States)

    Halimi, C; Montembault, A; Guerry, A; Delair, T; Viguier, E; Fulchiron, R; David, L

    2015-01-01

    A new generation of dermal filler for wrinkle filler based on chitosan was compared to current hyaluronic acid-based dermal fillers by using a new rheological performance criterion based on viscosity during injection related to Newtonian viscosity. In addition an in vivo evaluation was performed for preclinical evidence of chitosan use as dermal filler. In this way, biocompatibility and dermis reconstruction was evaluated on a pig model.

  20. Regulation of Aeroallergen Immunity by the Innate Immune System: Laboratory Evidence for a New Paradigm

    OpenAIRE

    Horner, Anthony A.

    2009-01-01

    Over the last decade, it has become increasingly clear that innate responses to microbes are mediated largely by toll-like receptors (TLRs), which recognize a diverse family of molecules produced by viruses, bacteria and fungi. This article will present evidence that TLRs also play a dominant role in innate responses to non-infectious immunostimulatory materials present in house dust extracts (HDEs) and the living environments they represent. However, our investigations challenge the commonly...

  1. The influence of system quality characteristics on health care providers' performance: Empirical evidence from Malaysia.

    Science.gov (United States)

    Mohd Salleh, Mohd Idzwan; Zakaria, Nasriah; Abdullah, Rosni

    The Ministry of Health Malaysia initiated the total hospital information system (THIS) as the first national electronic health record system for use in selected public hospitals across the country. Since its implementation 15 years ago, there has been the critical requirement for a systematic evaluation to assess its effectiveness in coping with the current system, task complexity, and rapid technological changes. The study aims to assess system quality factors to predict the performance of electronic health in a single public hospital in Malaysia. Non-probability sampling was employed for data collection among selected providers in a single hospital for two months. Data cleaning and bias checking were performed before final analysis in partial least squares-structural equation modeling. Convergent and discriminant validity assessments were satisfied the required criterions in the reflective measurement model. The structural model output revealed that the proposed adequate infrastructure, system interoperability, security control, and system compatibility were the significant predictors, where system compatibility became the most critical characteristic to influence an individual health care provider's performance. The previous DeLone and McLean information system success models should be extended to incorporate these technological factors in the medical system research domain to examine the effectiveness of modern electronic health record systems. In this study, care providers' performance was expected when the system usage fits with patients' needs that eventually increased their productivity. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  2. An evidence-based assessment of the clinical guidelines for replanted avulsed teeth. Part II: prescription of systemic antibiotics.

    Science.gov (United States)

    Hinckfuss, Susan Elisabeth; Messer, Louise Brearley

    2009-04-01

    Current clinical guidelines recommend prescribing systemic antibiotic therapy (SAT) for patients having an avulsed permanent tooth replanted. The principles of evidence-based dentistry can be used to assess whether this is the best approach based on currently-available evidence. The objective of this study was to use the principles of evidence-based dentistry to answer the PICO question: (P) for a replanted avulsed permanent tooth, (I) is prescribing SAT, (C) compared with not prescribing SAT, (O) associated with an increased likelihood of successful periodontal healing after tooth replantation? A literature search was performed across four internet databases (Ovid Medline, Cochrane Library, PubMed, ISI Web of Science), for relevant citations (n = 35 702). Limiting citations to those in English and removing duplicates produced a set of titles (n = 14 742) that were sieved according to evidence-based dentistry principles. Relevant titles were selected for abstract assessment (n = 782), identifying papers for examination (n = 74). Inclusion criteria were applied and three papers (326 total teeth) met the final criteria for meta-analysis. Meta-analyses found no statistically significant difference between prescribing or not prescribing antibiotics for acceptable periodontal healing without progressive root resorption (common odds ratio = 0.90, SE = 0.29, 95% confidence intervals = 0.51-1.58). The evidence for an association between prescribing SAT and an increased likelihood of acceptable periodontal healing outcome is inconclusive. This investigation of antibiotic use as defined in the clinical guidelines indicates there is inconclusive clinical evidence from studies of replanted avulsed human teeth to either contradict or support the guideline. Pending future research to the contrary, dentists are recommended to follow current guidelines in prescribing SAT when replanting avulsed teeth.

  3. INSTABILITY IN THE CEE BANKING SYSTEM. EVIDENCE FROM THE RECENT FINANCIAL CRISIS

    Directory of Open Access Journals (Sweden)

    Renata Karkowska

    2013-12-01

    Full Text Available Sparked by the recent great recession and the role of financial markets, considerable interest exists among researchers within both the academic and public community in measuring and modeling systemic risk. This article introduces a new framework for measuring systemic risk by using a risk-adjusted balance sheet approach. In this regard, the analysis of 21 largest commercial banks operating in 7 countries from Central and Eastern Europe, shows potential risk which could threaten all the financial system. The paper concludes new directions for measuring systemic risk by using Merton model. It shows how risk management tools can be applied in new ways to measure and analyze systemic risk in European banking system.

  4. Scientific Evidence-Based Effects of Hydrotherapy on Various Systems of the Body

    OpenAIRE

    Mooventhan, A; Nivethitha, L

    2014-01-01

    The use of water for various treatments (hydrotherapy) is probably as old as mankind. Hydrotherapy is one of the basic methods of treatment widely used in the system of natural medicine, which is also called as water therapy, aquatic therapy, pool therapy, and balneotherapy. Use of water in various forms and in various temperatures can produce different effects on different system of the body. Many studies/reviews reported the effects of hydrotherapy only on very few systems and there is lack...

  5. Reducing Cancer Burden in the Population: An Overview of Epidemiologic Evidence to Support Policies, Systems, and Environmental Changes.

    Science.gov (United States)

    Platz, Elizabeth A

    2017-01-01

    "Reducing Cancer Burden in the Population: Epidemiologic Evidence to Support Policies, Systems, and Environmental Changes" is a compilation of 11 reviews addressing aspects of primary prevention of cancer (early life factors, vitamin D, and periodontal disease and the oral microbiome); primary and secondary prevention (in the transgender population); surveillance following secondary prevention (personalizing follow-up of patients diagnosed with an adenoma based on colorectal cancer risk); tertiary prevention (physical activity as an adjuvant to cancer treatment, measurement of patient-reported physical functioning in cancer treatment trials, and implementation of palliative care recommendations); and all 3 (changing epidemiology of oral cancers). Authors discuss policies, systems, and environment (PSE) changes that may be supported by epidemiologic evidence, for example, how existing public health and clinical policies and guidelines targeting noncancer outcomes may indirectly reduce cancer burden and how some cancer control policies could be refined to enhance effectiveness. Authors also discuss where systems and environment changes are necessary to ensure routine implementation of up-to-date, evidence-based policies and guidelines. Two other articles discuss infrastructure to support identification of existing and emerging cancer problems that could be reduced or avoided, including by PSE changes. These frameworks may guide impactful cancer research relevant to cancer centers' catchment areas, as well as cancer control efforts in countries where noncommunicable diseases including cancer are on the rise. The weight of the evidence of these reviews supports opportunities for PSE changes and infrastructure that could reduce the cancer burden in populations. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Is decentralization good for logistics systems? Evidence on essential medicine logistics in Ghana and Guatemala.

    Science.gov (United States)

    Bossert, Thomas J; Bowser, Diana M; Amenyah, Johnnie K

    2007-03-01

    Efficient logistics systems move essential medicines down the supply chain to the service delivery point, and then to the end user. Experts on logistics systems tend to see the supply chain as requiring centralized control to be most effective. However, many health reforms have involved decentralization, which experts fear has disrupted the supply chain and made systems less effective. There is no consensus on an appropriate methodology for assessing the effectiveness of decentralization in general, and only a few studies have attempted to address decentralization of logistics systems. This paper sets out a framework and methodology of a pioneering exploratory study that examines the experiences of decentralization in two countries, Guatemala and Ghana, and presents suggestive results of how decentralization affected the performance of their logistics systems. The analytical approach assessed decentralization using the principal author's 'decision space' approach, which defines decentralization as the degree of choice that local officials have over different health system functions. In this case the approach focused on 15 different logistics functions and measured the relationship between the degree of choice and indicators of performance for each of the functions. The results of both studies indicate that less choice (i.e. more centralized) was associated with better performance for two key functions (inventory control and information systems), while more choice (i.e. more decentralized) over planning and budgeting was associated with better performance. With different systems of procurement in Ghana and Guatemala, we found that a system with some elements of procurement that are centralized (selection of firms and prices fixed by national tender) was positively related in Guatemala but negatively related in Ghana, where a system of 'cash and carry' cost recovery allowed more local choice. The authors conclude that logistics systems can be effectively

  7. An Update on the Conceptual-Production Systems Model of Apraxia: Evidence from Stroke

    Science.gov (United States)

    Stamenova, Vessela; Black, Sandra E.; Roy, Eric A.

    2012-01-01

    Limb apraxia is a neurological disorder characterized by an inability to pantomime and/or imitate gestures. It is more commonly observed after left hemisphere damage (LHD), but has also been reported after right hemisphere damage (RHD). The Conceptual-Production Systems model (Roy, 1996) suggests that three systems are involved in the control of…

  8. Interleukin-6 and lung inflammation: evidence for a causative role in inducing respiratory system resistance increments.

    Science.gov (United States)

    Rubini, Alessandro

    2013-10-01

    Interleukin-6 is a multifunctional cytokine that has been shown to be increased in some pathological conditions involving the respiratory system such as those experimentally induced in animals or spontaneously occurring in humans. Experimental data demonstrating that interleukin-6 plays a significant role in commonly occurring respiratory system inflammatory diseases are reviewed here. Those diseases, i.e. asthma and chronic obstructive pulmonary disease, are characterised by mechanical derangements of the respiratory system, for the most part due to increased elastance and airway resistance. Recent findings showing that interleukin-6 has a causative role in determining an increase in airway resistance are reviewed. The end-inflation occlusion method was used to study the mechanical properties of the respiratory system before and after interleukin-6 administration. The cytokine was shown to induce significant, dose-dependent increments in both the resistive pressure dissipation due to frictional forces opposing the airflow in the airway (ohmic resistance) and the additional resistive pressure dissipation due to the visco-elastic properties of the system, i.e. stress relaxation (visco-elastic resistance). There were no alterations in respiratory system elastance. Even when administered to healthy mammals, interleukin-6 determines a significant effect on respiratory system resistance causing an increase in the mechanical work of breathing during inspiration. IL-6 hypothetically plays an active role in the pathogenesis of respiratory system diseases and the mechanisms that may be involved are discussed here.

  9. What Is the Proposed Role of Research Evidence in England's "Self-Improving" School System?

    Science.gov (United States)

    Godfrey, David

    2017-01-01

    This article examines the English government's vision for how research is proposed to lead to improvements in the system in the context of a school-led, self-improving system and rapid and sweeping legislative reforms. The debate about the role of research in the teaching profession has been sharpened by a large consultation effort in the academic…

  10. Assessing E-Learning System in Higher Education Institutes: Evidence from Structural Equation Modelling

    Science.gov (United States)

    Ali, Muhammad; Raza, Syed Ali; Qazi, Wasim; Puah, Chin-Hong

    2018-01-01

    Purpose: This study aims to examine university students' acceptance of e-learning systems in Pakistan. A Web-based learning system is a new form of utilizing technological features. Although, developed countries have initiated and established the concept for e-learning, developing countries require empirical support to implement e-learning.…

  11. Evidence for a role of KISS-1/GPR54 system in decreased ...

    African Journals Online (AJOL)

    Short fasting has been shown to suppress luteinizing hormone (LH) secretion in ewes, however, the molecular mechanism underlying this phenomenon is not clear. Based on recent discovery of the crucial role of KiSS-1/GPR54 system in the central control of the GnRH axis, we hypothesized that KiSS-1/GPR54 system was ...

  12. Laparoscopic surgery for benign and malign diseases of the digestive system: indications, limitations, and evidence.

    Science.gov (United States)

    Küper, Markus Alexander; Eisner, Friederike; Königsrainer, Alfred; Glatzle, Jörg

    2014-05-07

    The laparoscopic technique was introduced in gastrointestinal surgery in the mid 1980s. Since then, the development of this technique has been extraordinary. Triggered by technical innovations (stapling devices or coagulation/dissecting devices), nowadays any type of gastrointestinal resection has been successfully performed laparoscopically and can be performed laparoscopically dependent on the patient's condition. This summary gives an overview over 30 years of laparoscopic surgery with focus on today's indications and evidence. Main indications remain the more common procedures, e.g., appendectomy, cholecystectomy, bariatric procedures or colorectal resections. For all these indications, the laparoscopic approach has become the gold standard with less perioperative morbidity. Regarding oncological outcome there have been several high-quality randomized controlled trials which demonstrated equivalency between laparoscopic and open colorectal resections. Less common procedures like esophagectomy, oncological gastrectomy, liver and pancreatic resections can be performed successfully as well by an experienced surgeon. However, the evidence for these special indications is poor and a general recommendation cannot be given. In conclusion, laparoscopic surgery has revolutionized the field of gastrointestinal surgery by reducing perioperative morbidity without disregarding surgical principles especially in oncological surgery.

  13. Regulation of aeroallergen immunity by the innate immune system: laboratory evidence for a new paradigm.

    Science.gov (United States)

    Horner, Anthony A

    2010-01-01

    Over the last decade, it has become increasingly clear that innate responses to microbes are mediated largely by toll-like receptors (TLRs), which recognize a diverse family of molecules produced by viruses, bacteria and fungi. This article will present evidence that TLRs also play a dominant role in innate responses to non-infectious immunostimulatory materials present in house dust extracts (HDEs) and the living environments they represent. However, our investigations challenge the commonly held view that microbial products in ambient air protect against the allergic march by promoting protective Th1 biased responses to inspired aeroallergens. Instead, all HDEs studied to date have preferentially promoted the development of Th2 biased airway hypersensitivities when used as adjuvants for intranasal (i.n.) vaccination. In contrast, daily low dose i.n. HDE delivery was found to promote the development of aeroallergen tolerance. This article will review these experimental findings as evidence to propose a new paradigm by which airborne TLR ligands and other stimulants of innate immunity may influence aeroallergen specific immunity and the genesis of allergic respiratory diseases.

  14. Early accretion of water and volatile elements to the inner Solar System: evidence from angrites.

    Science.gov (United States)

    Sarafian, Adam R; Hauri, Erik H; McCubbin, Francis M; Lapen, Thomas J; Berger, Eve L; Nielsen, Sune G; Marschall, Horst R; Gaetani, Glenn A; Righter, Kevin; Sarafian, Emily

    2017-05-28

    Inner Solar System bodies are depleted in volatile elements relative to chondrite meteorites, yet the source(s) and mechanism(s) of volatile-element depletion and/or enrichment are poorly constrained. The timing, mechanisms and quantities of volatile elements present in the early inner Solar System have vast implications for diverse processes, from planetary differentiation to the emergence of life. We report major, trace and volatile-element contents of a glass bead derived from the D'Orbigny angrite, the hydrogen isotopic composition of this glass bead and that of coexisting olivine and silicophosphates, and the 207 Pb- 206 Pb age of the silicophosphates, 4568 ± 20 Ma. We use volatile saturation models to demonstrate that the angrite parent body must have been a major body in the early inner Solar System. We further show via mixing calculations that all inner Solar System bodies accreted volatile elements with carbonaceous chondrite H and N isotope signatures extremely early in Solar System history. Only a small portion (if any) of comets and gaseous nebular H species contributed to the volatile content of the inner Solar System bodies.This article is part of the themed issue 'The origin, history and role of water in the evolution of the inner Solar System'. © 2017 The Author(s).

  15. Evidence of Nervous System Sensitization in Commonly Presenting and Persistent Painful Tendinopathies : A Systematic Review

    NARCIS (Netherlands)

    Plinsinga, Melanie L.; Brink, Michel S.; Vicenzino, Bill; Van Wilgen, C. Paul

    2015-01-01

    STUDY DESIGN: Systematic review. OBJECTIVES: To elucidate if there is sensitization of the nervous system in those with persistent rotator cuff (shoulder), lateral elbow, patellar, and Achilles tendinopathies. BACKGROUND: Tendinopathy can be difficult to treat, and persistent intractable pain and

  16. A Case for Tamper-Resistant and Tamper-Evident Computer Systems

    National Research Council Canada - National Science Library

    Solihin, Yan

    2007-01-01

    .... These attacks attempt to snoop or modify data transfer between various chips in a computer system such as between the processor and memory, and between processors in a multiprocessor interconnect network...

  17. Facilitating ambulatory electronic health record system implementation: evidence from a qualitative study.

    Science.gov (United States)

    McAlearney, Ann Scheck; Sieck, Cynthia; Hefner, Jennifer; Robbins, Julie; Huerta, Timothy R

    2013-01-01

    Ambulatory care practices have increasing interest in leveraging the capabilities of electronic health record (EHR) systems, but little information is available documenting how organizations have successfully implemented these systems. Objective. To characterize elements of successful electronic health record (EHR) system implementation and to synthesize the key informants' perspectives about successful implementation practices. Key informant interviews and focus groups were conducted with a purposive sample of individuals from US healthcare organizations identified for their success with ambulatory EHR implementation. Rigorous qualitative data analyses used both deductive and inductive methods. Participants identified personal and system-related barriers, at both the individual and organization levels, including poor computer skills, productivity losses, resistance to change, and EHR system failure. Implementation success was reportedly facilitated by careful planning and consistent communication throughout distinct stages of the implementation process. A significant element of successful implementation was an emphasis on optimization, both during "go-live" and, subsequently, when users had more experience with the system. Successful EHR implementation requires both detailed planning and clear mechanisms to deal with unforeseen or unintended consequences. Focusing on user buy-in early and including plans for optimization can facilitate greater success.

  18. [Endocrine disruptors : Evidence from epidemiological studies necessitates a critical review of model systems].

    Science.gov (United States)

    Hoffmann, M; Gebauer, S; Nüchter, M; Baber, R; Ried, J; von Bergen, M; Kiess, W

    2017-06-01

    Endocrine disruptive chemicals (EDCs) cause adverse health effects through interaction with endocrine systems. They are classified by chemical structure, effects on specific endocrine systems, bioaccumulation, persistence in the environment, or clinically observable effects. For research of the complex mechanisms of action in the human body, only in vitro model systems have so far been available, that have insufficient high-throughput capacity, which makes risk evaluation more difficult. In addition, in industrial nations, living people are often exposed to mixtures of substances, with various effects. The clinical importance of epigenetic changes caused by the action of EDCs during vulnerable phases of development is currently unclear. Epidemiological studies are criticized because reproducibility is not always guaranteed. Nevertheless, they remain the method of choice for the development and analysis of suitable model systems. Positive associations, in spite of sometimes conflicting results, are key in the selection of factors that can then be analysed in model systems in an unbiased way. This article depicts the mainly positive epidemiological findings for EDC-caused effects in the fields of growth and metabolism, neurocognitive development and sexual development and reproduction. As a result, there is a need for closer linkage between epidemiological studies and mechanistic research into model systems, especially focusing on the interaction of different EDCs and the consequences of prenatal and early life exposure.

  19. Facilitating Ambulatory Electronic Health Record System Implementation: Evidence from a Qualitative Study

    Directory of Open Access Journals (Sweden)

    Ann Scheck McAlearney

    2013-01-01

    Full Text Available Background. Ambulatory care practices have increasing interest in leveraging the capabilities of electronic health record (EHR systems, but little information is available documenting how organizations have successfully implemented these systems. Objective. To characterize elements of successful electronic health record (EHR system implementation and to synthesize the key informants' perspectives about successful implementation practices. Methods. Key informant interviews and focus groups were conducted with a purposive sample of individuals from US healthcare organizations identified for their success with ambulatory EHR implementation. Rigorous qualitative data analyses used both deductive and inductive methods. Results. Participants identified personal and system-related barriers, at both the individual and organization levels, including poor computer skills, productivity losses, resistance to change, and EHR system failure. Implementation success was reportedly facilitated by careful planning and consistent communication throughout distinct stages of the implementation process. A significant element of successful implementation was an emphasis on optimization, both during “go-live” and, subsequently, when users had more experience with the system. Conclusion. Successful EHR implementation requires both detailed planning and clear mechanisms to deal with unforeseen or unintended consequences. Focusing on user buy-in early and including plans for optimization can facilitate greater success.

  20. Measuring Use of Evidence Based Psychotherapy for Posttraumatic Stress Disorder in a Large National Healthcare System.

    Science.gov (United States)

    Maguen, Shira; Madden, Erin; Patterson, Olga V; DuVall, Scott L; Goldstein, Lizabeth A; Burkman, Kristine; Shiner, Brian

    2018-02-15

    To derive a method of identifying use of evidence-based psychotherapy (EBP) for post-traumatic stress disorder (PTSD), we used clinical note text from national Veterans Health Administration (VHA) medical records. Using natural language processing, we developed machine-learning algorithms to classify note text on a large scale in an observational study of Iraq and Afghanistan veterans with PTSD and one post-deployment psychotherapy visit by 8/5/15 (N = 255,968). PTSD visits were linked to 8.1 million psychotherapy notes. Annotators labeled 3467 randomly-selected psychotherapy notes (kappa = 0.88) to indicate receipt of EBP. We met our performance targets of overall classification accuracy (0.92); 20.2% of veterans received ≥ one session of EBP over the study period. Our method can assist with identifying EBP use and studying EBP-associated outcomes in routine clinical practice.

  1. Evidence of a tectonic transient within the Idrija fault system in Western Slovenia

    Science.gov (United States)

    Vičič, Blaž; Costa, Giovanni; Aoudia, Abdelkrim

    2017-04-01

    Western Slovenia and North-eastern Italy are areas of medium rate seismicity with rare historic earthquakes of higher magnitudes. From mainly reverse component faulting in north-western part of the region where 1976 Friuli earthquakes took place, tectonic regime changes to mostly strike-slip faulting in the Dinaric region, continuing towards southeast. In the northern part of the Idrija fault system, which represent the broader Dinaric strike-slip system there were two strong earthquakes in the recent times - Mw=5.6 1998 and Mw=5.2 2004 earthquakes. Further to the south, along the Idrija fault system, Idrija fault is the causative fault of 1511 Mw=6.8 earthquake. The southeastern most part of the Idrija fault system produced a Mw=5.2 earthquake in 1926 and few historic Mw>4 earthquakes. Since 2004 Mw=5.2 earthquake, no stronger earthquakes were recorded in the region covered by dense seismic network. Seismicity is mostly concentrated in Friuli region and north-western part of Idrija fault system - mostly on the Ravne fault which is the causative fault for the 1998 and 2004 earthquakes. In the central part of the fault system no strong or moderate earthquakes were recorded, except of an earthquake along the Idrija fault in 2014 of magnitude 3.4. Low magnitude background seismicity is burst like with no apparent temporal or spatial distribution. Seismicity of the southern part of Idrija fault system is again a bit higher than in the central part of the fault system with earthquakes up to Mw=4.4 that happened in 2014. In this study, detailed analysis of the seismicity is performed with manual relocation of the seismicity in the period between 2006 and 2016. With manual inspection of the waveform data, slight temporal clustering of seismicity is observed. We use a template algorithm method to increase the detection rate of the seismicity. Templates of seismicity in the north-western and south-eastern part of Idrija fault system are created. The continuous waveform data

  2. The Multiple-Demand System in the Novelty of Musical Improvisation: Evidence from an MRI Study on Composers

    Directory of Open Access Journals (Sweden)

    Jing Lu

    2017-12-01

    Full Text Available The multiple-demand (MD system has proven to be associated with creating structured mental programs in comprehensive behaviors, but the functional mechanisms of this system have not been clarified in the musical domain. In this study, we explored the hypothesis that the MD system is involved in a comprehensive music-related behavior known as musical improvisation. Under a functional magnetic resonance imaging (fMRI paradigm, 29 composers were recruited to improvise melodies through visual imagery tasks according to familiar and unfamiliar cues. We found that the main regions of the MD system were significantly activated during both musical improvisation conditions. However, only a greater involvement of the intraparietal sulcus (IPS within the MD system was shown when improvising with unfamiliar cues. Our results revealed that the MD system strongly participated in musical improvisation through processing the novelty of melodies, working memory, and attention. In particular, improvising with unfamiliar cues required more musical transposition manipulations. Moreover, both functional and structural analyses indicated evidence of neuroplasticity in MD regions that could be associated with musical improvisation training. These findings can help unveil the functional mechanisms of the MD system in musical cognition, as well as improve our understanding of musical improvisation.

  3. The complement system is dysfunctional in metabolic disease: Evidences in plasma and adipose tissue from obese and insulin resistant subjects.

    Science.gov (United States)

    Moreno-Navarrete, José María; Fernández-Real, José Manuel

    2017-10-26

    The relationship between chronic low-grade inflammation, insulin resistance and other obesity-associated metabolic disturbances is increasingly recognized. The possible mechanisms that trigger these immunologic alterations remain to be fully understood. The complement system is a crucial element of immune defense system, being important in the activation of innate and adaptative immune response, promoting the clearance of apoptotic and damaged endogenous cells and participating in processes of tissue development, degeneration, and regeneration. Circulating components of the complement system appear to be dysregulated in obesity-associated metabolic disturbances. The activation of the complement system is also evident in adipose tissue from obese subjects, in association with subclinical inflammation and alterations in glucose metabolism. The possible contribution of some components of the complement system in the development of insulin resistance and obesity-associated metabolic disturbances, and the possible role of complement system in adipose tissue physiology is reviewed here. The modulation of the complement system could constitute a potential target in the pathophysiology and therapy of obesity and associated metabolic disease. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. No evidence for mirror system dysfunction in schizophrenia from a multimodal TMS/EEG study.

    Science.gov (United States)

    Andrews, Sophie C; Enticott, Peter G; Hoy, Kate E; Thomson, Richard H; Fitzgerald, Paul B

    2015-08-30

    Dysfunctional mirror neuron systems have been proposed to contribute to the social cognitive deficits observed in schizophrenia. A few studies have explored mirror systems in schizophrenia using various techniques such as TMS (levels of motor resonance) or EEG (levels of mu suppression), with mixed results. This study aimed to use a novel multimodal approach (i.e. concurrent TMS and EEG) to further investigate mirror systems and social cognition in schizophrenia. Nineteen individuals with schizophrenia or schizoaffective disorder and 19 healthy controls participated. Single-pulse TMS was applied to M1 during the observation of hand movements designed to elicit mirror system activity. Single EEG electrodes (C3, CZ, C4) recorded brain activity. Participants also completed facial affect recognition and theory of mind tasks. The schizophrenia group showed significant deficits in facial affect recognition and higher level theory of mind compared to healthy controls. A significant positive relationship was revealed between mu suppression and motor resonance for the overall sample, indicating concurrent validity of these measures. Levels of mu suppression and motor resonance were not significantly different between groups. These findings indicate that in stable outpatients with schizophrenia, mirror system functioning is intact, and therefore their social cognitive difficulties may be caused by alternative pathophysiology. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  5. Evidence for an ABC-Type Riboflavin Transporter System in Pathogenic Spirochetes

    Science.gov (United States)

    Deka, Ranjit K.; Brautigam, Chad A.; Biddy, Brent A.; Liu, Wei Z.; Norgard, Michael V.

    2013-01-01

    ABSTRACT Bacterial transporter proteins are involved in the translocation of many essential nutrients and metabolites. However, many of these key bacterial transport systems remain to be identified, including those involved in the transport of riboflavin (vitamin B2). Pathogenic spirochetes lack riboflavin biosynthetic pathways, implying reliance on obtaining riboflavin from their hosts. Using structural and functional characterizations of possible ligand-binding components, we have identified an ABC-type riboflavin transport system within pathogenic spirochetes. The putative lipoprotein ligand-binding components of these systems from three different spirochetes were cloned, hyperexpressed in Escherichia coli, and purified to homogeneity. Solutions of all three of the purified recombinant proteins were bright yellow. UV-visible spectra demonstrated that these proteins were likely flavoproteins; electrospray ionization mass spectrometry and thin-layer chromatography confirmed that they contained riboflavin. A 1.3-Å crystal structure of the protein (TP0298) encoded by Treponema pallidum, the syphilis spirochete, demonstrated that the protein’s fold is similar to the ligand-binding components of ABC-type transporters. The structure also revealed other salient details of the riboflavin binding site. Comparative bioinformatics analyses of spirochetal genomes, coupled with experimental validation, facilitated the discovery of this new ABC-type riboflavin transport system(s). We denote the ligand-binding component as riboflavin uptake transporter A (RfuA). Taken together, it appears that pathogenic spirochetes have evolved an ABC-type transport system (RfuABCD) for survival in their host environments, particularly that of the human host. PMID:23404400

  6. Systemic Inflammation and Evidence of a Cardio-splenic Axis in Patients with Psoriasis

    DEFF Research Database (Denmark)

    Hjuler, Kasper F; Gormsen, Lars C; Vendelbo, Mikkel H

    2017-01-01

    The spleen is thought to play a role in atherosclerosis-associated immunity and cardiovascular research has indicated the existence of a cardio-splenic axis. The aim of this study was to assess splenic 18F-fluorodeoxyglucose uptake as a measure of systemic inflammation in patients with untreated...... inflammation. These results support the existence of systemic inflammation in patients with psoriasis, and provide the rationale for a mechanistic link between psoriasis-driven inflammation and cardiovascular comorbidity through a spleen-atherosclerotic axis....

  7. Regulation in the face of uncertainty: the evidence on electronic nicotine delivery systems (e-cigarettes).

    Science.gov (United States)

    Farsalinos, Konstantinos E; Le Houezec, Jacques

    2015-01-01

    Tobacco smoking is the largest single preventable cause of many chronic diseases and death. Effective treatments exist; however, few smokers use them and most try to quit by themselves. Most of the tobacco cigarette's toxicity is related to the combustion process. Models of harm reduction applied to tobacco suggest that switching from inhalation of combustible products to a noncombustible nicotine delivery product would likely result in a vast reduction in tobacco-related death and illness. Currently available evidence raises no doubt that electronic cigarettes (e-cigs) are by far less harmful than smoking (although probably not absolutely safe) and have the potential to be the most effective tobacco harm reduction products due to their unique property of resembling smoking and providing satisfaction to the user. A lot of controversy is surrounding e-cigs and their regulation, much of which is based on the precautionary principle. Although monitoring and further research is definitely needed, the arguments used to implement severe restrictions or bans are mostly hypothetical, weakly supported by evidence, and, in some cases, derived from mispresentation or misinterpretation of the study findings. Regulators should keep in mind that the target population is smokers who want to reduce or quit their deadly tobacco consumption. To achieve this goal, smokers should be honestly informed on the relative harmfulness of the different products. E-cigs are not tobacco products and are not used as medications. For this reason, a specific regulatory scheme is needed, separate from tobacco or medicinal products regulation. Regulation should implement specific quality criteria for products, rules for the exclusion of chemicals of reasonable concern, and appropriate testing for possible contaminants. Additionally, manufacturing standards derived from the food industry should be implemented and adjusted for specific conditions related to e-cigs. Finding the appropriate balance

  8. The Environmental Belief Systems of Organic and Conventional Farmers: Evidence from Central-Southern England

    Science.gov (United States)

    Kings, David; Ilbery, Brian

    2010-01-01

    Little comparative work has been conducted on the environmental belief systems and behaviours of conventional and organic farmers, especially in relation to farming culture, the environment and lowland farmland avifauna. Adopting a modified behavioural approach, this paper analyses the ways in which the environmental attitudes and understandings…

  9. Inferences on the evidence for radioactive 53Mn in the early Solar System

    International Nuclear Information System (INIS)

    Typhoon Lee

    1986-01-01

    Time-scales for various processes during the formation of the early Solar System have been inferred from data on several now-extinct radionuclides. The author examines recently reported data on an extinct nuclide, 53 Mn, and shows that the data are inconsistent with the predictions of a single-stage evolution model. Alternative interpretations of the inconsistency are discussed. (U.K.)

  10. Supervisory Neglect and Risk of Harm. Evidence from the Canadian Child Welfare System

    Science.gov (United States)

    Ruiz-Casares, Monica; Trocme, Nico; Fallon, Barbara

    2012-01-01

    Objective: This study explores prevalence and characteristics associated with supervisory neglect and physical harm in children in the child welfare system in Canada. Methods: The sample included all substantiated primary maltreatment investigations in the 2008 Canadian Incidence Study of Reported Child Abuse and Neglect excluding cases where…

  11. Multiple Systems for Cognitive Control: Evidence from a Hybrid Prime-Simon Task

    Science.gov (United States)

    Schlaghecken, Friederike; Refaat, Malik; Maylor, Elizabeth A.

    2011-01-01

    Cognitive control resolves conflicts between appropriate and inappropriate response tendencies. Is this achieved by a unitary all-purpose conflict control system, or do independent subsystems deal with different aspects of conflicting information? In a fully factorial hybrid prime-Simon task, participants responded to the identity of targets…

  12. The approximate number system and its relation to early math achievement: evidence from the preschool years.

    Science.gov (United States)

    Bonny, Justin W; Lourenco, Stella F

    2013-03-01

    Humans rely on two main systems of quantification; one is nonsymbolic and involves approximate number representations (known as the approximate number system or ANS), and the other is symbolic and allows for exact calculations of number. Despite the pervasiveness of the ANS across development, recent studies with adolescents and school-aged children point to individual differences in the precision of these representations that, importantly, have been shown to relate to symbolic math competence even after controlling for general aspects of intelligence. Such findings suggest that the ANS, which humans share with nonhuman animals, interfaces specifically with a uniquely human system of formal mathematics. Other findings, however, point to a less straightforward picture, leaving open questions about the nature and ontogenetic origins of the relation between these two systems. Testing children across the preschool period, we found that ANS precision correlated with early math achievement but, critically, that this relation was nonlinear. More specifically, the correlation between ANS precision and math competence was stronger for children with lower math scores than for children with higher math scores. Taken together, our findings suggest that early-developing connections between the ANS and mathematics may be fundamentally discontinuous. Possible mechanisms underlying such nonlinearity are discussed. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Impact of product platforms on lean production systems : evidence from industrial machinery manufacturing

    NARCIS (Netherlands)

    Alblas, A.A.; Wortmann, J.C.

    2012-01-01

    The present study describes the effects of product platform changes on lean production systems. Current research into product platforms focuses mostly on the development stage. However, although the initial development of platforms is an important issue, product platforms often evolve during later

  14. Evidences of Polymorphism Associated with Circadian System and Risk of Pathologies: A Review of the Literature

    Directory of Open Access Journals (Sweden)

    F. J. Valenzuela

    2016-01-01

    Full Text Available The circadian system is a supraphysiological system that modulates different biological functions such as metabolism, sleep-wake, cellular proliferation, and body temperature. Different chronodisruptors have been identified, such as shift work, feeding time, long days, and stress. The environmental changes and our modern lifestyle can alter the circadian system and increase the risk of developing pathologies such as cancer, preeclampsia, diabetes, and mood disorder. This system is organized by transcriptional/tranductional feedback loops of clock genes Clock, Bmal1, Per1–3, and Cry1-2. How molecular components of the clock are able to influence the development of diseases and their risk relation with genetic components of polymorphism of clock genes is unknown. This research describes different genetic variations in the population and how these are associated with risk of cancer, metabolic diseases such as diabetes, obesity, and dyslipidemias, and also mood disorders such as depression, bipolar disease, excessive alcohol intake, and infertility. Finally, these findings will need to be implemented and evaluated at the level of genetic interaction and how the environment factors trigger the expression of these pathologies will be examined.

  15. Maltreatment, Academic Difficulty, and Systems-Involved Youth: Current Evidence and Opportunities

    Science.gov (United States)

    Stone, Susan; Zibulsky, Jamie

    2015-01-01

    Youth involved in child-serving systems of care (e.g., child welfare and juvenile justice) often exhibit specific academic performance problems. The magnitude of academic risk among these students is a serious concern given that school attachment, performance, and attainment closely relate to indicators of well-being across the lifespan. It is…

  16. Understanding Learning Styles, Attitudes and Intentions in Using e-Learning System: Evidence from Brunei

    Science.gov (United States)

    Seyal, Afzaal H.; Rahman, Mohd Noah A.

    2015-01-01

    This study investigates the students' learning style, their attitudes about educational technologies in general and e-learning management system (e-LMS) in particular and their behavioral intentions to use the e-learning platform in a single institution of higher learning in Brunei Darussalam. In this study, a survey, using the VARK Questionnaire…

  17. Imaging Evidence for Disturbances in Multiple Learning and Memory Systems in Persons with Autism Spectrum Disorders

    Science.gov (United States)

    Goh, Suzanne; Peterson, Bradley S.

    2012-01-01

    Aim: The aim of this article is to review neuroimaging studies of autism spectrum disorders (ASD) that examine declarative, socio-emotional, and procedural learning and memory systems. Method: We conducted a search of PubMed from 1996 to 2010 using the terms "autism,""learning,""memory," and "neuroimaging." We limited our review to studies…

  18. The Adaptability of Marketing Systems to Interventions in Developing Countries: Evidence from the Pineapple System in Benin

    NARCIS (Netherlands)

    Hounhouigan, M.H.; Ingenbleek, P.T.M.; Lans, van der I.A.; Trijp, van H.C.M.; Linnemann, A.R.

    2014-01-01

    In general marketing theory, marketing systems are assumed to adapt to facilitate further economic development. However, such adaptability may be less obvious in the context of developing countries due to features in the social matrix of these countries. The present study explores adaptation in the

  19. Chlorogenic acid-arabinose hybrid domains in coffee melanoidins: Evidences from a model system.

    Science.gov (United States)

    Moreira, Ana S P; Coimbra, Manuel A; Nunes, Fernando M; Passos, Cláudia P; Santos, Sónia A O; Silvestre, Armando J D; Silva, André M N; Rangel, Maria; Domingues, M Rosário M

    2015-10-15

    Arabinose from arabinogalactan side chains was hypothesized as a possible binding site for chlorogenic acids in coffee melanoidins. To investigate this hypothesis, a mixture of 5-O-caffeoylquinic acid (5-CQA), the most abundant chlorogenic acid in green coffee beans, and (α1 → 5)-L-arabinotriose, structurally related to arabinogalactan side chains, was submitted to dry thermal treatments. The compounds formed during thermal processing were identified by electrospray ionization mass spectrometry (ESI-MS) and characterized by tandem MS (ESI-MS(n)). Compounds composed by one or two CQAs covalently linked with pentose (Pent) residues (1-12) were identified, along with compounds bearing a sugar moiety but composed exclusively by the quinic or caffeic acid moiety of CQAs. The presence of isomers was demonstrated by liquid chromatography online coupled to ESI-MS and ESI-MS(n). Pent1-2CQA were identified in coffee samples. These results give evidence for a diversity of chlorogenic acid-arabinose hybrids formed during roasting, opening new perspectives for their identification in melanoidin structures. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Spontaneous Time Symmetry Breaking in System with Mixed Strategy Nash Equilibrium: Evidences in Experimental Economics Data

    Science.gov (United States)

    Wang, Zhijian; Xu, Bin; Zhejiang Collaboration

    2011-03-01

    In social science, laboratory experiment with human subjects' interaction is a standard test-bed for studying social processes in micro level. Usually, as in physics, the processes near equilibrium are suggested as stochastic processes with time-reversal symmetry (TRS). To the best of our knowledge, near equilibrium, the breaking time symmetry, as well as the existence of robust time anti-symmetry processes, has not been reported clearly in experimental economics till now. By employing Markov transition method to analysis the data from human subject 2x2 Games with wide parameters and mixed Nash equilibrium, we study the time symmetry of the social interaction process near Nash equilibrium. We find that, the time symmetry is broken, and there exists a robust time anti-symmetry processes. We also report the weight of the time anti-symmetry processes in the total processes of each the games. Evidences in laboratory marketing experiments, at the same time, are provided as one-dimension cases. In these cases, time anti-symmetry cycles can also be captured. The proposition of time anti-symmetry processes is small, but the cycles are distinguishable.

  1. Primary immune system responders to nucleus pulposus cells: evidence for immune response in disc herniation

    Directory of Open Access Journals (Sweden)

    K Murai

    2010-01-01

    Full Text Available Although intervertebral disc herniation and associated sciatica is a common disease, its molecular pathogenesis is not well understood. Immune responses are thought to be involved. This study provides direct evidence that even non-degenerated nucleus pulposus (NP cells elicit immune responses. An in vitro colony forming inhibition assay demonstrated the suppressive effects of autologous spleen cells on NP cells and an in vitro cytotoxicity assay showed the positive cytotoxic effects of natural killer (NK cells and macrophages on NP cells. Non-degenerated rat NP tissues transplanted into wild type rats and immune-deficient mice demonstrated a significantly higher NP cell survival rate in immune-deficient mice. Immunohistochemical staining showed the presence of macrophages and NK cells in the transplanted NP tissues. These results suggest that even non-degenerated autologous NP cells are recognized by macrophages and NK cells, which may have an immunological function in the early phase of disc herniation. These findings contribute to understanding resorption and the inflammatory reaction to disc herniation.

  2. Evidence-based research on the value of school nurses in an urban school system.

    Science.gov (United States)

    Baisch, Mary J; Lundeen, Sally P; Murphy, M Kathleen

    2011-02-01

    With the increasing acuity of student health problems, growing rates of poverty among urban families, and widening racial/ethnic health disparities in child and adolescent health indicators, the contributions of school nurses are of increasing interest to policymakers. This study was conducted to evaluate the impact of school nurses on promoting a healthy school environment and healthy, resilient learners. A mixed-methods approach was used for this study. Using a cross-sectional design, surveys captured the level of satisfaction that school staff had with the nurse in their school, as well as their perceptions of the impact of the nurse on the efficient management of student health concerns. Using a quasi-experimental design, data from electronic school records were used to compare rates of immunization and completeness of health records in schools with nurses. This study provides evidence that school nurses positively influenced immunization rates, the accuracy of student health records, and management of student health concerns. This research demonstrates that teachers and other staff consider nurse interventions vital to eliminating barriers to student learning and improving overall school health. A cost analysis revealed the estimated annual cost per school for the time staff spent managing health concerns. In an environment of scarce resources, school boards need quality evaluation data to justify hiring and retaining school nurses to support improved school health environments. © 2011, American School Health Association.

  3. Genetic evidence implicates the immune system and cholesterol metabolism in the aetiology of Alzheimer's disease.

    Directory of Open Access Journals (Sweden)

    Lesley Jones

    2010-11-01

    Full Text Available Late Onset Alzheimer's disease (LOAD is the leading cause of dementia. Recent large genome-wide association studies (GWAS identified the first strongly supported LOAD susceptibility genes since the discovery of the involvement of APOE in the early 1990s. We have now exploited these GWAS datasets to uncover key LOAD pathophysiological processes.We applied a recently developed tool for mining GWAS data for biologically meaningful information to a LOAD GWAS dataset. The principal findings were then tested in an independent GWAS dataset.We found a significant overrepresentation of association signals in pathways related to cholesterol metabolism and the immune response in both of the two largest genome-wide association studies for LOAD.Processes related to cholesterol metabolism and the innate immune response have previously been implicated by pathological and epidemiological studies of Alzheimer's disease, but it has been unclear whether those findings reflected primary aetiological events or consequences of the disease process. Our independent evidence from two large studies now demonstrates that these processes are aetiologically relevant, and suggests that they may be suitable targets for novel and existing therapeutic approaches.

  4. A new tyrannosaur with evidence for anagenesis and crocodile-like facial sensory system.

    Science.gov (United States)

    Carr, Thomas D; Varricchio, David J; Sedlmayr, Jayc C; Roberts, Eric M; Moore, Jason R

    2017-03-30

    A new species of tyrannosaurid from the upper Two Medicine Formation of Montana supports the presence of a Laramidian anagenetic (ancestor-descendant) lineage of Late Cretaceous tyrannosaurids. In concert with other anagenetic lineages of dinosaurs from the same time and place, this suggests that anagenesis could have been a widespread mechanism generating species diversity amongst dinosaurs, and perhaps beyond. We studied the excellent fossil record of the tyrannosaurid to test that hypothesis. Phylogenetic analysis places this new taxon as the sister species to Daspletosaurus torosus. However, given their close phylogenetic relationship, geographic proximity, and temporal succession, where D. torosus (~76.7-75.2 Ma) precedes the younger new species (~75.1-74.4 Ma), we argue that the two forms most likely represent a single anagenetic lineage. Daspletosaurus was an important apex predator in the late Campanian dinosaur faunas of Laramidia; its absence from later units indicates it was extinct before Tyrannosaurus rex dispersed into Laramidia from Asia. In addition to its evolutionary implications, the texture of the facial bones of the new taxon, and other derived tyrannosauroids, indicates a scaly integument with high tactile sensitivity. Most significantly, the lower jaw shows evidence for neurovasculature that is also seen in birds.

  5. Evidence for the Primo Vascular System above the Epicardia of Rat Hearts

    Directory of Open Access Journals (Sweden)

    Ho-Sung Lee

    2013-01-01

    Full Text Available We for the first time reported evidence for the existence of a novel network, a PVS, abovethe epicardium of the rat heart. (1 We were consecutively able to visualize the PVs and the PNs above the epicardial spaces of five rats’ hearts by using Cr-Hx spraying or injection. (2 Hematoxylin and eosin (H&E and toluidine blue staining of the PVs and the PNs showed that they consisted of a basophilic matrix; specifically the PNs contained several mast cells, some of which were degranulating into pericardial space. Also, 4′, 6-diamidino-2 phenylindole (DAPI images of the PVs and the PNs showed that they contained various kinds of cells. (3 Transmission electron microscopic (TEM longitudinal image of the PVs showed that the sinuses contained many granules with high-electron-density cores in parallel with putative endothelial cells. (4 TEM images of the PNs demonstrated that they consisted of lumen-containing cells surrounded by fibers and that they had mast cells that were degranulating toward the epicardium of the rat heart. The above data suggest that mast-cells-containing novel network exists above the epicardium of the rat heart.

  6. [Medicinal cannabis for diseases of the nervous system: no convincing evidence of effectiveness].

    Science.gov (United States)

    Killestein, J; Bet, P M; van Loenen, A C; Polman, C H

    2004-11-27

    --In 1996, the Netherlands Health Council issued a negative recommendation regarding the use of medication on the basis of cannabis (marihuana). However, interest in medicinal cannabis has certainly not waned since. --The neurological diseases for which cannabis could presently be used therapeutically are: multiple sclerosis, chronic (neuropathic) pain and the syndrome of Gilles de la Tourette. --Since September 2003, the Dutch Ministry of Health, Welfare and Sport delivers medicinal cannabis to Dutch pharmacies, so that now for the first time, medicinal cannabis can be given to patients on a prescription basis within the framework of the Opium Law. The result of this is that doctors and patients now assume that this is a medication for which the efficacy and safety have been established. --The question arises whether new scientific data have become available since 1996 that provide scientific support for the current Governmental policy. --In a recent clinical trial that has aroused much discussion, patients with multiple sclerosis and problematic spasticity were treated with oral cannabis or a placebo. There was no significant effect of treatment on the primary outcome measure, i.e. objectively determined spasticity. Nevertheless, it was concluded that the mobility was improved and that the pain was subjectively decreased. --Until now, convincing scientific evidence that cannabinoids are effective in neurological conditions is still lacking. --However, it is also not possible to conclude definitely that cannabinoids are ineffective; still, this is no basis for official stimulation of their use.

  7. Evidence-based use of electronic clinical tracking systems in advanced practice registered nurse education: an integrative review.

    Science.gov (United States)

    Branstetter, M Laurie; Smith, Lynette S; Brooks, Andrea F

    2014-07-01

    Over the past decade, the federal government has mandated healthcare providers to incorporate electronic health records into practice by 2015. This technological update in healthcare documentation has generated a need for advanced practice RN programs to incorporate information technology into education. The National Organization of Nurse Practitioner Faculties created core competencies to guide program standards for advanced practice RN education. One core competency is Technology and Information Literacy. Educational programs are moving toward the utilization of electronic clinical tracking systems to capture students' clinical encounter data. The purpose of this integrative review was to evaluate current research on advanced practice RN students' documentation of clinical encounters utilizing electronic clinical tracking systems to meet advanced practice RN curriculum outcome goals in information technology as defined by the National Organization of Nurse Practitioner Faculties. The state of the science depicts student' and faculty attitudes, preferences, opinions, and data collections of students' clinical encounters. Although electronic clinical tracking systems were utilized to track students' clinical encounters, these systems have not been evaluated for meeting information technology core competency standards. Educational programs are utilizing electronic clinical tracking systems with limited evidence-based literature evaluating the ability of these systems to meet the core competencies in advanced practice RN programs.

  8. The magmatic model for the origin of Archean Au-quartz vein ore systems: an assessment of the evidence

    International Nuclear Information System (INIS)

    Spooner, E.T.C.

    1991-01-01

    The magmatic model for the origin of Archean Au-quartz vein ore systems suggests that Au was derived by partition between silicate (± sulphide) melts of certain compositions and H 2 O-CO 2 -NaCl magmatic fluids. Supporting evidence includes partial/structural geological relationships, timing relationships, H and C isotope geochemistry, probable primary Au enrichment in the Lamaque stocks, and fluid inclusion volatile geochemistry. Evidence is currently negative with respect to various within- and sub-greenstone belt metamorphic/deep crustal fluid models for primary Au mineralization; however a U-Pb age for vein stage 3 sphene from the Camflo deposit, Quebec which is ∼ 55-60 Ma younger than the host stock at 2685-2680 Ma indicates dissolution/reprecipitation of Au by late, (?) upper crustal saline fluids. Evidence is accumulating that epithermal-meso thermal Au-Ag mineralization in island arc and cordilleran settings may also have been magmatically derived ± high level fluid mixing from calc-alkaline, shoshonitic and other igneous compositions. (author)

  9. Improving access and systems of care for evidence-based childhood obesity treatment: Conference key findings and next steps.

    Science.gov (United States)

    Wilfley, Denise E; Staiano, Amanda E; Altman, Myra; Lindros, Jeanne; Lima, Angela; Hassink, Sandra G; Dietz, William H; Cook, Stephen

    2017-01-01

    To improve systems of care to advance implementation of the U.S. Preventive Services Task Force recommendations for childhood obesity treatment (i.e., clinicians offer/refer children with obesity to intensive, multicomponent behavioral interventions of >25 h over 6 to 12 months to improve weight status) and to expand payment for these services. In July 2015, 43 cross-sector stakeholders attended a conference supported by the Agency for Healthcare Research and Quality, American Academy of Pediatrics Institute for Healthy Childhood Weight, and The Obesity Society. Plenary sessions presenting scientific evidence and clinical and payment practices were interspersed with breakout sessions to identify consensus recommendations. Consensus recommendations for childhood obesity treatment included: family-based multicomponent behavioral therapy; integrated care model; and multidisciplinary care team. The use of evidence-based protocols, a well-trained healthcare team, medical oversight, and treatment at or above the minimum dose (e.g., >25 h) are critical components to ensure effective delivery of high-quality care and to achieve clinically meaningful weight loss. Approaches to secure reimbursement for evidence-based obesity treatment within payment models were recommended. Continued cross-sector collaboration is crucial to ensure a unified approach to increase payment and access for childhood obesity treatment and to scale up training to ensure quality of care. © 2016 The Obesity Society.

  10. Do emerging markets matter in the world oil pricing system? Evidence of imported crude by China and India

    International Nuclear Information System (INIS)

    Hong Li; Lin Xiaowen, Sharon

    2011-01-01

    This paper provides empirical evidence on the changing structure of world oil price system by identifying an additional driver-emerging market factor. We choose China and India as a representative of emerging markets to examine if the quantity of crude oil imported by China and India is significant in the existing oil pricing system (. Our data starts from January 2002 and ends in March 2010, which includes the oil shock of 2007-2008. We utilize cointegration and error correction model framework developed by and in the analysis. Our results indicate that demand from emerging markets has become a significant factor in the world oil pricing system since 2003. This result is significant as it lends empirical support to the widely held conjecture that the oil shock of 2007-2008 is a demand-led shock (). Our result also has significant policy implications that go beyond the oil shock. The emerging market factor is there to stay and reflects the changing power between emerging and developed economies in the world economic system as a result of decades of fast economic development in the former. It will certainly influence policy issues related to oil and beyond. - Highlights: → We test the existing oil price modelling with data from 2002-2010. → We find evidence of structural breaks in the world oil pricing model. → We find that emerging market factor is a new driver in the world oil pricing system since 2003. → The emerging market factor lends empirical support to 'consumption-led' conjecture of oil shock. → New factor reflects significant changes of oil demand landscape following shifting economic power.

  11. Interface design recommendations for computerised clinical audit and feedback: Hybrid usability evidence from a research-led system.

    Science.gov (United States)

    Brown, Benjamin; Balatsoukas, Panos; Williams, Richard; Sperrin, Matthew; Buchan, Iain

    2016-10-01

    Audit and Feedback (A&F) is a widely used quality improvement technique that measures clinicians' clinical performance and reports it back to them. Computerised A&F (e-A&F) system interfaces may consist of four key components: (1) Summaries of clinical performance; (2) Patient lists; (3) Patient-level data; (4) Recommended actions. There is a lack of evidence regarding how to best design e-A&F interfaces; establishing such evidence is key to maximising usability, and in turn improving patient safety. To evaluate the usability of a novel theoretically-informed and research-led e-A&F system for primary care (the Performance Improvement plaN GeneratoR: PINGR). (1) Describe PINGR's design, rationale and theoretical basis; (2) Identify usability issues with PINGR; (3) Understand how these issues may interfere with the cognitive goals of end-users; (4) Translate the issues into recommendations for the user-centred design of e-A&F systems. Eight experienced health system evaluators performed a usability inspection using an innovative hybrid approach consisting of five stages: (1) Development of representative user tasks, Goals, and Actions; (2) Combining Heuristic Evaluation and Cognitive Walkthrough methods into a single protocol to identify usability issues; (3) Consolidation of issues; (4) Severity rating of consolidated issues; (5) Analysis of issues according to usability heuristics, interface components, and Goal-Action structure. A final list of 47 issues were categorised into 8 heuristic themes. The most error-prone heuristics were 'Consistency and standards' (13 usability issues; 28% of the total) and 'Match between system and real world' (n=10, 21%). The recommended actions component of the PINGR interface had the most usability issues (n=21, 45%), followed by patient-level data (n=5, 11%), patient lists (n=4, 9%), and summaries of clinical performance (n=4, 9%). The most error-prone Actions across all user Goals were: (1) Patient selection from a list; (2) Data

  12. Effects of Job Accessibility Improved by Public Transport System: Natural Experimental Evidence from the Copenhagen Metro

    DEFF Research Database (Denmark)

    Pons Rotger, Gabriel Angel; Nielsen, Thomas Alexander Sick

    2015-01-01

    This study examines the effect of accessibility to urban jobs via a public transport system on individual earnings and commuting behaviour. The effect of improved public transport based accessibility on these outcomes is determined by exploiting the exogenous variation in access to a public rail...... and Metro system resulting from the construction of a new terminal Metro station connecting southern townships to Copenhagen city centre. The results show that public transport based job accessibility has a positive and permanent effect on individual earnings. The increase in earnings is associated...... with a change in commuting patterns as the improved access to public transport facilitates a shift from employment within the township to better paid jobs in the city centre, as well as in other suburbs of the Copenhagen Metropolitan area...

  13. Scientific evidence for the use of current traditional systemic therapies in patients with hidradenitis suppurativa.

    Science.gov (United States)

    Alhusayen, Raed; Shear, Neil H

    2015-11-01

    Traditional systemic therapies are frequently prescribed for the treatment of hidradenitis suppurativa (HS). Clinicians consider antibiotics, retinoids, antiandrogens, immunosuppressants, and less common treatment, such as fumarates, in the management of HS. Different classes of medications have been selected to treat HS based on their ability to target various pathways of the condition. Concerns about infection, such as infection with Clostridium difficile, necessitates switching therapy or shortening the course of therapy with specific antibiotics. This review explores the outcomes with the use of numerous medical therapies and postulates explanations for their efficacy or lack of response. Data on long-term safety and efficacy with traditional systemic therapies are lacking. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  14. Lead isotope evidence for a young formation age of the Earth–Moon system

    DEFF Research Database (Denmark)

    Connelly, James; Bizzarro, Martin

    2016-01-01

    A model of a giant impact between two planetary bodies is widely accepted to account for the Earth–Moon system. Despite the importance of this event for understanding early Earth evolution and the inventory of Earth's volatiles critical to life, the timing of the impact is poorly constrained. We...... is ∼100 Myr younger than most current estimates for the age of the Moon but fully consistent with recent ages for lunar ferroan anorthosite and the timing of Earth's first crust inferred from the terrestrial zircon record. The estimated loss of ∼98% of terrestrial Pb relative to the Solar System bulk...... composition by the end of the Moon-forming process implies that the current inventory of Earth's most volatile elements, including water, arrived during post-impact veneering by volatile-rich bodies....

  15. A cognitive neuroscience perspective on psychopathy: evidence for paralimbic system dysfunction.

    Science.gov (United States)

    Kiehl, Kent A

    2006-06-15

    Psychopathy is a complex personality disorder that includes interpersonal and affective traits such as glibness, lack of empathy, guilt or remorse, shallow affect, and irresponsibility, and behavioral characteristics such as impulsivity, poor behavioral control, and promiscuity. Much is known about the assessment of psychopathy; however, relatively little is understood about the relevant brain disturbances. The present review integrates data from studies of behavioral and cognitive changes associated with focal brain lesions or insults and results from psychophysiology, cognitive psychology and cognitive and affective neuroscience in health and psychopathy. The review illustrates that the brain regions implicated in psychopathy include the orbital frontal cortex, insula, anterior and posterior cingulate, amygdala, parahippocampal gyrus, and anterior superior temporal gyrus. The relevant functional neuroanatomy of psychopathy thus includes limbic and paralimbic structures that may be collectively termed 'the paralimbic system'. The paralimbic system dysfunction model of psychopathy is discussed as it relates to the extant literature on psychopathy.

  16. Systemic-constructivist couple therapy (SCCT): Description of approach, theoretical advances, and published longitudinal evidence.

    Science.gov (United States)

    Reid, David W; Doell, Faye K; Dalton, E Jane; Ahmad, Saunia

    2008-12-01

    The systemic-constructivist approach to studying and benefiting couples was derived from qualitative and quantitative research on distressed couples over the past 10 years. Systemic-constructivist couple therapy (SCCT) is the clinical intervention that accompanies the approach. SCCT guides the therapist to work with both the intrapersonal and the interpersonal aspects of marriage while also integrating the social-environmental context of the couple. The theory that underlies SCCT is explained, including concepts such as we-ness and interpersonal processing. The primary components of the therapy are described. Findings described previously in an inaugural monograph containing extensive research demonstrating the long-term utility of SCCT are reviewed. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  17. Impact of the Accounting Information System on Corporate Governance: Evidence from Turkish Non-Listed Companies

    Directory of Open Access Journals (Sweden)

    Ali Uyar

    2017-03-01

    Full Text Available the abuses of managers have the ability to create major problems. In order to avoid future scandals, this study investigates the association between the accounting information system and corporate governance. We hope that these findings will contribute towards the enhancement of good corporate governance created by the accounting function of business organizations. The results of empirical analyses indicate that bookkeeping, financial reporting, and the budgeting system have a positive impact on the corporate governance level, whereas the adoption of Turkish Accounting / Financial Reporting Standards do not. Thus, in order to foster corporate governance, managers should establish internal reporting procedures as well as internal control and monitoring devices before attempting external control through independent auditing.

  18. Inequity in a market-based health system: evidence from Canada's dental sector

    OpenAIRE

    Michel Grignon; Jeremiah Hurley; Li Wang; Sara Allin

    2008-01-01

    We study the extent and drivers of income-related inequity in utilization of dental services in Canada using the concentration-index approach that has been widely applied to study equity in physician and hospital services. Because dental care is almost wholly privately financed in Canada, our estimates provide a benchmark for income-related inequity of utilization in private health systems. Although a number of studies document a link between income and utilization, our study is one of the fe...

  19. Is the human mirror neuron system plastic? Evidence from a transcranial magnetic stimulation study.

    Science.gov (United States)

    Mehta, Urvakhsh Meherwan; Waghmare, Avinash V; Thirthalli, Jagadisha; Venkatasubramanian, Ganesan; Gangadhar, Bangalore N

    2015-10-01

    Virtual lesions in the mirror neuron network using inhibitory low-frequency (1Hz) transcranial magnetic stimulation (TMS) have been employed to understand its spatio-functional properties. However, no studies have examined the influence of neuro-enhancement by using excitatory high-frequency (20Hz) repetitive transcranial magnetic stimulation (HF-rTMS) on these networks. We used three forms of TMS stimulation (HF-rTMS, single and paired pulse) to investigate whether the mirror neuron system facilitates the motor system during goal-directed action observation relative to inanimate motion (motor resonance), a marker of putative mirror neuron activity. 31 healthy individuals were randomized to receive single-sessions of true or sham HF-rTMS delivered to the left inferior frontal gyrus - a component of the human mirror system. Motor resonance was assessed before and after HF-rTMS using three TMS cortical reactivity paradigms: (a) 120% of resting motor threshold (RMT), (b) stimulus intensity set to evoke motor evoked potential of 1-millivolt amplitude (SI1mV) and (c) a short latency paired pulse paradigm. Two-way RMANOVA showed a significant group (true versus sham) X occasion (pre- and post-HF-rTMS motor resonance) interaction effect for SI1mV [F(df)=6.26 (1, 29), p=0.018] and 120% RMT stimuli [F(df)=7.01 (1, 29), p=0.013] indicating greater enhancement of motor resonance in the true HF-rTMS group than the sham-group. This suggests that HF-rTMS could adaptively modulate properties of the mirror neuron system. This neuro-enhancement effect is a preliminary step that can open translational avenues for novel brain stimulation therapeutics targeting social-cognition deficits in schizophrenia and autism. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Effects of terlipressin on the aquaretic system. Evidence of antidiuretic effects

    DEFF Research Database (Denmark)

    Krag, Aleksander Ahm; Bendtsen, Flemming; Pedersen, Erling B.

    2008-01-01

    Background and aims: The vasopressin analogue terlipressin is believed selectively to cause vasoconstriction by a V1-receptor stimulation. However, a possible antidiuretic effect by V2-receptors stimulation has never been ruled out. Patients and methods: 22 patients with ascites, including 7 with...... is a clear indication of activation of the antidiuretic system (V2 receptor effect). Key words: aquaporine-2, vasopressin, hepatorenal syndrome, cirrhosis....

  1. Review and Synthesis of Evidence Regarding Environmental Risks Posed by Munitions Constituents (MC) in Aquatic Systems

    Science.gov (United States)

    2017-10-01

    Risks Posed by Munitions Constituents (MC) in Aquatic Systems En vi ro nm en ta l L ab or at or y Guilherme R. Lotufo, Mark A. Chappell, Cynthia L...public release; distribution is unlimited. The U.S. Army Engineer Research and Development Center (ERDC) solves the nation’s toughest engineering ...and environmental challenges. ERDC develops innovative solutions in civil and military engineering , geospatial sciences, water resources, and

  2. Evidence for a biological dawn and dusk in the human circadian timing system

    Science.gov (United States)

    Wehr, T A; Aeschbach, D; Duncan, W C

    2001-01-01

    Because individuals differ in the phase angle at which their circadian rhythms are entrained to external time cues, averaging group data relative to clock time sometimes obscures abrupt changes that are characteristic of waveforms of the rhythms in individuals. Such changes may have important implications for the temporal organization of human circadian physiology. To control for variance in phase angle of entrainment, we used dual internal reference points – onset and offset of the nocturnal period of melatonin secretion – to calculate average profiles of circadian rhythm data from five previously published studies. Onset and/or offset of melatonin secretion were found to coincide with switch-like transitions between distinct diurnal and nocturnal periods of circadian rhythms in core body temperature, sleepiness, power in the theta band of the wake EEG, sleep propensity and rapid eye movement (REM) sleep propensity. Transitions between diurnal and nocturnal periods of sleep–wake and cortisol circadian rhythms were found to lag the other transitions by 1–3 h. When the duration of the daily light period was manipulated experimentally, melatonin-onset-related transitions in circadian rhythms appeared to be entrained to the light-to-dark transition, while melatonin-offset-related transitions appeared to be entrained to the dark-to-light transition. These results suggest a model of the human circadian timing system in which two states, one diurnal and one nocturnal, alternate with one another, and in which transitions between the states are switch-like and are separately entrained to dawn and dusk. This description of the human circadian system is similar to the Pittendrigh–Daan model of the rodent circadian system, and it suggests that core features of the system in other mammals are conserved in humans. PMID:11559786

  3. Comparative analyses of olfactory systems in terrestrial crabs (Brachyura: evidence for aerial olfaction?

    Directory of Open Access Journals (Sweden)

    Jakob Krieger

    2015-12-01

    Full Text Available Adaptations to a terrestrial lifestyle occurred convergently multiple times during the evolution of the arthropods. This holds also true for the “true crabs” (Brachyura, a taxon that includes several lineages that invaded land independently. During an evolutionary transition from sea to land, animals have to develop a variety of physiological and anatomical adaptations to a terrestrial life style related to respiration, reproduction, development, circulation, ion and water balance. In addition, sensory systems that function in air instead of in water are essential for an animal’s life on land. Besides vision and mechanosensory systems, on land, the chemical senses have to be modified substantially in comparison to their function in water. Among arthropods, insects are the most successful ones to evolve aerial olfaction. Various aspects of terrestrial adaptation have also been analyzed in those crustacean lineages that evolved terrestrial representatives including the taxa Anomala, Brachyura, Amphipoda, and Isopoda. We are interested in how the chemical senses of terrestrial crustaceans are modified to function in air. Therefore, in this study, we analyzed the brains and more specifically the structure of the olfactory system of representatives of brachyuran crabs that display different degrees of terrestriality, from exclusively marine to mainly terrestrial. The methods we used included immunohistochemistry, detection of autofluorescence- and confocal microscopy, as well as three-dimensional reconstruction and morphometry. Our comparative approach shows that both the peripheral and central olfactory pathways are reduced in terrestrial members in comparison to their marine relatives, suggesting a limited function of their olfactory system on land. We conclude that for arthropod lineages that invaded land, evolving aerial olfaction is no trivial task.

  4. A novel statistical approach shows evidence for multi-system physiological dysregulation during aging.

    Science.gov (United States)

    Cohen, Alan A; Milot, Emmanuel; Yong, Jian; Seplaki, Christopher L; Fülöp, Tamàs; Bandeen-Roche, Karen; Fried, Linda P

    2013-03-01

    Previous studies have identified many biomarkers that are associated with aging and related outcomes, but the relevance of these markers for underlying processes and their relationship to hypothesized systemic dysregulation is not clear. We address this gap by presenting a novel method for measuring dysregulation via the joint distribution of multiple biomarkers and assessing associations of dysregulation with age and mortality. Using longitudinal data from the Women's Health and Aging Study, we selected a 14-marker subset from 63 blood measures: those that diverged from the baseline population mean with age. For the 14 markers and all combinatorial sub-subsets we calculated a multivariate distance called the Mahalanobis distance (MHBD) for all observations, indicating how "strange" each individual's biomarker profile was relative to the baseline population mean. In most models, MHBD correlated positively with age, MHBD increased within individuals over time, and higher MHBD predicted higher risk of subsequent mortality. Predictive power increased as more variables were incorporated into the calculation of MHBD. Biomarkers from multiple systems were implicated. These results support hypotheses of simultaneous dysregulation in multiple systems and confirm the need for longitudinal, multivariate approaches to understanding biomarkers in aging. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  5. Lead isotope evidence for a young formation age of the Earth-Moon system

    Science.gov (United States)

    Connelly, J. N.; Bizzarro, M.

    2016-10-01

    A model of a giant impact between two planetary bodies is widely accepted to account for the Earth-Moon system. Despite the importance of this event for understanding early Earth evolution and the inventory of Earth's volatiles critical to life, the timing of the impact is poorly constrained. We explore a data-based, two-stage Pb isotope evolution model in which the timing of the loss of volatile Pb relative to refractory U in the aftermath of the giant impact is faithfully recorded in the Pb isotopes of bulk silicate Earth. Constraining the first stage Pb isotopic evolution permits calculating an age range of 4.426-4.417 Ga for the inflection in the U/Pb ratio related to the giant impact. This model is supported by Pb isotope data for angrite meteorites that we use to demonstrate volatility-driven, planetary-scale Pb loss was an efficient process during the early Solar System. The revised age is ∼100 Myr younger than most current estimates for the age of the Moon but fully consistent with recent ages for lunar ferroan anorthosite and the timing of Earth's first crust inferred from the terrestrial zircon record. The estimated loss of ∼98% of terrestrial Pb relative to the Solar System bulk composition by the end of the Moon-forming process implies that the current inventory of Earth's most volatile elements, including water, arrived during post-impact veneering by volatile-rich bodies.

  6. The nervous system and metabolic dysregulation: emerging evidence converges on ketogenic diet therapy

    Directory of Open Access Journals (Sweden)

    David N. Ruskin

    2012-03-01

    Full Text Available A link between metabolism and brain function is clear. Since ancient times, epileptic seizures were noted as treatable with fasting, and historical observations of the therapeutic benefits of fasting on epilepsy were confirmed nearly 100 years ago. Shortly thereafter a high-fat, low-carbohydrate ketogenic diet debuted as a therapy to reduce seizures. This strict regimen could mimic the metabolic effects of fasting while allowing adequate caloric intake for ongoing energy demands. Today, ketogenic diet therapy, which forces predominantly ketone-based rather than glucose-based metabolism, is now well-established as highly successful in reducing seizures. More recently, cellular metabolic dysfunction in the nervous system has been recognized as existing side-by-side with nervous system disorders - although often with much less obvious cause-and-effect as the relationship between fasting and seizures. Rekindled interest in metabolic and dietary therapies for brain disorders complements new insight into their mechanisms and broader implications. Here we describe the emerging relationship between a ketogenic diet and adenosine as a way to reset brain metabolism and neuronal activity and disrupt a cycle of dysfunction. We also provide an overview of the effects of a ketogenic diet on cognition and recent data on the effects of a ketogenic diet on pain, and explore the relative time course quantified among hallmark metabolic changes, altered neuron function and altered animal behavior assessed after diet administration. We predict continued applications of metabolic therapies in treating dysfunction including and beyond the nervous system.

  7. Configuring Balanced Scorecards for Measuring Health System Performance: Evidence from 5 Years' Evaluation in Afghanistan

    Science.gov (United States)

    Edward, Anbrasi; Kumar, Binay; Kakar, Faizullah; Salehi, Ahmad Shah; Burnham, Gilbert; Peters, David H.

    2011-01-01

    Background In 2004, Afghanistan pioneered a balanced scorecard (BSC) performance system to manage the delivery of primary health care services. This study examines the trends of 29 key performance indicators over a 5-year period between 2004 and 2008. Methods and Findings Independent evaluations of performance in six domains were conducted annually through 5,500 patient observations and exit interviews and 1,500 provider interviews in >600 facilities selected by stratified random sampling in each province. Generalized estimating equation (GEE) models were used to assess trends in BSC parameters. There was a progressive improvement in the national median scores scaled from 0–100 between 2004 and 2008 in all six domains: patient and community satisfaction of services (65.3–84.5, pscorecard reconfigurations are needed to integrate effectiveness and efficiency measures and accommodate changes in health systems policy and strategy architecture to ensure its continued relevance and effectiveness as a comprehensive health system performance measure. The process of BSC design and implementation can serve as a valuable prototype for health policy planners managing performance in similar health care contexts. Please see later in the article for the Editors' Summary PMID:21814499

  8. Performance of the internal audit department under ERP systems: empirical evidence from Taiwanese firms

    Science.gov (United States)

    Tsai, Wen-Hsien; Chen, Hui-Chiao; Chang, Jui-Chu; Leu, Jun-Der; Chao Chen, Der; Purbokusumo, Yuyun

    2015-10-01

    In this study, the performance of the internal audit department (IAD) and its contribution to a company under enterprise resource planning (ERP) systems was examined. It is anticipated that this will provide insight into the factors perceived to be crucial to a company's effectiveness. A theoretical framework was developed and tested using the sample of Taiwanese companies. Using mail survey procedures, we elicited perceptions from key internal auditors about the ERP system and auditing software, as well as their opinions concerning the IAD's effectiveness and its contribution within a company. Data were analysed using the partial least square (PLS) regression to test the hypotheses. Drawing upon a sample of Taiwanese firms, the study suggests that a firm can improve the performance of the IAD through an enterprise-wide integrated, effective ERP system and appropriate auditing software. At the same time, the performance of the IAD can also contribute significantly to the company. The results also show that investments in computer-assisted auditing techniques (CAATs) are crucial due to their tremendous effectiveness in regard to the performance of the IAD and for the contributions CAATs can make to a company.

  9. Evidence for a Xer/dif system for chromosome resolution in archaea.

    Science.gov (United States)

    Cortez, Diego; Quevillon-Cheruel, Sophie; Gribaldo, Simonetta; Desnoues, Nicole; Sezonov, Guennadi; Forterre, Patrick; Serre, Marie-Claude

    2010-10-21

    Homologous recombination events between circular chromosomes, occurring during or after replication, can generate dimers that need to be converted to monomers prior to their segregation at cell division. In Escherichia coli, chromosome dimers are converted to monomers by two paralogous site-specific tyrosine recombinases of the Xer family (XerC/D). The Xer recombinases act at a specific dif site located in the replication termination region, assisted by the cell division protein FtsK. This chromosome resolution system has been predicted in most Bacteria and further characterized for some species. Archaea have circular chromosomes and an active homologous recombination system and should therefore resolve chromosome dimers. Most archaea harbour a single homologue of bacterial XerC/D proteins (XerA), but not of FtsK. Therefore, the role of XerA in chromosome resolution was unclear. Here, we have identified dif-like sites in archaeal genomes by using a combination of modeling and comparative genomics approaches. These sites are systematically located in replication termination regions. We validated our in silico prediction by showing that the XerA protein of Pyrococcus abyssi specifically recombines plasmids containing the predicted dif site in vitro. In contrast to the bacterial system, XerA can recombine dif sites in the absence of protein partners. Whereas Archaea and Bacteria use a completely different set of proteins for chromosome replication, our data strongly suggest that XerA is most likely used for chromosome resolution in Archaea.

  10. The Nervous System and Metabolic Dysregulation: Emerging Evidence Converges on Ketogenic Diet Therapy

    Science.gov (United States)

    Ruskin, David N.; Masino, Susan A.

    2012-01-01

    A link between metabolism and brain function is clear. Since ancient times, epileptic seizures were noted as treatable with fasting, and historical observations of the therapeutic benefits of fasting on epilepsy were confirmed nearly 100 years ago. Shortly thereafter a high fat, low-carbohydrate ketogenic diet (KD) debuted as a therapy to reduce seizures. This strict regimen could mimic the metabolic effects of fasting while allowing adequate caloric intake for ongoing energy demands. Today, KD therapy, which forces predominantly ketone-based rather than glucose-based metabolism, is now well-established as highly successful in reducing seizures. Cellular metabolic dysfunction in the nervous system has been recognized as existing side-by-side with nervous system disorders – although often with much less obvious cause-and-effect as the relationship between fasting and seizures. Rekindled interest in metabolic and dietary therapies for brain disorders complements new insight into their mechanisms and broader implications. Here we describe the emerging relationship between a KD and adenosine as a way to reset brain metabolism and neuronal activity and disrupt a cycle of dysfunction. We also provide an overview of the effects of a KD on cognition and recent data on the effects of a KD on pain, and explore the relative time course quantified among hallmark metabolic changes, altered neuron function and altered animal behavior assessed after diet administration. We predict continued applications of metabolic therapies in treating dysfunction including and beyond the nervous system. PMID:22470316

  11. Evidence for Bacterial Sulfate Reduction in a Fissured-porous Karst System in Southern Germany

    Science.gov (United States)

    Einsiedl, F.; Mayer, B.

    2005-12-01

    Twenty five percent of the world's population uses karst water as drinking water resources. Since karst groundwater systems are highly vulnerable to contamination, groundwater protection and self purification is a major challenge. Up to now research in karst groundwater systems has predominantly concentrated on hydrodynamic processes. Little is known about anoxic processes in oxygen dominated, fracture-matrix diffusion controlled karst aquifers. Isotope measurements comprise a promising tool to identify biogeochemical processes such as bacterial (dissimilatory) sulfate reduction in karstic aquifers. The goal of this study was to determine the sources and the processes affecting sulfate in an oxygen-rich karst aquifer in southern Germany and their dependence on hydrogeological parameters. This was achieved by interpreting tritium data with a simple lumped parameter approach and assessing variations in concentrations and isotopic compositions of sulfate and dissolved inorganic carbon (DIC) with respect to groundwater age. Young groundwater (characterized by comparatively high sulfate concentrations (0.36 mM) and δ34S values similar to those of recent atmospheric deposition (1.5‰). In contrast groundwater with mean residence times >60 years had significantly lower sulfate concentrations (0.08 mM) and markedly higher δ34S values (7.5‰). These results indicate that in karst systems with matrix porosity, bacterial (dissimilatory) sulfate reduction may occur. This process has the potential to contribute to long-term biodegradation of contaminants in the porous rock matrix representing the dominant water reservoir in fissured-porous karst aquifers.

  12. Immunoediting: evidence of the multifaceted role of the immune system in self-metastatic tumor growth.

    Science.gov (United States)

    Enderling, Heiko; Hlatky, Lynn; Hahnfeldt, Philip

    2012-07-28

    The role of the immune system in tumor progression has been a subject for discussion for many decades. Numerous studies suggest that a low immune response might be beneficial, if not necessary, for tumor growth, and only a strong immune response can counter tumor growth and thus inhibit progression. We implement a cellular automaton model previously described that captures the dynamical interactions between the cancer stem and non-stem cell populations of a tumor through a process of self-metastasis. By overlaying on this model the diffusion of immune reactants into the tumor from a peripheral source to target cells, we simulate the process of immune-system-induced cell kill on tumor progression. A low cytotoxic immune reaction continuously kills cancer cells and, although at a low rate, thereby causes the liberation of space-constrained cancer stem cells to drive self-metastatic progression and continued tumor growth. With increasing immune system strength, however, tumor growth peaks, and then eventually falls below the intrinsic tumor sizes observed without an immune response. With this increasing immune response the number and proportion of cancer stem cells monotonically increases, implicating an additional unexpected consequence, that of cancer stem cell selection, to the immune response. Cancer stem cells and immune cytotoxicity alone are sufficient to explain the three-step "immunoediting" concept - the modulation of tumor growth through inhibition, selection and promotion.

  13. A complex alloantigen system in Florida sandhill cranes, Grus canadensis pratensis: Evidence for the major histocompatibility (B) system

    Science.gov (United States)

    Jarvi, S.I.; Gee, G.F.; Miller, M.M.; Briles, W.E.

    1995-01-01

    The B blood group system constitutes the major histocompatibility complex (Mhc) in birds. The Mhc is a cluster of genes largely devoted to the processing and presentation of antigen. The Mhc is highly polymorphic in many species and, thus, useful in the evaluation of genetic diversity for fitness traits within populations of a variety of animals. Correlations found between particular Mhc haplotypes and resistance to certain diseases emphasize the importance of understanding the functional significance of diversity of the Mhc, particularly in species threatened with extinction. As part of studies focused on genetic diversity in wild birds, serological techniques were used to define a highly polymorphic alloantigen system in seven families of Florida sandhill cranes (Grus canadensis pratensis). The results of analyses with antisera produced within the crane families and with chicken Mhc antigen-specific reagents revealed a single major alloantigen system that is likely the Mhc of the Florida sandhill crane. Preliminary experiments indicate that these crane alloantisera will provide a means of defining .the Mhc in other species of cranes.

  14. Regulation in the face of uncertainty: the evidence on electronic nicotine delivery systems (e-cigarettes

    Directory of Open Access Journals (Sweden)

    Farsalinos KE

    2015-09-01

    Full Text Available Konstantinos E Farsalinos,1,2 Jacques Le Houezec3,4 1Department of Cardiology, Onassis Cardiac Surgery Center, Kallithea, 2Department of Pharmacy, University of Patras, Patras, Greece; 3Division of Epidemiology and Public Health, UK Centre for Tobacco and Alcohol Studies, University of Nottingham, Nottingham, England, UK; 4Addiction Research Unit, INSERM 1178 (Mental and Public Health, Paris, France Abstract: Tobacco smoking is the largest single preventable cause of many chronic diseases and death. Effective treatments exist; however, few smokers use them and most try to quit by themselves. Most of the tobacco cigarette's toxicity is related to the combustion process. Models of harm reduction applied to tobacco suggest that switching from inhalation of combustible products to a noncombustible nicotine delivery product would likely result in a vast reduction in tobacco-related death and illness. Currently available evidence raises no doubt that electronic cigarettes (e-cigs are by far less harmful than smoking (although probably not absolutely safe and have the potential to be the most effective tobacco harm reduction products due to their unique property of resembling smoking and providing satisfaction to the user. A lot of controversy is surrounding e-cigs and their regulation, much of which is based on the precautionary principle. Although monitoring and further research is definitely needed, the arguments used to implement severe restrictions or bans are mostly hypothetical, weakly supported by evidence, and, in some cases, derived from mispresentation or misinterpretation of the study findings. Regulators should keep in mind that the target population is smokers who want to reduce or quit their deadly tobacco consumption. To achieve this goal, smokers should be honestly informed on the relative harmfulness of the different products. E-cigs are not tobacco products and are not used as medications. For this reason, a specific regulatory

  15. European evidence-based recommendations for diagnosis and treatment of childhood-onset systemic lupus erythematosus: the SHARE initiative.

    Science.gov (United States)

    Groot, Noortje; de Graeff, Nienke; Avcin, Tadej; Bader-Meunier, Brigitte; Brogan, Paul; Dolezalova, Pavla; Feldman, Brian; Kone-Paut, Isabelle; Lahdenne, Pekka; Marks, Stephen D; McCann, Liza; Ozen, Seza; Pilkington, Clarissa; Ravelli, Angelo; Royen-Kerkhof, Annet van; Uziel, Yosef; Vastert, Bas; Wulffraat, Nico; Kamphuis, Sylvia; Beresford, Michael W

    2017-11-01

    Childhood-onset systemic lupus erythematosus (cSLE) is a rare, multisystem and potentially life-threatening autoimmune disorder with significant associated morbidity. Evidence-based guidelines are sparse and management is often based on clinical expertise. SHARE (Single Hub and Access point for paediatric Rheumatology in Europe) was launched to optimise and disseminate management regimens for children and young adults with rheumatic diseases like cSLE. Here, we provide evidence-based recommendations for diagnosis and treatment of cSLE. In view of extent and complexity of cSLE and its various manifestations, recommendations for lupus nephritis and antiphospholipid syndrome will be published separately. Recommendations were generated using the EULAR (European League Against Rheumatism) standard operating procedure. An expert committee consisting of paediatric rheumatologists and representation of paediatric nephrology from across Europe discussed evidence-based recommendations during two consensus meetings. Recommendations were accepted if >80% agreement was reached. A total of 25 recommendations regarding key approaches to diagnosis and treatment of cSLE were made. The recommendations include 11 on diagnosis, 9 on disease monitoring and 5 on general treatment. Topics included: appropriate use of SLE classification criteria, disease activity and damage indices; adequate assessment of autoantibody profiles; secondary macrophage activation syndrome; use of hydroxychloroquine and corticosteroid-sparing regimens; and the importance of addressing poor adherence. Ten recommendations were accepted regarding general diagnostic strategies and treatment indications of neuropsychiatric cSLE. The SHARE recommendations for cSLE and neuropsychiatric manifestations of cSLE have been formulated by an evidence-based consensus process to support uniform, high-quality standards of care for children with cSLE. © Article author(s) (or their employer(s) unless otherwise stated in the

  16. Gesture and intonation are "sister systems" of infant communication: Evidence from regression patterns of language development.

    Science.gov (United States)

    Snow, David P

    2017-01-01

    This study investigates infants' transition from nonverbal to verbal communication using evidence from regression patterns. As an example of regressions, prelinguistic infants learning American Sign Language (ASL) use pointing gestures to communicate. At the onset of single signs, however, these gestures disappear. Petitto (1987) attributed the regression to the children's discovery that pointing has two functions, namely, deixis and linguistic pronouns. The 1:2 relation (1 form, 2 functions) violates the simple 1:1 pattern that infants are believed to expect. This kind of conflict, Petitto argued, explains the regression. Based on the additional observation that the regression coincided with the boundary between prelinguistic and linguistic communication, Petitto concluded that the prelinguistic and linguistic periods are autonomous. The purpose of the present study was to evaluate the 1:1 model and to determine whether it explains a previously reported regression of intonation in English. Background research showed that gestures and intonation have different forms but the same pragmatic meanings, a 2:1 form-function pattern that plausibly precipitates the regression. The hypothesis of the study was that gestures and intonation are closely related. Moreover, because gestures and intonation change in the opposite direction, the negative correlation between them indicates a robust inverse relationship. To test this prediction, speech samples of 29 infants (8 to 16 months) were analyzed acoustically and compared to parent-report data on several verbal and gestural scales. In support of the hypothesis, gestures alone were inversely correlated with intonation. In addition, the regression model explains nonlinearities stemming from different form-function configurations. However, the results failed to support the claim that regressions linked to early words or signs reflect autonomy. The discussion ends with a focus on the special role of intonation in children

  17. Sources of osmium to the modern oceans: New evidence from the 190Pt-186Os system

    Science.gov (United States)

    McDaniel, D.K.; Walker, R.J.; Hemming, S.R.; Horan, M.F.; Becker, H.; Grauch, R.I.

    2004-01-01

    High precision Os isotope analysis of young marine manganese nodules indicate that whereas the composition of modern seawater is radiogenic with respect to 187Os/188Os, it has 186Os/188Os that is within uncertainty of the chondritic value. Marine Mn nodule compositions thus indicate that the average continental source of Os to modern seawater had long-term high Re/Os compared to Pt/Os. Analyses of loess and freshwater Mn nodules support existing evidence that average upper continental crust (UCC) has resolvably suprachondritic 186Os/188Os, as well as radiogenic 187Os/188Os. Modeling the composition of seawater as a two-component mixture of oceanic/cosmic Os with chondritic Os compositions and continentally-derived Os demonstrates that, insofar as estimates for the composition of average UCC are accurate, congruently weathered average UCC cannot be the sole continental source of Os to seawater. Our analysis of four Cambrian black shales confirm that organic-rich sediments can have 187Os/188Os ratios that are much higher than average UCC, but 186Os/188Os compositions that are generally between those of chondrites and average-UCC. Preferential weathering of black shales can result in dissolved Os discharged to the ocean basins that has a much lower 186Os/188Os than does average upper crust. Modeling the available data demonstrates that augmentation of estimated average UCC compositions with less than 0.1% additional black shale and 1.4% additional ultramafic rock can produce a continental end-member Os isotopic composition that satisfies the requirements imposed by the marine Mn nodule data. The interplay of these two sources provides a mechanism by which the 187Os/188Os of seawater can change as sources and weathering conditions change, yet seawater 186Os/188Os varies only minimally. ?? 2004 Elsevier Ltd.

  18. Evidence Suggesting a Role of Iron in a Mouse Model of Nephrogenic Systemic Fibrosis.

    Directory of Open Access Journals (Sweden)

    Chhanda Bose

    Full Text Available Nephrogenic systemic fibrosis is associated with gadolinium contrast exposure in patients with reduced kidney function and carries high morbidity and mortality. We have previously demonstrated that gadolinium contrast agents induce in vivo systemic iron mobilization and in vitro differentiation of peripheral blood mononuclear cells into ferroportin (iron exporter-expressing fibrocytic cells. In the present study we examined the role of iron in a mouse model of nephrogenic systemic fibrosis. Chronic kidney disease was induced in 8-week-old male Balb/C mice with a two-step 5/6 nephrectomy surgery. Five groups of mice were studied: control (n = 5, sham surgery control (n = 5, chronic kidney disease control (n = 4, chronic kidney disease injected with 0.5 mmol/kg body weight of Omniscan 3 days per week, for a total of 10 injections (n = 8, and chronic kidney disease with Omniscan plus deferiprone, 125 mg/kg, in drinking water (n = 9. Deferiprone was continued for 16 weeks until the end of the experiment. Mice with chronic kidney disease injected with Omniscan developed skin changes characteristic of nephrogenic systemic fibrosis including hair loss, reddening, ulceration, and skin tightening by 10 to 16 weeks. Histopathological sections demonstrated dermal fibrosis with increased skin thickness (0.25±0.06 mm, sham; 0.34±+0.3 mm, Omniscan-injected. Additionally, we observed an increase in tissue infiltration of ferroportin-expressing, fibrocyte-like cells accompanied by tissue iron accumulation in the skin of the Omniscan-treated mice. The deferiprone-treated group had significantly decreased skin thickness (p<0.05 and significantly decreased dermal fibrosis compared to the Omniscan-only group. In addition, iron chelation prevented tissue infiltration of ferroportin-expressing, fibrocyte-like cells. Our in vitro experiments demonstrated that exposure to Omniscan resulted in the release of catalytic iron and this was prevented by the iron chelator

  19. Mercury pollution on district of Dimembe river system North Sulawesi, Indonesia, due to traditional gold mining activities

    Science.gov (United States)

    Ayhuan, D.; Atteng, O.; Dondokambey, A.; Randuk, M.

    2003-05-01

    Mercury contamination caused by the amalgamation of gold in small scale gold mining is a environmental problem. Small-scale gold mining (SSGM) is common in mineral endowed developing countries. It offers an important means of livehood and has served as a safety net in times of natural calamities or economic distress. In north Sulawesi Province alone, approximately 22,000 small-scale gold miners were active in 1998, and produced an estimated 10 tonnes of gold bullion. Activities of traditional / illegal gold mining (PETI) in Dimembe of district, which is located in Minahasa Regency, North Sulawesi Province. The major environmental concern associated with PETI in mercury pollution from processing of gold-bearing ore. In both the inorganic and organic forms, mercury is one of the most toxic substances to humans. One of the environmental pollution is water pollution on district of Dimembe river system that is probably caused by the use of mercury (Hg) in processing mine ore. This mercury is used in an iron rolling vessel, wllich is called tromol. Mercury concentration at employed in this operation reaches 1 kg out of 30 kg ore. Sampling stage was conducted at Warat river, downstream Taiawaan river, Merut river and Kadumut river on late April 2002 by BAPEDALDA team together with Health Laboratory staff. Material which were sampled was water. Sampling methods carried out were bottle sample immersed about 10 cm below the water surface. The analysis method used was mercury analyzer. The analysis result show that total concentration of mercury range from 1. 69 to 25. 54 ppb. This concentration is closed to Water Quality Standard IV Class that is 0.005 mg/L (Regulation Government No. 82/2001). The result of this research indicate that the district of Dimembe river system in the gold mining area have been contaminated by mercury.

  20. Implementing evidence-based patient self-management programs in the Veterans Health Administration: perspectives on delivery system design considerations.

    Science.gov (United States)

    Damush, T M; Jackson, G L; Powers, B J; Bosworth, H B; Cheng, E; Anderson, J; Guihan, M; LaVela, S; Rajan, S; Plue, L

    2010-01-01

    While many patient self-management (PSM) programs have been developed and evaluated for effectiveness, less effort has been devoted to translating and systematically delivering PSM in primary and specialty care. Therefore, the purpose of this paper is to review delivery system design considerations for implementing self-management programs in practice. As lessons are learned about implementing PSM programs in Veterans Health Administration (VHA), resource allocation by healthcare organization for formatting PSM programs, providing patient access, facilitating PSM, and incorporating support tools to foster PSM among its consumers can be refined and tailored. Redesigning the system to deliver and support PSM will be important as implementation researchers translate evidence based PSM practices into routine care and evaluate its impact on the health-related quality of life of veterans living with chronic disease.

  1. Understanding the cephalopod immune system based on functional and molecular evidence.

    Science.gov (United States)

    Gestal, C; Castellanos-Martínez, S

    2015-09-01

    Cephalopods have the most advanced circulatory and nervous system among the mollusks. Recently, they have been included in the European directive which state that suffering and pain should be minimized in cephalopods used in experimentation. The knowledge about cephalopod welfare is still limited and several gaps are yet to be filled, especially in reference to pathogens, pathologies and immune response of these mollusks. In light of the requirements of the normative, in addition to the ecologic and economic importance of cephalopods, in this review we update the work published to date concerning cephalopod immune system. Significant advances have been reached in relation to the characterization of haemocytes and defensive mechanisms comprising cellular and humoral factors mainly, but not limited, in species of high economic value like Sepia officinalis and Octopus vulgaris. Moreover, the improvement of molecular approaches has helped to discover several immune-related genes/proteins. These immune genes/proteins include antimicrobial peptides, phenoloxidases, antioxidant enzymes, serine protease inhibitor, lipopolysaccharide-induced TNF-α factor, Toll-like receptors, lectins, even clusters of differentiation among others. Most of them have been found in haemocytes but also in gills and digestive gland, and the characterization as well as their precise role in the immune response of cephalopods is still pending to be elucidated. The assessment of immune parameters in cephalopods exposed to contaminants is just starting, but the negative impact of some pollutants on the immune response of the common octopus has been reported. This review summarizes the current status of our knowledge about the cephalopod immune system that seems to be far from simply. On the contrary, the advances gained to date point out a complex innate immunity in cephalopods. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Are mirror neurons the basis of speech perception? Evidence from five cases with damage to the purported human mirror system.

    Science.gov (United States)

    Rogalsky, Corianne; Love, Tracy; Driscoll, David; Anderson, Steven W; Hickok, Gregory

    2011-01-01

    The discovery of mirror neurons in macaque has led to a resurrection of motor theories of speech perception. Although the majority of lesion and functional imaging studies have associated perception with the temporal lobes, it has also been proposed that the 'human mirror system', which prominently includes Broca's area, is the neurophysiological substrate of speech perception. Although numerous studies have demonstrated a tight link between sensory and motor speech processes, few have directly assessed the critical prediction of mirror neuron theories of speech perception, namely that damage to the human mirror system should cause severe deficits in speech perception. The present study measured speech perception abilities of patients with lesions involving motor regions in the left posterior frontal lobe and/or inferior parietal lobule (i.e., the proposed human 'mirror system'). Performance was at or near ceiling in patients with fronto-parietal lesions. It is only when the lesion encroaches on auditory regions in the temporal lobe that perceptual deficits are evident. This suggests that 'mirror system' damage does not disrupt speech perception, but rather that auditory systems are the primary substrate for speech perception.

  3. Understanding physicians' acceptance of the Medline system for practicing evidence-based medicine: a decomposed TPB model.

    Science.gov (United States)

    Hung, Shin-Yuan; Ku, Yi-Cheng; Chien, Jui-Chi

    2012-02-01

    Evidence-based medicine (EBM) supports physicians in their improvement of clinical quality and enhances hospitals' improvement of patient safety. Many health care institutions implement information systems to support physicians practicing EBM. However, studies exploring the antecedent factors of physicians' usage intention of information systems facilitating EBM practice are rare. Hence this study proposed a research model based on the decomposed theory of the planned behavior model (decomposed TPB) to investigate the factors influencing physicians' acceptance of the Medline system. A field survey was conducted in Taiwan to collect data from physicians with experience in using the Medline system. A valid sample of 224 physicians was collected for data analysis. Structural equation modeling using the partial least squares (PLS) method with bootstrap estimate was used to test the research model. The findings of this study show that a physician's usage intention is significantly influenced by three factors, i.e. attitude, the subjective norm, and perceived behavior control. Furthermore, these three factors can be predicted by perceived usefulness and perceived ease of use, interpersonal influence, personal innovativeness in IT and self-efficacy, respectively. The results of this study indicate that our research model provides an effective prediction of the intention of physicians to use the Medline system and provides valuable implications for academics and practitioners. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  4. Party System Nationalization and Non-Uniform Vote Switching: Evidence from the Czech Republic

    Czech Academy of Sciences Publication Activity Database

    Linek, Lukáš; Lyons, Pat

    2010-01-01

    Roč. 46, č. 3 (2010), s. 375-399 ISSN 0038-0288 R&D Projects: GA ČR GA407/07/1395 Institutional research plan: CEZ:AV0Z70280505 Keywords : party system nationalisation * vote switching * ecological inference Subject RIV: AD - Politology ; Political Sciences Impact factor: 0.389, year: 2010 http://sreview.soc.cas.cz/uploads/c926357558e5bf662b62f54b2ba9293933f542c6_LinekLyonssoccas2010-3.pdf

  5. Effects of Job Accessibility Improved by Public Transport System: Natural Experimental Evidence from the Copenhagen Metro

    DEFF Research Database (Denmark)

    Pons Rotger, Gabriel Angel; Nielsen, Thomas Alexander Sick

    2015-01-01

    This study examines the effect of accessibility to urban jobs via a public transport system on individual earnings and commuting behaviour. The effect of improved public transport based accessibility on these outcomes is determined by exploiting the exogenous variation in access to a public rail ...... with a change in commuting patterns as the improved access to public transport facilitates a shift from employment within the township to better paid jobs in the city centre, as well as in other suburbs of the Copenhagen Metropolitan area...

  6. FMRI evidence for the involvement of the procedural memory system in morphological processing of a second language.

    Directory of Open Access Journals (Sweden)

    Christos Pliatsikas

    Full Text Available Behavioural evidence suggests that English regular past tense forms are automatically decomposed into their stem and affix (played  = play+ed based on an implicit linguistic rule, which does not apply to the idiosyncratically formed irregular forms (kept. Additionally, regular, but not irregular inflections, are thought to be processed through the procedural memory system (left inferior frontal gyrus, basal ganglia, cerebellum. It has been suggested that this distinction does not to apply to second language (L2 learners of English; however, this has not been tested at the brain level. This fMRI study used a masked-priming task with regular and irregular prime-target pairs (played-play/kept-keep to investigate morphological processing in native and highly proficient late L2 English speakers. No between-groups differences were revealed. Compared to irregular pairs, regular pairs activated the pars opercularis, bilateral caudate nucleus and the right cerebellum, which are part of the procedural memory network and have been connected with the processing of morphologically complex forms. Our study is the first to provide evidence for native-like involvement of the procedural memory system in processing of regular past tense by late L2 learners of English.

  7. Developing a service platform definition to promote evidence-based planning and funding of the mental health service system.

    Science.gov (United States)

    Lee, Yong Yi; Meurk, Carla S; Harris, Meredith G; Diminic, Sandra; Scheurer, Roman W; Whiteford, Harvey A

    2014-11-26

    Ensuring that a mental health system provides 'value for money' requires policy makers to allocate resources to the most cost-effective interventions. Organizing cost-effective interventions into a service delivery framework will require a concept that can guide the mapping of evidence regarding disorder-level interventions to aggregations of services that are meaningful for policy makers. The 'service platform' is an emerging concept that could be used to this end, however no explicit definition currently exists in the literature. The aim of this study was to develop a service platform definition that is consistent with how policy makers conceptualize the major elements of the mental health service system and to test the validity and utility of this definition through consultation with mental health policy makers. We derived a provisional definition informed by existing literature and consultation with experienced mental health researchers. Using a modified Delphi method, we obtained feedback from nine Australian policy makers. Respondents provided written answers to a questionnaire eliciting their views on the acceptability, comprehensibility and usefulness of a service platform definition which was subject to qualitative analysis. Overall, respondents understood the definition and found it both acceptable and useful, subject to certain conditions. They also provided suggestions for its improvement. Our findings suggest that the service platform concept could be a useful way of aggregating mental health services as a means for presenting priority setting evidence to policy makers in mental health. However, further development and testing of the concept is required.

  8. Dolphin genome provides evidence for adaptive evolution of nervous system genes and a molecular rate slowdown

    Science.gov (United States)

    McGowen, Michael R.; Grossman, Lawrence I.; Wildman, Derek E.

    2012-01-01

    Cetaceans (dolphins and whales) have undergone a radical transformation from the original mammalian bodyplan. In addition, some cetaceans have evolved large brains and complex cognitive capacities. We compared approximately 10 000 protein-coding genes culled from the bottlenose dolphin genome with nine other genomes to reveal molecular correlates of the remarkable phenotypic features of these aquatic mammals. Evolutionary analyses demonstrated that the overall synonymous substitution rate in dolphins has slowed compared with other studied mammals, and is within the range of primates and elephants. We also discovered 228 genes potentially under positive selection (dN/dS > 1) in the dolphin lineage. Twenty-seven of these genes are associated with the nervous system, including those related to human intellectual disabilities, synaptic plasticity and sleep. In addition, genes expressed in the mitochondrion have a significantly higher mean dN/dS ratio in the dolphin lineage than others examined, indicating evolution in energy metabolism. We encountered selection in other genes potentially related to cetacean adaptations such as glucose and lipid metabolism, dermal and lung development, and the cardiovascular system. This study underlines the parallel molecular trajectory of cetaceans with other mammalian groups possessing large brains. PMID:22740643

  9. Targeting the Glutamatergic System to Treat Pathological Gambling: Current Evidence and Future Perspectives

    Directory of Open Access Journals (Sweden)

    Mauro Pettorruso

    2014-01-01

    Full Text Available Pathological gambling or gambling disorder has been defined by the DSM-5 as a behavioral addiction. To date, its pathophysiology is not completely understood and there is no FDA-approved treatment for gambling disorders. Glutamate is the principal excitatory neurotransmitter in the nervous system and it has been recently involved in the pathophysiology of addictive behaviors. In this paper, we review the current literature on a class of drugs that act as modulating glutamate system in PG. A total of 19 studies have been included, according to inclusion and exclusion criteria. Clinical trial and case series using glutamatergic drugs (N-acetylcysteine, memantine, amantadine, topiramate, acamprosate, baclofen, gabapentin, pregabalin, and modafinil will be presented to elucidate the effectiveness on gambling behaviors and on the related clinical dimensions (craving, withdrawal, and cognitive symptoms in PG patients. The results have been discussed to gain more insight in the pathophysiology and treatment of PG. In conclusion, manipulation of glutamatergic neurotransmission appears to be promising in developing improved therapeutic agents for the treatment of gambling disorders. Further studies are required. Finally, we propose future directions and challenges in this research area.

  10. Knowledge Organisations and High-Tech Regional Innovation Systems in Developing Countries: Evidence from Argentina

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    Carolina Pasciaroni

    2016-06-01

    Full Text Available In the globally and knowledge based economy, the universities and other knowledge organisations are valued for their ability to contribute to the regional innovation processes. This is particularly relevant for the developing countries in South America since their R&D spending is highly concentrated on the public knowledge infrastructure. However, there are few studies examining the role of knowledge organizations at regional level in Latin America. The proposed study aims to analyse the role played by knowledge organisations in the formation of a high-tech Regional Innovation Systems in Argentina. This country has a number of attractive features relative to the positive evolution of its R&D spending and the recent implementation of a policy that promotes cooperation between firms and knowledge organisations among high-tech sectors. As evidenced in developed regions, the organisations under study play a key role in the promotion of a high-tech Regional Innovation Systems. However, this prominent role is not based on those local factors identified in the literature, such as organisational and institutional local assets, but on national science and technology policies and individual initiatives conducted by the faculties involved.

  11. The kiss/kissr systems are dispensable for zebrafish reproduction: evidence from gene knockout studies.

    Science.gov (United States)

    Tang, Haipei; Liu, Yun; Luo, Daji; Ogawa, Satoshi; Yin, Yike; Li, Shuisheng; Zhang, Yong; Hu, Wei; Parhar, Ishwar S; Lin, Haoran; Liu, Xiaochun; Cheng, Christopher H K

    2015-02-01

    The kiss1/gpr54 signaling system is considered to be a critical regulator of reproduction in most vertebrates. However, this presumption has not been tested vigorously in nonmammalian vertebrates. Distinct from mammals, multiple kiss1/gpr54 paralogous genes (kiss/kissr) have been identified in nonmammalian vertebrates, raising the possibility of functional redundancy among these genes. In this study, we have systematically generated the zebrafish kiss1(-/-), kiss2(-/-), and kiss1(-/-);kiss2(-/-) mutant lines as well as the kissr1(-/-), kissr2(-/-), and kissr1(-/-);kissr2(-/-) mutant lines using transcription activator-like effector nucleases. We have demonstrated that spermatogenesis and folliculogenesis as well as reproductive capability are not impaired in all of these 6 mutant lines. Collectively, our results indicate that kiss/kissr signaling is not absolutely required for zebrafish reproduction, suggesting that the kiss/kissr systems play nonessential roles for reproduction in certain nonmammalian vertebrates. These findings also demonstrated that fish and mammals have evolved different strategies for neuroendocrine control of reproduction.

  12. Systemic inflammatory response to smoking in chronic obstructive pulmonary disease: evidence of a gender effect.

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    Rosa Faner

    Full Text Available BACKGROUND: Tobacco smoking is the main risk factor of chronic obstructive pulmonary disease (COPD but not all smokers develop the disease. An abnormal pulmonary and systemic inflammatory response to smoking is thought to play a major pathogenic role in COPD, but this has never been tested directly. METHODS: We studied the systemic biomarker and leukocyte transcriptomic response (Affymetrix microarrays to smoking exposure in 10 smokers with COPD and 10 smokers with normal spirometry. We also studied 10 healthy never smokers (not exposed to smoking as controls. Because some aspects of COPD may differ in males and females, and the inflammatory response to other stressors (infection might be different in man and women, we stratified participant recruitment by sex. Differentially expressed genes were validated by q-PCR. Ontology enrichment was evaluated and interaction networks inferred. RESULTS: Principal component analysis identified sex differences in the leukocyte transcriptomic response to acute smoking. In both genders, we identified genes that were differentially expressed in response to smoking exclusively in COPD patients (COPD related signature or smokers with normal spirometry (Smoking related signature, their ontologies and interaction networks. CONCLUSIONS: The use of an experimental intervention (smoking exposure to investigate the transcriptomic response of peripheral leukocytes in COPD is a step beyond the standard case-control transcriptomic profiling carried out so far, and has facilitated the identification of novel COPD and Smoking expression related signatures which differ in males and females.

  13. Dolphin genome provides evidence for adaptive evolution of nervous system genes and a molecular rate slowdown.

    Science.gov (United States)

    McGowen, Michael R; Grossman, Lawrence I; Wildman, Derek E

    2012-09-22

    Cetaceans (dolphins and whales) have undergone a radical transformation from the original mammalian bodyplan. In addition, some cetaceans have evolved large brains and complex cognitive capacities. We compared approximately 10,000 protein-coding genes culled from the bottlenose dolphin genome with nine other genomes to reveal molecular correlates of the remarkable phenotypic features of these aquatic mammals. Evolutionary analyses demonstrated that the overall synonymous substitution rate in dolphins has slowed compared with other studied mammals, and is within the range of primates and elephants. We also discovered 228 genes potentially under positive selection (dN/dS > 1) in the dolphin lineage. Twenty-seven of these genes are associated with the nervous system, including those related to human intellectual disabilities, synaptic plasticity and sleep. In addition, genes expressed in the mitochondrion have a significantly higher mean dN/dS ratio in the dolphin lineage than others examined, indicating evolution in energy metabolism. We encountered selection in other genes potentially related to cetacean adaptations such as glucose and lipid metabolism, dermal and lung development, and the cardiovascular system. This study underlines the parallel molecular trajectory of cetaceans with other mammalian groups possessing large brains.

  14. Comparing eye movements during position tracking and identity tracking: No evidence for separate systems.

    Science.gov (United States)

    Wu, Chia-Chien; Wolfe, Jeremy M

    2018-02-01

    There is an ongoing debate as to whether people track multiple moving objects in a serial fashion or with a parallel mechanism. One recent study compared eye movements when observers tracked identical objects (Multiple Object Tracking-MOT task) versus when they tracked the identities of different objects (Multiple Identity Tracking-MIT task). Distinct eye-movement patterns were found and attributed to two separate tracking systems. However, the same results could be caused by differences in the stimuli viewed during tracking. In the present study, object identities in the MIT task were invisible during tracking, so observers performed MOT and MIT tasks with identical stimuli. Observer were able to track either position and identity depending on the task. There was no difference in eye movements between position tracking and identity tracking. This result suggests that, while observers can use different eye-movement strategies in MOT and MIT, it is not necessary.

  15. A cognitive neuroscience perspective on psychopathy: Evidence for paralimbic system dysfunction

    Science.gov (United States)

    Kiehl, Kent A.

    2009-01-01

    Psychopathy is a complex personality disorder that includes interpersonal and affective traits such as glibness, lack of empathy, guilt or remorse, shallow affect, and irresponsibility, and behavioral characteristics such as impulsivity, poor behavioral control, and promiscuity. Much is known about the assessment of psychopathy; however, relatively little is understood about the relevant brain disturbances. The present review integrates data from studies of behavioral and cognitive changes associated with focal brain lesions or insults and results from psychophysiology, cognitive psychology and cognitive and affective neuroscience in health and psychopathy. The review illustrates that the brain regions implicated in psychopathy include the orbital frontal cortex, insula, anterior and posterior cingulate, amygdala, parahippocampal gyrus, and anterior superior temporal gyrus. The relevant functional neuroanatomy of psychopathy thus includes limbic and paralimbic structures that may be collectively termed ‘the paralimbic system’. The paralimbic system dysfunction model of psychopathy is discussed as it relates to the extant literature on psychopathy. PMID:16712954

  16. INTERFEROMETRIC EVIDENCE FOR RESOLVED WARM DUST IN THE DQ TAU SYSTEM

    International Nuclear Information System (INIS)

    Boden, Andrew F.; Sargent, Anneila I.; Carpenter, John M.; Akeson, Rachel L.; Ciardi, David R.; Bary, Jeffrey S.; Skrutskie, Michael F.

    2009-01-01

    We report on near-infrared (IR) interferometric observations of the double-lined pre-main sequence binary system DQ Tau. We model these data with a visual orbit for DQ Tau supported by the spectroscopic orbit and analysis of Mathieu et al. Further, DQ Tau exhibits significant near-IR excess; modeling our data requires inclusion of near-IR light from an 'excess' source. Remarkably, the excess source is resolved in our data, similar in scale to the binary itself (∼0.2 AU at apastron), rather than the larger circumbinary disk (∼0.4 AU radius). Our observations support the Mathieu et al. and Carr et al. inference of significant warm material near the DQ Tau binary.

  17. Prevalence of Smoking and Associated Factors: Evidence From the CHILILAB Demographic Surveillance System in Vietnam.

    Science.gov (United States)

    Thi Thanh Huong, Le; Khanh Long, Tran; Xuan Son, Phung; Thi Tuyet-Hanh, Tran

    2017-07-01

    This study analyzed secondary data from Chi Linh Health and Demographic Surveillance System (CHILILAB) database to identify smoking prevalence and associated demographic factors. Data were extracted from the database of the CHILILAB 2016, which included information on individual smoking behaviors, as well as individual and household demographic data. Descriptive and binary logistic regression analyses were performed with significance level of 0.05. The smoking prevalences were 34.7%, 0.9%, and 16.1% for men, women, and both genders, respectively. A total of 78.2% of current smokers smoked daily inside their houses. Lower smoking status was associated with younger age, being student, rich, and/or single. Future efforts should not only spend on further reduction of smoking rate in Chi Linh Town but should also pay special attention on reducing the prevalence of in-home smoking. This will help to decrease the risk of nonsmokers being exposed to secondhand smoke in their home environment.

  18. New evidence on the state of stress of the san andreas fault system.

    Science.gov (United States)

    Zoback, M D; Zoback, M L; Mount, V S; Suppe, J; Eaton, J P; Healy, J H; Oppenheimer, D; Reasenberg, P; Jones, L; Raleigh, C B; Wong, I G; Scotti, O; Wentworth, C

    1987-11-20

    Contemporary in situ tectonic stress indicators along the San Andreas fault system in central California show northeast-directed horizontal compression that is nearly perpendicular to the strike of the fault. Such compression explains recent uplift of the Coast Ranges and the numerous active reverse faults and folds that trend nearly parallel to the San Andreas and that are otherwise unexplainable in terms of strike-slip deformation. Fault-normal crustal compression in central California is proposed to result from the extremely low shear strength of the San Andreas and the slightly convergent relative motion between the Pacific and North American plates. Preliminary in situ stress data from the Cajon Pass scientific drill hole (located 3.6 kilometers northeast of the San Andreas in southern California near San Bernardino, California) are also consistent with a weak fault, as they show no right-lateral shear stress at approximately 2-kilometer depth on planes parallel to the San Andreas fault.

  19. The Third Pillar of the Basel Accord: Evidence of borrower discipline in the Kyrgyz banking system

    Directory of Open Access Journals (Sweden)

    Edgar Demetrio Tovar-García

    2016-07-01

    Full Text Available We empirically study the asset side of market discipline in the banking system of the Kyrgyz Republic, examining whether borrowers are willing to pay higher interest rates to high-quality banks. Based on dynamic panel models and a dataset with bank information from 23 banks over the period 2010–2012, our findings suggest the presence of market discipline induced by borrowers. In other words, banks with higher capital ratios and liquidity charge higher interest rates on loans. This result has several implications for the banking policy in Kyrgyzstan, where we can recommend to policymakers a disclosure policy following the Third Pillar of Basel III, because not only can the bank's creditors use bank information to penalize the excessive bank risk, but borrowers can also use this information to discipline their banks.

  20. Appointment reminder systems are effective but not optimal: results of a systematic review and evidence synthesis employing realist principles

    Directory of Open Access Journals (Sweden)

    McLean SM

    2016-04-01

    Full Text Available Sionnadh Mairi McLean,1 Andrew Booth,2 Melanie Gee,3 Sarah Salway,2 Mark Cobb,4 Sadiq Bhanbhro,3 Susan A Nancarrow5 1Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK; 2School of Health and Related Research, University of Sheffield, Sheffield, UK; 3Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK; 4Therapeutics & Palliative Care, Sheffield Teaching Hospitals, Sheffield, UK; 5School of Health and Human Science, Southern Cross University, East Lismore, NSW, Australia Abstract: Missed appointments are an avoidable cost and resource inefficiency which impact upon the health of the patient and treatment outcomes. Health care services are increasingly utilizing reminder systems to manage these negative effects. This study explores the effectiveness of reminder systems for promoting attendance, cancellations, and rescheduling of appointments across all health care settings and for particular patient groups and the contextual factors which indicate that reminders are being employed sub-optimally. We used three inter-related reviews of quantitative and qualitative evidence. Firstly, using pre-existing models and theories, we developed a conceptual framework to inform our understanding of the contexts and mechanisms which influence reminder effectiveness. Secondly, we performed a review following Centre for Reviews and Dissemination guidelines to investigate the effectiveness of different methods of reminding patients to attend health service appointments. Finally, to supplement the effectiveness information, we completed a review informed by realist principles to identify factors likely to influence non-attendance behaviors and the effectiveness of reminders. We found consistent evidence that all types of reminder systems are effective at improving appointment attendance across a range of health care settings and patient populations. Reminder systems may also increase cancellation and

  1. Evidence against a systemic humoral factor controlling the intestinal compensatory response following X-irradiation

    International Nuclear Information System (INIS)

    Sharp, J.G.; Osborne, J.W.; Iowa Univ., Iowa City

    1981-01-01

    The investigation was devised to determine whether changes noted in the unirradiated duodenum and colon of single rats after X-irradiation of only the exteriorized rat jejunum and ileum are mediated by a systemic humoral factor. Littermate Holtzman male rats were joined in parabiosis and one month later, the temporarily exteriorized jejunum and ileum of one member was exposed to 1.000 R of 250 kVp X-irradiation. Two days after X-irradiation, and 1, 12 and 24 h after 1 μCi/g bodyweight 3 H-thymidine was injected i.p. rats were sacrificed and appropriate tissues removed. Single rats which had the exteriorized jejunum and ileum irradiated were studied from 1-3 days after irradiation. Crypt cell migration rates were determined employing autoradiography. Tritium content and columnar cell migration rate in duodenum and colon of unirradiated rats compared to irradiated rats indicated that irradiation of one member of the pair had no effect on tritium incorporation or epithelial cell migration in the duodenum or colon of the unirradiated partner. Epithelial cell proliferation and crypt cell migration were increased in unirradiated duodenum and colon of single intestine-irradiated rats. Essentially the same changes were seen in the irradiated member of a parabiotic pair, but none of these changes were noted in the unirradiated member. The absence of stimulation in the unirradiated parabiont suggests that either a systemic humoral factor is not present after X-irradiation or is not present in sufficient concentration to be detected by these methods. (orig./MG)

  2. Evidence for Systemic Infection by Puccinia horiana, Causal Agent of Chrysanthemum White Rust, in Chrysanthemum.

    Science.gov (United States)

    Bonde, M R; Murphy, C A; Bauchan, G R; Luster, D G; Palmer, C L; Nester, S E; Revell, J M; Berner, D K

    2015-01-01

    Puccinia horiana, causal agent of the disease commonly known as chrysanthemum white rust (CWR), is a quarantine-significant fungal pathogen of chrysanthemum in the United States and indigenous to Asia. The pathogen was believed to have been eradicated in the United States but recently reappeared on several occasions in northeastern United States. The objective of the study presented here was to determine whether P. horiana could systemically infect chrysanthemum plants, thus providing a means of survival through winters. Scanning and transmission electron microscopy revealed the development of P. horiana on the surface and within leaves, stems, or crowns of inoculated chrysanthemum plants artificially exposed to northeastern U.S. winter temperatures. P. horiana penetrated leaves directly through the cuticle and then colonized the mesophyll tissue both inter- and intracellularly. An electron-dense material formed at the interface between fungal and host mesophyll cells, suggesting that the pathogen adhered to the plant cells. P. horiana appeared to penetrate mesophyll cell walls by enzymatic digestion, as indicated by the absence of deformation lines in host cell walls at penetration sites. The fungus was common in vascular tissue within the infected crown, often nearly replacing the entire contents of tracheid cell walls. P. horiana frequently passed from one tracheid cell to an adjacent tracheid cell by penetration either through pit pairs or nonpitted areas of the cell walls. Individual, presumed, fungal cells in mature tracheid cells of the crown and stems arising from infected crowns suggested that the pathogen might have been moving at least partially by means of the transpiration stream. The demonstration that chrysanthemum plants can be systemically infected by P. horiana suggests that additional disease control measures are required to effectively control CWR.

  3. Antioxidants and embryo phenotype: is there experimental evidence for strong integration of the antioxidant system?

    Science.gov (United States)

    Possenti, Cristina Daniela; Karadas, Filiz; Colombo, Graziano; Caprioli, Manuela; Rubolini, Diego; Milzani, Aldo; Donne, Isabella Dalle; Saino, Nicola; Parolini, Marco

    2017-02-15

    Organisms have evolved complex defense systems against oxidative stress. Bird eggs contain maternally derived antioxidants that protect embryos from oxidative damage. The antioxidant system components are thought to be integrated, but few studies have analyzed the covariation between antioxidant concentrations, embryo 'oxidative status' and morphology. In addition, no study has tested the effects of experimental change in yolk antioxidant concentration on other antioxidants, on their reciprocal relationships and on their relationships with embryo oxidative status or growth, which are expected if antioxidants defenses are integrated. In yellow-legged gull ( Larus michahellis ) embryos, we analyzed the covariation between several antioxidants, markers of 'oxidative status' [total antioxidant capacity (TAC), concentration of pro-oxidants (TOS), lipid peroxidation (LPO) and protein carbonylation (PC)] in the yolk, liver and brain, and morphology. Yolk and liver antioxidant concentrations were positively correlated reciprocally and with embryo size, and positively predicted TAC but not oxidative status. TOS and LPO were positively correlated in the liver, while TAC and LPO were negatively correlated in the brain. Weak relationships existed between antioxidants and TOS, PC and LPO. The effects of antioxidants on oxidative status and morphology were non-synergistic. An experimental physiological increase in yolk vitamin E had very weak effects on the relationships between other antioxidants or oxidative status and vitamin E concentration, the concentration of other antioxidants or oxidative status; the covariation between other antioxidants and oxidative status, and relationships between morphology or oxidative status and other antioxidants, challenging the common wisdom of strong functional relationships among antioxidants, at least for embryos in the wild. © 2017. Published by The Company of Biologists Ltd.

  4. Social roles and performance of social-ecological systems: evidence from behavioral lab experiments

    Directory of Open Access Journals (Sweden)

    Irene Perez

    2015-09-01

    Full Text Available Social roles are thought to play an important role in determining the capacity for collective action in a community regarding the use of shared resources. Here we report on the results of a study using a behavioral experimental approach regarding the relationship between social roles and the performance of social-ecological systems. The computer-based irrigation experiment that was the basis of this study mimics the decisions faced by farmers in small-scale irrigation systems. In each of 20 rounds, which are analogous to growing seasons, participants face a two-stage commons dilemma. First they must decide how much to invest in the public infrastructure, e.g., canals and water diversion structures. Second, they must decide how much to extract from the water made available by that public infrastructure. Each round begins with a 60-second communication period before the players make their investment and extraction decisions. By analyzing the chat messages exchanged among participants during the communication stage of the experiment, we coded up to three roles per participant using the scheme of seven roles known to be important in the literature: leader, knowledge generator, connector, follower, moralist, enforcer, and observer. Our study supports the importance of certain social roles (e.g., connector previously highlighted by several case study analyses. However, using qualitative comparative analysis we found that none of the individual roles was sufficient for groups to succeed, i.e., to reach a certain level of group production. Instead, we found that a combination of at least five roles was necessary for success. In addition, in the context of upstream-downstream asymmetry, we observed a pattern in which social roles assumed by participants tended to differ by their positions. Although our work generated some interesting insights, further research is needed to determine how robust our findings are to different action situations, such as

  5. Provincial Health Accounts in Kerman, Iran: An Evidence of a “Mixed” Healthcare Financing System

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Mehrolhassani

    2014-02-01

    Full Text Available Background Provincial Health Accounts (PHA as a subset of National Health Accounts (NHA present financial information for health sectors. It leads to a logical decision making for policy-makers in order to achieve health system goals, especially Fair Financial Contribution (FFC. This study aimed to examine Health Accounts in Kerman Province. Methods The present analytical study was carried out retrospectively between 2008 and 2011. The research population consisted of urban and rural households as well as providers and financial agents in health sectors of Kerman Province. The purposeful sampling included 16 provincial organizations. To complete data, the report on Kerman household expenditure was taken as a data source from the Governor-General’s office. In order to classify the data, the International Classification for Health Accounts (ICHA method was used, in which data set was adjusted for the province. Results During the study, the governmental and non-governmental fund shares of the health sector in Kerman were 27.22% and 72.78% respectively. The main portion of financial sources (59.41 was related to private household funds, of which the Out-of-Pocket (OOP payment mounted to 92.35%. Overall, 54.86% of all financial sources were covered by OOP. The greatest portion of expenditure of Total Healthcare Expenditures (THEs (65.19% was related to curative services. Conclusion The major portion of healthcare expenditures was related to the OOP payment which is compatible with the national average rate in Iran. However, health expenditure per capita, was two and a half times higher than the national average. By performing the Family Physician Program (FPP and emphasizing Social Determinant of Health (SDH approach in the Iranian health system, the portion of OOP payment and curative expenditure are expected to be controlled in the medium term. It is suggested that PHA should be examined annually in a more comprehensive manner to monitor

  6. Use of a systems approach and evidence-based One Health for zoonoses research.

    Science.gov (United States)

    Asokan, G V; Asokan, Vanitha; Fedorowicz, Zbys; Tharyan, Prathap

    2011-05-01

    The World Health Organization estimates that 25% of the 57 million annual deaths that occur globally are caused by microbes. A study reported 1415 species of infectious organisms are known to be pathogenic to humans. Zoonoses constitute 61% of all known infectious diseases, with humans serving as the primary reservoir for only 3% of them. Of the 175 infectious species considered to be emerging, 75% are zoonotic. Zoonotic diseases and their impact on human and animal health are not monitored, prevented, and treated in an integrated way, despite the fact that etiologies and treatments are similar across species. The efficacy and resistance of a drug in one species has a bearing on others, in the context of zoonoses. Further, an RCT involving many species is effective in a natural setting, is robust, and may require fewer human volunteers. One Health is based on a systems approach and a collaborative effort of multiple disciplines - working locally, nationally, and globally - to attain optimal health for people, animals, and the environment. Systematic reviews and meta-analyses have so far been independent and discipline oriented. Pooling of results for diagnostic test accuracies and treatment effects of drugs for zoonoses across species has to be done, since the results of preclinical trials emanate from laboratory animals. The Cochrane Collaboration is the platform of choice to initiate a new group on zoonoses to carry out systematic meta-analyses of diagnostic tests and drug efficacies without bias, thus underpinning the systems approach and One Health. © 2011 Blackwell Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

  7. Ruthenium isotopic evidence for an inner Solar System origin of the late veneer.

    Science.gov (United States)

    Fischer-Gödde, Mario; Kleine, Thorsten

    2017-01-25

    The excess of highly siderophile elements in the Earth's mantle is thought to reflect the addition of primitive meteoritic material after core formation ceased. This 'late veneer' either comprises material remaining in the terrestrial planet region after the main stages of the Earth's accretion, or derives from more distant asteroidal or cometary sources. Distinguishing between these disparate origins is important because a late veneer consisting of carbonaceous chondrite-like asteroids or comets could be the principal source of the Earth's volatiles and water. Until now, however, a 'genetic' link between the late veneer and such volatile-rich materials has not been established or ruled out. Such genetic links can be determined using ruthenium (Ru) isotopes, because the Ru in the Earth's mantle predominantly derives from the late veneer, and because meteorites exhibit Ru isotope variations arising from the heterogeneous distribution of stellar-derived dust. Although Ru isotopic data and the correlation of Ru and molybdenum (Mo) isotope anomalies in meteorites were previously used to argue that the late veneer derives from the same type of inner Solar System material as do Earth's main building blocks, the Ru isotopic composition of carbonaceous chondrites has not been determined sufficiently well to rule them out as a source of the late veneer. Here we show that all chondrites, including carbonaceous chondrites, have Ru isotopic compositions distinct from that of the Earth's mantle. The Ru isotope anomalies increase from enstatite to ordinary to carbonaceous chondrites, demonstrating that material formed at greater heliocentric distance contains larger Ru isotope anomalies. Therefore, these data refute an outer Solar System origin for the late veneer and imply that the late veneer was not the primary source of volatiles and water on the Earth.

  8. Ruthenium isotopic evidence for an inner Solar System origin of the late veneer

    Science.gov (United States)

    Fischer-Gödde, Mario; Kleine, Thorsten

    2017-01-01

    The excess of highly siderophile elements in the Earth’s mantle is thought to reflect the addition of primitive meteoritic material after core formation ceased. This ‘late veneer’ either comprises material remaining in the terrestrial planet region after the main stages of the Earth’s accretion, or derives from more distant asteroidal or cometary sources. Distinguishing between these disparate origins is important because a late veneer consisting of carbonaceous chondrite-like asteroids or comets could be the principal source of the Earth’s volatiles and water. Until now, however, a ‘genetic’ link between the late veneer and such volatile-rich materials has not been established or ruled out. Such genetic links can be determined using ruthenium (Ru) isotopes, because the Ru in the Earth’s mantle predominantly derives from the late veneer, and because meteorites exhibit Ru isotope variations arising from the heterogeneous distribution of stellar-derived dust. Although Ru isotopic data and the correlation of Ru and molybdenum (Mo) isotope anomalies in meteorites were previously used to argue that the late veneer derives from the same type of inner Solar System material as do Earth’s main building blocks, the Ru isotopic composition of carbonaceous chondrites has not been determined sufficiently well to rule them out as a source of the late veneer. Here we show that all chondrites, including carbonaceous chondrites, have Ru isotopic compositions distinct from that of the Earth’s mantle. The Ru isotope anomalies increase from enstatite to ordinary to carbonaceous chondrites, demonstrating that material formed at greater heliocentric distance contains larger Ru isotope anomalies. Therefore, these data refute an outer Solar System origin for the late veneer and imply that the late veneer was not the primary source of volatiles and water on the Earth.

  9. Little evidence of systemic and adipose tissue inflammation in overweight individuals

    Directory of Open Access Journals (Sweden)

    Leanne M Redman

    2012-04-01

    Full Text Available Context. The effect of weight loss by diet alone or diet in conjunction with exercise on low grade inflammation in non-obese (overweight individuals is not known.Objective. Test the hypothesis that 24 weeks of moderate CR (25% by diet only or with aerobic exercise would reduce markers of systemic inflammation and attenuate inflammation gene expression in subcutaneous adipose tissue. Design. Randomized controlled trial. Setting: Institutional Research Center. Participants. Thirty-five overweight (BMI:27.8±0.7kg/m2 but otherwise healthy participants (16M/19F completed the study. Intervention. Participants were randomized to either calorie restriction (CR: 25% reduction in energy intake, n=12, caloric restriction+exercise (CR+EX: 12.5% reduction in energy intake+12.5% increase in exercise energy expenditure, n=12 or control (healthy weight-maintenance diet, n=11 for 6 months. Main outcome measures. Fasting serum markers of inflammation (Leptin, hsCRP, IL-6, TNF-α and inflammation-related genes (CD68, IL-6, TNF-α, MIF, MCP-1, Adiponectin, PAI-1 in subcutaneous adipose tissue. Results. CR and CR+EX lost similar amounts of body weight (-10±1%, fat mass (-24±3%, visceral fat (-27±3% and had increased insulin sensitivity (CR:40±20%, CR+EX:66±22%. Leptin was significantly decreased from baseline (P<0.001 in both groups however TNF-α and IL-6 were not changed. hsCRP was decreased in CR+EX. There was no change in the expression of genes involved in macrophage infiltration (CD68, MIF, MCP-1, PAI-1 or inflammation (IL-6, TNF-, adiponectin in either CR or CR+EX. Conclusion. A 10% weight loss with a 25% CR diet alone or with exercise did not impact markers of systemic inflammation or the expression of inflammation-related adipose genes in overweight individuals.

  10. Consumers' Response to an On-Shelf Nutrition Labelling System in Supermarkets: Evidence to Inform Policy and Practice.

    Science.gov (United States)

    Hobin, Erin; Bollinger, Bryan; Sacco, Jocelyn; Liebman, Eli; Vanderlee, Lana; Zuo, Fei; Rosella, Laura; L'abbe, Mary; Manson, Heather; Hammond, David

    2017-09-01

    Policy Points: On-shelf nutrition labelling systems in supermarkets, such as the Guiding Stars system, are intended to provide consumers with simple, standardized nutrition information to support more informed and healthier food choices. Policies that support the provision of simplified nutrition labelling systems may encourage consumers to make positive shifts in food-purchasing behaviors. The shifts in consumer food-purchasing patterns observed in our study after the introduction of the Guiding Stars system in supermarkets translated into measurable nutritional benefits, including more items purchased with slightly less trans fat and sugar and more fiber and omega-3 fatty acids. This study is one of the first to report the positive impact of an on-shelf nutrition labelling system on supermarket sales and revenues-key information that was specifically requested by the US National Academies, as such labelling interventions may be more sustainable if they lead to higher revenues. Providing a nutrition rating system on the front of food packages or on retail shelf tags has been proposed as a policy strategy for supporting healthier food choices. Guiding Stars is an on-shelf nutrition labelling system that scores foods in a supermarket based on nutritional quality; scores are then translated into ratings of 0 to 3 stars. It is consistent with evidence-informed recommendations for well-designed labels, except for not labelling 0-star products. The largest supermarket retailer in Canada rolled out the Guiding Stars system in supermarkets across Ontario, Canada. The aim of our study was to examine the extent to which consumers respond to an on-shelf nutrition labelling system in supermarkets to inform current and future nutrition labelling policies and practices. Capitalizing on a natural experiment, we conducted a quasi-experimental study across 3 supermarket banners (or "chains") in Ontario, one of which implemented the Guiding Stars system in 2012. We used aggregated

  11. Photometric and spectroscopic evidence for a dense ring system around Centaur Chariklo

    Science.gov (United States)

    Duffard, R.; Pinilla-Alonso, N.; Ortiz, J. L.; Alvarez-Candal, A.; Sicardy, B.; Santos-Sanz, P.; Morales, N.; Colazo, C.; Fernández-Valenzuela, E.; Braga-Ribas, F.

    2014-08-01

    Context. A stellar occultation observed on 3rd June 2013 revealed the presence of two dense and narrow rings separated by a small gap around the Centaur object (10 199) Chariklo. The composition of these rings is not known. We suspect that water ice is present in the rings, as is the case for Saturn and other rings around the giant planets. Aims: In this work, we aim to determine if the variability in the absolute magnitude of Chariklo and the temporal variation of the spectral ice feature, even when it disappeared in 2007, can be explained by an icy ring system whose aspect angle changes with time. Methods: We explained the variations on the absolute magnitude of Chariklo and its ring by modeling the light reflected by a system as the one described above. Using X-shooter at VLT, we obtained a new reflectance spectra. We compared this new set of data with the ones available in the literature. We showed how the water ice feature is visible in 2013 in accordance with the ring configuration, which had an opening angle of nearly 34° in 2013. Finally, we also used models of light scattering to fit the visible and near-infrared spectra that shows different characteristics to obtain information on the composition of Chariklo and its rings. Results: We showed that absolute photometry of Chariklo from the literature and new photometric data that we obtained in 2013 can be explained by a ring of particles whose opening angle changes as a function of time. We used the two possible pole solutions for the ring system and found that only one of them, α = 151.30 ± 0.5, δ = 41.48 ± 0.2° (λ = 137.9 ± 0.5, β = 27.7 ± 0.2°), provides the right variation of the aspect angle with time to explain the photometry, whereas the other possible pole solution fails to explain the photometry. From spectral modeling, we derived the composition of the Chariklo surface and that of the rings using the result on the pole solution. Chariklo surface is composed with about 60% of amorphous

  12. Evidence for alternative quaternary structure in a bacterial Type III secretion system chaperone

    Energy Technology Data Exchange (ETDEWEB)

    Barta, Michael L.; Zhang, Lingling; Picking, Wendy L.; Geisbrecht, Brian V. (UMKC); (OKLU)

    2010-10-05

    Type III secretion systems are a common virulence mechanism in many Gram-negative bacterial pathogens. These systems use a nanomachine resembling a molecular needle and syringe to provide an energized conduit for the translocation of effector proteins from the bacterial cytoplasm to the host cell cytoplasm for the benefit of the pathogen. Prior to translocation specialized chaperones maintain proper effector protein conformation. The class II chaperone, Invasion plasmid gene (Ipg) C, stabilizes two pore forming translocator proteins. IpgC exists as a functional dimer to facilitate the mutually exclusive binding of both translocators. In this study, we present the 3.3 {angstrom} crystal structure of an amino-terminally truncated form (residues 10-155, denoted IpgC10-155) of the class II chaperone IpgC from Shigella flexneri. Our structure demonstrates an alternative quaternary arrangement to that previously described for a carboxy-terminally truncated variant of IpgC (IpgC{sup 1-151}). Specifically, we observe a rotationally-symmetric 'head-to-head' dimerization interface that is far more similar to that previously described for SycD from Yersinia enterocolitica than to IpgC1-151. The IpgC structure presented here displays major differences in the amino terminal region, where extended coil-like structures are seen, as opposed to the short, ordered alpha helices and asymmetric dimerization interface seen within IpgC{sup 1-151}. Despite these differences, however, both modes of dimerization support chaperone activity, as judged by a copurification assay with a recombinant form of the translocator protein, IpaB. Conclusions: From primary to quaternary structure, these results presented here suggest that a symmetric dimerization interface is conserved across bacterial class II chaperones. In light of previous data which have described the structure and function of asymmetric dimerization, our results raise the possibility that class II chaperones may

  13. Aligning Leadership Across Systems and Organizations to Develop Strategic Climate to for Evidence-Based Practice Implementation

    Science.gov (United States)

    Aarons, Gregory A.; Farahnak, Lauren R.; Ehrhart, Mark G.; Sklar, Marisa

    2015-01-01

    There has been a growing impetus to bridge the gap between basic science discovery, development of evidence-based practices (EBPs) and their availability and delivery in order to improve public health impact of such practices. In seeking to capitalize on factors that support implementation and sustainment of EBPs, it is important to consider that healthcare is delivered within the outer context of public health systems, and the inner context of healthcare organizations and workgroups. Leaders have a key role in determining the nature of system and organizational context. This article will addresses the role of leadership across levels in developing strategic climate for EBP implementation within the outer (i.e., system) and inner (i.e., organization, work group) contexts of healthcare. Within the framework of Edgar Schein’s “climate embedding mechanisms,” we describe strategies that leaders at the system, organization, and work group levels can consider and apply to develop a strategic climates that support the implementation and sustainment of EBP in healthcare and allied healthcare settings. PMID:24641560

  14. Inequity in a market-based health system: Evidence from Canada's dental sector.

    Science.gov (United States)

    Grignon, Michel; Hurley, Jeremiah; Wang, Li; Allin, Sara

    2010-11-01

    We study the extent and drivers of income-related inequity in utilization of dental services in Canada using the concentration-index approach that has been widely applied to study inequity in physician and hospital services. Because dental care is almost wholly privately financed in Canada, our estimates provide a benchmark for income-related inequity of utilization in private health systems. Although a number of studies document a link between income and utilization, our study is one of the few measuring income-related inequity in dental care utilization. A unique feature of our study is that we analyze separately inequity in total dental visits and in preventive visits. This is important because the case for equity is much clearer for preventive dental care. We also examine the impact of controlling for need using a wider variety of need indicators than previous analyses. We confirm that most oral health indicators perform poorly as need adjustors because they reflect past dental care use: individuals with higher levels of utilization also are in better oral health. Our most important finding is that access to preventive care is the most "pro-rich" type of dental care utilization and that income-related inequity in preventive dental care utilization is three times larger than what is measured for specialist services utilization in Canada. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  15. Understanding the acceptance factors of an Hospital Information System: evidence from a French University Hospital.

    Science.gov (United States)

    Ologeanu-Taddei, R; Morquin, D; Domingo, H; Bourret, R

    2015-01-01

    The goal of this study was to examine the perceived usefulness, the perceived ease of use and the perceived behavioral control of a Hospital Information System (HIS) for the care staff. We administrated a questionnaire composed of open-end and closed questions, based on the main concepts of Technology Acceptance Model. As results, the perceived usefulness, ease of use and behavioral control (self-efficacy and organizational support) are correlated with medical occupations. As an example, we found that a half of the medical secretaries consider the HIS is ease of use, at the opposite to the anesthesiologists, surgeons and physicians. Medical secretaries reported also the highest rate of PBC and a high rate of PU. Pharmacists reported the highest rate of PU but a low rate of PBC, which is similar to the rate of the surgeons and physicians. Content analysis of open questions highlights factors influencing these constructs: ergonomics, errors in the documenting process, insufficient compatibility with the medical department or the occupational group. Consequently, we suggest that the gap between the perceptions of the different occupational groups may be explained by the use of different modules and by interdependency of the care stare staff.

  16. Non-centralized and functionally localized nervous system of ophiuroids: evidence from topical anesthetic experiments

    Directory of Open Access Journals (Sweden)

    Yoshiya Matsuzaka

    2017-04-01

    Full Text Available Ophiuroids locomote along the seafloor by coordinated rhythmic movements of multi-segmented arms. The mechanisms by which such coordinated movements are achieved are a focus of interest from the standpoints of neurobiology and robotics, because ophiuroids appear to lack a central nervous system that could exert centralized control over five arms. To explore the underlying mechanism of arm coordination, we examined the effects of selective anesthesia to various parts of the body of ophiuroids on locomotion. We observed the following: (1 anesthesia of the circumoral nerve ring completely blocked the initiation of locomotion; however, initiation of single arm movement, such as occurs during the retrieval of food, was unaffected, indicating that the inability to initiate locomotion was not due to the spread of the anesthetic agent. (2 During locomotion, the midsegments of the arms periodically made contact with the floor to elevate the disc. In contrast, the distal segments of the arms were pointed aborally and did not make contact with the floor. (3 When the midsegments of all arms were anesthetized, arm movements were rendered completely uncoordinated. In contrast, even when only one arm was left intact, inter-arm coordination was preserved. (4 Locomotion was unaffected by anesthesia of the distal arms. (5 A radial nerve block to the proximal region of an arm abolished coordination among the segments of that arm, rendering it motionless. These findings indicate that the circumoral nerve ring and radial nerves play different roles in intra- and inter-arm coordination in ophiuroids.

  17. Evidence for multiple sources of 10Be in the early solar system

    DEFF Research Database (Denmark)

    Wielandt, Daniel Kim Peel; Nagashima, Kazuhide; Krot, Alexander N.

    2012-01-01

    Beryllium-10 is a short-lived radionuclide (t 1/2 = 1.4 Myr) uniquely synthesized by spallation reactions and inferred to have been present when the solar system's oldest solids (calcium-aluminum-rich inclusions, CAIs) formed. Yet, the astrophysical site of 10Be nucleosynthesis is uncertain. We...... report Li-Be-B isotope measurements of CAIs from CV chondrites, including CAIs that formed with the canonical 26Al/27Al ratio of ~5 × 10–5 (canonical CAIs) and CAIs with Fractionation and Unidentified Nuclear isotope effects (FUN-CAIs) characterized by 26Al/27Al ratios much lower than the canonical value....... Our measurements demonstrate the presence of four distinct fossil 10Be/9Be isochrons, lower in the FUN-CAIs than in the canonical CAIs, and variable within these classes. Given that FUN-CAI precursors escaped evaporation-recondensation prior to evaporative melting, we suggest that the 10Be/9Be ratio...

  18. Acceptance and willingness to pay for solar home system: Survey evidence from northern area of Pakistan

    Directory of Open Access Journals (Sweden)

    Abdullah

    2017-11-01

    Full Text Available The importance of solar energy has been accepted worldwide for the generation of electricity, but unfortunately, Pakistan has yet to exert efforts on the development of this source of energy. The purpose of this research is to explore the public acceptance and interest in solar home system (SHS. Moreover, the expectations of the public towards SHS development in Pakistan and the difficulties they face in SHS usage are identified. The result of the survey indicates that about 81% of the respondents show higher interest in SHS. However, many respondents claim that some hindrances obstruct them from using SHS which includes; high cost of solar panels, lack of information and trust on solar panel providers. Almost 60% of the respondents expect that government provision of incentives could be the best way to boost the usage of SHS countrywide. For the successful implementation of new SHS policy, the government of Pakistan needs to establish solar power plants, increase installation of solar panels, provides funding and full information for conducting independent research. In addition, almost 90% of the respondents believe that government should take the lead in developing the SHS sector. Therefore, this study provides some valuable references for SHS promotion in Pakistan.

  19. Parasitic manipulation and neuroinflammation: Evidence from the system Microphallus papillorobustus (Trematoda - Gammarus (Crustacea

    Directory of Open Access Journals (Sweden)

    Thomas Frederic

    2010-04-01

    Full Text Available Abstract Background Neuropathological consequences of neuroinflammatory processes have been implicated in a wide range of diseases affecting the central nervous system (CNS. Glial cells, the resident immune cells of the CNS, respond to tissue injury by releasing proinflammatory cytokines and free radicals such as nitric oxide. We explored the possibility that neuroimmune responses are involved in parasitic manipulation of host behavior in a trematode-crustacean association. The cerebral larva of the flatworm Microphallus papillorobustus alters responses to environmental stimuli - and thus reflex pathways - in the crustacean Gammarus insensibilis, in a way that enhances predation of the crustacean by birds, definitive hosts of the parasite. Results Immunocytochemical experiments followed by confocal microscopy were performed to study the distribution of glutamine synthetase, a glial cell marker, and nitric oxide synthase in the brain of gammarids. Astrocyte-like glia and their processes were abundant at the surface of the parasites while levels of nitric oxide synthase were elevated at the host-parasite interface in the brain of gammarids harboring mature cerebral larvae and demonstrating altered behavior. Conclusion Taken together these results lend support to the neuroinflammation hypothesis whereby a chronic CNS specific immune response induced by the parasite plays a role in the disruption of neuromodulation, neuronal integrity, and behavior in infected hosts.

  20. Evidence of arsenic release promoted by disinfection by-products within drinking-water distribution systems.

    Science.gov (United States)

    Andra, Syam S; Makris, Konstantinos C; Botsaris, George; Charisiadis, Pantelis; Kalyvas, Harris; Costa, Costas N

    2014-02-15

    Changes in disinfectant type could trigger a cascade of reactions releasing pipe-anchored metals/metalloids into finished water. However, the effect of pre-formed disinfection by-products on the release of sorbed contaminants (arsenic-As in particular) from drinking water distribution system pipe scales remains unexplored. A bench-scale study using a factorial experimental design was performed to evaluate the independent and interaction effects of trihalomethanes (TTHM) and haloacetic acids (HAA) on arsenic (As) release from either scales-only or scale-biofilm conglomerates (SBC) both anchored on asbestos/cement pipe coupons. A model biofilm (Pseudomonas aeruginosa) was allowed to grow on select pipe coupons prior experimentation. Either TTHM or HAA individual dosing did not promote As release from either scales only or SBC, detecting water. In the case of scales-only coupons, the combination of the highest spike level of TTHM and HAA significantly (pwater in pipe networks remains to be investigated in the field. Copyright © 2013 Elsevier B.V. All rights reserved.

  1. [Life expectancy, strenuous work and pension system's fairness. First evidence from the Work Histories Italian Panel].

    Science.gov (United States)

    Leombruni, Roberto; Richiardi, Matteo; Demaria, Moreno; Costa, Giuseppe

    2010-01-01

    the study aims to estimate the differentials in life expectancy by income and work history in Italy during the 2000's, in order to evaluate the level of actuarial equity of the recent Italian retirement reform in computing benefits proportional to the contributions paid. retrospective cohort study. mortality follow up of a 1% sample of the Italian workforce employed or self employed in the private sector, retired between 1985 and 2003 (about 63,000 people), whose work history and income since 1985 is registered in the National Institute for Social Insurance (INPS) data base. mortality differentials computed through Cox model. social inequalities in survival in favour of the more advantaged categories of income and occupational classes are observed. the principle of actuarial equity assumes that life expectancy varies only according to age and birth cohort; nevertheless inequalities in life expectancy exist also along other dimensions, like income and occupational class: this means that the system is producing an opposite redistribution, from the careers more socially disadvantaged to the less disadvantaged ones.

  2. Systemic lupus erythematous increased lung cancer risk: Evidence from a meta-analysis.

    Science.gov (United States)

    Wu, Yusheng; Hou, Qian

    2016-01-01

    Several studies suggested that systemic lupus erythematosus (SLE) were associated with the risk of lung cancer. However, other studies did not confirm the result. Therefore, we conducted a meta-analysis to investigate this association. A systematic literature search was conducted using the PubMed, Cochrane Library, EMBASE, Chinese National Knowledge Infrastructure, and WANFANG databases for relevant published articles. The strength of the associations between SLE and lung cancer risk was measured by odds ratio (ORs) and 95% confidence interval (CIs). All 12 studies, involving a total of 57,890 SLE patients were included in the meta-analysis. A statistically significant association between SLE and lung cancer risk was found. The data showed that SLE patients had an increased lung cancer risk (OR = 1.60; 95% CI: 1.44-1.77; P analysis of study design, population and hospital based studies also showed an increased lung cancer risks (OR = 1.68; 95% CI: 1.49-1.89; P analysis of follow-up duration, significant results were observed in the study with more than 10 years (OR = 1.72; 95% CI: 1.08-2.73; P = 0.02) and risk (OR = 1.58; 95% CI: 1.42-1.76; P analysis suggested that SLE was associated with an increased lung cancer risk.

  3. Evidence for participation of the methionine sulfoxide reductase repair system in plant seed longevity.

    Science.gov (United States)

    Châtelain, Emilie; Satour, Pascale; Laugier, Edith; Ly Vu, Benoit; Payet, Nicole; Rey, Pascal; Montrichard, Françoise

    2013-02-26

    Seeds are in a natural oxidative context leading to protein oxidation. Although inevitable for proper progression from maturation to germination, protein oxidation at high levels is detrimental and associated with seed aging. Oxidation of methionine to methionine sulfoxide is a common form of damage observed during aging in all organisms. This damage is reversible through the action of methionine sulfoxide reductases (MSRs), which play key roles in lifespan control in yeast and animal cells. To investigate the relationship between MSR capacity and longevity in plant seeds, we first used two Medicago truncatula genotypes with contrasting seed quality. After characterizing the MSR family in this species, we analyzed gene expression and enzymatic activity in immature and mature seeds exhibiting distinct quality levels. We found a very strong correlation between the initial MSR capacities in different lots of mature seeds of the two genotypes and the time to a drop in viability to 50% after controlled deterioration. We then analyzed seed longevity in Arabidopsis thaliana lines, in which MSR gene expression has been genetically altered, and observed a positive correlation between MSR capacity and longevity in these seeds as well. Based on our data, we propose that the MSR repair system plays a decisive role in the establishment and preservation of longevity in plant seeds.

  4. Fuel input substitution under tradable carbon permits system. Evidence from Finnish energy plants 2003-2007

    Energy Technology Data Exchange (ETDEWEB)

    Linden, M. (Joensuu Univ. (Finland), Dept. of Business and Economics., email:mika.linden@joensuu.fi); Maekelae, M.; Uusivuori, J. (The Finnish Forest Reserch Institute (Metla), Vantaa (Finland))

    2009-07-01

    Following the Kyoto protocol and the European Union climate policies larger than 20 MW energy plants are part of the EU's emissions-trading scheme (ETS). This greenhouse gas emission mitigation strategy, tradable carbon quota system, started in 2005. The scheme is not mandatory for the firms with size less than 20MW. Also the firms using renewable fuels will not pay for allowances. Advanced energy production technologies enable power and heating plants to use both nonrenewable fossil fuels and renewable wood fuels in energy production. Wood fuel demand may constitute a substitute for fossil fuel demand if the price of tradable carbon allowances is relatively high. In this context plant level panel data from years 2003 - 2007 in Finland is analyzed with panel and mixed models. Econometric demand equations are specified for the ratio of wood and fossil fuel. The results show that high allowance prices in the years 2005 and 2006 compared to the years 2003 and 2004 decreased the use of fossil fuels and the demand for wood fuels increased. This increase was the larger the smaller proportional user of wood-fuel a plant was. However the downturn of allowance prices in year 2007 ended this process. The heterogeneity of energy plants in size, industry and location determines the intensity and extension of fuel use but their role is limited in the fuel substitution. (orig.)

  5. Sleep disturbances in systemic sclerosis: evidence for the role of gastrointestinal symptoms, pain and pruritus.

    Science.gov (United States)

    Milette, Katherine; Hudson, Marie; Körner, Annett; Baron, Murray; Thombs, Brett D

    2013-09-01

    SSc is a rare autoimmune CTD characterized by thickening and fibrosis of skin and internal organs. There is significant mortality and no cure. Sleep disturbance has been identified as an important contributor to poor quality of life. The objective was to investigate socio-demographic and medical factors potentially associated with sleep disturbance in SSc. The sample consisted of patients from the Canadian Scleroderma Research Group's (CSRG) 15-centre, pan-Canadian Registry assessed with the 8-item Patient-Reported Outcome Measurement Information System (PROMIS) sleep disturbance scale short form, version 1.0. Pearson's correlations were used to assess bivariate association of socio-demographic and medical variables with PROMIS sleep scores. The independent association of PROMIS sleep disturbance scores and factors previously identified as associated with sleep disturbance in the general population, in SSc and other rheumatic diseases, was assessed using multiple linear regression. Among 397 patients in the study (88% female, mean age 57.5 years), 25% (n = 98) had diffuse cutaneous SSc. Mean duration since onset of non-RP symptoms was 10.6 years. Number of gastrointestinal symptoms (standardized regression coefficient β = 0.19, P = 0.001), pain severity (β = 0.21, P sleep disturbance. Gastrointestinal symptoms, pain and pruritus were associated with sleep disturbance in SSc. Additional research is needed on sleep in SSc so that well-informed sleep interventions can be developed and tested.

  6. Local Government Systems and Decentralization: Evidence from Pakistan’s Devolution Plan

    Directory of Open Access Journals (Sweden)

    Muhammad Shakil Ahmad

    2013-03-01

    Full Text Available The discourse of governance and development practitioners continues to embrace community participation and community empowerment as an elementary means of building local capacity for poverty reduction, development and change at the local level. This article is a review of the decentralization initiatives of local government systems after the announcement of the devolution plan in Pakistan. It evaluates the initiatives’ participatory methods to ascertain the extent to which they have improved the process of community development at the local level. This article also measures the impact of community empowerment on the sustainability of community-driven projects implemented under the decentralization initiative through community-based organizations known as Citizen Community Boards (CCBs. Document analysis and literature review methodologies were employed to gain further insight into the decentralization phenomenon in Pakistan. The results describe human development, improvements in community empowerment and the sustainability of local projects; however, the sense of community has yet to be translated into shared benefits for rural communities. The fundamental goal of decentralization seems to be elusive because only power was transferred to the local level, whereas there is little support for community capacity building and community access to resources and the elites still control the electoral process. It is argued that community development initiatives in Pakistan require continuous support from local governments to boost local rural economies. Likewise, community-local government participatory development strategies can lead to strong local ownership and empowerment in rural communities.

  7. Impact of Bisphenol A on the Cardiovascular System — Epidemiological and Experimental Evidence and Molecular Mechanisms

    Directory of Open Access Journals (Sweden)

    Xiaoqian Gao

    2014-08-01

    Full Text Available Bisphenol A (BPA is a ubiquitous plasticizing agent used in the manufacturing of polycarbonate plastics and epoxy resins. There is well-documented and broad human exposure to BPA. The potential risk that BPA poses to the human health has attracted much attention from regulatory agencies and the general public, and has been extensively studied. An emerging and rapidly growing area in the study of BPA’s toxicity is its impact on the cardiovascular (CV system. Recent epidemiological studies have shown that higher urinary BPA concentration in humans is associated with various types of CV diseases, including angina, hypertension, heart attack and coronary and peripheral arterial disease. Experimental studies have demonstrated that acute BPA exposure promotes the development of arrhythmias in female rodent hearts. Chronic exposure to BPA has been shown to result in cardiac remodeling, atherosclerosis, and altered blood pressure in rodents. The underlying mechanisms may involve alteration of cardiac Ca2+ handling, ion channel inhibition/activation, oxidative stress, and genome/transcriptome modifications. In this review, we discuss these recent findings that point to the potential CV toxicity of BPA, and highlight the knowledge gaps in this growing research area.

  8. Reassessment of the evidence for postcranial skeletal pneumaticity in Triassic archosaurs, and the early evolution of the avian respiratory system.

    Directory of Open Access Journals (Sweden)

    Richard J Butler

    Full Text Available Uniquely among extant vertebrates, birds possess complex respiratory systems characterised by the combination of small, rigid lungs, extensive pulmonary air sacs that possess diverticula that invade (pneumatise the postcranial skeleton, unidirectional ventilation of the lungs, and efficient crosscurrent gas exchange. Crocodilians, the only other living archosaurs, also possess unidirectional lung ventilation, but lack true air sacs and postcranial skeletal pneumaticity (PSP. PSP can be used to infer the presence of avian-like pulmonary air sacs in several extinct archosaur clades (non-avian theropod dinosaurs, sauropod dinosaurs and pterosaurs. However, the evolution of respiratory systems in other archosaurs, especially in the lineage leading to crocodilians, is poorly documented. Here, we use µCT-scanning to investigate the vertebral anatomy of Triassic archosaur taxa, from both the avian and crocodilian lineages as well as non-archosaurian diapsid outgroups. Our results confirm previous suggestions that unambiguous evidence of PSP (presence of internal pneumatic cavities linked to the exterior by foramina is found only in bird-line (ornithodiran archosaurs. We propose that pulmonary air sacs were present in the common ancestor of Ornithodira and may have been subsequently lost or reduced in some members of the clade (notably in ornithischian dinosaurs. The development of these avian-like respiratory features might have been linked to inferred increases in activity levels among ornithodirans. By contrast, no crocodile-line archosaur (pseudosuchian exhibits evidence for unambiguous PSP, but many of these taxa possess the complex array of vertebral laminae and fossae that always accompany the presence of air sacs in ornithodirans. These laminae and fossae are likely homologous with those in ornithodirans, which suggests the need for further investigation of the hypothesis that a reduced, or non-invasive, system of pulmonary air sacs may be have

  9. KAMUTHE video microanalysis system for use in Brazil: translation, cross-cultural adaptation and evidence of validity and reliability

    Directory of Open Access Journals (Sweden)

    Gustavo Schulz Gattino

    2016-11-01

    Full Text Available Background KAMUTHE is a video microanalysis system which observes preverbal communication within the music therapy setting. This system is indicated for children with autism spectrum disorder (ASD or multiple disabilities. The purpose of this study was to translate, adapt to Brazilian Portuguese language and analyze some psychometric properties (reliability and validity evidence of KAMUTHE administration in Brazil for individuals with ASD. Participants and procedure Translation, back translation, analysis by judges, and pilot application were performed to obtain evidence of content and face validity. The second part of this study was to administer KAMUTHE in 39 consecutive children with ASD. An individual session of improvisational music therapy was applied to assess the different behaviors included in KAMUTHE. The intra-rater reliability, concurrent validity and convergent validity were analyzed. Results Translation and cross-cultural adaptation were followed and some cultural adaptations were needed. Inter-rater reliability was very good (ICCs 0.95-0.99 for the three child’s behaviors analyzed. Criteria validity with a moderate negative association was found (r = –.38, p = .017 comparing the behavior “Gazes at therapist” and the level of ASD along with the Childhood Autism Rating Scale (CARS. Convergent validity was established between the behavior “Gazes at therapist” and the two nonlinguistic communication scales (social interaction and interests of the Children’s Communication Checklist (CCC with a moderate correlation (r = –.43, p = .005. Conclusions The administration of the KAMUTHE video microanalysis system showed positive results in children with ASD. Further studies are needed to improve the reliability and validity of the instrument in Brazil.

  10. Reassessment of the evidence for postcranial skeletal pneumaticity in Triassic archosaurs, and the early evolution of the avian respiratory system.

    Science.gov (United States)

    Butler, Richard J; Barrett, Paul M; Gower, David J

    2012-01-01

    Uniquely among extant vertebrates, birds possess complex respiratory systems characterised by the combination of small, rigid lungs, extensive pulmonary air sacs that possess diverticula that invade (pneumatise) the postcranial skeleton, unidirectional ventilation of the lungs, and efficient crosscurrent gas exchange. Crocodilians, the only other living archosaurs, also possess unidirectional lung ventilation, but lack true air sacs and postcranial skeletal pneumaticity (PSP). PSP can be used to infer the presence of avian-like pulmonary air sacs in several extinct archosaur clades (non-avian theropod dinosaurs, sauropod dinosaurs and pterosaurs). However, the evolution of respiratory systems in other archosaurs, especially in the lineage leading to crocodilians, is poorly documented. Here, we use µCT-scanning to investigate the vertebral anatomy of Triassic archosaur taxa, from both the avian and crocodilian lineages as well as non-archosaurian diapsid outgroups. Our results confirm previous suggestions that unambiguous evidence of PSP (presence of internal pneumatic cavities linked to the exterior by foramina) is found only in bird-line (ornithodiran) archosaurs. We propose that pulmonary air sacs were present in the common ancestor of Ornithodira and may have been subsequently lost or reduced in some members of the clade (notably in ornithischian dinosaurs). The development of these avian-like respiratory features might have been linked to inferred increases in activity levels among ornithodirans. By contrast, no crocodile-line archosaur (pseudosuchian) exhibits evidence for unambiguous PSP, but many of these taxa possess the complex array of vertebral laminae and fossae that always accompany the presence of air sacs in ornithodirans. These laminae and fossae are likely homologous with those in ornithodirans, which suggests the need for further investigation of the hypothesis that a reduced, or non-invasive, system of pulmonary air sacs may be have been present

  11. Spotlight on blisibimod and its potential in the treatment of systemic lupus erythematosus: evidence to date

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    Lenert A

    2017-03-01

    Full Text Available Aleksander Lenert,1 Timothy B Niewold,2 Petar Lenert3 1Division of Rheumatology, University of Kentucky, Kentucky Clinic, Lexington, KY, 2Division of Rheumatology and Department of Immunology, Mayo Clinic, Rochester, MN, 3Division of Immunology, Department of Internal Medicine, The University of Iowa, Iowa City, IA, USA Abstract: B cells in general and BAFF (B cell activating factor of the tumor necrosis factor [TNF] family in particular have been primary targets of recent clinical trials in systemic lupus erythematosus (SLE. In 2011, belimumab, a monoclonal antibody against BAFF, became the first biologic agent approved for the treatment of SLE. Follow-up studies have shown excellent long-term safety and tolerability of belimumab. In this review, we critically analyze blisibimod, a novel BAFF-neutralizing agent. In contrast to belimumab that only blocks soluble BAFF trimer but not soluble 60-mer or membrane BAFF, blisibimod blocks with high affinity all three forms of BAFF. Furthermore, blisibimod has a unique structure built on four high-affinity BAFF-binding peptides fused to the IgG1-Fc carrier. It was tested in phase I and II trials in SLE where it showed safety and tolerability. While it failed to reach the primary endpoint in a recent phase II trial, post hoc analysis demonstrated its efficacy in SLE patients with higher disease activity. Based on these results, blisibimod is currently undergoing phase III trials targeting this responder subpopulation of SLE patients. The advantage of blisibimod, compared to its competitors, lies in its higher avidity for BAFF, but a possible drawback may come from its immunogenic potential and the anticipated loss of efficacy over time. Keywords: BAFF, APRIL, lupus, B cells, blisibimod

  12. Preliminary evidence for a change in spectral sensitivity of the circadian system at night

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    Parsons Robert H

    2005-12-01

    Full Text Available Abstract Background It is well established that the absolute sensitivity of the suprachiasmatic nucleus to photic stimulation received through the retino-hypothalamic tract changes throughout the 24-hour day. It is also believed that a combination of classical photoreceptors (rods and cones and melanopsin-containing retinal ganglion cells participate in circadian phototransduction, with a spectral sensitivity peaking between 440 and 500 nm. It is still unknown, however, whether the spectral sensitivity of the circadian system also changes throughout the solar day. Reported here is a new study that was designed to determine whether the spectral sensitivity of the circadian retinal phototransduction mechanism, measured through melatonin suppression and iris constriction, varies at night. Methods Human adult males were exposed to a high-pressure mercury lamp [450 lux (170 μW/cm2 at the cornea] and an array of blue light emitting diodes [18 lux (29 μW/cm2 at the cornea] during two nighttime experimental sessions. Both melatonin suppression and iris constriction were measured during and after a one-hour light exposure just after midnight and just before dawn. Results An increase in the percentage of melatonin suppression and an increase in pupil constriction for the mercury source relative to the blue light source at night were found, suggesting a temporal change in the contribution of photoreceptor mechanisms leading to melatonin suppression and, possibly, iris constriction by light in humans. Conclusion The preliminary data presented here suggest a change in the spectral sensitivity of circadian phototransduction mechanisms at two different times of the night. These findings are hypothesized to be the result of a change in the sensitivity of the melanopsin-expressing retinal ganglion cells to light during the night.

  13. Evidence of new risk genetic factor to systemic lupus erythematosus: the UBASH3A gene.

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    Lina-Marcela Diaz-Gallo

    Full Text Available The ubiquitin associated and Src-homology 3 (SH3 domain containing A (UBASH3a is a suppressor of T-cell receptor signaling, underscoring antigen presentation to T-cells as a critical shared mechanism of diseases pathogenesis. The aim of the present study was to determine whether the UBASH3a gene influence the susceptibility to systemic lupus erythematosus (SLE in Caucasian populations. We evaluated five UBASH3a polymorphisms (rs2277798, rs2277800, rs9976767, rs13048049 and rs17114930, using TaqMan® allelic discrimination assays, in a discovery cohort that included 906 SLE patients and 1165 healthy controls from Spain. The SNPs that exhibit statistical significance difference were evaluated in a German replication cohort of 360 SLE patients and 379 healthy controls. The case-control analysis in the Spanish population showed a significant association between the rs9976767 and SLE (Pc = 9.9E-03 OR = 1.21 95%CI = 1.07-1.37 and a trend of association for the rs2277798 analysis (P = 0.09 OR = 0.9 95%CI = 0.79-1.02. The replication in a German cohort and the meta-analysis confirmed that the rs9976767 (Pc = 0.02; Pc = 2.4E-04, for German cohort and meta-analysis, respectively and rs2277798 (Pc = 0.013; Pc = 4.7E-03, for German cohort and meta-analysis, respectively UBASH3a variants are susceptibility factors for SLE. Finally, a conditional regression analysis suggested that the most likely genetic variation responsible for the association was the rs9976767 polymorphism. Our results suggest that UBASH3a gene plays a role in the susceptibility to SLE. Moreover, our study indicates that UBASH3a can be considered as a common genetic factor in autoimmune diseases.

  14. The nervous system of Paludicella articulata - first evidence of a neuroepithelium in a ctenostome ectoproct.

    Science.gov (United States)

    Weber, Anna V; Wanninger, Andreas; Schwaha, Thomas F

    2014-01-01

    Comparatively few data are available concerning the structure of the adult nervous system in the Ectoprocta or Bryozoa. In contrast to all other ectoprocts, the cerebral ganglion of phylactolaemates contains a central fluid-filled lumen surrounded by a neuroepithelium. Preliminary observations have shown a small lumen within the cerebral ganglion of the ctenostome Paludicella articulata. Ctenostome-grade ectoprocts are of phylogenetic relevance since they are considered to have retained ancestral ectoproct features. Therefore, the ctenostome Paludicella articulata was analyzed in order to contribute to the basal neural bauplan of ctenostomes and the Ectoprocta in general. The presence of a lumen and a neuroepithelial organization of the nerve cells within the cerebral ganglion are confirmed. Four tentacle nerves project from the cerebral ganglion into each tentacle. Three of the tentacle nerves (one abfrontal and two latero-frontal nerves) have an intertentacular origin, whereas the medio-frontal nerve arises from the cerebral ganglion. Six to eight visceral nerves and four tentacle sheath nerves are found to emanate from the cerebral ganglion and innervate the digestive tract and the tentacle sheath, respectively. The situation in P. articulata corresponds to the situation found in other ctenostomes and supports the notion that four tentacle nerves are the ancestral configuration in Ectoprocta and not six as proposed earlier. The presence of a lumen in the ganglion represents the ancestral state in Ectoprocta which disappears during ontogeny in all except in adult Phylactolaemata and P. articulata. It appears likely that it has been overlooked in earlier studies owing to its small size.

  15. Malaria mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites

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    P. Kim Streatfield

    2014-10-01

    Full Text Available Background: Malaria continues to be a major cause of infectious disease mortality in tropical regions. However, deaths from malaria are most often not individually documented, and as a result overall understanding of malaria epidemiology is inadequate. INDEPTH Network members maintain population surveillance in Health and Demographic Surveillance System sites across Africa and Asia, in which individual deaths are followed up with verbal autopsies. Objective: To present patterns of malaria mortality determined by verbal autopsy from INDEPTH sites across Africa and Asia, comparing these findings with other relevant information on malaria in the same regions. Design: From a database covering 111,910 deaths over 12,204,043 person-years in 22 sites, in which verbal autopsy data were handled according to the WHO 2012 standard and processed using the InterVA-4 model, over 6,000 deaths were attributed to malaria. The overall period covered was 1992–2012, but two-thirds of the observations related to 2006–2012. These deaths were analysed by site, time period, age group and sex to investigate epidemiological differences in malaria mortality. Results: Rates of malaria mortality varied by 1:10,000 across the sites, with generally low rates in Asia (one site recording no malaria deaths over 0.5 million person-years and some of the highest rates in West Africa (Nouna, Burkina Faso: 2.47 per 1,000 person-years. Childhood malaria mortality rates were strongly correlated with Malaria Atlas Project estimates of Plasmodium falciparum parasite rates for the same locations. Adult malaria mortality rates, while lower than corresponding childhood rates, were strongly correlated with childhood rates at the site level. Conclusions: The wide variations observed in malaria mortality, which were nevertheless consistent with various other estimates, suggest that population-based registration of deaths using verbal autopsy is a useful approach to understanding the

  16. Evidence of bacterial biofilm in tubing from hydraulic pathway of hemodialysis system.

    Science.gov (United States)

    Man, N K; Degremont, A; Darbord, J C; Collet, M; Vaillant, P

    1998-07-01

    cleaning and disinfection procedures used for hemodialysis systems should aim to detach and neutralize biofilm when necessary.

  17. Evidence from stable isotopes and10Be for solar system formation triggered by a low-mass supernova.

    Science.gov (United States)

    Banerjee, Projjwal; Qian, Yong-Zhong; Heger, Alexander; Haxton, W C

    2016-11-22

    About 4.6 billion years ago, some event disturbed a cloud of gas and dust, triggering the gravitational collapse that led to the formation of the solar system. A core-collapse supernova, whose shock wave is capable of compressing such a cloud, is an obvious candidate for the initiating event. This hypothesis can be tested because supernovae also produce telltale patterns of short-lived radionuclides, which would be preserved today as isotopic anomalies. Previous studies of the forensic evidence have been inconclusive, finding a pattern of isotopes differing from that produced in conventional supernova models. Here we argue that these difficulties either do not arise or are mitigated if the initiating supernova was a special type, low in mass and explosion energy. Key to our conclusion is the demonstration that short-lived 10 Be can be readily synthesized in such supernovae by neutrino interactions, while anomalies in stable isotopes are suppressed.

  18. Evidence from stable isotopes and 10Be for solar system formation triggered by a low-mass supernova

    Science.gov (United States)

    Banerjee, Projjwal; Qian, Yong-Zhong; Heger, Alexander; Haxton, W. C.

    2016-11-01

    About 4.6 billion years ago, some event disturbed a cloud of gas and dust, triggering the gravitational collapse that led to the formation of the solar system. A core-collapse supernova, whose shock wave is capable of compressing such a cloud, is an obvious candidate for the initiating event. This hypothesis can be tested because supernovae also produce telltale patterns of short-lived radionuclides, which would be preserved today as isotopic anomalies. Previous studies of the forensic evidence have been inconclusive, finding a pattern of isotopes differing from that produced in conventional supernova models. Here we argue that these difficulties either do not arise or are mitigated if the initiating supernova was a special type, low in mass and explosion energy. Key to our conclusion is the demonstration that short-lived 10Be can be readily synthesized in such supernovae by neutrino interactions, while anomalies in stable isotopes are suppressed.

  19. Representation of complex vocalizations in the Lusitanian toadfish auditory system: evidence of fine temporal, frequency and amplitude discrimination

    Science.gov (United States)

    Vasconcelos, Raquel O.; Fonseca, Paulo J.; Amorim, M. Clara P.; Ladich, Friedrich

    2011-01-01

    Many fishes rely on their auditory skills to interpret crucial information about predators and prey, and to communicate intraspecifically. Few studies, however, have examined how complex natural sounds are perceived in fishes. We investigated the representation of conspecific mating and agonistic calls in the auditory system of the Lusitanian toadfish Halobatrachus didactylus, and analysed auditory responses to heterospecific signals from ecologically relevant species: a sympatric vocal fish (meagre Argyrosomus regius) and a potential predator (dolphin Tursiops truncatus). Using auditory evoked potential (AEP) recordings, we showed that both sexes can resolve fine features of conspecific calls. The toadfish auditory system was most sensitive to frequencies well represented in the conspecific vocalizations (namely the mating boatwhistle), and revealed a fine representation of duration and pulsed structure of agonistic and mating calls. Stimuli and corresponding AEP amplitudes were highly correlated, indicating an accurate encoding of amplitude modulation. Moreover, Lusitanian toadfish were able to detect T. truncatus foraging sounds and A. regius calls, although at higher amplitudes. We provide strong evidence that the auditory system of a vocal fish, lacking accessory hearing structures, is capable of resolving fine features of complex vocalizations that are probably important for intraspecific communication and other relevant stimuli from the auditory scene. PMID:20861044

  20. Application of simplified Complexity Theory concepts for healthcare social systems to explain the implementation of evidence into practice.

    Science.gov (United States)

    Chandler, Jacqueline; Rycroft-Malone, Jo; Hawkes, Claire; Noyes, Jane

    2016-02-01

    To examine the application of core concepts from Complexity Theory to explain the findings from a process evaluation undertaken in a trial evaluating implementation strategies for recommendations about reducing surgical fasting times. The proliferation of evidence-based guidance requires a greater focus on its implementation. Theory is required to explain the complex processes across the multiple healthcare organizational levels. This social healthcare context involves the interaction between professionals, patients and the organizational systems in care delivery. Complexity Theory may provide an explanatory framework to explain the complexities inherent in implementation in social healthcare contexts. A secondary thematic analysis of qualitative process evaluation data informed by Complexity Theory. Seminal texts applying Complexity Theory to the social context were annotated, key concepts extracted and core Complexity Theory concepts identified. These core concepts were applied as a theoretical lens to provide an explanation of themes from a process evaluation of a trial evaluating the implementation of strategies to reduce surgical fasting times. Sampled substantive texts provided a representative spread of theoretical development and application of Complexity Theory from late 1990's-2013 in social science, healthcare, management and philosophy. Five Complexity Theory core concepts extracted were 'self-organization', 'interaction', 'emergence', 'system history' and 'temporality'. Application of these concepts suggests routine surgical fasting practice is habituated in the social healthcare system and therefore it cannot easily be reversed. A reduction to fasting times requires an incentivised new approach to emerge in the surgical system's priority of completing the operating list. The application of Complexity Theory provides a useful explanation for resistance to change fasting practice. Its utility in implementation research warrants further attention and

  1. Feasibility of a rapid response mechanism to meet policymakers' urgent needs for research evidence about health systems in a low income country: a case study.

    Science.gov (United States)

    Mijumbi, Rhona M; Oxman, Andrew D; Panisset, Ulysses; Sewankambo, Nelson K

    2014-09-10

    Despite the recognition of the importance of evidence-informed health policy and practice, there are still barriers to translating research findings into policy and practice. The present study aimed to establish the feasibility of a rapid response mechanism, a knowledge translation strategy designed to meet policymakers' urgent needs for evidence about health systems in a low income country, Uganda. Rapid response mechanisms aim to address the barriers of timeliness and relevance of evidence at the time it is needed. A rapid response mechanism (service) designed a priori was offered to policymakers in the health sector in Uganda. In the form of a case study, data were collected about the profile of users of the service, the kinds of requests for evidence, changes in answers, and courses of action influenced by the mechanism and their satisfaction with responses and the mechanism in general. We found that in the first 28 months, the service received 65 requests for evidence from 30 policymakers and stakeholders, the majority of whom were from the Ministry of Health. The most common requests for evidence were about governance and organization of health systems. It was noted that regular contact between the policymakers and the researchers at the response service was an important factor in response to, and uptake of the service. The service seemed to increase confidence for policymakers involved in the policymaking process. Rapid response mechanisms designed to meet policymakers' urgent needs for research evidence about health systems are feasible and acceptable to policymakers in low income countries.

  2. Human avoidance and approach learning: evidence for overlapping neural systems and experiential avoidance modulation of avoidance neurocircuitry.

    Science.gov (United States)

    Schlund, Michael W; Magee, Sandy; Hudgins, Caleb D

    2011-12-01

    Adaptive functioning is thought to reflect a balance between approach and avoidance neural systems with imbalances often producing pathological forms of avoidance. Yet little evidence is available in healthy adults demonstrating a balance between approach and avoidance neural systems and modulation in avoidance neurocircuitry by vulnerability factors for avoidance. Consequently, we used functional magnetic resonance imaging (fMRI) to compare changes in brain activation associated with human avoidance and approach learning and modulation of avoidance neurocircuitry by experiential avoidance. fMRI tracked trial-by-trial increases in activation while adults learned through trial and error an avoidance response that prevented money loss and an approach response that produced money gain. Avoidance and approach cues elicited similar experience-dependent increases in activation in a fronto-limbic-striatal network. Positive and negative reinforcing outcomes (i.e., money gain and avoidance of loss) also elicited similar increases in activation in frontal and striatal regions. Finally, increased experiential avoidance and self-punishment coping was associated with decreased activation in medial/superior frontal regions, anterior cingulate, amygdala and hippocampus. These findings suggest avoidance and approach learning recruit a similar fronto-limbic-striatal network in healthy adults. Increased experiential avoidance also appears to be associated with reduced frontal and limbic reactivity in avoidance, establishing an important link between maladaptive avoidance coping and altered responses in avoidance neurocircuitry. Copyright © 2011 Elsevier B.V. All rights reserved.

  3. Evidence of transfer by conjugation of type IV secretion system genes between Bartonella species and Rhizobium radiobacter in amoeba.

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    Watcharee Saisongkorh

    Full Text Available BACKGROUND: Bartonella species cospeciate with mammals and live within erythrocytes. Even in these specific niches, it has been recently suggested by bioinformatic analysis of full genome sequences that Lateral Gene Transfer (LGT may occur but this has never been demonstrated biologically. Here we describe the sequence of the B. rattaustraliani (AUST/NH4(T circular plasmid (pNH4 that encodes the tra cluster of the Type IV secretion system (T4SS and we eventually provide evidence that Bartonella species may conjugate and exchange this plasmid inside amoeba. PRINCIPAL FINDINGS: The T4SS of pNH4 is critical for intracellular viability of bacterial pathogens, exhibits bioinformatic evidence of LGT among bacteria living in phagocytic protists. For instance, 3 out of 4 T4SS encoding genes from pNH4 appear to be closely related to Rhizobiales, suggesting that gene exchange occurs between intracellular bacteria from mammals (bartonellae and plants (Rhizobiales. We show that B. rattaustraliani and Rhizobium radiobacter both survived within the amoeba Acanthamoeba polyphaga and can conjugate together. Our findings further support the hypothesis that tra genes might also move into and out of bacterial communities by conjugation, which might be the primary means of genomic evolution for intracellular adaptation by cross-talk of interchangeable genes between Bartonella species and plant pathogens. CONCLUSIONS: Based on this, we speculate that amoeba favor the transfer of genes as phagocytic protists, which allows for intraphagocytic survival and, as a consequence, promotes the creation of potential pathogenic organisms.

  4. AIMD - a validated, simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies

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    Peter Bragge

    2017-03-01

    Full Text Available Abstract Background Proliferation of terms describing the science of effectively promoting and supporting the use of research evidence in healthcare policy and practice has hampered understanding and development of the field. To address this, an international Terminology Working Group developed and published a simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies. This paper presents results of validation work and a second international workgroup meeting, culminating in the updated AIMD framework [Aims, Ingredients, Mechanism, Delivery]. Methods Framework validity was evaluated against terminology schemas (n = 51; primary studies (n = 37; and reporting guidelines (n = 10. Framework components were independently categorized as fully represented, partly represented, or absent by two researchers. Opportunities to refine the framework were systematically recorded. A meeting of the expanded international Terminology Working Group updated the framework by reviewing and deliberating upon validation findings and refinement proposals. Results There was variation in representativeness of the components across the three types of literature, in particular for the component ‘causal mechanisms’. Analysis of primary studies revealed that representativeness of this concept lowered from 92 to 68% if only explicit, rather than explicit and non-explicit references to causal mechanisms were included. All components were very well represented in reporting guidelines, however the level of description of these was lower than in other types of literature. Twelve opportunities were identified to improve the framework, 9 of which were operationalized at the meeting. The updated AIMD framework comprises four components: (1 Aims: what do you want your intervention to achieve and for whom? (2 Ingredients: what comprises the intervention? (3 Mechanisms: how do you propose the intervention will

  5. The effects of global health initiatives on country health systems: a review of the evidence from HIV/AIDS control.

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    Biesma, Regien G; Brugha, Ruairí; Harmer, Andrew; Walsh, Aisling; Spicer, Neil; Walt, Gill

    2009-07-01

    This paper reviews country-level evidence about the impact of global health initiatives (GHIs), which have had profound effects on recipient country health systems in middle and low income countries. We have selected three initiatives that account for an estimated two-thirds of external funding earmarked for HIV/AIDS control in resource-poor countries: the Global Fund to Fight AIDS, TB and Malaria, the World Bank Multi-country AIDS Program (MAP) and the US President's Emergency Plan for AIDS Relief (PEPFAR). This paper draws on 31 original country-specific and cross-country articles and reports, based on country-level fieldwork conducted between 2002 and 2007. Positive effects have included a rapid scale-up in HIV/AIDS service delivery, greater stakeholder participation, and channelling of funds to non-governmental stakeholders, mainly NGOs and faith-based bodies. Negative effects include distortion of recipient countries' national policies, notably through distracting governments from coordinated efforts to strengthen health systems and re-verticalization of planning, management and monitoring and evaluation systems. Sub-national and district studies are needed to assess the degree to which GHIs are learning to align with and build the capacities of countries to respond to HIV/AIDS; whether marginalized populations access and benefit from GHI-funded programmes; and about the cost-effectiveness and long-term sustainability of the HIV and AIDS programmes funded by the GHIs. Three multi-country sets of evaluations, which will be reporting in 2009, will answer some of these questions.

  6. Modeling the Construct of an Expert Evidence-Adaptive Knowledge Base for a Pressure Injury Clinical Decision Support System

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    Peck Chui Betty Khong

    2017-07-01

    Full Text Available The selection of appropriate wound products for the treatment of pressure injuries is paramount in promoting wound healing. However, nurses find it difficult to decide on the most optimal wound product(s due to limited live experiences in managing pressure injuries resulting from successfully implemented pressure injury prevention programs. The challenges of effective decision-making in wound treatments by nurses at the point of care are compounded by the yearly release of wide arrays of newly researched wound products into the consumer market. A clinical decision support system for pressure injury (PI-CDSS was built to facilitate effective decision-making and selection of optimal wound treatments. This paper describes the development of PI-CDSS with an expert knowledge base using an interactive development environment, Blaze Advisor. A conceptual framework using decision-making and decision theory, knowledge representation, and process modelling guided the construct of the PI-CDSS. This expert system has incorporated the practical and relevant decision knowledge of wound experts in assessment and wound treatments in its algorithm. The construct of the PI-CDSS is adaptive, with scalable capabilities for expansion to include other CDSSs and interoperability to interface with other existing clinical and administrative systems. The algorithm was formatively evaluated and tested for usability. The treatment modalities generated after using patient-specific assessment data were found to be consistent with the treatment plan(s proposed by the wound experts. The overall agreement exceeded 90% between the wound experts and the generated treatment modalities for the choice of wound products, instructions, and alerts. The PI-CDSS serves as a just-in-time wound treatment protocol with suggested clinical actions for nurses, based on the best evidence available.

  7. Self-organization in the flow of complex fluids (colloid and polymer systems): part 1: experimental evidence.

    Science.gov (United States)

    Malkin, A Ya; Semakov, A V; Kulichikhin, V G

    2010-06-14

    Different types of regular and irregular self-organized structures observed in deformation of colloid and polymer substances ("complex fluids") are discussed and classified. This review is focused on experimental evidence of structure formation and self-organization in shear flows, which have many similar features in systems of different types. For single-phase (uniform) polymer systems regular periodic surface structures are observed. Two main types of these structures are possible: small-scale regular screw-like periodic structures along the whole stream (usually called "shark-skin") and long-period smooth and distorted parts of a stream attributed as a "stick-slip" effect. The origin of surface irregularities of both types is elasticity of a liquid. In the limiting case of high enough Weissenberg numbers, medium loses fluidity and should be treated as a rubbery matter. The liquid-to-rubbery transition at high Weissenberg numbers is considered as the dominating mechanism of instability, leading in particular to the wall slip and rupture of a stream. Secondary flows ("vorticity") in deformation polymeric substances and complex fluids are also obliged to their elasticity and the observed Couette-Taylor-like cells, though being similar to well-known inertial secondary flows, are completely determined by elasticity of colloid and polymeric systems. In deformation of colloidal systems, suspensions and other dense concentrated heterophase materials, structure formation takes place at rest and the destroying of the structure happens as the yield stress. In opposite to this case, strong deformations can lead to the shear-induced structure formation and jamming. These effects are of general meaning for any complex fluids as well as for dense suspensions and granular media. Strong deformations also lead to separation of a stream into different parts (several "bands") with various properties of liquids in these parts. So, two principal effects common for any polymers and

  8. Sedimentary evidence of historical and prehistorical earthquakes along the Venta de Bravo Fault System, Acambay Graben (Central Mexico)

    Science.gov (United States)

    Lacan, Pierre; Ortuño, María; Audin, Laurence; Perea, Hector; Baize, Stephane; Aguirre-Díaz, Gerardo; Zúñiga, F. Ramón

    2018-03-01

    The Venta de Bravo normal fault is one of the longest structures in the intra-arc fault system of the Trans-Mexican Volcanic Belt. It defines, together with the Pastores Fault, the 80 km long southern margin of the Acambay Graben. We focus on the westernmost segment of the Venta de Bravo Fault and provide new paleoseismological information, evaluate its earthquake history, and assess the related seismic hazard. We analyzed five trenches, distributed at three different sites, in which Holocene surface faulting offsets interbedded volcanoclastic, fluvio-lacustrine and colluvial deposits. Despite the lack of known historical destructive earthquakes along this fault, we found evidence of at least eight earthquakes during the late Quaternary. Our results indicate that this is one of the major seismic sources of the Acambay Graben, capable of producing by itself earthquakes with magnitudes (MW) up to 6.9, with a slip rate of 0.22-0.24 mm yr- 1 and a recurrence interval between 1940 and 2390 years. In addition, a possible multi-fault rupture of the Venta de Bravo Fault together with other faults of the Acambay Graben could result in a MW > 7 earthquake. These new slip rates, earthquake recurrence rates, and estimation of slips per event help advance our understanding of the seismic hazard posed by the Venta de Bravo Fault and provide new parameters for further hazard assessment.

  9. New Evidence for the Dynamical Decay of a Multiple System in the Orion Kleinmann–Low Nebula

    Energy Technology Data Exchange (ETDEWEB)

    Luhman, K. L. [Department of Astronomy and Astrophysics, The Pennsylvania State University, University Park, PA 16802 (United States); Robberto, M.; Gabellini, M. Giulia Ubeira; Ubeda, L. [Space Telescope Science Institute, 3700 San Martin Drive, Baltimore, MD 21218 (United States); Tan, J. C. [Department of Astronomy, University of Florida, Gainesville, FL 32611 (United States); Andersen, M. [Gemini Observatory, Casilla 603, La Serena (Chile); Manara, C. F. [Scientific Support Office, Directorate of Science, European Space Research and Technology Centre, Keplerlaan 1, NL-2201 AZ Noordwijk (Netherlands); Platais, I., E-mail: kluhman@astro.psu.edu [Johns Hopkins University, Department of Physics and Astronomy, 3400 North Charles Street, Baltimore, MD 21218 (United States)

    2017-03-20

    We have measured astrometry for members of the Orion Nebula Cluster with images obtained in 2015 with the Wide Field Camera 3 on board the Hubble Space Telescope . By comparing those data to previous measurements with the Near-Infrared Camera and Multi-Object Spectrometer on Hubble in 1998, we have discovered that a star in the Kleinmann–Low Nebula, source x from Lonsdale et al., is moving with an unusually high proper motion of 29 mas yr{sup −1}, which corresponds to 55 km s{sup −1} at the distance of Orion. Previous radio observations have found that three other stars in the Kleinmann–Low Nebula (the Becklin–Neugebauer object and sources I and n) have high proper motions (5–14 mas yr{sup −1}) and were near a single location ∼540 years ago, and thus may have been members of a multiple system that dynamically decayed. The proper motion of source x is consistent with ejection from that same location 540 years ago, which provides strong evidence that the dynamical decay did occur and that the runaway star BN originated in the Kleinmann–Low Nebula rather than the nearby Trapezium cluster. However, our constraint on the motion of source n is significantly smaller than the most recent radio measurement, which indicates that it did not participate in the event that ejected the other three stars.

  10. Evidence of a suffocation alarm system sensitive to clinically-effective treatments with the panicolytics clonazepam and fluoxetine.

    Science.gov (United States)

    Schimitel, Fagna Giacomin; Müller, Cláudia Janaina Torres; Tufik, Sérgio; Schenberg, Luiz Carlos

    2014-12-01

    Dyspnea, 'hunger for air', and the urge to flee are the cardinal symptoms of respiratory-type panic attacks. Patients also show baseline respiratory abnormalities and a higher rate of comorbid and antecedent respiratory diseases. Panic attacks are also precipitated by both the infusion of 0.5 M sodium lactate and the inhalation of 5-7% carbon dioxide (CO2) in predisposed patients, but not in healthy volunteers nor patients without panic disorder. Further studies show that patients with panic are also hyper-responsive to hypoxia. These and other observations led Klein (1993) to suggest that clinical panic is the misfiring of a suffocation alarm system. In rats, cytotoxic hypoxia of chemoreceptor cells by intravenous injection of potassium cyanide (KCN) produces short-lasting flight behaviors reminiscent of panic attacks. KCN-induced flight behaviors are blocked both by denervation of chemoreceptor cells and lesion of dorsal periaqueductal gray matter, a likely substrate of panic. Herein, we show that KCN-evoked flight behaviors are also attenuated by both acute and chronic treatment with clonazepam (0.01-0.3 mg/kg, intraperitoneally (i.p.)) and fluoxetine (1-4 mg/kg/day, i.p. for 21 days), respectively. Attenuation of KCN-evoked panic-like behaviors by clinically-effective treatment with panicolytics adds fresh evidence to the false suffocation alarm theory of panic disorder. © The Author(s) 2014.

  11. THE HAT-P-13 EXOPLANETARY SYSTEM: EVIDENCE FOR SPIN-ORBIT ALIGNMENT AND A THIRD COMPANION

    International Nuclear Information System (INIS)

    Winn, Joshua N.; Albrecht, Simon; Johnson, John Asher; Howard, Andrew W.; Marcy, Geoffrey W.; Bakos, Gaspar A.; Hartman, Joel; Torres, Guillermo; Narita, Norio

    2010-01-01

    We present new radial velocity (RV) measurements of HAT-P-13, a star with two previously known companions: a transiting giant planet 'b' with an orbital period of 3 days and a more massive object 'c' on a 1.2 yr, highly eccentric orbit. For this system, dynamical considerations would lead to constraints on planet b's interior structure, if it could be shown that the orbits are coplanar and apsidally locked. By modeling the Rossiter-McLaughlin effect, we show that planet b's orbital angular momentum vector and the stellar spin vector are well aligned on the sky (λ = 1.9 ± 8.6 deg). The refined orbital solution favors a slightly eccentric orbit for planet b (e = 0.0133 ± 0.0041), although it is not clear whether it is apsidally locked with c's orbit (Δω = 36 +27 -36 deg). We find a long-term trend in the star's RV and interpret it as evidence for an additional body 'd', which may be another planet or a low-mass star. Predictions are given for the next few inferior conjunctions of c, when transits may happen.

  12. Chronic myelomonocytic leukemia with antecedent refractory anemia with excess blasts: further evidence for the arbitrary nature of current classification systems.

    Science.gov (United States)

    Breccia, M; Cannella, L; Frustaci, A; Stefanizzi, C; D'Elia, G M; Alimena, G

    2008-07-01

    From a retrospective analysis of our series of myelodysplastic patients, we found 16 patients who were initially diagnosed as having a refractory anemia with excess of blasts (RAEB) according to FAB criteria, but later on (median time 4 months, range 2-8) developed a peripheral monocytosis >1 x 10(9)/L, leading to a disease re-classification into a dysplastic type of chronic myelomonocytic leukemia (MD-CMML). Analysis of clinical and prognostic aspects in this subgroup of patients as compared with those of primarily diagnosed MD-CMML patients, showed some significant differences in Hb level, platelet count, percentage of immature circulating precursor (IPC), bone marrow blastosis and trilineage dysplasia. Median survival for present group of patients was 33 months compared with 20 months for MD-CMML. Different prognostic scores were applied for evaluation of risk distribution and relative impact on survival prediction. We suggest on a possible atypical presentation of CMML and indicate a careful attention to be addressed to myelodysplastic patients who develop peripheral monocytosis, who might have a CMML variant, with more favourable prognosis and prolonged survival. Furthermore, we believe this is a further evidence for the arbitrary nature of current classification systems, which definitely exclude CMML from myelodysplastic syndromes.

  13. Social networks and implementation of evidence-based practices in public youth-serving systems: a mixed-methods study

    Directory of Open Access Journals (Sweden)

    Fuentes Dahlia

    2011-09-01

    Full Text Available Abstract Background The present study examines the structure and operation of social networks of information and advice and their role in making decisions as to whether to adopt new evidence-based practices (EBPs among agency directors and other program professionals in 12 California counties participating in a large randomized controlled trial. Methods Interviews were conducted with 38 directors, assistant directors, and program managers of county probation, mental health, and child welfare departments. Grounded-theory analytic methods were used to identify themes related to EBP adoption and network influences. A web-based survey collected additional quantitative information on members of information and advice networks of study participants. A mixed-methods approach to data analysis was used to create a sociometric data set (n = 176 for examination of associations between advice seeking and network structure. Results Systems leaders develop and maintain networks of information and advice based on roles, responsibility, geography, and friendship ties. Networks expose leaders to information about EBPs and opportunities to adopt EBPs; they also influence decisions to adopt EBPs. Individuals in counties at the same stage of implementation accounted for 83% of all network ties. Networks in counties that decided not to implement a specific EBP had no extra-county ties. Implementation of EBPs at the two-year follow-up was associated with the size of county, urban versus rural counties, and in-degree centrality. Collaboration was viewed as critical to implementing EBPs, especially in small, rural counties where agencies have limited resources on their own. Conclusions Successful implementation of EBPs requires consideration and utilization of existing social networks of high-status systems leaders that often cut across service organizations and their geographic jurisdictions. Trial Registration NCT00880126

  14. Evidence for a Role of Orexin/Hypocretin System in Vestibular Lesion-Induced Locomotor Abnormalities in Rats.

    Science.gov (United States)

    Pan, Leilei; Qi, Ruirui; Wang, Junqin; Zhou, Wei; Liu, Jiluo; Cai, Yiling

    2016-01-01

    Vestibular damage can induce locomotor abnormalities in both animals and humans. Rodents with bilateral vestibular loss showed vestibular deficits syndrome such as circling, opisthotonus as well as locomotor and exploratory hyperactivity. Previous studies have investigated the changes in the dopamine system after vestibular loss, but the results are inconsistent and inconclusive. Numerous evidences indicate that the orexin system is implicated in central motor control. We hypothesized that orexin may be potentially involved in vestibular loss-induced motor disorders. In this study, we examined the effects of arsanilate- or 3,3'-iminodipropionitrile (IDPN)-induced vestibular lesion (AVL or IVL) on the orexin-A (OXA) labeling in rat hypothalamus using immunohistochemistry. The vestibular lesion-induced locomotor abnormalities were recorded and verified using a histamine H4 receptor antagonist JNJ7777120 (20 mg/kg, i.p.). The effects of the orexin receptor type 1 antagonist SB334867 (16 μg, i.c.v.) on these behavior responses were also investigated. At 72 h post-AVL and IVL, animals exhibited vestibular deficit syndrome and locomotor hyperactivity in the home cages. These responses were significantly alleviated by JNJ7777120 which also eliminated AVL-induced increases in exploratory behavior in an open field. The numbers of OXA-labeled neurons in the hypothalamus were significantly increased in the AVL animals at 72 h post-AVL and in the IVL animals at 24, 48, and 72 h post-IVL. SB334867 significantly attenuated the vestibular deficit syndrome and locomotor hyperactivity at 72 h post-AVL and IVL. It also decreased exploratory behavior in the AVL animals. These results suggested that the alteration of OXA expression might contribute to locomotor abnormalities after acute vestibular lesion. The orexin receptors might be the potential therapeutic targets for vestibular disorders.

  15. Evidence for a role of orexin/hypocretin system in vestibular lesion-induced locomotor abnormalities in rats

    Directory of Open Access Journals (Sweden)

    Leilei Pan

    2016-07-01

    Full Text Available Vestibular damage can induce locomotor abnormalities in both animals and humans. Rodents with bilateral vestibular loss showed vestibular deficits syndrome such as circling, opisthotonus as well as locomotor and exploratory hyperactivity. Previous studies have investigated the changes in the dopamine system after vestibular loss, but the results are inconsistent and inconclusive. Numerous evidences indicate that the orexin system is implicated in central motor control. We hypothesized that orexin may be potentially involved in vestibular loss-induced motor disorders. In this study, we examined the effects of arsanilate- or 3, 3′-iminodipropionitrile (IDPN-induced vestibular lesion (AVL or IVL on the orexin-A (OXA labeling in rat hypothalamus using immunohistochemistry. The vestibular lesion-induced locomotor abnormalities were recorded and verified using a histamine H4 receptor antagonist JNJ7777120 (20 mg/kg, i.p.. The effects of the orexin receptor type 1 antagonist SB334867 (16 μg, i.c.v. on these behavior responses were also investigated. At 72 h post-AVL and IVL, animals exhibited vestibular deficit syndrome and locomotor hyperactivity in the home cages. These responses were significantly alleviated by JNJ7777120 which also eliminated AVL-induced increases in exploratory behavior in an open field. The numbers of OXA-labeled neurons in the hypothalamus were significantly increased in the AVL animals at 72 h post-AVL and in the IVL animals at 24, 48 and 72 h post-IVL. SB334867 significantly attenuated the vestibular deficit syndrome and locomotor hyperactivity at 72 h post-AVL and IVL. It also decreased exploratory behavior in the AVL animals. These results suggested that the alteration of OXA expression might contribute to locomotor abnormalities after acute vestibular lesion. The orexin receptors might be the potential therapeutic targets for vestibular disorders.

  16. High-performance work systems in health care management, part 2: qualitative evidence from five case studies.

    Science.gov (United States)

    McAlearney, Ann Scheck; Garman, Andrew N; Song, Paula H; McHugh, Megan; Robbins, Julie; Harrison, Michael I

    2011-01-01

    : A capable workforce is central to the delivery of high-quality care. Research from other industries suggests that the methodical use of evidence-based management practices (also known as high-performance work practices [HPWPs]), such as systematic personnel selection and incentive compensation, serves to attract and retain well-qualified health care staff and that HPWPs may represent an important and underutilized strategy for improving quality of care and patient safety. : The aims of this study were to improve our understanding about the use of HPWPs in health care organizations and to learn about their contribution to quality of care and patient safety improvements. : Guided by a model of HPWPs developed through an extensive literature review and synthesis, we conducted a series of interviews with key informants from five U.S. health care organizations that had been identified based on their exemplary use of HPWPs. We sought to explore the applicability of our model and learn whether and how HPWPs were related to quality and safety. All interviews were recorded, transcribed, and subjected to qualitative analysis. : In each of the five organizations, we found emphasis on all four HPWP subsystems in our conceptual model-engagement, staff acquisition/development, frontline empowerment, and leadership alignment/development. Although some HPWPs were common, there were also practices that were distinctive to a single organization. Our informants reported links between HPWPs and employee outcomes (e.g., turnover and higher satisfaction/engagement) and indicated that HPWPs made important contributions to system- and organization-level outcomes (e.g., improved recruitment, improved ability to address safety concerns, and lower turnover). : These case studies suggest that the systematic use of HPWPs may improve performance in health care organizations and provide examples of how HPWPs can impact quality and safety in health care. Further research is needed to specify

  17. Patients at the centre: methodological considerations for evaluating evidence from health interventions involving patients use of web-based information systems.

    Science.gov (United States)

    Cummings, Elizabeth; Turner, Paul

    2010-09-15

    Building an evidence base for healthcare interventions has long been advocated as both professionally and ethically desirable. By supporting meaningful comparison amongst different approaches, a good evidence base has been viewed as an important element in optimising clinical decision-making and the safety and quality of care. Unsurprisingly, medical research has put considerable effort into supporting the development of this evidence base, and the randomised controlled trial has become the dominant methodology. Recently however, a body of research has begun to question, not just this methodology per se, but also the extent to which the evidence it produces may marginalise individual patient experiences, priorities and perceptions.Simultaneously, the widespread adoption and utilisation of information systems (IS) in health care has also prompted initiatives to develop a stronger base of evidence about their impacts. These calls have been stimulated both by numerous system failures and research expressing concerns about the limitations of information systems methodologies in health care environments. Alongside the potential of information systems to produce positive, negative and unintended consequences, many measures of success, impact or benefit appear to have little to do with improvements in care, health outcomes or individual patient experiences.Combined these methodological concerns suggest the need for more detailed examination. This is particularly the case, given the prevalence within contemporary clinical and IS discourses on health interventions advocating the need to put the 'patient at the centre' by engaging them in their own care and/or 'empowering' them through the use of information systems.This paper aims to contribute to these on-going debates by focusing on the socio-technical processes by which patients' interests and outcomes are measured, defined and evaluated within health interventions that involve them using web-based information systems

  18. Patients at the Centre: Methodological Considerations for Evaluating Evidence from Health Interventions Involving Patients Use of Web-Based Information Systems

    Science.gov (United States)

    Cummings, Elizabeth; Turner, Paul

    2010-01-01

    Building an evidence base for healthcare interventions has long been advocated as both professionally and ethically desirable. By supporting meaningful comparison amongst different approaches, a good evidence base has been viewed as an important element in optimising clinical decision-making and the safety and quality of care. Unsurprisingly, medical research has put considerable effort into supporting the development of this evidence base, and the randomised controlled trial has become the dominant methodology. Recently however, a body of research has begun to question, not just this methodology per se, but also the extent to which the evidence it produces may marginalise individual patient experiences, priorities and perceptions. Simultaneously, the widespread adoption and utilisation of information systems (IS) in health care has also prompted initiatives to develop a stronger base of evidence about their impacts. These calls have been stimulated both by numerous system failures and research expressing concerns about the limitations of information systems methodologies in health care environments. Alongside the potential of information systems to produce positive, negative and unintended consequences, many measures of success, impact or benefit appear to have little to do with improvements in care, health outcomes or individual patient experiences. Combined these methodological concerns suggest the need for more detailed examination. This is particularly the case, given the prevalence within contemporary clinical and IS discourses on health interventions advocating the need to put the ‘patient at the centre’ by engaging them in their own care and/or ‘empowering’ them through the use of information systems. This paper aims to contribute to these on-going debates by focusing on the socio-technical processes by which patients’ interests and outcomes are measured, defined and evaluated within health interventions that involve them using web

  19. Decoupling of Sleepiness from Sleep Time and Intensity during Chronic Sleep Restriction: Evidence for a Role of the Adenosine System

    Science.gov (United States)

    Kim, Youngsoo; Bolortuya, Yunren; Chen, Lichao; Basheer, Radhika; McCarley, Robert W.; Strecker, Robert E.

    2012-01-01

    Study Objective: Sleep responses to chronic sleep restriction (CSR) might be very different from those observed after short-term total sleep deprivation. For example, after sleep restriction continues for several consecutive days, animals no longer express compensatory increases in daily sleep time and sleep intensity. However, it is unknown if these allostatic, or adaptive, sleep responses to CSR are paralleled by behavioral and neurochemical measures of sleepiness. Design: This study was designed to investigate CSR-induced changes in (1) sleep time and intensity as a measure of electrophysiological sleepiness, (2) sleep latency as a measure of behavioral sleepiness, and (3) brain adenosine A1 (A1R) and A2a receptor (A2aR) mRNA levels as a putative neurochemical correlate of sleepiness. Subjects: Male Sprague-Dawley rats Interventions: A 5-day sleep restriction (SR) protocol consisting of 18-h sleep deprivation and 6-h sleep opportunity each day. Measurement and Results: Unlike the first SR day, rats did not sleep longer or deeper on days 2 through 5, even though they exhibited significant elevations of behavioral sleepiness throughout all 5 SR days. For all SR days and recovery day 1, A1R mRNA in the basal forebrain was maintained at elevated levels, whereas A2aR mRNA in the frontal cortex was maintained at reduced levels. Conclusion: CSR leads to a decoupling of sleepiness from sleep time and sleep intensity, suggesting that there are at least two different sleep regulatory systems: one mediating sleepiness (homeostatic) and the other mediating sleep time/intensity (allostatic). The time course of changes observed in adenosine receptor mRNA levels suggests that the basal forebrain and cortical adenosine system might mediate sleepiness rather than sleep time or intensity. Citation: Kim Y; Bolortuya Y; Chen L; Basheer R; McCarley RW; Strecker RE. Decoupling of sleepiness from sleep time and intensity during chronic sleep restriction: evidence for a role of the

  20. The Importance of Sample Return in Establishing Chemical Evidence for Life on Mars or Other Solar System Bodies

    Science.gov (United States)

    Glavin, D. P.; Conrad, P.; Dworkin, J. P.; Eigenbrode, J.; Mahaffy, P. R.

    2011-01-01

    The search for evidence of life on Mars and elsewhere will continue to be one of the primary goals of NASA s robotic exploration program over the next decade. NASA and ESA are currently planning a series of robotic missions to Mars with the goal of understanding its climate, resources, and potential for harboring past or present life. One key goal will be the search for chemical biomarkers including complex organic compounds important in life on Earth. These include amino acids, the monomer building blocks of proteins and enzymes, nucleobases and sugars which form the backbone of DNA and RNA, and lipids, the structural components of cell membranes. Many of these organic compounds can also be formed abiotically as demonstrated by their prevalence in carbonaceous meteorites [1], though, their molecular characteristics may distinguish a biological source [2]. It is possible that in situ instruments may reveal such characteristics, however, return of the right sample (i.e. one with biosignatures or having a high probability of biosignatures) to Earth would allow for more intensive laboratory studies using a broad array of powerful instrumentation for bulk characterization, molecular detection, isotopic and enantiomeric compositions, and spatially resolved chemistry that may be required for confirmation of extant or extinct Martian life. Here we will discuss the current analytical capabilities and strategies for the detection of organics on the Mars Science Laboratory (MSL) using the Sample Analysis at Mars (SAM) instrument suite and how sample return missions from Mars and other targets of astrobiological interest will help advance our understanding of chemical biosignatures in the solar system.

  1. Tackling malnutrition: a systematic review of 15-year research evidence from INDEPTH health and demographic surveillance systems

    Directory of Open Access Journals (Sweden)

    Samuelina S. Arthur

    2015-10-01

    Full Text Available Background: Nutrition is the intake of food in relation to the body's dietary needs. Malnutrition results from the intake of inadequate or excess food. This can lead to reduced immunity, increased susceptibility to disease, impaired physical and mental development, and reduced productivity. Objective: To perform a systematic review to assess research conducted by the International Network for the Demographic Evaluation of Populations and their Health (INDEPTH of health and demographic surveillance systems (HDSSs over a 15-year period on malnutrition, its determinants, the effects of under and over nutrition, and intervention research on malnutrition in low- and middle-income countries (LMICs. Methods: Relevant publication titles were uploaded onto the Zotero research tool from different databases (60% from PubMed. Using the keywords ‘nutrition’, ‘malnutrition’, ‘over and under nutrition’, we selected publications that were based only on data generated through the longitudinal HDSS platform. All titles and abstracts were screened to determine inclusion eligibility and full articles were independently assessed according to inclusion/exclusion criteria. For inclusion in this study, papers had to cover research on at least one of the following topics: the problem of malnutrition, its determinants, its effects, and intervention research on malnutrition. One hundred and forty eight papers were identified and reviewed, and 67 were selected for this study. Results: The INDEPTH research identified rising levels of overweight and obesity, sometimes in the same settings as under-nutrition. Urbanisation appears to be protective against under-nutrition, but it heightens the risk of obesity. Appropriately timed breastfeeding interventions were protective against malnutrition. Conclusions: Although INDEPTH has expanded the global knowledge base on nutrition, many questions remain unresolved. There is a need for more investment in nutrition research

  2. Tackling malnutrition: a systematic review of 15-year research evidence from INDEPTH health and demographic surveillance systems

    Science.gov (United States)

    Arthur, Samuelina S.; Nyide, Bongiwe; Soura, Abdramane Bassiahi; Kahn, Kathleen; Weston, Mark; Sankoh, Osman

    2015-01-01

    Background Nutrition is the intake of food in relation to the body's dietary needs. Malnutrition results from the intake of inadequate or excess food. This can lead to reduced immunity, increased susceptibility to disease, impaired physical and mental development, and reduced productivity. Objective To perform a systematic review to assess research conducted by the International Network for the Demographic Evaluation of Populations and their Health (INDEPTH) of health and demographic surveillance systems (HDSSs) over a 15-year period on malnutrition, its determinants, the effects of under and over nutrition, and intervention research on malnutrition in low- and middle-income countries (LMICs). Methods Relevant publication titles were uploaded onto the Zotero research tool from different databases (60% from PubMed). Using the keywords ‘nutrition’, ‘malnutrition’, ‘over and under nutrition’, we selected publications that were based only on data generated through the longitudinal HDSS platform. All titles and abstracts were screened to determine inclusion eligibility and full articles were independently assessed according to inclusion/exclusion criteria. For inclusion in this study, papers had to cover research on at least one of the following topics: the problem of malnutrition, its determinants, its effects, and intervention research on malnutrition. One hundred and forty eight papers were identified and reviewed, and 67 were selected for this study. Results The INDEPTH research identified rising levels of overweight and obesity, sometimes in the same settings as under-nutrition. Urbanisation appears to be protective against under-nutrition, but it heightens the risk of obesity. Appropriately timed breastfeeding interventions were protective against malnutrition. Conclusions Although INDEPTH has expanded the global knowledge base on nutrition, many questions remain unresolved. There is a need for more investment in nutrition research in LMICs in order to

  3. Genome scan of human systemic lupus erythematosus: Evidence for linkage on chromosome 1q in African-American pedigrees

    Science.gov (United States)

    Moser, Kathy L.; Neas, Barbara R.; Salmon, Jane E.; Yu, Hua; Gray-McGuire, Courtney; Asundi, Neeraj; Bruner, Gail R.; Fox, Jerome; Kelly, Jennifer; Henshall, Stephanie; Bacino, Debra; Dietz, Myron; Hogue, Robert; Koelsch, Gerald; Nightingale, Lydia; Shaver, Tim; Abdou, Nabih I.; Albert, Daniel A.; Carson, Craig; Petri, Michelle; Treadwell, Edward L.; James, Judith A.; Harley, John B.

    1998-01-01

    Systemic lupus erythematosus (SLE) is an autoimmune disorder characterized by production of autoantibodies against intracellular antigens including DNA, ribosomal P, Ro (SS-A), La (SS-B), and the spliceosome. Etiology is suspected to involve genetic and environmental factors. Evidence of genetic involvement includes: associations with HLA-DR3, HLA-DR2, Fcγ receptors (FcγR) IIA and IIIA, and hereditary complement component deficiencies, as well as familial aggregation, monozygotic twin concordance >20%, λs > 10, purported linkage at 1q41–42, and inbred mouse strains that consistently develop lupus. We have completed a genome scan in 94 extended multiplex pedigrees by using model-based linkage analysis. Potential [log10 of the odds for linkage (lod) > 2.0] SLE loci have been identified at chromosomes 1q41, 1q23, and 11q14–23 in African-Americans; 14q11, 4p15, 11q25, 2q32, 19q13, 6q26–27, and 12p12–11 in European-Americans; and 1q23, 13q32, 20q13, and 1q31 in all pedigrees combined. An effect for the FcγRIIA candidate polymorphism) at 1q23 (lod = 3.37 in African-Americans) is syntenic with linkage in a murine model of lupus. Sib-pair and multipoint nonparametric analyses also support linkage (P 2.0). Our results are consistent with the presumed complexity of genetic susceptibility to SLE and illustrate racial origin is likely to influence the specific nature of these genetic effects. PMID:9843982

  4. Alcohol Consumption and Binge Drinking Among Adult Population: Evidence From the CHILILAB Health and Demographic Surveillance System in Vietnam.

    Science.gov (United States)

    Pham, Cuong V; Tran, Hanh T D; Tran, Ngan T

    Alcohol contributes to severe social and health problems and is a major risk factor for noncommunicable diseases in Vietnam. Over the years, there has been an increase in consumption per capita as well as a rapid expansion of commercially prepared alcohol. To describe the prevalence of alcohol consumption and binge drinking in a random sample of people 15 years of age and older living in Chi Linh who were also a part of the Chi Linh Health and Demographic Surveillance System (CHILILAB HDSS) and to determine the association between alcohol use and sociodemographic characteristics. Data on alcohol consumption of 5438 people 15 years of age and older were extracted from the CHILILAB HDSS information collected in 2016. Descriptive statistics and multiple logistic regression were utilized to assess the association between current drinkers and binge drinkers with socioeconomic groups. The overall prevalence of alcohol use 1 month prior to interview was 41.1%, which is composed of 75.1% males and 17.3% females. Among the 41% of alcohol drinkers, 31.7% reported binge drinking over the last 30 days. The proportion of binge drinking was also found to be higher among males than among females. The association between current drinkers, binge drinkers and gender, area of residence, education, and family income level was statistically significant. This study confirms that alcohol use among current and binge drinkers is common among males in Vietnam and that it is also a rising issue among females. Alcohol use is also associated with sociodemographic factors and income level. The results of this study provide evidence of harmful alcohol use among the Vietnamese population, which could help policy makers further advocate for the approval of the Vietnamese alcohol harm reduction law in the coming years. The results of this study reaffirm the need for public health strategies, including the formulation of laws and policies to reduce the harmful effects of alcohol consumption in

  5. Cost consequences of implementing an electronic decision support system for ordering laboratory tests in primary care: evidence from a controlled prospective study in the Netherlands.

    NARCIS (Netherlands)

    Poley, M.J.; Edelenbos, K.I.; Mosseveld, M.; Wijk, M.A.M. van; Bakker, D. de; Lei, J. van der; Rutten-van Mölken, M.P.M.H.

    2007-01-01

    BACKGROUND: The economic consequences of interventions to promote rational, evidence-based use of laboratory tests by physicians are not yet fully understood. We evaluated the cost consequences of a computer-based, guideline-driven decision-support system (CDSS) for ordering blood tests in primary

  6. Climate for evidence-informed health systems: a profile of systematic review production in 41 low- and middle-income countries, 1996-2008.

    Science.gov (United States)

    Law, Tyler; Lavis, John; Hamandi, Ali; Cheung, Andrew; El-Jardali, Fadi

    2012-01-01

    To describe systematic review production in 41 countries in Africa, the Americas, Asia and the eastern Mediterranean to understand one dimension of the climate for evidence-informed health systems and to provide a baseline for an evaluation of knowledge translation initiatives. Our focus was systematic reviews published between 1996 and 2008 that had a corresponding author based in, or that appeared to target, one of the countries in these regions. We searched both Medline and Embase using validated search strategies, identified citations with a country name in the corresponding author's institutional affiliation or as a textword (i.e., an explicit mention in the title or abstract) or keyword, and coded articles describing a systematic review. We followed the same citation identification procedure for Health Systems Evidence, a database containing systematic reviews about health systems. Systematic review production increased between three-fold (for Africa in Medline) and 110-fold (for Asia in Embase) between the first period (1996-2002) and second period (2003-2008). In the second period, China was more often the home of corresponding authors and the target of reviews than any other country. No systematic reviews were produced by a corresponding author based in nine countries, or appeared to target five countries. Only 48 reviews identified through Medline and Embase addressed health systems, and 35 health systems reviews identified through Health Systems Evidence addressed these countries. In many countries, those seeking to support evidence-informed health systems cannot turn to experienced local systematic reviewers to help them to find and use systematic reviews or to conduct reviews on high priority topics when none exists. These findings suggest the need for local capacity-building initiatives.

  7. Seismicity and fluid geochemistry at Lassen Volcanic National Park, California: Evidence for two circulation cells in the hydrothermal system

    Science.gov (United States)

    Janik, Cathy J.; McLaren, Marcia K.

    2010-01-01

    Seismic analysis and geochemical interpretations provide evidence that two separate hydrothermal cells circulate within the greater Lassen hydrothermal system. One cell originates south to SW of Lassen Peak and within the Brokeoff Volcano depression where it forms a reservoir of hot fluid (235–270°C) that boils to feed steam to the high-temperature fumarolic areas, and has a plume of degassed reservoir liquid that flows southward to emerge at Growler and Morgan Hot Springs. The second cell originates SSE to SE of Lassen Peak and flows southeastward along inferred faults of the Walker Lane belt (WLB) where it forms a reservoir of hot fluid (220–240°C) that boils beneath Devils Kitchen and Boiling Springs Lake, and has an outflow plume of degassed liquid that boils again beneath Terminal Geyser. Three distinct seismogenic zones (identified as the West, Middle, and East seismic clusters) occur at shallow depths (inversions indicate primarily N–S oriented normal faulting and E–W extension, with some oblique faulting and right lateral shear in the East cluster. The different focal mechanisms as well as spatial and temporal earthquake patterns for the East cluster indicate a greater influence by regional tectonics and inferred faults within the WLB. A fourth, deeper (5–10 km) seismogenic zone (the Devils Kitchen seismic cluster) occurs SE of the East cluster and trends NNW from Sifford Mountain toward the Devils Kitchen thermal area where fumarolic temperatures are ≤123°C. Lassen fumaroles discharge geothermal gases that indicate mixing between a N2-rich, arc-type component and gases derived from air-saturated meteoric recharge water. Most gases have relatively weak isotopic indicators of upper mantle or volcanic components, except for gas from Sulphur Works where δ13C–CO2, δ34S–H2S, and δ15N–N2 values indicate a contribution from the mantle and a subducted sediment source in an arc volcanic setting.

  8. Developmental Validation of the ParaDNA® Screening System - A presumptive test for the detection of DNA on forensic evidence items.

    Science.gov (United States)

    Dawnay, Nick; Stafford-Allen, Beccy; Moore, Dave; Blackman, Stephen; Rendell, Paul; Hanson, Erin K; Ballantyne, Jack; Kallifatidis, Beatrice; Mendel, Julian; Mills, DeEtta K; Nagy, Randy; Wells, Simon

    2014-07-01

    Current assessment of whether a forensic evidence item should be submitted for STR profiling is largely based on the personal experience of the Crime Scene Investigator (CSI) and the submissions policy of the law enforcement authority involved. While there are chemical tests that can infer the presence of DNA through the detection of biological stains, the process remains mostly subjective and leads to many samples being submitted that give no profile or not being submitted although DNA is present. The ParaDNA(®) Screening System was developed to address this issue. It consists of a sampling device, pre-loaded reaction plates and detection instrument. The test uses direct PCR with fluorescent HyBeacon™ detection of PCR amplicons to identify the presence and relative amount of DNA on an evidence item and also provides a gender identification result in approximately 75 minutes. This simple-to-use design allows objective data to be acquired by both DNA analyst and non-specialist personnel, to enable a more informed submission decision to be made. The developmental validation study described here tested the sensitivity, reproducibility, accuracy, inhibitor tolerance, and performance of the ParaDNA Screening System on a range of mock evidence items. The data collected demonstrates that the ParaDNA Screening System identifies the presence of DNA on a variety of evidence items including blood, saliva and touch DNA items. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  9. Joint development of evidence-based medical record by doctors and patients through integrated Chinese and Western medicine on digestive system diseases.

    Science.gov (United States)

    Li, Bo; Gao, Hong-yang; Gao, Rui; Zhao, Ying-pan; Li, Qing-na; Zhao, Yang; Tang, Xu-dong; Shang, Hong-cai

    2016-02-01

    Building the clinical therapeutic evaluation system by combing the evaluation given by doctors and patients can form a more comprehensive and objective evaluation system. A literature search on the practice of evidence-based evaluation was conducted in key biomedical databases, i.e. PubMed, Excerpt Medica Database, China Biology Medicine disc and China National Knowledge Infrastructure. However, no relevant study on the subjects of interest was identified. Therefore, drawing on the principles of narrative medicine and expert opinion from systems of Chinese medicine and Western medicine, we propose to develop and pilot-test a novel evidence-based medical record format that captures the perspectives of both patients and doctors in a clinical trial. Further, we seek to evaluate a strategic therapeutic approach that integrates the wisdom of Chinese medicine with the scientific basis of Western medicine in the treatment of digestive system disorders. Evaluation of therapeutic efficacy of remedies under the system of Chinese medicine is an imperative ongoing research. The present study intends to identify a novel approach to assess the synergistic benefits achievable from an integrated therapeutic approach combining Chinese and Western system of medicine to treat digestive system disorders.

  10. A Survey on the Impact of Accounting Information System on Tasks Efficiency: Evidence from Malaysian Public Sector Agencies

    OpenAIRE

    Zakaria, Wan Zuriati Wan; Ilias, Norazlina; Wahab, Norlidawahi

    2017-01-01

    The purpose of the study is to assess the impact of accounting information system on the users’ tasks efficiency. The tasks efficiency is an important construct for measuring system success or effectiveness. It is because an effective system would assist and support users in performing their tasks efficiently. In the study, accounting information system is referred to the computerised accounting information system, which was developed for facilitating organisations to gather, store and disse...

  11. Integrative Families and Systems Treatment: A Middle Path toward Integrating Common and Specific Factors in Evidence-Based Family Therapy

    Science.gov (United States)

    Fraser, J. Scott; Solovey, Andrew D.; Grove, David; Lee, Mo Yee; Greene, Gilbert J.

    2012-01-01

    A moderate common factors approach is proposed as a synthesis or middle path to integrate common and specific factors in evidence-based approaches to high-risk youth and families. The debate in family therapy between common and specific factors camps is reviewed and followed by suggestions from the literature for synthesis and creative flexibility…

  12. Evidence-based treatment and supervision practices for co-occurring mental and substance use disorders in the criminal justice system.

    Science.gov (United States)

    Peters, Roger H; Young, M Scott; Rojas, Elizabeth C; Gorey, Claire M

    2017-07-01

    Over seven million persons in the United States are supervised by the criminal justice system, including many who have co-occurring mental and substance use disorders (CODs). This population is at high risk for recidivism and presents numerous challenges to those working in the justice system. To provide a contemporary review of the existing research and examine key issues and evidence-based treatment and supervision practices related to CODs in the justice system. We reviewed COD research involving offenders that has been conducted over the past 20 years and provide an analysis of key findings. Several empirically supported frameworks are available to guide services for offenders who have CODs, including Integrated Dual Disorders Treatment (IDDT), the Risk-Need-Responsivity (RNR) model, and Cognitive-Behavioral Therapy (CBT). Evidence-based services include integrated assessment that addresses both sets of disorders and the risk for criminal recidivism. Although several evidence-based COD interventions have been implemented at different points in the justice system, there remains a significant gap in services for offenders who have CODs. Existing program models include Crisis Intervention Teams (CIT), day reporting centers, specialized community supervision teams, pre- and post-booking diversion programs, and treatment-based courts (e.g., drug courts, mental health courts, COD dockets). Jail-based COD treatment programs provide stabilization of acute symptoms, medication consultation, and triage to community services, while longer-term prison COD programs feature Modified Therapeutic Communities (MTCs). Despite the availability of multiple evidence-based interventions that have been implemented across diverse justice system settings, these services are not sufficiently used to address the scope of treatment and supervision needs among offenders with CODs.

  13. Use of health systems and policy research evidence in the health policymaking in eastern Mediterranean countries: views and practices of researchers

    Directory of Open Access Journals (Sweden)

    El-Jardali Fadi

    2012-01-01

    Full Text Available Abstract Background Limited research exists on researchers' knowledge transfer and exchange (KTE in the eastern Mediterranean region (EMR. This multi-country study explores researchers' views and experiences regarding the role of health systems and policy research evidence in health policymaking in the EMR, including the factors that influence health policymaking, barriers and facilitators to the use of evidence, and the factors that increase researchers' engagement in KTE. Methods Researchers who published health systems and policy relevant research in 12 countries in the EMR (Bahrain, Egypt, Iran, Jordan, Lebanon, Libya, Morocco, Oman, Palestine, Sudan, Syria, and Yemen were surveyed. Descriptive analysis and Linear Mixed Regression Models were performed for quantitative sections and the simple thematic analysis approach was used for open-ended questions. Results A total of 238 researchers were asked to complete the survey (response rate 56%. Researchers indicated transferring results to other researchers (67.2% and policymakers in the government (40.5%. Less than one-quarter stated that they produced policy briefs (14.5%, disseminated messages that specified possible actions (24.4%, interacted with policymakers and stakeholders in priority-setting (16%, and involved them in their research (19.8%. Insufficient policy dialogue opportunities and collaboration between researchers and policymakers and stakeholders (67.9%, practical constraints to implementation (66%, non-receptive policy environment (61.3%, and politically sensitive findings (57.7% hindered the use of evidence. Factors that increase researchers' engagement in KTE activities in the region were associated with involving policymakers and stakeholders at various stages such as priority-setting exercises and provision of technical assistance. Conclusions Researchers in the EMR recognize the importance of using health systems evidence in health policymaking. Potential strategies to

  14. Use of health systems and policy research evidence in the health policymaking in eastern Mediterranean countries: views and practices of researchers

    Science.gov (United States)

    2012-01-01

    Background Limited research exists on researchers' knowledge transfer and exchange (KTE) in the eastern Mediterranean region (EMR). This multi-country study explores researchers' views and experiences regarding the role of health systems and policy research evidence in health policymaking in the EMR, including the factors that influence health policymaking, barriers and facilitators to the use of evidence, and the factors that increase researchers' engagement in KTE. Methods Researchers who published health systems and policy relevant research in 12 countries in the EMR (Bahrain, Egypt, Iran, Jordan, Lebanon, Libya, Morocco, Oman, Palestine, Sudan, Syria, and Yemen) were surveyed. Descriptive analysis and Linear Mixed Regression Models were performed for quantitative sections and the simple thematic analysis approach was used for open-ended questions. Results A total of 238 researchers were asked to complete the survey (response rate 56%). Researchers indicated transferring results to other researchers (67.2%) and policymakers in the government (40.5%). Less than one-quarter stated that they produced policy briefs (14.5%), disseminated messages that specified possible actions (24.4%), interacted with policymakers and stakeholders in priority-setting (16%), and involved them in their research (19.8%). Insufficient policy dialogue opportunities and collaboration between researchers and policymakers and stakeholders (67.9%), practical constraints to implementation (66%), non-receptive policy environment (61.3%), and politically sensitive findings (57.7%) hindered the use of evidence. Factors that increase researchers' engagement in KTE activities in the region were associated with involving policymakers and stakeholders at various stages such as priority-setting exercises and provision of technical assistance. Conclusions Researchers in the EMR recognize the importance of using health systems evidence in health policymaking. Potential strategies to improve the use of

  15. Ethics issues in scientific data and service provision: evidence and challenges for the European Plate Observing System (EPOS)

    Science.gov (United States)

    Cocco, Massimo; Freda, Carmela; Haslinger, Florian; Consortium, Epos

    2016-04-01

    Addressing Ethics issues is nowadays a relevant challenge for any initiative, program or project dealing with scientific data and products provision, access to services for scientific purposes and communication with different stakeholders, including society. This is corroborated by the evidence that Ethics has very high priority in EU funded research. Indeed, all the activities carried out under Horizon 2020 must comply with ethical principles and national, Union and international legislation. This implies that "For all activities funded by the European Union, Ethics is an integral part of research from beginning to end, and ethical compliance is seen as pivotal to achieve real research excellence." Here, we present the experience of EPOS, a public pan-European research infrastructure. EPOS aims at integrating data, data products, services and software (DDSS) for solid Earth science generated and provided by monitoring networks, observing systems and facilities belonging to European countries. EPOS fosters the integrated use of multidisciplinary solid Earth data to improve the understanding of physical and chemical processes controlling earthquakes, volcanic eruptions, tsunamis as well as those driving tectonics and surface dynamics. The EPOS integration plan will make significant contributions to understanding and mitigating geo-hazards, yielding data for hazard assessment, data products for engaging different stakeholders, and services for training, education and communication to society. Numerous national research infrastructures engaged in EPOS are deployed for the monitoring of areas prone to geo-hazards and for the surveillance of the national territory including areas used for exploiting geo-resources. The EPOS community is therefore already trained to provide services to public (civil defence agencies, local and national authorities) and private (petroleum industry, mining industry, geothermal companies, aviation security) stakeholders. Our ability to

  16. A process to establish and use base period prices for national forest system transaction evidence timber appraisal

    Science.gov (United States)

    Richard W. Haynes; Kenneth E. Skog; Richard Aubuchon

    2016-01-01

    The USDA Forest Service is required to appraise timber prior to it being offered for sale. Currently the Forest Service uses a transaction evidence based approach, but concerns have been raised about availability—both in number and applicability—of timber sales used as the basis of this approach. In addition to the problem of few sales, in certain situations a notable...

  17. Comorbidity ascertainment from the ESRD Medical Evidence Report and Medicare claims around dialysis initiation: a comparison using US Renal Data System data.

    Science.gov (United States)

    Krishnan, Mahesh; Weinhandl, Eric D; Jackson, Scott; Gilbertson, David T; Lacson, Eduardo

    2015-11-01

    The end-stage renal disease Medical Evidence Report serves as a source of comorbid condition data for risk adjustment of quality metrics. We sought to compare comorbid condition data in the Medical Evidence Report around dialysis therapy initiation with diagnosis codes in Medicare claims. Observational cohort study using US Renal Data System data. Medicare-enrolled elderly (≥66 years) patients who initiated maintenance dialysis therapy July 1 to December 31, 2007, 2008, or 2009. 12 comorbid conditions ascertained from claims during the 6 months before dialysis therapy initiation, the Medical Evidence Report, and claims during the 3 months after dialysis therapy initiation. None. Comorbid condition prevalence according to claims before dialysis therapy initiation generally exceeded prevalence according to the Medical Evidence Report. The κ statistics for comorbid condition designations other than diabetes ranged from 0.06 to 0.43. Discordance of designations was associated with age, race, sex, and end-stage renal disease Network. During 23,930 patient-years of follow-up from 4 to 12 months after dialysis therapy initiation (8,930 deaths), designations from claims during the 3 months after initiation better discriminated risk of death than designations from the Medical Evidence Report (C statistics of 0.674 vs 0.616). Between the Medical Evidence Report and claims, standardized mortality ratios changed by >10% for more than half the dialysis facilities. Neither the Medical Evidence Report nor diagnosis codes in claims constitute a gold standard of comorbid condition data; results may not apply to nonelderly patients or patients without Medicare coverage. Discordance of comorbid condition designations from the Medical Evidence Report and claims around dialysis therapy initiation was substantial and significantly associated with patient characteristics, including location. These patterns may engender bias in risk-adjusted quality metrics. In lieu of the Medical

  18. Quasi-experimental study designs series-paper 12: strengthening global capacity for evidence synthesis of quasi-experimental health systems research.

    Science.gov (United States)

    Rockers, Peter C; Tugwell, Peter; Grimshaw, Jeremy; Oliver, Sandy; Atun, Rifat; Røttingen, John-Arne; Fretheim, Atle; Ranson, M Kent; Daniels, Karen; Luiza, Vera Lucia; Bärnighausen, Till

    2017-09-01

    Evidence from quasi-experimental studies is often excluded from systematic reviews of health systems research despite the fact that such studies can provide strong causal evidence when well conducted. This article discusses global coordination of efforts to institutionalize the inclusion of causal evidence from quasi-experiments in systematic reviews of health systems research. In particular, we are concerned with identifying opportunities for strengthening capacity at the global and local level for implementing protocols necessary to ensure that reviews that include quasi-experiments are consistently of the highest quality. We first describe the current state of the global infrastructure that facilitates the production of systematic reviews of health systems research. We identify five important types of actors operating within this infrastructure: review authors; synthesis collaborations that facilitate the review process; synthesis interest groups that supplement the work of the larger collaborations; review funders; and end users, including policymakers. Then, we examine opportunities for intervening to build the capacity of each type of actors to support the inclusion of quasi-experiments in reviews. Finally, we suggest practical next steps for proceeding with capacity building efforts. Because of the complexity and relative nascence of the field, we recommend a carefully planned and executed approach to strengthening global capacity for the inclusion of quasi-experimental studies in systematic reviews. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. How to Present Evidence-Based Usability Design Principles Dedicated to Medication-Related Alerting Systems to Designers and Evaluators? Results from a Workshop.

    Science.gov (United States)

    Marcilly, Romaric; Monkman, Helen; Villumsen, Sidsel; Kaufman, David; Beuscart-Zephir, Marie-Catherine

    2016-01-01

    Medication alerting system use errors and lack of adoption are often attributed to usability issues. Previous work has used evidence from the literature to reveal usability principles specific to medication alerting systems and identify potential consequences of violating these principles. The current study sought to explore how best to convey these principles to designers and evaluators of these systems to facilitate their work. To this aim, a workshop with 19 participants was used to generate ideas and opinions on how to deliver these topic-specific design principles in a way that would be most helpful for them. Participants generated ideas for how (e.g., a collaborative, continuously updated forum) and what (e.g., illustrations, checklists, evidence sources and strength, consequences of violations) information is most useful to disseminate usability principles for medication alerting systems. Participants, especially designers, expressed desire to use these principles in practice and avoid previously documented mistakes and therefore make design and evaluation of these systems more effective and efficient. Those insights are discussed in terms of feasibility and logistical challenges to developing the proposed documentation). To move this work forward, a more collaborative approach of Human Factors specialists in medical informatics is necessary.

  20. Cohesive Referencing Errors During Narrative Production as Clinical Evidence of Central Nervous System Abnormality in School-Aged Children With Fetal Alcohol Spectrum Disorders.

    Science.gov (United States)

    Thorne, John C; Coggins, Truman E

    2016-11-01

    Previous evidence suggests that cohesive referencing errors made during narratives may be a behavior that is revealing of underlying central nervous system abnormality in children with fetal alcohol spectrum disorders (FASD). The current research extends this evidence. Retrospective analysis of narrative and clinical data from 152 children (ages 6 to 14), 72 of whom had confirmed FASD, was used. Narrative analysis was conducted blind to diagnostic status, age, or gender. Group performance was compared. The associations between measures of cohesive referencing and clinically gathered indices of the degree of central nervous system abnormality were examined. Results show clear associations between elevated rates of cohesive referencing errors and central nervous system abnormality. Elevated error rates were more common in children with FASD than those without, and prevalence increased predictably across groups with more severe central nervous system abnormality. Risk is particularly elevated for those with microcephaly or a diagnosis of fetal alcohol syndrome. Cohesive referencing errors during narrative are a viable behavioral marker of the kinds of central nervous system abnormality associated with prenatal alcohol exposure, having significant potential to become a valuable diagnostic and research tool.

  1. Protocol for the Quick Clinical study: a randomised controlled trial to assess the impact of an online evidence retrieval system on decision-making in general practice

    Directory of Open Access Journals (Sweden)

    Kidd Michael R

    2006-08-01

    Full Text Available Abstract Background Online information retrieval systems have the potential to improve patient care but there are few comparative studies of the impact of online evidence on clinicians' decision-making behaviour in routine clinical work. Methods/design A randomized controlled parallel design is employed to assess the effectiveness of an online evidence retrieval system, Quick Clinical (QC in improving clinical decision-making processes in general practice. Eligible clinicians are randomised either to receive access or not to receive access to QC in their consulting rooms for 12 months. Participants complete pre- and post trial surveys. Two-hundred general practitioners are recruited. Participants must be registered to practice in Australia, have a computer with Internet access in their consulting room and use electronic prescribing. Clinicians planning to retire or move to another practice within 12 months or participating in any other clinical trial involving electronic extraction of prescriptions data are excluded from the study. The primary end-points for the study is clinician acceptance and use of QC and the resulting change in decision-making behaviour. The study will examine prescribing patterns related to frequently prescribed medications where there has been a recent significant shift in recommendations regarding their use based upon new evidence. Secondary outcome measures include self-reported changes in diagnosis, patient education, prescriptions written, investigations and referrals. Discussion A trial under experimental conditions is an effective way of examining the impact of using QC in routine general practice consultations.

  2. Perspective: NutriGrade: A Scoring System to Assess and Judge the Meta-Evidence of Randomized Controlled Trials and Cohort Studies in Nutrition Research.

    Science.gov (United States)

    Schwingshackl, Lukas; Knüppel, Sven; Schwedhelm, Carolina; Hoffmann, Georg; Missbach, Benjamin; Stelmach-Mardas, Marta; Dietrich, Stefan; Eichelmann, Fabian; Kontopantelis, Evangelos; Iqbal, Khalid; Aleksandrova, Krasimira; Lorkowski, Stefan; Leitzmann, Michael F; Kroke, Anja; Boeing, Heiner

    2016-11-01

    The objective of this study was to develop a scoring system (NutriGrade) to evaluate the quality of evidence of randomized controlled trial (RCT) and cohort study meta-analyses in nutrition research, building upon previous tools and expert recommendations. NutriGrade aims to assess the meta-evidence of an association or effect between different nutrition factors and outcomes, taking into account nutrition research-specific requirements not considered by other tools. In a pretest study, 6 randomly selected meta-analyses investigating diet-disease relations were evaluated with NutriGrade by 5 independent raters. After revision, NutriGrade was applied by the same raters to 30 randomly selected meta-analyses in the same thematic area. The reliability of ratings of NutriGrade items was calculated with the use of a multirater κ, and reliability of the total (summed scores) was calculated with the use of intraclass correlation coefficients (ICCs). The following categories for meta-evidence evaluation were established: high (8-10), moderate (6-7.99), low (4-5.99), and very low (0-3.99). The NutriGrade scoring system (maximum of 10 points) comprises the following items: 1) risk of bias, study quality, and study limitations, 2) precision, 3) heterogeneity, 4) directness, 5) publication bias, 6) funding bias, 7) study design, 8) effect size, and 9) dose-response. The NutriGrade score varied between 2.9 (very low meta-evidence) and 8.8 (high meta-evidence) for meta-analyses of RCTs, and it ranged between 3.1 and 8.8 for meta-analyses of cohort studies. The κ value of the ratings for each scoring item varied from 0.32 (95% CI: 0.22, 0.42) for risk of bias for cohort studies and 0.95 (95% CI: 0.91, 0.99) for study design, with a mean κ of 0.66 (95% CI: 0.53, 0.79). The ICC of the total score was 0.81 (95% CI: 0.69, 0.90). The NutriGrade scoring system showed good agreement and reliability. The initial findings regarding the performance of this newly established scoring system

  3. The stress response and immune system share, borrow, and reconfigure their physiological network elements: Evidence from the insects.

    Science.gov (United States)

    Adamo, Shelley A

    2017-02-01

    The classic biomedical view is that stress hormone effects on the immune system are largely pathological, especially if the stress is chronic. However, more recent interpretations have focused on the potential adaptive function of these effects. This paper examines stress response-immune system interactions from a physiological network perspective, using insects because of their simpler physiology. For example, stress hormones can reduce disease resistance, yet activating an immune response results in the release of stress hormones in both vertebrates and invertebrates. From a network perspective, this phenomenon is consistent with the 'sharing' of the energy-releasing ability of stress hormones by both the stress response and the immune system. Stress-induced immunosuppression is consistent with the stress response 'borrowing' molecular components from the immune system to increase the capacity of stress-relevant physiological processes (i.e. a trade off). The insect stress hormones octopamine and adipokinetic hormone can also 'reconfigure' the immune system to help compensate for the loss of some of the immune system's molecular resources (e.g. apolipophorin III). This view helps explain seemingly maladaptive interactions between the stress response and immune system. The adaptiveness of stress hormone effects on individual immune components may be apparent only from the perspective of the whole organism. These broad principles will apply to both vertebrates and invertebrates. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Evidence-Based Development

    DEFF Research Database (Denmark)

    Hertzum, Morten; Simonsen, Jesper

    2004-01-01

    Systems development is replete with projects that represent substantial resource investments but result in systems that fail to meet users’ needs. Evidence-based development is an emerging idea intended to provide means for managing customer-vendor relationships and working systematically toward...... and electronic patient records for diabetes patients, this paper reports research in progress regarding the prospects and pitfalls of evidence-based development....

  5. Is there a domain-general cognitive structuring system? Evidence from structural priming across music, math, action descriptions, and language.

    Science.gov (United States)

    Van de Cavey, Joris; Hartsuiker, Robert J

    2016-01-01

    Cognitive processing in many domains (e.g., sentence comprehension, music listening, and math solving) requires sequential information to be organized into an integrational structure. There appears to be some overlap in integrational processing across domains, as shown by cross-domain interference effects when for example linguistic and musical stimuli are jointly presented (Koelsch, Gunter, Wittfoth, & Sammler, 2005; Slevc, Rosenberg, & Patel, 2009). These findings support theories of overlapping resources for integrational processing across domains (cfr. SSIRH Patel, 2003; SWM, Kljajevic, 2010). However, there are some limitations to the studies mentioned above, such as the frequent use of unnaturalistic integrational difficulties. In recent years, the idea has risen that evidence for domain-generality in structural processing might also be yielded though priming paradigms (cfr. Scheepers, 2003). The rationale behind this is that integrational processing across domains regularly requires the processing of dependencies across short or long distances in the sequence, involving respectively less or more syntactic working memory resources (cfr. SWM, Kljajevic, 2010), and such processing decisions might persist over time. However, whereas recent studies have shown suggestive priming of integrational structure between language and arithmetics (though often dependent on arithmetic performance, cfr. Scheepers et al., 2011; Scheepers & Sturt, 2014), it remains to be investigated to what extent we can also find evidence for priming in other domains, such as music and action (cfr. SWM, Kljajevic, 2010). Experiment 1a showed structural priming from the processing of musical sequences onto the position in the sentence structure (early or late) to which a relative clause was attached in subsequent sentence completion. Importantly, Experiment 1b showed that a similar structural manipulation based on non-hierarchically ordered color sequences did not yield any priming effect

  6. Nurse staffing and system integration and change indicators in acute care hospitals: evidence from a balanced scorecard.

    Science.gov (United States)

    McGillis Hall, Linda; Peterson, Jessica; Baker, G Ross; Brown, Adalsteinn D; Pink, George H; McKillop, Ian; Daniel, Imtiaz; Pedersen, Cheryl

    2008-01-01

    This study examined relationships between financial indicators for nurse staffing and organizational system integration and change indicators. These indicators, along with hospital location and type, were examined in relation to the nursing financial indicators. Results showed that different indicators predicted each of the outcome variables. Nursing care hours were predicted by the hospital type, geographic location, and the system. Both nursing and patient care hours were significantly related to dissemination and benchmarking of clinical data.

  7. The Effect of E-commerce on Malaysian Tax System: an Empirical Evidence From Academicians and Malaysian Tax Practitioners

    OpenAIRE

    Palil, Mohd Rizal

    2004-01-01

    The explosion of information technology (IT) nowadays has created new phenomena in shopping activities. Consumers can easily buy products via Internet. Within a minute, the products will be delivered instantly and accurately. This scenario is known as e-commerce. The emergence of e-commerce affects consumers' shopping behavior as well as taxation system. The objective of this research is to reveal the effects of e-commerce upon Malaysian taxation system by emphasizing in scope of charge 'deri...

  8. Evidence for phenotypic plasticity in aggressive triple-negative breast cancer: human biology is recapitulated by a novel model system.

    Directory of Open Access Journals (Sweden)

    Nicholas C D'Amato

    Full Text Available Breast cancers with a basal-like gene signature are primarily triple-negative, frequently metastatic, and carry a poor prognosis. Basal-like breast cancers are enriched for markers of breast cancer stem cells as well as markers of epithelial-mesenchymal transition (EMT. While EMT is generally thought to be important in the process of metastasis, in vivo evidence of EMT in human disease remains rare. Here we report a novel model of human triple-negative breast cancer, the DKAT cell line, which was isolated from an aggressive, treatment-resistant triple-negative breast cancer that demonstrated morphological and biochemical evidence suggestive of phenotypic plasticity in the patient. The DKAT cell line displays a basal-like phenotype in vitro when cultured in serum-free media, and undergoes phenotypic changes consistent with EMT/MET in response to serum-containing media, a unique property among the breast cancer cell lines we tested. This EMT is marked by increased expression of the transcription factor Zeb1, and Zeb1 is required for the enhanced migratory ability of DKAT cells in the mesenchymal state. DKAT cells also express progenitor-cell markers, and single DKAT cells are able to generate tumorspheres containing both epithelial and mesenchymal cell types. In vivo, as few as ten DKAT cells are capable of forming xenograft tumors which display a range of epithelial and mesenchymal phenotypes. The DKAT model provides a novel model to study the molecular mechanisms regulating phenotypic plasticity and the aggressive biology of triple-negative breast cancers.

  9. The Relationship Between the Use of Complementary and Alternative Medicine and the Use of Biomedical Services: Evidence From East Asian Medical Systems.

    Science.gov (United States)

    Shim, Jae-Mahn

    2016-01-01

    To provide East Asian evidence to the relationship between the use of complementary and alternative medicine (CAM) and the use of biomedicine, this article examines the institutionalization of traditional East Asian medicine (EM) in China, Korea, and Japan and how it affects the relationship between EM use and biomedicine use. It uses the 2010 East Asian Social Survey. Logistic regressions specify the statistical association between EM use and biomedical physician visits. These models show that the high institutional acceptance of EM promotes the concurrent use of EM and biomedicine. In addition, since these countries feature different ways of institutionalizing EM (unification in China, equalization in Korea, and subjugation in Japan), the concurrent use is more obvious under the Chinese and the Korean system than the Japanese system. It concludes that the CAM use can be complementary to biomedicine, depending on how CAM and biomedicine are institutionalized in medical systems. © 2015 APJPH.

  10. Barriers, facilitators and views about next steps to implementing supports for evidence-informed decision-making in health systems: a qualitative study.

    Science.gov (United States)

    Ellen, Moriah E; Léon, Grégory; Bouchard, Gisèle; Ouimet, Mathieu; Grimshaw, Jeremy M; Lavis, John N

    2014-12-05

    Mobilizing research evidence for daily decision-making is challenging for health system decision-makers. In a previous qualitative paper, we showed the current mix of supports that Canadian health-care organizations have in place and the ones that are perceived to be helpful to facilitate the use of research evidence in health system decision-making. Factors influencing the implementation of such supports remain poorly described in the literature. Identifying the barriers to and facilitators of different interventions is essential for implementation of effective, context-specific, supports for evidence-informed decision-making (EIDM) in health systems. The purpose of this study was to identify (a) barriers and facilitators to implementing supports for EIDM in Canadian health-care organizations, (b) views about emerging development of supports for EIDM, and (c) views about the priorities to bridge the gaps in the current mix of supports that these organizations have in place. This qualitative study was conducted in three types of health-care organizations (regional health authorities, hospitals, and primary care practices) in two Canadian provinces (Ontario and Quebec). Fifty-seven in-depth semi-structured telephone interviews were conducted with senior managers, library managers, and knowledge brokers from health-care organizations that have already undertaken strategic initiatives in knowledge translation. The interviews were taped, transcribed, and then analyzed thematically using NVivo 9 qualitative data analysis software. Limited resources (i.e., money or staff), time constraints, and negative attitudes (or resistance) toward change were the most frequently identified barriers to implementing supports for EIDM. Genuine interest from health system decision-makers, notably their willingness to invest money and resources and to create a knowledge translation culture over time in health-care organizations, was the most frequently identified facilitator to

  11. Use of health systems and policy research evidence in the health policymaking in eastern Mediterranean countries: views and practices of researchers.

    Science.gov (United States)

    El-Jardali, Fadi; Lavis, John N; Ataya, Nour; Jamal, Diana

    2012-01-11

    Limited research exists on researchers' knowledge transfer and exchange (KTE) in the eastern Mediterranean region (EMR). This multi-country study explores researchers' views and experiences regarding the role of health systems and policy research evidence in health policymaking in the EMR, including the factors that influence health policymaking, barriers and facilitators to the use of evidence, and the factors that increase researchers' engagement in KTE. Researchers who published health systems and policy relevant research in 12 countries in the EMR (Bahrain, Egypt, Iran, Jordan, Lebanon, Libya, Morocco, Oman, Palestine, Sudan, Syria, and Yemen) were surveyed. Descriptive analysis and Linear Mixed Regression Models were performed for quantitative sections and the simple thematic analysis approach was used for open-ended questions. A total of 238 researchers were asked to complete the survey (response rate 56%). Researchers indicated transferring results to other researchers (67.2%) and policymakers in the government (40.5%). Less than one-quarter stated that they produced policy briefs (14.5%), disseminated messages that specified possible actions (24.4%), interacted with policymakers and stakeholders in priority-setting (16%), and involved them in their research (19.8%). Insufficient policy dialogue opportunities and collaboration between researchers and policymakers and stakeholders (67.9%), practical constraints to implementation (66%), non-receptive policy environment (61.3%), and politically sensitive findings (57.7%) hindered the use of evidence. Factors that increase researchers' engagement in KTE activities in the region were associated with involving policymakers and stakeholders at various stages such as priority-setting exercises and provision of technical assistance. Researchers in the EMR recognize the importance of using health systems evidence in health policymaking. Potential strategies to improve the use of research evidence emphasize two

  12. A Universal Velocity Dispersion Profile for Pressure Supported Systems: Evidence for MONDian Gravity across Seven Orders of Magnitude in Mass

    Energy Technology Data Exchange (ETDEWEB)

    Durazo, R.; Hernandez, X.; Sánchez, S. F. [Instituto de Astronomía, Universidad Nacional Autónoma de México, Apartado Postal 70-264 C.P. 04510 México D.F., México (Mexico); Sodi, B. Cervantes [Instituto de Radioastronomía y Astrofísica, Universidad Nacional Autónoma de México, Campus Morelia, A.P. 3-72, C.P. 58089 Michoacán, México (Mexico)

    2017-03-10

    For any MONDian extended theory of gravity where the rotation curves of spiral galaxies are explained through a change in physics rather than the hypothesis of dark matter, a generic dynamical behavior is expected for pressure supported systems: an outer flattening of the velocity dispersion profile occurring at a characteristic radius, where both the amplitude of this flat velocity dispersion and the radius at which it appears are predicted to show distinct scalings with the total mass of the system. By carefully analyzing the dynamics of globular clusters and elliptical galaxies, we are able to significantly extend the astronomical diversity of objects in which MONDian gravity has been tested, from spiral galaxies to the much larger mass range covered by pressure supported systems. We show that a universal projected velocity dispersion profile accurately describes various classes of pressure supported systems, and further, that the expectations of extended gravity are met across seven orders of magnitude in mass. These observed scalings are not expected under dark matter cosmology, and would require particular explanations tuned at the scales of each distinct astrophysical system.

  13. System barriers to the evidence-based care of acute coronary syndrome patients in China: qualitative analysis.

    Science.gov (United States)

    Ranasinghe, Isuru; Rong, Ye; Du, Xin; Wang, Yangfang; Gao, Runlin; Patel, Anushka; Wu, Yangfeng; Iedema, Rick; Hao, Zhixin; Hu, Dayi; Turnbull, Fiona

    2014-03-01

    Organizational and wider health system factors influence the implementation and success of interventions. Clinical Pathways in Acute Coronary Syndromes 2 is a cluster randomized trial of a clinical pathway-based intervention to improve acute coronary syndrome care in hospitals in China. We performed a qualitative evaluation to examine the system-level barriers to implementing clinical pathways in the dynamic healthcare environment of China. A qualitative descriptive analysis of 40 in-depth interviews with health professionals conducted in a sample of 10 hospitals purposively selected to explore barriers to implementation of the intervention. Qualitative data were analyzed using the Framework method. In-depth interviews identified 5 key system-level barriers to effective implementation: (1) leadership support for implementing quality improvement, (2) variation in the capacity of clinical services and quality improvement resources, (3) fears of patient disputes and litigation, (4) healthcare funding constraints and high out-of-pocket expenses, and (5) patient-related factors. System-level barriers affect the ability of acute coronary syndrome clinical pathways to change practice. Addressing these barriers in the context of current and planned national health system reform will be critical for future improvements in the management of acute coronary syndromes, and potentially other hospitalized conditions, in China. Clinical Trial Registration- URL: http://www.anzctr.org.au/default.aspx. Register. Unique identifier: ACTRN12609000491268.

  14. The Impact of Supervisory Board Composition on CSR Reporting. Evidence from the German Two-Tier System

    Directory of Open Access Journals (Sweden)

    Dominik Dienes

    2016-01-01

    Full Text Available Corporate social responsibility (CSR reporting is becoming increasingly relevant in light of modern corporate governance. There is growing activity among empirical research in one-tier systems that considers the link between board composition and CSR reporting. This study is the first of its kind on the German two-tier system with special regard for the supervisory board. We analyze gender diversity, expertise, the presence of former managers, frequency of meetings, and the size of the supervisory board. Our multiple regressions indicate that gender diversity has a positive impact on CSR disclosure intensity, which is in line with prior studies on one-tier systems. Our findings have implications for both users and public policy and suggest that current European corporate governance regulations could help to increase the decision usefulness of CSR reporting.

  15. Joint impact of ERP systems and non financial performance indicators on corporate financial performance: Evidence from French listed companies

    Directory of Open Access Journals (Sweden)

    Ahmed Kouki

    2015-01-01

    Full Text Available This paper aims to examine the joint impact of Enterprise Resource Planning systems (ERP systems and Non Financial Performance Indicators (NFPI on corporate financial performance. Our study is based on a comparative analysis between firms that adopt ERP only, firms that use NFPI only and firms that combining both strategies (ERP and NFPI during the period from 2001 to 2006.The implementation process remains highly uncertain. In fact, the use of Non Financial performance indicators is an important determinant of corporate financial performance. At the operational level, combining ERP systems with NFPI reflects a long-term business strategy to improve business process. In summary, the ERP and NFPI literatures demonstrate the vital importance of aligning business process, information technologies and key performance indicators with the strategic objectives of the firm. Results support the hypothesis in which firms that combining ERP and NFPI have significantly higher ROA than either ERP-only or NFPI-only firms.

  16. Shelf sedimentation off the Ganges-Brahmaputra river system: Evidence for sediment bypassing to the Bengal fan

    Science.gov (United States)

    Kuehl, Steven A.; Hariu, Tina M.; Moore, Willard S.

    1989-12-01

    The nature of shelf sedimentation seaward of the world's largest sediment dispersal system is examined by using sedimentological and geochronological techniques on a unique suite of sediment cores and grab samples. Sediments from the Ganges-Brahmaputra river system are currently accumulating on the shelf in water depths of less than about 80 m, forming a clinoform-like deposit similar to subaqueous deltas found off other major river systems. The highest sediment accumulation rates on the shelf occur near the head of the Swatch of No Ground, a major submarine canyon that indents the shelf west of the present river mouths. This observation, together with textural data, suggests that river sediments are transported seaward and westward and that the Swatch of No Ground is currently a major conduit for the transport of sediments from the Bengal shelf.

  17. Patient and provider perspectives on quality and health system effectiveness in a transition economy: evidence from Ukraine.

    Science.gov (United States)

    Luck, J; Peabody, J W; DeMaria, L M; Alvarado, C S; Menon, R

    2014-08-01

    Facing a severe population health crisis due to noncommunicable diseases, Ukraine and other former Soviet republics and Eastern European countries have a pressing need for more effective health systems. Policies to enhance health system effectiveness should consider the perspectives of different stakeholder groups, including providers as well as patients. In addition, policies that directly target the quality of clinical care should be based on objective performance measures. In 2009 and 2010 we conducted a coordinated series of household and facility-level surveys to capture the perspectives of Ukrainian household members, outpatient clinic patients, and physicians regarding the country's health system overall, as well as the quality, access, and affordability of health care. We objectively measured the quality of care for heart failure and chronic obstructive pulmonary disease using CPV(®) vignettes. There was broad agreement among household respondents (79%) and physicians (95%) that Ukraine's health system should be reformed. CPV(®) results indicate that the quality of care for common noncommunicable diseases is poor in all regions of the country and in hospitals as well as polyclinics. However, perspectives about the quality of care differ, with household respondents seeing quality as a serious concern, clinic patients having more positive perceptions, and physicians not viewing quality as a reform priority. All stakeholder groups viewed affordability as a problem. These findings have several implications for policies to enhance health system effectiveness. The shared desire for health system reform among all stakeholder groups provides a basis for action in Ukraine. Improving quality, strengthening primary care, and enhancing affordability should be major goals of new health policies. Policies to improve quality directly, such as pay-for-performance, would be mutually reinforcing with purchasing reforms such as transparent payment mechanisms. Such policies

  18. Development of electronic document management system for scientific and technical design administration automation (evidence from European Organization for Nuclear Research)

    International Nuclear Information System (INIS)

    Titov, R.N.

    2011-01-01

    The new principles and methods of electronic document management system construction are developed. The software package for electronic document handling is made, it provides automation of work flow management and permits to trace and correct on-line the flow of documents. The formal models of electronic documents describing complex hierarchic structures of data with the use of XML-trees are considered. On the base of investigations conducted the CERN electronic document management system has been upgraded, it allowed to shorten more than twofold the time for automation of new business processes [ru

  19. Integration of an Evidence Base into a Probabilistic Risk Assessment Model. The Integrated Medical Model Database: An Organized Evidence Base for Assessing In-Flight Crew Health Risk and System Design

    Science.gov (United States)

    Saile, Lynn; Lopez, Vilma; Bickham, Grandin; FreiredeCarvalho, Mary; Kerstman, Eric; Byrne, Vicky; Butler, Douglas; Myers, Jerry; Walton, Marlei

    2011-01-01

    This slide presentation reviews the Integrated Medical Model (IMM) database, which is an organized evidence base for assessing in-flight crew health risk. The database is a relational database accessible to many people. The database quantifies the model inputs by a ranking based on the highest value of the data as Level of Evidence (LOE) and the quality of evidence (QOE) score that provides an assessment of the evidence base for each medical condition. The IMM evidence base has already been able to provide invaluable information for designers, and for other uses.

  20. Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries.

    Science.gov (United States)

    Seidman, Gabriel; Atun, Rifat

    2017-04-13

    Task shifting has become an increasingly popular way to increase access to health services, especially in low-resource settings. Research has demonstrated that task shifting, including the use of community health workers (CHWs) to deliver care, can improve population health. This systematic review investigates whether task shifting in low-income and middle-income countries (LMICs) results in efficiency improvements by achieving cost savings. Using the PRISMA guidelines for systematic reviews, we searched PubMed, Embase, CINAHL, and the Health Economic Evaluation Database on March 22, 2016. We included any original peer-review articles that demonstrated cost impact of a task shifting program in an LMIC. We identified 794 articles, of which 34 were included in our study. We found that substantial evidence exists for achieving cost savings and efficiency improvements from task shifting activities related to tuberculosis and HIV/AIDS, and additional evidence exists for the potential to achieve cost savings from activities related to malaria, NCDs, NTDs, childhood illness, and other disease areas, especially at the primary health care and community levels. Task shifting presents a viable option for health system cost savings in LMICs. Going forward, program planners should carefully consider whether task shifting can improve population health and health systems efficiency in their countries, and researchers should investigate whether task shifting can also achieve cost savings for activities related to emerging global health priorities and health systems strengthening activities such as supply chain management or monitoring and evaluation.

  1. Evidence of the St. Clair-Detroit River system as a dispersal corridor and nursery habitat for transient larval burbot

    Science.gov (United States)

    McCullough, Darrin E.; Roseman, Edward F.; Keeler, Kevin M.; DeBruyne, Robin L.; Pritt, Jeremy J.; Thompson, Patricia A.; Ireland, Stacey A.; Ross, Jason E.; Bowser, Dustin; Hunter, Robert D.; Castle, Dana Kristina; Fischer, Jason; Provo, Stacy A.

    2015-01-01

    Burbot Lota lota are distributed across the Laurentian Great Lakes where they occupy a top piscivore role. The St. Clair-Detroit River System is known to provide a migration corridor as well as spawning and nursery habitat for many indigenous fishes of economic and ecological significance. However, knowledge is scant of the early life history of burbot and the importance of this system in their dispersal, survival, and recruitment. In order to assess the role of the St. Clair-Detroit River System to burbot ecology, we collected larval burbot during ichthyoplankton surveys in this system from 2010 to 2013 as part of a habitat restoration monitoring program. More and larger burbot larvae were found in the St. Clair River than in the lower Detroit River, although this may be due to differences in sampling methods between the two rivers. Consistent with existing studies, larval burbot exhibited ontogenesis with a distinct transition from a pelagic zooplankton-based diet to a benthic macroinvertebrate-based diet. Our results demonstrate that the St. Clair-Detroit Rivers provide food resources, required habitat, and a migration conduit between the upper and lower Great Lakes, but the contribution of these fish to the lower lakes requires further examination.

  2. TAP Research Summary: Examining the Evidence and Impact of "TAP: The System for Teacher and Student Advancement"

    Science.gov (United States)

    Barnett, J. H.; Rinthapol, N.; Hudgens, T.

    2014-01-01

    Researchers at NIET and elsewhere have studied the effectiveness of "TAP: The System for Teacher and Student Advancement" (TAP) in raising student achievement, improving the quality of instruction and increasing the ability of high-need schools to recruit, retain and support effective teachers. This document describes some of the most…

  3. Silica Debris Star Systems — Spitzer Evidence for Lunar Formation Events & Crustal Stripping or Magma Oceans & Late Heavy Bombardments?

    Science.gov (United States)

    Lisse, C. M.; Chen, C. H.; Wyatt, M. C.; Morlok, A.; Thebault, P.; Orton, G. S.; Fletcher, L. N.; Fujiwara, H.; Bridges, J. C.; Elkins-Tanton, L. T.; Gaidos, E. J.; Trang, D.

    2010-03-01

    Recent work (Lisse et al., 2009) has detected amorphous silica and SiO gas around 12-m.y.-old HD172555, at the right age to form rocky planets. Here we discuss the location, lifetime, and source of the material, using inferences gleaned from HD172555 and three new silica systems.

  4. Local or systemic treatment for New World cutaneous leishmaniasis? Re-evaluating the evidence for the risk of mucosal leishmaniasis

    NARCIS (Netherlands)

    Blum, Johannes; Lockwood, Diana N. J.; Visser, Leo; Harms, Gundel; Bailey, Mark S.; Caumes, Eric; Clerinx, Jan; van Thiel, Pieter P. A. M.; Morizot, Gloria; Hatz, Christoph; Buffet, Pierre

    2012-01-01

    This review addresses the question of whether the risk of developing mucosal leishmaniasis (ML) warrants systemic treatment in all patients with New World cutaneous leishmaniasis (CL) or whether local treatment might be an acceptable alternative. The risk of patients with New World CL developing ML

  5. National systems of innovation: determinants and industrial policy measures, empirical evidence for OECD; Sistemas nacionales de innovacion: determinantes y acciones de politica industrial. Evidencia empirica para la OCDE

    Energy Technology Data Exchange (ETDEWEB)

    Hervas, J. L.; Rojas, R.; Sempere, F.; Albors, J.

    2012-11-01

    The paper presents an attempt to tackle the main gaps in the national innovation systems (NIS) literature: the problem specifying the boundaries of the NIS and the lack of connection between theory and empirics. For this purpose, the paper uses 55 countries as sample and constructs an NIS index based on a factor analysis of 28 variables. Empirical evidence shows that a firm's strategies, technology infrastructure, government governance, education and linkages are the main components of the NIS. The implications are important for policy-makers and the academia. (Author) 49 refs.

  6. A Longitudinal Study of State Strategies and Policies to Accelerate Evidence-Based Practices in the Context of Systems Transformation

    Science.gov (United States)

    Rieckmann, Traci; Abraham, Amanda; Zwick, Janet; Rasplica, Caitlin; McCarty, Dennis

    2015-01-01

    Objective To profile state agency efforts to promote implementation of three evidence-based practices (EBPs): screening and brief intervention (SBIRT), psychosocial interventions, and medication-assisted treatment (MAT). Data Sources/Study Setting Primary data collected from representatives of 50 states and the District of Columbia’s Single State Authorities from 2007 to 2009. Study Design/Data Collection The study used mixed methods, in-depth, semistructured interviews and quantitative surveys. Interviews assessed state and provider strategies to accelerate implementation of EBPs. Principal Findings Statewide implementation of psychosocial interventions and MAT increased significantly over 3 years. In the first two assessments, states that contracted directly with providers were more likely to link use of EBPs to reimbursement, and states with indirect contract, through counties and other entities, increased recommendations, and some requirements for provision of specific EBPs. The number of states using legislation as a policy lever to promote EBPs was unchanged. Conclusions Health care reform and implementation of parity in coverage increases access to treatment for alcohol and drug use. Science-based substance abuse treatment will become even more crucial as payers seek consistent quality of care. This study provides baseline data on service delivery, contracting, and financing as state agencies and treatment providers prepare for implementation of the Affordable Care Act. PMID:25532616

  7. Further evidence for the absence of a hypoxic fraction in the 9L rat tumour multicellular spheroid system

    International Nuclear Information System (INIS)

    Gutin, P.H.; Barcellos, M.H.; Shrieve, D.C.; Sano, Y.; Bernstein, M.; Deen, D.F.

    1982-01-01

    The 9L gliosarcoma is an N-methylnitrosourea-induced rat brain tumour that has served as a predictive model for the efficacy of various chemotherapeutic agents against human brain tumours. Because it is one of two known animal tumour models that has no hypoxic fraction, the 9L model is of questionable value for the study of the radiobiology of hypoxic cell sensitizers. Hypoxic 9L monolayer cells are sensitive to misonidazole, as shown by the abrupt decrease in survival after a 2-4 h radiation exposure. However, when 9L spheroids in the size ranges of 200-300, 300-400, 500-600 and 1027+-33μm were incubated in euoxic spinner culture for up to 96 h in 1.5 or 3.0 mM misonidazole, there was no effect on the survival of the dissociated cells over a dose range 0-20 Gy. It is concluded that, in view of the demonstrated sensitivity to misonidazole of hypoxic 9L cells in monolayer culture, this finding provides further evidence that there are no hypoxic cells even in large 9L spheroids with a histologically distinct zone of central necrosis. Moreover, 9L spheroids irradiated in the presence of 3.0 mM misonidazole showed no dose enhancement. (U.K.)

  8. A Longitudinal Study of State Strategies and Policies to Accelerate Evidence-Based Practices in the Context of Systems Transformation.

    Science.gov (United States)

    Rieckmann, Traci; Abraham, Amanda; Zwick, Janet; Rasplica, Caitlin; McCarty, Dennis

    2015-08-01

    To profile state agency efforts to promote implementation of three evidence-based practices (EBPs): screening and brief intervention (SBIRT), psychosocial interventions, and medication-assisted treatment (MAT). Primary data collected from representatives of 50 states and the District of Columbia's Single State Authorities from 2007 to 2009. The study used mixed methods, in-depth, semistructured interviews and quantitative surveys. Interviews assessed state and provider strategies to accelerate implementation of EBPs. Statewide implementation of psychosocial interventions and MAT increased significantly over 3 years. In the first two assessments, states that contracted directly with providers were more likely to link use of EBPs to reimbursement, and states with indirect contract, through counties and other entities, increased recommendations, and some requirements for provision of specific EBPs. The number of states using legislation as a policy lever to promote EBPs was unchanged. Health care reform and implementation of parity in coverage increases access to treatment for alcohol and drug use. Science-based substance abuse treatment will become even more crucial as payers seek consistent quality of care. This study provides baseline data on service delivery, contracting, and financing as state agencies and treatment providers prepare for implementation of the Affordable Care Act. © Health Research and Educational Trust.

  9. Palaeoclimatic controls on hydrological systems: Evidence from U-Th dated calcite veins in the Fennoscandian and Canadian shields

    International Nuclear Information System (INIS)

    McDermott, F.; Frape, S.K.; Hawkesworth, C.J.

    1996-01-01

    The purpose of this paper is to present mass spectrometric U-Th age data for eleven weak acid leachates of calcite bearing fracture fillings from threes sites on the Fennoscandian and Canadian shields (Stripa, Sweden; the Underground Research Laboratory, Canada, and Olkiluoto, Finland). These age data define a bimodal distribution with ranges of 84-90 ka and 173-203 ka. In detail, four leachates from the Group I fractures at Stripa yield an age of 87.2 ± 3.2 ka, and three from open fractures (Group III) yield ages in the range 178 ± 8 to 201 ± 6 ka. The latter age range is identical to that defined by samples from the Canadian site (202.8 ± +6.4 -6.0 ka). Taken together, these ages coincide with the end of the interglacials of the marine oxygen isotope stages V and VII, and are interpreted as reflecting the shutoff of meteoric recharge due to the onset of permafrost at these high latitudes. Five leachates from another group of closed, fluorite bearing fractures at Stripa (Group II) are close to secular equilibrium but show evidence for U uptake during the last 1 Ma. (author). 29 refs, 3 figs, 1 tab

  10. Enhancing Sustainability of Cotton Production Systems in West Africa: A Summary of Empirical Evidence from Burkina Faso

    Directory of Open Access Journals (Sweden)

    Jeffrey Vitale

    2011-07-01

    Full Text Available Africa has been hesitant to adopt agricultural biotechnology, lagging behind global trends over the past decade. One exception is Burkina Faso, a West African country that commercially released 125,000 ha of Bt cotton in 2009. Bt cotton may serve as a working example of how African countries can enhance sustainability using modern, science-driven technology to increase production levels while reducing input use and energy consumption. This paper reports the potential impact that Bt cotton can have on sustainability in Burkina Faso’s cotton sector based by summarizing empirical evidence from previously published studies. Based on the summary of published data collected from six years of field trials and producer surveys, Bt cotton increased cotton yields by an average of 21.3% and raised income by $106.14 per ha. Using an energy balance model, the introduction of Bt cotton would also result in a 6.6% saving in energy use. The significant increase in productivity and economic returns could be the catalyst for Burkina Faso, and other African countries, to emerge from the decade or so of stagnation and regain their competitive stance in world cotton markets while providing environmental and social benefits.

  11. VALUE-BASED EVIDENCES TO FACE THE NEW CHALLENGES OF HEALTH PROMOTION IN A SUSTAINABLE HEALTHCARE SYSTEM.

    Directory of Open Access Journals (Sweden)

    Claudia Marotta

    2017-10-01

    Full Text Available Thirty years ago, starting from a new awareness of the limits of biomedical power and healthcare services to solve all population’ health problems, the Ottawa Conference coined a New Public Health by defining Health Promotion (HP as “the process of enabling people to increase control over and to improve their health and well-being”. Since then and over the next 30 years, several programs have been developed all over the world to translate HP concepts into practical actions and many health successes have been achieved as well. Nowadays, even if the global health context has strongly changed, the original principles of HP still provide a solid ground for action, being the community engagement and empowerment of women and men still at the heart of any health strategy, in a shared responsibility of all society’s sectors approach. However, since now HP promotion efforts have been directed toward priority health problems in a issue- settings-based approach, but in a sustainable and ethical prospective this will be not enough now: a deeper attention on effectiveness is request and an evidence- and value-based HP approach is needed to support the Public Health community and the policy-making, including the new challenges related to Public Health Genomics.

  12. Correlation between Systemic Arterial Hypertension and Bone Morphogenetic Protein-2 in Central Obese Non-Diabetic Men with Evidence of Coronary Artery Calcification

    Directory of Open Access Journals (Sweden)

    Antonia Anna Lukito

    2011-12-01

    Full Text Available BACKGROUND: Previous studies have confirmed separately the relationship between obesity, insulin-resistance, hypertension and bone morphogenetic protein-2 (BMP-2 with coronary artery calcification, a parameter of subclinical atherosclerosis. It was also reported that BMPs may function as proinflammatory, prohypertensive and proatherogenic mediators. The study aimed to assess the correlation between systemic hypertension and BMP-2 plasma concentration in central-obese non-diabetic men with evidence of coronary artery calcification. METHODS: This was a cross sectional study on 60 central-obese non-diabetic men, of an average age of 55.2 years, with evidence of coronary calcification, who came for health check-up and met the inclusion criteria consecutively as defined by waist circumference >90 cm and fasting blood glucose <126 mg/dL. Coronary calcification was defined by coronary artery calcium (CAC score ≥10 Agatson-unit Dual Source 64 slice CT scan. RESULTS: There is positive correlation between hypertension and BMP-2 in central-obese non-diabetic men with evidence of coronary artery calcification. BMP-2 plasma concentration was higher in the hypertensive subjects. The correlation was stronger in younger (<55 years old subjects and subjects with insulin-resitance. KEYWORDS: hypertension, BMP-2, coronary calcification, central obesity, age, insulin resistance.

  13. The Impact of Urban Transit Systems on Property Values: A Model and Some Evidences from the City of Naples

    Directory of Open Access Journals (Sweden)

    Mariano Gallo

    2018-01-01

    Full Text Available A hedonic model for estimating the effects of transit systems on real estate values is specified and calibrated for the city of Naples. The model is used to estimate the external benefits concerning property values which may be attributed to the Naples metro at the present time and in two future scenarios. The results show that only high-frequency metro lines have appreciable effects on real estate values, while low-frequency metro lines and bus lines produce no significant impacts. Our results show that the impacts on real estate values of the metro system in Naples are significant, with corresponding external benefits estimated at about 7.2 billion euros or about 8.5% of the total value of real estate assets.

  14. Assessing organizational culture in complex sociotechnical systems. Methodological evidence from studies in nuclear power plant maintenance organizations

    International Nuclear Information System (INIS)

    Reiman, T.

    2007-03-01

    Failures in industrial organizations dealing with hazardous technologies can have widespread consequences for the safety of the workers and the general population. Psychology can have a major role in contributing to the safe and reliable operation of these technologies. Most current models of safety management in complex sociotechnical systems such as nuclear power plant maintenance are either non-contextual or based on an overly-rational image of an organization. Thus, they fail to grasp either the actual requirements of the work or the socially-constructed nature of the work in question. The general aim of the present study is to develop and test a methodology for contextual assessment of organizational culture in complex sociotechnical systems. This is done by demonstrating the findings that the application of the emerging methodology produces in the domain of maintenance of a nuclear power plant (NPP). The concepts of organizational culture and organizational core task (OCT) are operationalized and tested in the case studies

  15. Immaterial Evidence

    Directory of Open Access Journals (Sweden)

    Ivanov N. A.

    2012-11-01

    Full Text Available It is substantiated in the article that some of the objects which either could serve as instruments of a crime for criminal actions, or they were obtained through the commission of a crime, are immaterial objects, and they may be conditionally designated as evidence. The author relates to immaterial evidence physical fields, radiation, undocumented information, computer programs, property rights, intangible benefits, heat and electric power, and information processes.

  16. What Drives the Formation of Technological Cooperation Between University and Industry in Less-Developed Innovation Systems? Evidence From Brazil

    OpenAIRE

    L. de Araújo Burcharth, Ana Luiza

    2011-01-01

    Interorganisational patterns of collaboration have long been recognised in the literature for their potential to promote learning and innovative capabilities, in particular those encompassing university and industry interactions. Yet they are scarcely found in underdeveloped Innovation Systems such as the Brazilian one and little is known about why or how they are established. Drawing upon a comparative case study, this paper investigates in which context technological cooperation between uni...

  17. Evidence of bottom-up limitations in nearshore marine systems based on otolith proxies of fish growth

    Science.gov (United States)

    von Biela, Vanessa R.; Kruse, Gordon H.; Mueter, Franz J.; Black, Bryan A.; Douglas, David C.; Helser, Thomas E.; Zimmerman, Christian E.

    2015-01-01

    Fish otolith growth increments were used as indices of annual production at nine nearshore sites within the Alaska Coastal Current (downwelling region) and California Current (upwelling region) systems (~36–60°N). Black rockfish (Sebastes melanops) and kelp greenling (Hexagrammos decagrammus) were identified as useful indicators in pelagic and benthic nearshore food webs, respectively. To examine the support for bottom-up limitations, common oceanographic indices of production [sea surface temperature (SST), upwelling, and chlorophyll-a concentration] during summer (April–September) were compared to spatial and temporal differences in fish growth using linear mixed models. The relationship between pelagic black rockfish growth and SST was positive in the cooler Alaska Coastal Current and negative in the warmer California Current. These contrasting growth responses to SST among current systems are consistent with the optimal stability window hypothesis in which pelagic production is maximized at intermediate levels of water column stability. Increased growth rates of black rockfish were associated with higher chlorophyll concentrations in the California Current only, but black rockfish growth was unrelated to the upwelling index in either current system. Benthic kelp greenling growth rates were positively associated with warmer temperatures and relaxation of downwelling (upwelling index near zero) in the Alaska Coastal Current, while none of the oceanographic indices were related to their growth in the California Current. Overall, our results are consistent with bottom-up forcing of nearshore marine ecosystems—light and nutrients constrain primary production in pelagic food webs, and temperature constrains benthic food webs.

  18. Pyruvate kinase M2 overexpression and poor prognosis in solid tumors of digestive system: evidence from 16 cohort studies.

    Science.gov (United States)

    Wu, Jiayuan; Hu, Liren; Chen, Manyu; Cao, Wenjun; Chen, Haicong; He, Taiping

    2016-01-01

    The expression of pyruvate kinase M2 (PKM2) has been linked to tumor formation and invasion. Specifically, the relationship between high PKM2 expression and prognosis has been evaluated in solid tumors of digestive system. However, the prognostic value of PKM2 remains controversial. A literature search of PubMed, Embase, and Cochrane databases was conducted until October 2015. The end point focused on overall survival (OS). The pooled hazard ratio (HR) or odds ratio and the 95% confidence intervals were calculated to correlate PKM2 overexpression with OS and clinicopathological characteristics by employing fixed- or random-effects models, depending on the heterogeneity of the included studies. We identified 18 cohorts in 16 studies involving 2,812 patients for this meta-analysis. Overall, the combined HR for OS in all tumor types was 1.74 (1.44-2.11; Pdigestive system, thereby suggesting that PKM2 might be an indicator of poor prognosis in digestive system cancers.

  19. Digital evidence

    Directory of Open Access Journals (Sweden)

    Lukić Tatjana

    2012-01-01

    Full Text Available Although computer makes human activities faster and easier, innovating and creating new forms of work and other kinds of activities, it also influenced the criminal activity. The development of information technology directly affects the development of computer forensics without which, it can not even imagine the discovering and proving the computer offences and apprehending the perpetrator. Information technology and computer forensic allows us to detect and prove the crimes committed by computer and capture the perpetrators. Computer forensics is a type of forensics which can be defined as a process of collecting, preserving, analyzing and presenting digital evidence in court proceedings. Bearing in mind, that combat against crime, in which computers appear as an asset or object of the offense, requires knowledge of digital evidence as well as specific rules and procedures, the author in this article specifically addresses the issues of digital evidence, forensic (computer investigation, specific rules and procedures for detecting, fixing and collecting digital evidence and use of this type of evidence in criminal proceedings. The author also delas with international standards regarding digital evidence and cyber-space investigation.

  20. Ginger and the beetle: Evidence of primitive pollination system in a Himalayan endemic alpine ginger (Roscoea alpina, Zingiberaceae).

    Science.gov (United States)

    Paudel, Babu Ram; Shrestha, Mani; Dyer, Adrian G; Li, Qing-Jun

    2017-01-01

    The Himalayan endemic alpine genus Roscoea, like other members of ginger family, exhibits the combination of floral traits that would fit pollination by long distant foragers such as bees, birds or flies. We studied the pollination biology of Roscoea alpina, observed potential floral visitors and determined their foraging behaviour, visitation frequency and pollination efficiency, to seek evidence in support of the pollination syndrome hypothesis. We also measured the floral spectra of R. alpina flowers to evaluate if signals fit with the currently known framework for observed floral visitors. We found that R. alpina have autonomous selfing and pollinator-mediated crossing, but lack apomixis. We observed that a beetle (Mylabris sp.), and a moth (Macroglossum nycteris) visit the flowers of R. alpina for pollen and nectar feeding respectively. Our field observations, the stigmatic pollen count and fruit set data indicated that the visit by the beetle was legitimate, while that of the moth was illegitimate. Emasculated flowers visited by beetles set as many fruits and seeds/fruit as auto-selfed and naturally pollinated flowers, while emasculated flowers excluded from beetle visits did not set fruit and seed; indicating that a single visit of a beetle to the flowers of R. alpina can facilitate pollination. We found that flower spectral signal of R. alpina does not fit typical spectra previously reported for beetle or bee-visited flowers. Our results suggest that, to ensure reproductive success in alpine habitat, R. alpina has evolved autonomous selfing as a predominant mode of reproduction, while beetle pollination would promote genetic diversity of this plant species. The visitation of beetles to the flowers of R. alpina, despite floral signal mismatch with the classically associated beetle vision, suggests that a different visual processing may operate in this plant-pollinator interaction at high altitudes.

  1. HIV/AIDS-related mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites

    Science.gov (United States)

    Streatfield, P. Kim; Khan, Wasif A.; Bhuiya, Abbas; Hanifi, Syed M.A.; Alam, Nurul; Millogo, Ourohiré; Sié, Ali; Zabré, Pascal; Rossier, Clementine; Soura, Abdramane B.; Bonfoh, Bassirou; Kone, Siaka; Ngoran, Eliezer K.; Utzinger, Juerg; Abera, Semaw F.; Melaku, Yohannes A.; Weldearegawi, Berhe; Gomez, Pierre; Jasseh, Momodou; Ansah, Patrick; Azongo, Daniel; Kondayire, Felix; Oduro, Abraham; Amu, Alberta; Gyapong, Margaret; Kwarteng, Odette; Kant, Shashi; Pandav, Chandrakant S.; Rai, Sanjay K.; Juvekar, Sanjay; Muralidharan, Veena; Wahab, Abdul; Wilopo, Siswanto; Bauni, Evasius; Mochamah, George; Ndila, Carolyne; Williams, Thomas N.; Khagayi, Sammy; Laserson, Kayla F.; Nyaguara, Amek; Van Eijk, Anna M.; Ezeh, Alex; Kyobutungi, Catherine; Wamukoya, Marylene; Chihana, Menard; Crampin, Amelia; Price, Alison; Delaunay, Valérie; Diallo, Aldiouma; Douillot, Laetitia; Sokhna, Cheikh; Gómez-Olivé, F. Xavier; Mee, Paul; Tollman, Stephen M.; Herbst, Kobus; Mossong, Joël; Chuc, Nguyen T.K.; Arthur, Samuelina S.; Sankoh, Osman A.; Byass, Peter

    2014-01-01

    Background As the HIV/AIDS pandemic has evolved over recent decades, Africa has been the most affected region, even though a large proportion of HIV/AIDS deaths have not been documented at the individual level. Systematic application of verbal autopsy (VA) methods in defined populations provides an opportunity to assess the mortality burden of the pandemic from individual data. Objective To present standardised comparisons of HIV/AIDS-related mortality at sites across Africa and Asia, including closely related causes of death such as pulmonary tuberculosis (PTB) and pneumonia. Design Deaths related to HIV/AIDS were extracted from individual demographic and VA data from 22 INDEPTH sites across Africa and Asia. VA data were standardised to WHO 2012 standard causes of death assigned using the InterVA-4 model. Between-site comparisons of mortality rates were standardised using the INDEPTH 2013 standard population. Results The dataset covered a total of 10,773 deaths attributed to HIV/AIDS, observed over 12,204,043 person-years. HIV/AIDS-related mortality fractions and mortality rates varied widely across Africa and Asia, with highest burdens in eastern and southern Africa, and lowest burdens in Asia. There was evidence of rapidly declining rates at the sites with the heaviest burdens. HIV/AIDS mortality was also strongly related to PTB mortality. On a country basis, there were strong similarities between HIV/AIDS mortality rates at INDEPTH sites and those derived from modelled estimates. Conclusions Measuring HIV/AIDS-related mortality continues to be a challenging issue, all the more so as anti-retroviral treatment programmes alleviate mortality risks. The congruence between these results and other estimates adds plausibility to both approaches. These data, covering some of the highest mortality observed during the pandemic, will be an important baseline for understanding the future decline of HIV/AIDS. PMID:25377330

  2. HIV/AIDS-related mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites

    Directory of Open Access Journals (Sweden)

    P. Kim Streatfield

    2014-10-01

    Full Text Available Background: As the HIV/AIDS pandemic has evolved over recent decades, Africa has been the most affected region, even though a large proportion of HIV/AIDS deaths have not been documented at the individual level. Systematic application of verbal autopsy (VA methods in defined populations provides an opportunity to assess the mortality burden of the pandemic from individual data. Objective: To present standardised comparisons of HIV/AIDS-related mortality at sites across Africa and Asia, including closely related causes of death such as pulmonary tuberculosis (PTB and pneumonia. Design: Deaths related to HIV/AIDS were extracted from individual demographic and VA data from 22 INDEPTH sites across Africa and Asia. VA data were standardised to WHO 2012 standard causes of death assigned using the InterVA-4 model. Between-site comparisons of mortality rates were standardised using the INDEPTH 2013 standard population. Results: The dataset covered a total of 10,773 deaths attributed to HIV/AIDS, observed over 12,204,043 person-years. HIV/AIDS-related mortality fractions and mortality rates varied widely across Africa and Asia, with highest burdens in eastern and southern Africa, and lowest burdens in Asia. There was evidence of rapidly declining rates at the sites with the heaviest burdens. HIV/AIDS mortality was also strongly related to PTB mortality. On a country basis, there were strong similarities between HIV/AIDS mortality rates at INDEPTH sites and those derived from modelled estimates. Conclusions: Measuring HIV/AIDS-related mortality continues to be a challenging issue, all the more so as anti-retroviral treatment programmes alleviate mortality risks. The congruence between these results and other estimates adds plausibility to both approaches. These data, covering some of the highest mortality observed during the pandemic, will be an important baseline for understanding the future decline of HIV/AIDS.

  3. History of Plant Phenological Observation in Hungary and Plans for Renewal of System to detect Evidence of the Climate Change

    Science.gov (United States)

    Hunkar, M.; Dunkel, Z.

    2009-04-01

    The first plant protection warning was issued 1760 by the Senate of the Town of Debrecen concerning the destruction of caterpillar's nest. In the middle of the 19th century the first responsible Hungarian Government issued a note in which the minister takes measurements for the phytosanitary safety of agricultural products. Though Hungary had not got independent institutional system for plant protection at the end of the 19th c., still in the middle of the 1870s, the territory of the country was protected with harmonised quarantine measures from the introduction of Colorado beetle. A new era started both in Europe and in Hungary with the devastation caused by Phylloxera vastatrix in vineyards. In 1876, the Act 29 definitely specified the measures to be taken for preventing the spread of the pest and the damages caused by it; and it was proclaimed in both Chambers of the Parliament. This incident resulted basically in the launching for the establishment of an independent plant protection institution. In l880, the National Committee on Phylloxera, then in 1881, the National Experimental Station for Phylloxera was set up, this latter considered as the first nucleus of the Hungarian plant protection organisation. The international plant protection convention, concluded in 1929 and signed by our country, had a great role in the history of the development of the plant protection organisation. Hungary agreed to establish an official plant protection organization which should consist of a plant protection service and a research institute. In compliance with the Ministerial Decree 49.000/1932 the Hungarian Plant Protection Service was set up which can now be taken for the first organisation of the uniform national plant protection administration system. Plant protection stations were established in 1954. The plant phenological observation network was run by the plant protection administration but financially was maintained by OMSZ therefore the main aim of the phenological

  4. Spectral Evidence for an Inner Carbon-rich Circumstellar Belt in the Young HD 36546 A-star System

    Energy Technology Data Exchange (ETDEWEB)

    Lisse, C. M. [JHU-APL, 11100 Johns Hopkins Road, Laurel, MD 20723 (United States); Sitko, M. L. [Department of Physics, University of Cincinnati, Cincinnati, OH 45221-0011 and Space Science Institute, Boulder, CO 80301 (United States); Russell, R. W. [The Aerospace Corporation, Los Angeles, CA 90009 (United States); Marengo, M. [Department of Physics and Astronomy, 12 Physics Hall, Iowa State University, Ames, IA 50010 (United States); Currie, T. [Subaru Telescope, National Astronomical Observatory of Japan, National Institutes of Natural Sciences, Hilo, HI 96720 (United States); Melis, C. [Center for Astrophysics and Space Sciences, University of California, San Diego, CA 92093-0424 (United States); Mittal, T. [Department of Earth and Planetary Sciences, McCone Hall, University of California at Berkeley, Berkeley, CA 94720 (United States); Song, I., E-mail: carey.lisse@jhuapl.edu, E-mail: ron.vervack@jhuapl.edu, E-mail: sitkoml@ucmail.uc.edu, E-mail: ray.russell@aero.org, E-mail: mmarengo@iastate.edu, E-mail: currie@naoj.org, E-mail: cmelis@ucsd.edu, E-mail: tmittal2@berkeley.edu, E-mail: song@physast.uga.edu [Department of Physics and Astronomy, University of Georgia, Athens, GA 30602-2451 (United States)

    2017-05-10

    Using the NASA/IRTF SpeX and BASS spectrometers we have obtained 0.7–13 μ m observations of the newly imaged 3–10 Myr old HD 36546 disk system. The SpeX spectrum is most consistent with the photospheric emission expected from an L {sub *} ∼ 20 L {sub ⊙}, solar abundance A1.5V star with little to no extinction, and excess emission from circumstellar dust detectable beyond 4.5 μ m. Non-detections of CO emission lines and accretion signatures point to the gas-poor circumstellar environment of a very old transition disk. Combining the SpeX + BASS spectra with archival WISE / AKARI / IRAS / Herschel photometry, we find an outer cold dust belt at ∼135 K and 20–40 au from the primary, likely coincident with the disk imaged by Subaru, and a new second inner belt with a temperature ∼570 K and an unusual, broad SED maximum in the 6–9 μ m region, tracing dust at 1.1–2.2 au. An SED maximum at 6–9 μ m has been reported in just two other A-star systems, HD 131488 and HD 121191, both of ∼10 Myr age. From Spitzer , we have also identified the ∼12 Myr old A7V HD 148657 system as having similar 5–35 μ m excess spectral features. The Spitzer data allows us to rule out water emission and rule in carbonaceous materials—organics, carbonates, SiC—as the source of the 6–9 μ m excess. Assuming a common origin for the four young A-star systems’ disks, we suggest they are experiencing an early era of carbon-rich planetesimal processing.

  5. The geochemistry of Don Juan Pond: Evidence for a deep groundwater flow system in Wright Valley, Antarctica

    Science.gov (United States)

    Toner, J. D.; Catling, D. C.; Sletten, R. S.

    2017-09-01

    Don Juan Pond (DJP), Antarctica, is one of the most unusual surface waters on Earth because of its CaCl2-rich composition. To investigate the evolution of pond waters during closed-basin evaporation and to understand the source of brines responsible for the chemistry of DJP, we apply a newly developed low-temperature aqueous model in the Na-K-Ca-Mg-Cl system to DJP. By modeling the closed-basin evaporation of DJP and comparing ionic ratios between DJP surface water, deep groundwater, shallow groundwater, and other surface chemistries in Wright Valley, we find that DJP is best explained by upwelling deep groundwater, as opposed to recent hypotheses proposing shallow groundwater sources. The early closed-basin evolution of brines in our model accurately predicts observed chemistries in DJP; however, late-stage closed-basin evaporation produces Mg-K-rich brines and salts that do not match the CaCl2-rich brine in DJP. Based on groundwater inflow rates to DJP, we estimate that even the most concentrated brines in DJP have undergone closed-basin evaporation for less than a year. To explain the observed lack of Mg2+ and K+ accumulation in DJP over time, and the surprisingly young age for the brines, we deduce that DJP is a localized upwelling from a regional groundwater flow-through system in which evaporated DJP brines are recycled back into the subsurface over yearly timescales. The existence of a regional groundwater flow system beneath DJP has implications for water and solute budgets in cold desert ecosystems, and may provide clues for the formation of groundwater and aqueous flows on Mars.

  6. The Defense Messaging System (DMS) in the Navy Regional Enterprise Messaging System (NREMS) Environment: Evidence that Size Does Matter in DoD Business Process Engineering

    National Research Council Canada - National Science Library

    Liburd, Alice Y; Ramsey, Avonna S

    2007-01-01

    .... MREM8 introduces a networked environment capable of push technology and centralized database and security management which should significantly reduce the DM8 shortfalls that have made the system...

  7. Effect of industrially produced trans fat on markers of systemic inflammation: evidence from a randomized trial in women

    DEFF Research Database (Denmark)

    Bendsen, Nathalie T.; Stender, Steen; Szecsi, Pal B.

    2011-01-01

    Consumption of industrially produced trans fatty acids (IP-TFA) has been positively associated with systemic markers of low-grade inflammation and endothelial dysfunction in cross-sectional studies, but results from intervention studies are inconclusive. Therefore, we conducted a 16 week double...... (15.7 g/day IP-TFA) or control oil without IP-TFA. After 16 weeks, IP-TFA intake increased baseline-adjusted serum tumor necrosis factor (TNF) α by 12% [95% confidence interval (CI): 5–20; P = 0.002] more in the IP-TFA group compared with controls. Plasma soluble TNF receptors 1 and 2 were also...

  8. Evidence for non-Markovian electron dynamics in the microwave absorption of a two-dimensional electron system

    Science.gov (United States)

    Dorozhkin, S. Â. I.; Kapustin, A. Â. A.; Dmitriev, I. Â. A.; Umansky, V.; von Klitzing, K.; Smet, J. H.

    2017-10-01

    We have studied the absorption of monochromatic microwave radiation in high-quality two-dimensional electron systems for the frequency span from 10 to 380 GHz using a bolometric method. For frequencies above 100 GHz the absorption exhibits an anomalous magnetic field dependence. Minima form at harmonics of the cyclotron resonance frequency. The results contrast previously reported data for other frequency ranges. Quasiclassical memory effects originating from the non-Markovian dynamics of electrons in a disorder potential containing short-range scatterers on top of a smooth potential background favorably account for the observed behavior.

  9. From Augustine of Hippo's Memory Systems to Our Modern Taxonomy in Cognitive Psychology and Neuroscience of Memory: A 16-Century Nap of Intuition before Light of Evidence.

    Science.gov (United States)

    Cassel, Jean-Christophe; Cassel, Daniel; Manning, Lilianne

    2013-03-01

    Over the last half century, neuropsychologists, cognitive psychologists and cognitive neuroscientists interested in human memory have accumulated evidence showing that there is not one general memory function but a variety of memory systems deserving distinct (but for an organism, complementary) functional entities. The first attempts to organize memory systems within a taxonomic construct are often traced back to the French philosopher Maine de Biran (1766-1824), who, in his book first published in 1803, distinguished mechanical memory, sensitive memory and representative memory, without, however, providing any experimental evidence in support of his view. It turns out, however, that what might be regarded as the first elaborated taxonomic proposal is 14 centuries older and is due to Augustine of Hippo (354-430), also named St Augustine, who, in Book 10 of his Confessions, by means of an introspective process that did not aim at organizing memory systems, nevertheless distinguished and commented on sensible memory, intellectual memory, memory of memories, memory of feelings and passion, and memory of forgetting. These memories were envisaged as different and complementary instances. In the current study, after a short biographical synopsis of St Augustine, we provide an outline of the philosopher's contribution, both in terms of questions and answers, and focus on how this contribution almost perfectly fits with several viewpoints of modern psychology and neuroscience of memory about human memory functions, including the notion that episodic autobiographical memory stores events of our personal history in their what, where and when dimensions, and from there enables our mental time travel. It is not at all meant that St Augustine's elaboration was the basis for the modern taxonomy, but just that the similarity is striking, and that the architecture of our current viewpoints about memory systems might have preexisted as an outstanding intuition in the philosopher

  10. A coordinated national model for diabetes prevention: linking health systems to an evidence-based community program.

    Science.gov (United States)

    Vojta, Deneen; Koehler, Timothy B; Longjohn, Matt; Lever, Jonathan A; Caputo, Nadine F

    2013-04-01

    YMCA Lifestyle Coaches were trained. The program enrolled 2369 participants, and 1723 participants completed the core program at an average service-delivery cost of about $400 each. For those individuals completing the program, average weight loss was about 5%. UHG anticipates that within 3 years, savings from reduced medical spending will outweigh initial costs. Large-scale prevention efforts can be scalable and sustainable with collaboration, health information technology, community-based delivery of evidence-based interventions, and novel payment structures that incentivize efficiency and outcomes linked to better health and lower future costs. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  11. Is soil microbial diversity affected by soil and groundwater salinity? Evidences from a coastal system in central Italy.

    Science.gov (United States)

    Canfora, Loredana; Salvati, Luca; Benedetti, Anna; Francaviglia, Rosa

    2017-07-01

    Little is known about composition, diversity, and abundance of microbial communities in environments affected by primary soil salinization, such as coastal lagoon systems. The main objective of this study was to investigate the impact of lagoon salinity, soil type, and land-use on inland soil and groundwater quality, and soil microbial community structure, diversity, and gene abundance, as evaluated by T-RFLP (terminal-restriction fragment length polymorphism) and qPCR (quantitative polymerase-chain-reaction). For this purpose, four sites oriented along a groundwater salinity gradient (Fogliano lagoon, central Italy) were studied under different recreational, grazing, and land-use conditions. Spatial variability in groundwater attributes was observed depending on salinity and soil electrical conductivity, both influenced by salt intrusion. A comparison of community abundance and number of phylotypes of bacteria, archaea, and fungi across varying soil depths pointed out marked differences across soils characterized by different soil type, land-use, and salinity. The latter significantly affected the microbial population richness and diversity and showed a dominance in terms of bacteria species. Our study provides a comprehensive overview of the spatial relationship between soil microbial community and soil degradation processes along a relatively underexplored environmental gradient in a coastal system, coming to the conclusion that salinity acts differently as a driver of microbial community structure in comparison with other saline environments.

  12. Feeding-dependent activation of enteric cells and sensory neurons by lymphatic fluid: evidence for a neurolymphocrine system.

    Science.gov (United States)

    Poole, Daniel P; Lee, Mike; Tso, Patrick; Bunnett, Nigel W; Yo, Sek Jin; Lieu, TinaMarie; Shiu, Amy; Wang, Jen-Chywan; Nomura, Daniel K; Aponte, Gregory W

    2014-04-15

    Lymphatic fluid is a plasma filtrate that can be viewed as having biological activity through the passive accumulation of molecules from the interstitial fluid. The possibility that lymphatic fluid is part of an active self-contained signaling process that parallels the endocrine system, through the activation of G-protein coupled receptors (GPCR), has remained unexplored. We show that the GPCR lysophosphatidic acid 5 (LPA5) is found in sensory nerve fibers expressing calcitonin gene-related peptide (CGRP) that innervate the lumen of lymphatic lacteals and enteric nerves. Using LPA5 as a model for nutrient-responsive GPCRs present on sensory nerves, we demonstrate that dietary protein hydrolysate (peptone) can induce c-Fos expression in enterocytes and nerves that express LPA5. Mesenteric lymphatic fluid (MLF) mobilizes intracellular calcium in cell models expressing LPA5 upon feeding in a time- and dose-dependent manner. Primary cultured neurons of the dorsal root ganglia expressing CGRP are activated by MLF, which is enhanced upon LPA5 overexpression. Activation is independent of the known LPA5 agonists, lysophosphatidic acid and farnesyl pyrophosphate. These data bring forth a pathway for the direct stimulation of sensory nerves by luminal contents and interstitial fluid. Thus, by activating LPA5 on sensory nerves, MLF provides a means for known and yet to be identified constituents of the interstitial fluid to act as signals to comprise a "neurolymphocrine" system.

  13. Pupillometric evidence for the locus coeruleus-noradrenaline system facilitating attentional processing of action-triggered visual stimuli

    Directory of Open Access Journals (Sweden)

    Ken eKihara

    2015-06-01

    Full Text Available It has been argued that attentional processing of visual stimuli is facilitated by a voluntary action that triggers the stimulus onset. However, the relationship between action-induced facilitation of attention and the neural substrates has not been well established. The present study investigated whether the locus coeruleus-noradrenaline (LC-NA system is involved in this facilitation effect. A rapid serial visual presentation paradigm was used to assess the dynamics of transient attention in humans. Participants were instructed to change a digit stream to a letter stream by pressing a button and specifying successive targets of four letters. Pupil dilation was measured as an index of LC-NA function. Accuracy of target identification was better when the temporal delay between participants' key press and target onset was 800 ms than when targets appeared just after the key press or when targets appeared without key press. Accuracy of target identification was positively correlated with both the peak amplitude of pupil dilation and the pupil size at the time of the key press. These results indicate that target identification in the visual task is closely linked to pupil dilation. We conclude that the LC-NA system plays an important role in the facilitation of transient attention driven by voluntary action.

  14. Utilization of alternative systems of medicine as health care services in India: Evidence on AYUSH care from NSS 2014.

    Directory of Open Access Journals (Sweden)

    Shalini Rudra

    Full Text Available AYUSH, an acronym for Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-Rigpa and Homeopathy represents the alternative systems of medicine recognized by the Government of India. Understanding the patterns of utilization of AYUSH care has been important for various reasons including an increased focus on its mainstreaming and integration with biomedicine-based health care system. Based on a nationally representative health survey 2014, we present an analysis to understand utilization of AYUSH care across socioeconomic and demographic groups in India. Overall, 6.9% of all patients seeking outpatient care in the reference period of last two weeks have used AYUSH services without any significant differentials across rural and urban India. Importantly, public health facilities play a key role in provisioning of AYUSH care in rural areas with higher utilization in Chhattisgarh, Kerala and West Bengal. Use of AYUSH among middle-income households is lower when compared with poorer and richer households. We also find that low-income households display a greater tendency for AYUSH self-medication. AYUSH care utilization is higher among patients with chronic diseases and also for treating skin-related and musculo-skeletal ailments. Although the overall share of AYUSH prescription drugs in total medical expenditure is only about 6% but the average expenditure for drugs on AYUSH and allopathy did not differ hugely. The discussion compares our estimates and findings with other studies and also highlights major policy issues around mainstreaming of AYUSH care.

  15. Mesothelioma incidence surveillance systems and claims for workers’ compensation. Epidemiological evidence and prospects for an integrated framework

    Science.gov (United States)

    2012-01-01

    Background Malignant mesothelioma is an aggressive and lethal tumour strongly associated with exposure to asbestos (mainly occupational). In Italy a large proportion of workers are protected from occupational diseases by public insurance and an epidemiological surveillance system for incident mesothelioma cases. Methods We set up an individual linkage between the Italian national mesothelioma register (ReNaM) and the Italian workers’ compensation authority (INAIL) archives. Logistic regression models were used to identify and test explanatory variables. Results We extracted 3270 mesothelioma cases with occupational origins from the ReNaM, matching them with 1625 subjects in INAIL (49.7%); 91.2% (1,482) of the claims received compensation. The risk of not seeking compensation is significantly higher for women and the elderly. Claims have increased significantly in recent years and there is a clear geographical gradient (northern and more developed regions having higher claims rates). The highest rates of compensation claims were after work known to involve asbestos. Conclusions Our data illustrate the importance of documentation and dissemination of all asbestos exposure modalities. Strategies focused on structural and systematic interaction between epidemiological surveillance and insurance systems are needed. PMID:22545679

  16. Mesothelioma incidence surveillance systems and claims for workers’ compensation. Epidemiological evidence and prospects for an integrated framework

    Directory of Open Access Journals (Sweden)

    Marinaccio Alessandro

    2012-07-01

    Full Text Available Abstract Background Malignant mesothelioma is an aggressive and lethal tumour strongly associated with exposure to asbestos (mainly occupational. In Italy a large proportion of workers are protected from occupational diseases by public insurance and an epidemiological surveillance system for incident mesothelioma cases. Methods We set up an individual linkage between the Italian national mesothelioma register (ReNaM and the Italian workers’ compensation authority (INAIL archives. Logistic regression models were used to identify and test explanatory variables. Results We extracted 3270 mesothelioma cases with occupational origins from the ReNaM, matching them with 1625 subjects in INAIL (49.7%; 91.2% (1,482 of the claims received compensation. The risk of not seeking compensation is significantly higher for women and the elderly. Claims have increased significantly in recent years and there is a clear geographical gradient (northern and more developed regions having higher claims rates. The highest rates of compensation claims were after work known to involve asbestos. Conclusions Our data illustrate the importance of documentation and dissemination of all asbestos exposure modalities. Strategies focused on structural and systematic interaction between epidemiological surveillance and insurance systems are needed.

  17. Evidence-Based Development

    DEFF Research Database (Denmark)

    Hertzum, Morten; Simonsen, Jesper

    2004-01-01

    Systems development is replete with projects that represent substantial resource investments but result in systems that fail to meet users’ needs. Evidence-based development is an emerging idea intended to provide means for managing customer-vendor relationships and working systematically toward...... meeting customer needs. We are suggesting that the effects of the use of a system should play a prominent role in the contractual definition of IT projects and that contract fulfilment should be determined on the basis of evidence of these effects. Based on two ongoing studies of home-care management...

  18. Evidence of a modern deep water magmatic hydrothermal system in the Canary Basin (eastern central Atlantic Ocean)

    Science.gov (United States)

    Medialdea, T.; Somoza, L.; González, F. J.; Vázquez, J. T.; de Ignacio, C.; Sumino, H.; Sánchez-Guillamón, O.; Orihashi, Y.; León, R.; Palomino, D.

    2017-08-01

    New seismic profiles, bathymetric data, and sediment-rock sampling document for the first time the discovery of hydrothermal vent complexes and volcanic cones at 4800-5200 m depth related to recent volcanic and intrusive activity in an unexplored area of the Canary Basin (Eastern Atlantic Ocean, 500 km west of the Canary Islands). A complex of sill intrusions is imaged on seismic profiles showing saucer-shaped, parallel, or inclined geometries. Three main types of structures are related to these intrusions. Type I consists of cone-shaped depressions developed above inclined sills interpreted as hydrothermal vents. Type II is the most abundant and is represented by isolated or clustered hydrothermal domes bounded by faults rooted at the tips of saucer-shaped sills. Domes are interpreted as seabed expressions of reservoirs of CH4 and CO2-rich fluids formed by degassing and contact metamorphism of organic-rich sediments around sill intrusions. Type III are hydrothermal-volcanic complexes originated above stratified or branched inclined sills connected by a chimney to the seabed volcanic edifice. Parallel sills sourced from the magmatic chimney formed also domes surrounding the volcanic cones. Core and dredges revealed that these volcanoes, which must be among the deepest in the world, are constituted by OIB-type, basanites with an outer ring of blue-green hydrothermal Al-rich smectite muds. Magmatic activity is dated, based on lava samples, at 0.78 ± 0.05 and 1.61 ± 0.09 Ma (K/Ar methods) and on tephra layers within cores at 25-237 ky. The Subvent hydrothermal-volcanic complex constitutes the first modern system reported in deep water oceanic basins related to intraplate hotspot activity.type="synopsis">type="main">Plain Language SummarySubmarine volcanism and associated hydrothermal systems are relevant processes for the evolution of the ocean basins, due their impact on the geochemistry of the oceans, their potential to form significant ore deposits, and their

  19. Community-based health care is an essential component of a resilient health system: evidence from Ebola outbreak in Liberia

    Directory of Open Access Journals (Sweden)

    Kendra Siekmans

    2017-01-01

    Full Text Available Abstract Background Trained community health workers (CHW enhance access to essential primary health care services in contexts where the health system lacks capacity to adequately deliver them. In Liberia, the Ebola outbreak further disrupted health system function. The objective of this study is to examine the value of a community-based health system in ensuring continued treatment of child illnesses during the outbreak and the role that CHWs had in Ebola prevention activities. Methods A descriptive observational study design used mixed methods to collect data from CHWs (structured survey, n = 60; focus group discussions, n = 16, government health facility workers and project staff. Monthly data on child diarrhea and pneumonia treatment were gathered from CHW case registers and local health facility records. Results Coverage for community-based treatment of child diarrhea and pneumonia continued throughout the outbreak in project areas. A slight decrease in cases treated during the height of the outbreak, from 50 to 28% of registers with at least one treatment per month, was attributed to directives not to touch others, lack of essential medicines and fear of contracting Ebola. In a climate of distrust, where health workers were reluctant to treat patients, sick people were afraid to self-identify and caregivers were afraid to take children to the clinic, CHWs were a trusted source of advice and Ebola prevention education. These findings reaffirm the value of recruiting and training local workers who are trusted by the community and understand the social and cultural complexities of this relationship. “No touch” integrated community case management (iCCM guidelines distributed at the height of the outbreak gave CHWs renewed confidence in assessing and treating sick children. Conclusions Investments in community-based health service delivery contributed to continued access to lifesaving treatment for child pneumonia and diarrhea

  20. The Transiting System GJ1214: High-Precision Defocused Transit Observations and a Search for Evidence of Transit Timing Variation

    DEFF Research Database (Denmark)

    Harpsøe, Kennet Bomann West; Hardis, S.; Hinse, T. C.

    2012-01-01

    Aims: We present 11 high-precision photometric transit observations of the transiting super-Earth planet GJ1214b. Combining these data with observations from other authors, we investigate the ephemeris for possible signs of transit timing variations (TTVs) using a Bayesian approach. Methods......: The observations are used to determine the photometric parameters and the physical properties of the GJ1214 system. Our results are in good agreement with published values. Individual times of mid-transit are measured with uncertainties as low as 10s, allowing us to reduce the uncertainty in the orbital period...... by a factor of two. Conclusions: A Bayesian analysis reveals that it is highly improbable that the observed transit times is explained by TTV, when compared with the simpler alternative of a linear ephemeris....

  1. Research on early warning of food security using a system dynamics model: evidence from Jiangsu province in China.

    Science.gov (United States)

    Xu, Jianling; Ding, Yi

    2015-01-01

    Analyzing the early warning of food security, this paper sets the self-sufficiency rate as the principal indicator in a standpoint of supplement. It is common to use the quantitative methods to forecast and warning the insecurity. However, this paper considers more about the probable outcome when the government intervenes. By constructing the causal feedbacks among grain supplement, demand, productive input, and the policy factors to simulate the future food security in Jiangsu province, conclusions can be drawn as the following: (1) The situation of food security is insecure if the self-sufficiency rate is under 68.3% according to the development of system inertia. (2) it is difficult to guarantee the food security in Jiangsu just depending on the increase of grain sown area. (3) The valid solution to ensure the food security in Jiangsu is to improve the productivity. © 2015 Institute of Food Technologists®

  2. Is There Evidence of Cost Benefits of Electronic Medical Records, Standards, or Interoperability in Hospital Information Systems? Overview of Systematic Reviews.

    Science.gov (United States)

    Reis, Zilma Silveira Nogueira; Maia, Thais Abreu; Marcolino, Milena Soriano; Becerra-Posada, Francisco; Novillo-Ortiz, David; Ribeiro, Antonio Luiz Pinho

    2017-08-29

    Electronic health (eHealth) interventions may improve the quality of care by providing timely, accessible information about one patient or an entire population. Electronic patient care information forms the nucleus of computerized health information systems. However, interoperability among systems depends on the adoption of information standards. Additionally, investing in technology systems requires cost-effectiveness studies to ensure the sustainability of processes for stakeholders. The objective of this study was to assess cost-effectiveness of the use of electronically available inpatient data systems, health information exchange, or standards to support interoperability among systems. An overview of systematic reviews was conducted, assessing the MEDLINE, Cochrane Library, LILACS, and IEEE Library databases to identify relevant studies published through February 2016. The search was supplemented by citations from the selected papers. The primary outcome sought the cost-effectiveness, and the secondary outcome was the impact on quality of care. Independent reviewers selected studies, and disagreement was resolved by consensus. The quality of the included studies was evaluated using a measurement tool to assess systematic reviews (AMSTAR). The primary search identified 286 papers, and two papers were manually included. A total of 211 were systematic reviews. From the 20 studies that were selected after screening the title and abstract, 14 were deemed ineligible, and six met the inclusion criteria. The interventions did not show a measurable effect on cost-effectiveness. Despite the limited number of studies, the heterogeneity of electronic systems reported, and the types of intervention in hospital routines, it was possible to identify some preliminary benefits in quality of care. Hospital information systems, along with information sharing, had the potential to improve clinical practice by reducing staff errors or incidents, improving automated harm detection

  3. Assessing the ability of health information systems in hospitals to support evidence-informed decisions in Kenya.

    Science.gov (United States)

    Kihuba, Elesban; Gathara, David; Mwinga, Stephen; Mulaku, Mercy; Kosgei, Rose; Mogoa, Wycliffe; Nyamai, Rachel; English, Mike

    2014-01-01

    Hospital management information systems (HMIS) is a key component of national health information systems (HIS), and actions required of hospital management to support information generation in Kenya are articulated in specific policy documents. We conducted an evaluation of core functions of data generation and reporting within hospitals in Kenya to facilitate interpretation of national reports and to provide guidance on key areas requiring improvement to support data use in decision making. The survey was a cross-sectional, cluster sample study conducted in 22 hospitals in Kenya. The statistical analysis was descriptive with adjustment for clustering. Most of the HMIS departments complied with formal guidance to develop departmental plans. However, only a few (3/22) had carried out a data quality audit in the 12 months prior to the survey. On average 3% (range 1-8%) of the total hospital income was allocated to the HMIS departments. About half of the records officer positions were filled and about half (13/22) of hospitals had implemented some form of electronic health record largely focused on improving patient billing and not linked to the district HIS. Completeness of manual patient registers varied, being 90% (95% CI 80.1-99.3%), 75.8% (95% CI 68.7-82.8%), and 58% (95% CI 50.4-65.1%) in maternal child health clinic, maternity, and pediatric wards, respectively. Vital events notification rates were low with 25.7, 42.6, and 71.3% of neonatal deaths, infant deaths, and live births recorded, respectively. Routine hospital reports suggested slight over-reporting of live births and under-reporting of fresh stillbirths and neonatal deaths. Study findings indicate that the HMIS does not deliver quality data. Significant constraints exist in data quality assurance, supervisory support, data infrastructure in respect to information and communications technology application, human resources, financial resources, and integration.

  4. Assessing the ability of health information systems in hospitals to support evidence-informed decisions in Kenya

    Directory of Open Access Journals (Sweden)

    Elesban Kihuba

    2014-07-01

    Full Text Available Background: Hospital management information systems (HMIS is a key component of national health information systems (HIS, and actions required of hospital management to support information generation in Kenya are articulated in specific policy documents. We conducted an evaluation of core functions of data generation and reporting within hospitals in Kenya to facilitate interpretation of national reports and to provide guidance on key areas requiring improvement to support data use in decision making. Design: The survey was a cross-sectional, cluster sample study conducted in 22 hospitals in Kenya. The statistical analysis was descriptive with adjustment for clustering. Results: Most of the HMIS departments complied with formal guidance to develop departmental plans. However, only a few (3/22 had carried out a data quality audit in the 12 months prior to the survey. On average 3% (range 1–8% of the total hospital income was allocated to the HMIS departments. About half of the records officer positions were filled and about half (13/22 of hospitals had implemented some form of electronic health record largely focused on improving patient billing and not linked to the district HIS. Completeness of manual patient registers varied, being 90% (95% CI 80.1–99.3%, 75.8% (95% CI 68.7–82.8%, and 58% (95% CI 50.4–65.1% in maternal child health clinic, maternity, and pediatric wards, respectively. Vital events notification rates were low with 25.7, 42.6, and 71.3% of neonatal deaths, infant deaths, and live births recorded, respectively. Routine hospital reports suggested slight over-reporting of live births and under-reporting of fresh stillbirths and neonatal deaths. Conclusions: Study findings indicate that the HMIS does not deliver quality data. Significant constraints exist in data quality assurance, supervisory support, data infrastructure in respect to information and communications technology application, human resources, financial

  5. THE EFFECT OF E-COMMERCE ON MALAYSIAN TAX SYSTEM: AN EMPIRICAL EVIDENCE FROM ACADEMICIANS AND MALAYSIAN TAX PRACTITIONERS

    Directory of Open Access Journals (Sweden)

    Mohd Rizal Palil

    2004-01-01

    Full Text Available The explosion of information technology (IT nowadays has created new phenomena in shopping activities. Consumers can easily buy products via Internet. Within a minute, the products will be delivered instantly and accurately. This scenario is known as e-commerce. The emergence of e-commerce affects consumers' shopping behavior as well as taxation system. The objective of this research is to reveal the effects of e-commerce upon Malaysian taxation system by emphasizing in scope of charge 'derive and remittance'. Research was conducted through questionnaires of 82 tax practitioners and 22 academicians. The research findings shown that derive and remittance basis is no longer appropriate in e-commerce environment. Scope of charge derives and remittances, which are practicing in Malaysia right now, are unable to maximized e-commerce tax revenue. Abstract in Bahasa Indonesia : Perkembangan dalam dunia teknologi akhir-akhir ini telah membawa banyak arus perubahan terutamanya dalam aktivitas belanja. Konsumen dapat membeli barang dengan mudah melalui internet. Dalam waktu beberapa menit, barang sampai di tangan konsumen. Skenario demikian dikenal sebagai perdagangan elektronis. Kemunculan perdagangan elektronis mengubah prilaku belanja konsumen serta sistem perpajakan di Malaysia. Tujuan penelitian ini adalah untuk mengetahui efek perdagangan elektronis terhadap sistem perpajakan di Malaysia dengan penekanan pada pengenaan pajak dan hak pemajakan. Penelitian dilakukan dengan menggunakan 82 sample praktisi perpajakan dan 22 akademisi. Hasil penelitian menunjukkan, bahwa praktek pengenaan pajak dalam perdagangan elektronis belum sesuai dengan aturan yang berlaku, sehingga tidak dapat memaksimalkan penerimaan pajak dari perdagangan elektronis. Kata kunci: sistem perpajakan Malaysia, perdagangan elektronik, akademik, praktisi perpajakan, pengenaan pajak.

  6. Absorption spectroscopic analysis of Astacus rhodopsin systems and evidence of metabolic regeneration of rhodopsins after light adaptation

    Energy Technology Data Exchange (ETDEWEB)

    Hamacher, K.

    1981-05-01

    A method was developed to isolate, from a single Astacus retina, purified rhabdoms almost entirely free from screening pigments. SDS-gelelectrophoretical analysis of the protein pattern of purified photoreceptor membranes yields a rhodopsin portion of 40 to 50% of the total protein. Absorption spectra of the rhodopsin system show that both, the membrane-bound chromoprotein (sonicated rhabdom suspension) and the digitonin-solubilized chromoprotein are thermostable and photoreversible at 0/sup 0/C and pH 7.0. Due to its photoreversibility metarhodopsin can be isomerized to rhodopsin by irradiation at lambda < 630 nm. As the extinction spectra of the two chromoprotein isomers overlap, only partial photochemical isomerization to rhodopsin is possible. The light-induced decrease of the rhodopsin portion in vivo depends on the state of adaptation of the Astacus eyes. The light-induced decrease of the rhodopsin mole fraction in vivo can be restored by a metabolic process of rhodopsin regeneration. The question whether dark regeneration is an enzymatic isomerization of metarhodopsin and/or a biochemical synthesis of rhodopsin cannot yet be answered. The course of the spectra of the digitonin-solubilized chromoprotein is remarkably dependent on the temperature. The kinetic of the thermal denaturation of the metarhodopsin corresponds to a first-order reaction with a half time tau/sub 1/2/ = 34 min at 30/sup 0/C. The process of the denaturation of the digitonin-solubilized chromoprotein at 20/sup 0/C, or 30/sup 0/C, respectively, - accompanied by the separation of retinal - is accelerated by irradiation of the system.

  7. Evidence for tectonic, lithologic, and thermal controls on fracture system geometries in an andesitic high-temperature geothermal field

    Science.gov (United States)

    Massiot, Cécile; Nicol, Andrew; McNamara, David D.; Townend, John

    2017-08-01

    Analysis of fracture orientation, spacing, and thickness from acoustic borehole televiewer (BHTV) logs and cores in the andesite-hosted Rotokawa geothermal reservoir (New Zealand) highlights potential controls on the geometry of the fracture system. Cluster analysis of fracture orientations indicates four fracture sets. Probability distributions of fracture spacing and thickness measured on BHTV logs are estimated for each fracture set, using maximum likelihood estimations applied to truncated size distributions to account for sampling bias. Fracture spacing is dominantly lognormal, though two subordinate fracture sets have a power law spacing. This difference in spacing distributions may reflect the influence of the andesitic sequence stratification (lognormal) and tectonic faults (power law). Fracture thicknesses of 9-30 mm observed in BHTV logs, and 1-3 mm in cores, are interpreted to follow a power law. Fractures in thin sections (˜5 μm thick) do not fit this power law distribution, which, together with their orientation, reflect a change of controls on fracture thickness from uniform (such as thermal) controls at thin section scale to anisotropic (tectonic) at core and BHTV scales of observation. However, the ˜5% volumetric percentage of fractures within the rock at all three scales suggests a self-similar behavior in 3-D. Power law thickness distributions potentially associated with power law fluid flow rates, and increased connectivity where fracture sets intersect, may cause the large permeability variations that occur at hundred meter scales in the reservoir. The described fracture geometries can be incorporated into fracture and flow models to explore the roles of fracture connectivity, stress, and mineral precipitation/dissolution on permeability in such andesite-hosted geothermal systems.

  8. Electrophysiological evidence for the involvement of the approximate number system in preschoolers' processing of spoken number words.

    Science.gov (United States)

    Pinhas, Michal; Donohue, Sarah E; Woldorff, Marty G; Brannon, Elizabeth M

    2014-09-01

    Little is known about the neural underpinnings of number word comprehension in young children. Here we investigated the neural processing of these words during the crucial developmental window in which children learn their meanings and asked whether such processing relies on the Approximate Number System. ERPs were recorded as 3- to 5-year-old children heard the words one, two, three, or six while looking at pictures of 1, 2, 3, or 6 objects. The auditory number word was incongruent with the number of visual objects on half the trials and congruent on the other half. Children's number word comprehension predicted their ERP incongruency effects. Specifically, children with the least number word knowledge did not show any ERP incongruency effects, whereas those with intermediate and high number word knowledge showed an enhanced, negative polarity incongruency response (N(inc)) over centroparietal sites from 200 to 500 msec after the number word onset. This negativity was followed by an enhanced, positive polarity incongruency effect (P(inc)) that emerged bilaterally over parietal sites at about 700 msec. Moreover, children with the most number word knowledge showed ratio dependence in the P(inc) (larger for greater compared with smaller numerical mismatches), a hallmark of the Approximate Number System. Importantly, a similar modulation of the P(inc) from 700 to 800 msec was found in children with intermediate number word knowledge. These results provide the first neural correlates of spoken number word comprehension in preschoolers and are consistent with the view that children map number words onto approximate number representations before they fully master the verbal count list.

  9. Archaeological Evidence for Resilience of Pacific Northwest Salmon Populations and the Socioecological System over the last ~7,500 years

    Directory of Open Access Journals (Sweden)

    Sarah K. Campbell

    2010-03-01

    Full Text Available Archaeological data on the long history of interaction between indigenous people and salmon have rarely been applied to conservation management. When joined with ethnohistoric records, archaeology provides an alternative conceptual view of the potential for sustainable harvests and can suggest possible social mechanisms for managing human behavior. Review of the ~7,500-year-long fish bone record from two subregions of the Pacific Northwest shows remarkable stability in salmon use. As major changes in the ecological and social system occurred over this lengthy period, persistence in the fishery is not due simply to a lack of perturbation, but rather indicates resilience in the ecological-human system. Of several factors possibly contributing to resilience, low human population size and harvesting pressure, habitat enhancement, and suppression of competing predators do not appear to be of major importance. Flexible resource use, including human use of a range of local resources, many of which are linked in a food web with salmon, likely contributed to resilience. Most important were the beliefs and social institutions (including ownership, regulation, rituals, and monitoring that placed restraints on salmon use as a common pool resource. In contrast, only a small fraction of our modern society relies economically on or has direct interaction with the fish, which limits our concern and willingness to fundamentally change behaviors that contribute to habitat degradation and loss, the main challenges facing salmon populations today. Salmon recovery efforts may benefit substantially from investing more resources into establishing links between community groups and actual fish populations, which would create a sense of proprietorship, one of the keys to resilience in the indigenous salmon fishery.

  10. Is the motor system necessary for processing action and abstract emotion words? Evidence from focal brain lesions

    Directory of Open Access Journals (Sweden)

    Felix R. Dreyer

    2015-11-01

    Full Text Available Neuroimaging and neuropsychological experiments suggest that modality-preferential cortices, including motor- and somatosensory areas contribute to the semantic processing of action related concrete words. In contrast, a possible role of modality-preferential – including sensorimotor – areas in processing abstract meaning remains under debate. However, recent fMRI studies indicate an involvement of the left sensorimotor cortex in the processing of abstract-emotional words (e.g. love. But are these areas indeed necessary for processing action-related and abstract words? The current study now investigates word processing in two patients suffering from focal brain lesion in the left frontocentral motor system. A speeded lexical decision task (LDT on meticulously matched word groups showed that the recognition of nouns from different semantic categories – related to food, animals, tools and abstract-emotional concepts – was differentially affected. Whereas patient HS with a lesion in dorsolateral central sensorimotor cortex next to the hand area showed a category-specific deficit in recognizing tool words, patient CA suffering from lesion centered in the left SMA was primarily impaired in abstract-emotional word processing. These results point to a causal role of the motor cortex in the semantic processing of both action-related object concepts and abstract-emotional concepts and therefore suggest that the motor areas previously found active in action-related and abstract word processing can serve a meaning-specific necessary role in word recognition. The category-specific nature of the observed dissociations is difficult to reconcile with the idea that sensorimotor systems are somehow peripheral or ‘epiphenomenal’ to meaning and concept processing. Rather, our results are consistent with the claim that cognition is grounded in action and perception and based on distributed action perception circuits reaching into sensorimotor areas.

  11. THE THREE-DIMENSIONAL STRUCTURE OF THE M31 SATELLITE SYSTEM; STRONG EVIDENCE FOR AN INHOMOGENEOUS DISTRIBUTION OF SATELLITES

    International Nuclear Information System (INIS)

    Conn, A. R.; Parker, Q. A.; Zucker, D. B.; Lewis, G. F.; Ibata, R. A.; Martin, N. F.; McConnachie, A. W.; Valls-Gabaud, D.; Tanvir, N.; Irwin, M. J.; Ferguson, A. M. N.; Chapman, S. C.

    2013-01-01

    We undertake an investigation into the spatial structure of the M31 satellite system utilizing the distance distributions presented in a previous publication. These distances make use of the unique combination of depth and spatial coverage of the Pan-Andromeda Archaeological Survey to provide a large, homogeneous sample consisting of 27 of M31's satellites, as well as M31 itself. We find that the satellite distribution, when viewed as a whole, is no more planar than one would expect from a random distribution of equal size. A disk consisting of 15 of the satellites is however found to be highly significant, and strikingly thin, with an rms thickness of just 12.34 +0.75 -0.43 kpc. This disk is oriented approximately edge-on with respect to the Milky Way and almost perpendicular to the Milky Way disk. It is also roughly orthogonal to the disk-like structure regularly reported for the Milky Way satellite system and in close alignment with M31's Giant Stellar Stream. A similar analysis of the asymmetry of the M31 satellite distribution finds that it is also significantly larger than one would expect from a random distribution. In particular, it is remarkable that 20 of the 27 satellites most likely lie on the Milky Way side of the galaxy, with the asymmetry being most pronounced within the satellite subset forming the aforementioned disk. This lopsidedness is all the more intriguing in light of the apparent orthogonality observed between the satellite disk structures of the Milky Way and M31.

  12. Exploring the link between products and services in low-income markets—Evidence from solar home systems

    International Nuclear Information System (INIS)

    Friebe, Christian A.; Flotow, Paschen von; Täube, Florian A.

    2013-01-01

    One of the key challenges of energy access in emerging markets and developing countries is how to reach households and communities that are unlikely to get a grid connection in the long term or those that are connected to the grid but suffer from regular blackouts or low voltage. By surveying entrepreneurs selling Solar Home Systems (SHSs) on a commercial basis in emerging and developing countries, this study is one of the first attempts to quantify the key elements of four potential Product Service Systems (PSSs): Cash, Credit, Leasing and Fee-for-Service. Whereas the Fee-for-Service approach was found to be suitable only under certain conditions, all PSSs share two key elements for successful market deployment: one or more years of maintenance, and customer support in financing these customers' new asset. Moreover, it appears that private sector companies are in principle able to deliver SHSs to households with incomes greater than USD 1000 per year. The implications for policy makers and development aid agencies are, first, to include maintenance services into public programmes or public–private partnerships and, second, to explicitly consider financial risks for entrepreneurs (e.g., customer commitment and repayment conditions). - Highlights: ► Explorative quantitative study among entrepreneurs across different low-income markets. ► Specific combinations of product and service are identified and evaluated. ► Cash, Credit and Leasing can be feasible from a private sector point of view. ► Fee-for-Service is very challenging for the private sector without any policy support. ► Combining the SHS with services such as finance and maintenance is key to success.

  13. Evidence-based librarianship: searching for the needed EBL evidence.

    Science.gov (United States)

    Eldredge, J D

    2000-01-01

    This paper discusses the challenges of finding evidence needed to implement Evidence-Based Librarianship (EBL). Focusing first on database coverage for three health sciences librarianship journals, the article examines the information contents of different databases. Strategies are needed to search for relevant evidence in the library literature via these databases, and the problems associated with searching the grey literature of librarianship. Database coverage, plausible search strategies, and the grey literature of library science all pose challenges to finding the needed research evidence for practicing EBL. Health sciences librarians need to ensure that systems are designed that can track and provide access to needed research evidence to support Evidence-Based Librarianship (EBL).

  14. Biometric System Vulnerability as a Compromising Factor for Integrity of Chain of Custody and Admissibility ofDigitalEvidence in Court of Justice: Analysis and Improvement Proposal

    Directory of Open Access Journals (Sweden)

    Zoran Cosic

    2014-06-01

    Full Text Available Biometric systems play an important role in digital investigation process as a important factor of authentication and verification applications, since they are strongly linked to the holder of a biometric  traits  and  possible  suspect.  Thus  it  is  important  that  biometric  systems  can  be designed  to  withstand  attacks  when  employed  in  security-critical  applications,  especially  in unattended  remote  applications  such  as  energy  plants,  access  to  borders  at  airports,  ecommerce  etc.  Biometric  recognition  either  raises  important  legal  issues  of  remediation, authority,  and  reliability,  and,  of  course,  privacy.  The  standard  assumptions  of  the technologists  who  design  new  techniques,  capabilities,  and  systems  are  very  different  from those embedded in the legal  system.  Legal precedent on the  use of biometric technology is growing, with some key cases going back decades and other more recent cases having raised serious questions about the admissibility of biometric evidence in court. In this paper authors is about to explain influence of reliability of biometric system on general acceptance of digital evidence  in  Court  of  Justice  process.  Through  paper  authors  are  also  about  to  propose vulnerability assessment of biometric system as improvementfactor of reliability of existing methodology  for  preserving  chain  of  custody  of  digital  evidence  called  DEMF  (Digital Evidence Management Framework. Improvement proposal is presented as an introduction of phase  of  biometric  vulnerability  evaluation  methodology  within  proposedframework called APDEMF (Admissibility procedure of DEMF. Using UML (Universal Modeling Language modeling  methodology  authors  are  about  to  represent  a  APDEMF  framework  which  will describe essential phases of the same process.

  15. Stratigraphic evolution of the Late Jurassic Hanifa Formation along the Tuwaiq Escarpment, Saudi Arabia: Evidence for a carbonate ramp system

    Science.gov (United States)

    Fallatah, Mohammed I.; Kerans, Charles

    2018-01-01

    A sequence stratigraphic framework of the Late Jurassic (Oxfordian) Hanifa Formation at its exposure in Central Arabia is presented for the first time. This study offers the first high-resolution stratigraphic framework of the Hanifa along the Tuwaiq Escarpment by measuring 15 sections ( 770 m total thickness) over an oblique-to-dip distance of 260 km and collecting 295 samples for petrographic analysis. On the basis of these data, the Hanifa Formation can be subdivided into eight facies; 1) tabular cross-bedded quartz-peloidal-skeletal grainstone, 2) cross-bedded skeletal-peloidal grainstone, 3) bioturbated foraminiferal wackestone/mud-dominated packstone, 4) oncolitic rudstone, 5) stromatoporoid-coral biostrome/bioherm, 6) peloidal/composite-grain grain-dominated packstone/grainstone, 7) bioturbated spiculitic wackestone/mud-dominated packstone, and 8) thinly-bedded argillaceous mudstone/wackestone. The vertical and lateral distributions of these facies along the exposure define their sequence setting using the principals of sequence stratigraphy. By recognizing erosional surfaces, facies offset, and changes in facies proportions, five third-order sequences, with an average duration of 1.1 Myr, are interpreted for the Hanifa Formation. The correlation of the sequences across the study area shows that only four sequences are preserved in the north where shallow-water deposits are well-developed. Facies trends within these sequences are further illustrated in depositional models representing the highstand systems tracts (HST) and the transgressive systems tracts (TST) of the Hanifa Formation. These proposed models represent depositional settings of a carbonate ramp with normal open-marine conditions. The HST depositional model is characterized by a high-energy shoreline and depicts the presence of an offshore, structurally controlled skeletal-peloidal shoal body described here for the first time at the Hanifa exposure in the Hozwa area. This work provides a

  16. Influences of Electromagnetic Energy on Bio-Energy Transport through Protein Molecules in Living Systems and Its Experimental Evidence.

    Science.gov (United States)

    Pang, Xiaofeng; Chen, Shude; Wang, Xianghui; Zhong, Lisheng

    2016-07-25

    The influences of electromagnetic fields (EMFs) on bio-energy transport and its mechanism of changes are investigated through analytic and numerical simulation and experimentation. Bio-energy transport along protein molecules is performed by soliton movement caused by the dipole-dipole electric interactions between neighboring amino acid residues. As such, EMFs can affect the structure of protein molecules and change the properties of the bio-energy transported in living systems. This mechanism of biological effect from EMFs involves the amino acid residues in protein molecules. To study and reveal this mechanism, we simulated numerically the features of the movement of solitons along protein molecules with both a single chain and with three channels by using the Runge-Kutta method and Pang's soliton model under the action of EMFs with the strengths of 25,500, 51,000, 76,500, and 102,000 V/m in the single-chain protein, as well as 17,000, 25,500, and 34,000 V/m in the three-chain protein, respectively. Results indicate that electric fields (EFs) depress the binding energy of the soliton, decrease its amplitude, and change its wave form. Also, the soliton disperses at 102,000 V/m in a single-chain protein and at 25,500 and 34,000 V/m in three-chain proteins. These findings signify that the influence of EMFs on the bio-energy transport cannot be neglected; however, these variations depend on both the strength and the direction of the EF in the EMF. This direction influences the biological effects of EMF, which decrease with increases in the angle between the direction of the EF and that of the dipole moment of amino acid residues; however, randomness at the macroscopic level remains. Lastly, we experimentally confirm the existence of a soliton and the validity of our conclusion by using the infrared spectra of absorption of the collagens, which is activated by another type of EF. Thus, we can affirm that both the described mechanism and the corresponding theory are

  17. Assessment of Physician's Systemic Treatment Preferences for Patients with Advanced Desmoid-Type Fibromatosis: Experience-Based Medicine in the Absence of High-Level Evidence.

    Science.gov (United States)

    Schöffski, Patrick; Requilé, Annelies; van Cann, Tom

    2018-01-01

    The treatment of advanced desmoid-type fibromatosis (DF) is poorly standardized and primarily based on physician's choice. We assessed systemic treatment preferences for advanced DF among European experts, with the aim to define a control treatment for prospective randomized trials. A structured questionnaire was sent to a group of physicians involved in DF treatment. 54 experts from 14 countries (Europe, Israel) responded. Disease progression and failure of local therapy were typical indications for systemic therapy. Treatment preferences for patients with sporadic DF versus DF associated with Gardner's syndrome were similar. Physicians use at least 5 different classes of drugs (27 agents). The most frequently used compounds were anti-estrogens and non-steroidal anti-inflammatory agents (NSAIDs), in combination or as single agents. The second and third most common systemic approach was chemotherapy based on methotrexate or an anthracycline. Trial activity was limited to 1 country/1 multicentric study. There is an unmet medical need for evidence-based treatments and well-designed studies. Clinical trials with systemic agents should ideally select a homogeneous DF population with advanced, progressive, ideally symptomatic disease and/or functional impairment after failure of wait-and-see and/or local treatments, and should be randomized, with placebo, anti-estrogens, NSAIDs, or physician's choice as comparator. © 2018 S. Karger GmbH, Freiburg.

  18. The Early Diagnosis of Boys and Girls in Academic Risk Using the Perceptual-Motor Diagnostic System: A Longitudinal Retrospective Study of Evidences of its Effectiveness

    Directory of Open Access Journals (Sweden)

    Emmanuel Herrera-González

    2015-09-01

    Full Text Available The main objective in this study is to evidence the efficiency of the Peques System as a useful tool to diagnose, at an early stage, possible difficulties which will affect the academic performance. In a 3-year longitudinal study, the Perceptual-Motor Diagnostic System (Peques was applied to a sample of 149 participants (77 boys and 72 girls, who were beginning preschool education. Peques classified 38 children with a high risk to lose a year at primary school level. After a three-year follow-up (first primary school level, it was determined that 23 of the 127 who remained in the study (18%, had failed the first, second or third school year. From the high-risk group diagnosed by the Peques System, an 83% indeed lost a school year. These boys and girls had difficulties in different aspects, such as their information processing capacity, motor development, corporal image, Gestalt development and corporal coordination. We concluded that Peques System was able to predict the academic failure in the primary school level, based on the perceptual-motor development reached at preschool level. Further, based on this experience it is recommended to pay special attention to perceptual-motor development, since it plays a basic role in the academic success of boys and girls.

  19. Is processing of symbols and words influenced by writing system? Evidence from Chinese, Korean, English, and Greek.

    Science.gov (United States)

    Altani, Angeliki; Georgiou, George K; Deng, Ciping; Cho, Jeung-Ryeul; Katopodi, Katerina; Wei, Wei; Protopapas, Athanassios

    2017-12-01

    We examined cross-linguistic effects in the relationship between serial and discrete versions of digit naming and word reading. In total, 113 Mandarin-speaking Chinese children, 100 Korean children, 112 English-speaking Canadian children, and 108 Greek children in Grade 3 were administered tasks of serial and discrete naming of words and digits. Interrelations among tasks indicated that the link between rapid naming and reading is largely determined by the format of the tasks across orthographies. Multigroup path analyses with discrete and serial word reading as dependent variables revealed commonalities as well as significant differences between writing systems. The path coefficient from discrete digits to discrete words was greater for the more transparent orthographies, consistent with more efficient sight-word processing. The effect of discrete word reading on serial word reading was stronger in alphabetic languages, where there was also a suppressive effect of discrete digit naming. However, the effect of serial digit naming on serial word reading did not differ among the four language groups. This pattern of relationships challenges a universal account of reading fluency acquisition while upholding a universal role of rapid serial naming, further distinguishing between multi-element interword and intraword processing. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Keweenaw hot spot: Geophysical evidence for a 1.1 Ga mantle plume beneath the Midcontinent Rift System

    Science.gov (United States)

    Hutchinson, D.R.; White, R.S.; Cannon, W.F.; Schulz, K.J.

    1990-01-01

    The Proterozoic Midcontinent Rift System of North America is remarkably similar to Phanerozoic rifted continental margins and flood basalt provinces. Like the younger analogues, the volcanism within this older rift can be explained by decompression melting and rapid extrusion of igneous material during lithospheric extension above a broad, asthenospheric, thermal anomaly which we call the Keweenaw hot spot. Great Lakes International Multidisciplinary Program on Crustal Evolution seismic reflection profiles constrain end-member models of melt thickness and stretching factors, which yield an inferred mantle potential temperature of 1500°–1570°C during rifting. Combined gravity modeling and subsidence calculations are consistent with stretching factors that reached 3 or 4 before rifting ceased, and much of the lower crust beneath the rift consists of relatively high density intruded or underplated synrift igneous material. The isotopic signature of Keweenawan volcanic rocks, presented in a companion paper by Nicholson and Shirey (this issue), is consistent with our model of passive rifting above an asthenospheric mantle plume.

  1. Do attitudes toward societal structure predict beliefs about free will and achievement? Evidence from the Indian caste system.

    Science.gov (United States)

    Srinivasan, Mahesh; Dunham, Yarrow; Hicks, Catherine M; Barner, David

    2016-01-01

    Intuitive theories about the malleability of intellectual ability affect our motivation and achievement in life. But how are such theories shaped by the culture in which an individual is raised? We addressed this question by exploring how Indian children's and adults' attitudes toward the Hindu caste system--and its deterministic worldview--are related to differences in their intuitive theories. Strikingly, we found that, beginning at least in middle school and continuing into adulthood, individuals who placed more importance on caste were more likely to adopt deterministic intuitive theories. We also found a developmental change in the scope of this relationship, such that in children, caste attitudes were linked only to abstract beliefs about personal freedom, but that by adulthood, caste attitudes were also linked to beliefs about the potential achievement of members of different castes, personal intellectual ability, and personality attributes. These results are the first to directly relate the societal structure in which a person is raised to the specific intuitive theories they adopt. © 2015 John Wiley & Sons Ltd.

  2. Evidence of cell-mediated cardiac myocyte injury involved in the heart failure of a patient with progressive systemic sclerosis.

    Science.gov (United States)

    Takahashi, N; Seko, Y; Azuma, M; Yagita, H; Okumura, K; Yazaki, Y

    1999-01-01

    A 54-year-old woman with progressive systemic sclerosis (PSS) was admitted to hospital because of dyspnea and chest pain. Echocardiogram revealed diffuse hypokinesis of the left ventricle (ejection fraction 24%). Methylprednisolone, heparin, and diuretics were administered, without benefit. Anemia, thrombocytopenia, and renal dysfunction rapidly progressed, and she died of heart failure on the 14th hospital day. Immunohistochemical study of the myocardial tissue showed mild to moderate cell infiltration, mainly consisting of natural killer (NK) cells, macrophages, cytotoxic T lymphocytes (CTLs), and T helper cells. Perforin, a cytolytic factor, was expressed in the infiltrating CTLs and NK cells, indicating that these cells were activated killer cells. Furthermore, human leukocyte antigen classes I and II, intercellular adhesion molecule-1, as well as costimulatory molecules B7-1, B7-2, and CD40, all of which are known not to be expressed in cardiac myocytes under normal conditions, were moderately to strongly expressed in cardiac myocytes. There was no detectable level of enterovirus genomes in the polymerase chain reaction products from the myocardial tissue of this patient. These findings strongly suggest that the infiltrating killer cells recognized cardiac myocytes as target cells and directly damaged them by releasing perforin. Enhanced expression of these antigens may have played an important role in the activation and cytotoxicity of the infiltrating killer cells. Absence of enterovirus genomes in the myocardial tissue may suggest that this autoimmune process is primarily induced by PSS.

  3. Ilaj bil hijamah (cupping therapy) in the Unani system of medicine: anecdotal practice to evidence based therapy.

    Science.gov (United States)

    Abbas Zaidi, S M; Jameel, S S; Jafri, Kehkashan; Khan, Shariq A; Ahmad, Ehsan

    2016-08-01

    Cupping (Hijamah) therapy is very well documented as a result of several thousand years of clinical experiences in Unani medicine. In this procedure, suction is created by various means either with or without bloodletting. Though this therapy is being widely practiced across the globe for treating many chronic and intractable ailments but many reports reveal its unscientific and improper practices which results in many complications. Therefore to develop standard operative procedures and to propose protocols of cupping therapy in various diseases is the need of hour. A thorough literature review of relevant journals and textbooks was performed to gather the maximum available data on cupping therapy. This paper seeks to introduce the general concepts of cupping therapy in Unani medicine and other traditional systems of medicine, shortcomings and limitations of the currently published studies and suggest ways to improve these technical/methodological flaws. In addition, the authors have also attempted to provide the cupping related materials, hypotheses, observations which will provide the researchers the base for evaluating their usefulness in future clinical trials.

  4. Understanding Regolith Physical Properties of Atmosphereless Solar System Bodies Based on Remote Sensing Photopolarimetric Observations: Evidence for Europa's Porous Surface

    Science.gov (United States)

    Nelson, R. M.; Boryta, M. D.; Hapke, B. W.; Manatt, K. S.; Shkuratov, Y.; Psarev, V.; Vandervoort, K.; Kroner, D. O.; Nebedum, A.; Vides, C.; Quinones, J.

    2017-12-01

    We studied the polarization and reflective properties of a suite of planetary regolith analogues with physical characteristics that might be expected to be found on a high albedo atmosphereless solar system body (ASSB). The angular scattering properties of thirteen well-sorted particle size fractions of aluminum oxide (Al2O3) were measured in the laboratory with a goniometric photopolarimeter (GPP) of unique design. Our results provide insight in support of efforts to understand the unusual reflectance and negative polarization behavior observed near small phase angles that has been reported over several decades on highly reflective ASSBs such as the asteroids 44 Nysa, 64 Angelina (Harris et al., 1989) and the Galilean satellites Io, Europa and Ganymede (Rosenbush et al., 1997; Mishchenko et al., 2006). Our measurements are consistent with the hypothesis that the surfaces of these ASSBs effectively scatter electromagnetic radiation as if they were extremely fine grained with void space > 95%, and grain sizes of the order effects of anthropogenic greenhouse gas emissions such as carbon dioxide(Teller et al., 1997). This work partially supported by the Cassini Saturn Orbiter Progrem Harris et al., 1989 . Icarus 81, 365-374. Mishchenko et al., 2006 Applied Optics, 45, 4459-4463. Rosenbush et al, 1997, Astrophys. J. 487, 402-414. Teller et al., 1997. UCRL-JC-128715.

  5. Evidence of limited carbon sequestration in soils under no-tillage systems in the Cerrado of Brazil

    Science.gov (United States)

    Corbeels, Marc; Marchão, Robelio Leandro; Neto, Marcos Siqueira; Ferreira, Eliann Garcia; Madari, Beata Emöke; Scopel, Eric; Brito, Osmar Rodrigues

    2016-02-01

    The Brazilian government aims at augmenting the area cropped under no-tillage (NT) from 32 to 40 million ha by 2020 as a means to mitigate CO2 emissions. We estimated soil carbon (C) sequestration under continuous NT systems in two municipalities in the Goiás state that are representative of the Cerrado. A chronosequence of NT fields of different age since conversion from conventional tillage (CT) was sampled in 2003 and 2011. Soil C levels of native Cerrado and pasture were measured for comparison. After about 11 to 14 years, soil C stocks under NT were highest and at the levels of those under natural Cerrado. Average annual rates of soil C sequestration estimated using the chronosequence approach were respectively 1.61 and 1.48 Mg C ha-1 yr-1 for the 2003 and 2011 sampling, and were higher than those observed using repeated sampling after eight years. The diachronic sampling revealed that the younger NT fields tended to show higher increases in soil C stocks than the older fields. Converting an extra 8 million ha of cropland from CT to NT represents an estimated soil C storage of about 8 Tg C yr-1 during 10 to 15 years.

  6. Pb isotope evidence for contaminant-metal dispersal in an international river system: The lower Danube catchment, Eastern Europe

    International Nuclear Information System (INIS)

    Bird, Graham; Brewer, Paul A.; Macklin, Mark G.; Nikolova, Mariyana; Kotsev, Tsvetan; Mollov, Mihail; Swain, Catherine

    2010-01-01

    Lead isotope signatures ( 207 Pb/ 206 Pb, 208 Pb/ 206 Pb, 208 Pb/ 204 Pb, 206 Pb/ 204 Pb), determined by magnetic sector ICP-MS in river channel sediment, metal ores and mine waste, have been used as geochemical tracers to quantify the delivery and dispersal of sediment-associated metals in the lower Danube River catchment. Due to a diverse geology and range of ore-body ages, Pb isotope signatures in ore-bodies within the lower Danube River catchment show considerable variation, even within individual metallogenic zones. It is also possible to discriminate between the Pb isotopic signatures in mine waste and river sediment within river systems draining individual ore bodies. Lead isotopic data, along with multi-element data; were used to establish the provenance of river sediments and quantify sedimentary contributions to mining-affected tributaries and to the Danube River. Data indicate that mining-affected tributaries in Serbia and Bulgaria contribute up to 30% of the river channel sediment load of the lower Danube River. Quantifying relative sediment contributions from mining-affected tributaries enables spatial patterns in sediment-associated metal and As concentrations to be interpreted in terms of key contaminant sources. Combining geochemical survey data with that regarding the provenance of contaminated sediments can therefore be used to identify foci for remediation and environmental management strategies.

  7. Evidence for degassing of fresh magma during the 2004-2008 eruption of Mount St. Helens: Subtle signals from the hydrothermal system

    Science.gov (United States)

    Bergfeld, Deborah; Evans, William C.; Spicer, Kurt R.; Hunt, Andrew G.; Kelly, Peter

    2017-01-01

    Results from chemical and isotopic analyses of water and gas collected between 2002 and 2016 from sites on and around Mount St. Helens are used to assess magmatic degassing related to the 2004-2008 eruption. During 2005 the chemistry of hot springs in The Breach of Mount St. Helens showed no obvious response to the eruption, and over the next few years, changes were subtle, giving only slight indications of perturbations in the system. By 2010 however, water chemistry, temperatures, and isotope compositions (δD and δ18O) clearly indicated some inputs of volatiles and heat associated with the eruption, but the changes were such that they could be attributed to a pre-existing, gas depleted magma. An increase of ~ 1.5‰ in the δ13C values of dissolved carbon in the springs was noted in 2006 and continued through 2009, a change that was mirrored by a similar shift in δ13C-CO2 in bubble gas emissions. These changes require input of a new source of carbon to the hydrothermal system and provide clear evidence of CO2 from an undegassed body of magma. Rising trends in 3He/4He ratios in gas also accompanied the increases in δ13C. Since 2011 maximum RC/RA values are ≥ 6.4 and are distinctly higher than 5 samples collected between 1986 and 2002, and provide additional evidence for some involvement of new magma as early as 2006, and possibly earlier, given the unknown time needed for CO2 and He to traverse the system and arrive at the springs.

  8. Assessment of the Anticipated Environmental Footprint of Future Nuclear Energy Systems. Evidence of the Beneficial Effect of Extensive Recycling

    Directory of Open Access Journals (Sweden)

    Jérôme Serp

    2017-09-01

    Full Text Available In this early 21st century, our societies have to face a tremendous and increasing energy need while mitigating the global climate change and preserving the environment. Addressing this challenge requires an energy transition from the current fossil energy-based system to a carbon-free energy production system, based on a relevant energy mix combining renewables and nuclear energy. However, such an energy transition will only occur if it is accepted by the population. Powerful and reliable tools, such as life cycle assessments (LCA, aiming at assessing the respective merits of the different energy mix for most of the environmental impact indicators are therefore mandatory for supporting a risk-informed decision-process at the societal level. Before studying the deployment of a given energy mix, a prerequisite is to perform LCAs on each of the components of the mix. This paper addresses two potential nuclear energy components: a nuclear fuel cycle based on the Generation III European Pressurized Reactors (EPR and a nuclear fuel cycle based on the Generation IV Sodium Fast Reactors (SFR. The basis of this study relies on the previous work done on the current French nuclear fuel cycle using the bespoke NELCAS tool specifically developed for studying nuclear fuel cycle environmental impacts. Our study highlights that the EPR already brings a limited improvement to the current fuel cycle thanks to a higher efficiency of the energy transformation and a higher burn-up of the nuclear fuel (−20% on most of the chosen indicators whereas the introduction of the GEN IV fast reactors will bring a significant breakthrough by suppressing the current front-end of the fuel cycle thanks to the use of depleted uranium instead of natural enriched uranium (this leads to a decrease of the impact from 17% on water consumption and withdrawal and up to 96% on SOx emissions. The specific case of the radioactive waste is also studied, showing that only the partitioning

  9. Equinoctial asymmetry of a low-latitude ionosphere-thermosphere system and equatorial irregularities: evidence for meridional wind control

    Directory of Open Access Journals (Sweden)

    T. Maruyama

    2009-05-01

    Full Text Available Nocturnal ionospheric height variations were analyzed along the meridian of 100° E by using ionosonde data. Two ionosondes were installed near the magnetic conjugate points at low latitudes, and the third station was situated near the magnetic equator. Ionospheric virtual heights were scaled every 15 min and vertical E×B drift velocities were inferred from the equatorial station. By incorporating the inferred equatorial vertical drift velocity, ionospheric bottom heights with the absence of wind were modeled for the two low-latitude conjugate stations, and the deviation in heights from the model outputs was used to infer the transequatorial meridional thermospheric winds. The results obtained for the September and March equinoxes of years 2004 and 2005, respectively, were compared, and a significant difference in the meridional wind was found. An oscillation with a period of approximately 7 h of the meridional wind existed in both the equinoxes, but its amplitude was larger in September as compared to that in March. When the equatorial height reached the maximum level due to the evening enhancement of the zonal electric field, the transequatorial meridional wind velocity reached approximately 10 and 40 m/s for the March and September equinoxes, respectively. This asymmetry of the ionosphere-thermosphere system was found to be associated with the previously reported equinoctial asymmetry of equatorial ionospheric irregularities; the probability for equatorial irregularities to occur is higher in March as compared to that in September at the Indian to Western Pacific longitudes. Numerical simulations of plasma bubble developments were conducted by incorporating the transequatorial neutral wind effect, and the results showed that the growth time (e-folding time of the bubble was halved when the wind velocity changed from 10 to 40 m/s.

  10. Application of an almost ideal demand system (AIDS) to Ethiopian rural residential energy use: Panel data evidence

    International Nuclear Information System (INIS)

    Guta, Dawit Diriba

    2012-01-01

    It is well known that poor rural households in low-income economies are reliant on traditional fuels to meet basic domestic energy needs, but little is known about the specific underlying socio-economic drivers of residential fuel choices in Ethiopia. I used the linear approximation almost ideal demand system (LAAIDS) with normalized prices to compute expenditure elasticity and a multinomial logit model (MLM) to examine household fuel use. The LAAIDS model result showed that expenditure was elastic for modern fuels, but inelastic for traditional fuels. Regression results from the MLM indicated that fuel choice behaviour of rural households could be more accurately described as ‘fuel stacking’ behaviour as opposed to the ‘energy ladder’ hypothesis. In rural areas household fuel choice may be constrained by limited access to commercial fuels and efficient cook stoves, supply dependency and affordability, consumer preferences and a web of other intricate factors. Rural households had less incentive for fuel switching due to underlying factors and the availability of fuel wood without direct financial cost. With continued deforestation and receding forests, households are expected to develop inter fuel substitution and switching behaviour conditional on access to modern energy technologies. - Highlights: ► Two step LAAIDS model and MLM were applied to analysis of residential fuel use. ► I examined issues of ‘energy ladder’ versus ‘fuel stacking’ behavior of households. ► Controlling other factors increase in welfare increases demand for modern fuel. ► Traditional fuels are income inelastic but not necessarily cheaper. ► Residential fuel choice is determined by intricate web of socio-economic factors.

  11. Uterine mechanisms of ipsilateral directed spermatozoa transport: Evidence for a contribution of the utero-ovarian countercurrent system.

    Science.gov (United States)

    Zervomanolakis, I; Ott, H W; Müller, J; Seeber, B E; Friess, S C; Mattle, V; Virgolini, I; Heute, D; Wildt, L

    2009-05-01

    Spermatozoa transport into uterus and fallopian tubes is directed to the side of the dominant follicle and seems to be controlled by the ipsilateral ovary. The objective of this study was to evaluate the temperature in the fallopian tubes as well as the concentrations of estradiol and progesterone in the utero-ovarian veins draining the ipsilateral ovary and compare these to the contralateral side of the uterus. A prospective clinical study. Academic-assisted reproductive technology program. Temperature was measured in both oviducts of 10 patients each in the early phase as well as during the late follicular phase during the course of examination of tubal patency and function. Blood samples of the ovarian veins were obtained during hysterectomy in 10 premenopausal patients with regular menstrual cycles. Five of the women were in the early follicular phase and 5 were in the late follicular phase. Late follicular phase temperature as well as concentrations of estradiol and progesterone were significantly higher in the ipsilateral tube and the utero-ovarian veins draining the ipsilateral ovary as compared to the contralateral side. No such differences were found during the early follicular phase of the cycle. These data support our view that the uterus and fallopian tubes during the late follicular phase immediately before ovulation are composed of two functional units with different functional properties acting as a peristaltic pump resulting in increased transport of spermatozoa into the oviduct ipsilateral to the ovary bearing the dominant follicle and that this effect is mediated in part by the utero-ovarian countercurrent system.

  12. Muscle activation during maximal effort tasks: evidence of the selective forces that shaped the musculoskeletal system of humans

    Directory of Open Access Journals (Sweden)

    David R. Carrier

    2015-12-01

    Full Text Available The selective forces that played a role in the evolution of the musculoskeletal system of the genus Homo have long been debated and remain poorly understood. In this investigation, we introduce a new approach for testing alternative hypotheses. Our analysis is based on the premise that natural selection can be expected to have resulted in muscles that are large enough to achieve necessary levels of maximum performance in essential behaviors, but not larger. We used surface electromyography in male subjects to identify maximum activation levels in 13 muscles of the back and leg during eight behaviors that have been suggested to have been important to foraging, hunting and fighting performance in early humans. We asked two questions: (1 what behaviors produce maximum activation in each of the investigated muscles and (2 are there specific behaviors that elicit maximum recruitment from all or most of the muscles? We found that in eight of the 13 muscles, the highest activity occurred during maximal effort vertical jumping (i.e. whole-body acceleration. Punching produced the highest median activity in the other five muscles. Together, jumping and punching accounted for 73% of the incidences of maximum activity among all of the muscles and from all of the subjects. Thus, the size of the muscles of the back and leg appear to be more related to the demands of explosive behaviors rather than those of high speed sprinting or sustained endurance running. These results are consistent with the hypothesis that selection on aggressive behavior played an important role in the evolution of the genus Homo.

  13. Evidence for sites of methylmercury formation in a flowing water system: impact of anthropogenic barriers and water management.

    Science.gov (United States)

    Pizarro-Barraza, Claudia; Gustin, Mae Sexauer; Peacock, Mary; Miller, Matthieu

    2014-04-15

    The Truckee River, California-Nevada, USA is impacted by mercury (Hg) contamination associated with legacy gold mining. In this work, we investigated the potential for hot-spots of methylmercury (MeHg) formation in the river. Mercury concentrations in multiple media were also used to assess the impacts of anthropogenic barriers, restoration, and water management in this flowing water ecosystem. Water samples were collected on a seasonal time step over 3 years, and analyzed for total Hg (THg) and MeHg concentrations, along with a variety of other water quality parameters. In addition, we measured THg and MeHg in sediments, THg in macroinvertebrates, and THg and δ(15)N and δ(13)C concentrations in fish. Differences in stable isotopes and Hg concentrations in fish were applied to understand the mobility of fish in the river. Mercury concentrations of specific macroinvertebrate species were used to identify sites of MeHg production. In general, loads of Hg and nutrients in the river reach above the Reno-Sparks metropolitan area were similar to that reported for pristine systems, while within and below the city, water quality impacts were observed. Fish isotope data showed that in the city reach food resources were different than those upriver and downriver. Based on Hg and isotope data, mobility of the fish in the river is impacted by anthropogenic obstructions and water manipulation. Below the city, particle bound Hg, derived from the legacy mining, continues to be input to the Truckee River. This Hg is deposited in riparian habitats and areas of river restoration, where it is methylated and becomes available to biota. During spring, when flows were highest, MeHg produced and stored in the sediments is mobilized and transported downriver. Fish and macroinvertebrate concentrations increased downriver indicating passive uptake from water. The information presented here could be useful for those doing river restoration and water manipulation in mercury contaminated

  14. Has the Copayment Ceiling Improved Financial Protection in the Korean National Health Insurance System? Evidence From the 2009 Policy Change.

    Science.gov (United States)

    Lee, Tae-Jin; Cheong, Chelim

    2017-11-01

    To relieve the financial burden faced by households, the Korean National Health Insurance (NHI) system introduced a "copayment ceiling," which evolved into a differential ceiling in 2009, with the copayment ceiling depending on patients' income. This study aimed to examine the effect of the differential copayment ceiling on financial protection and healthcare utilization, particularly focusing on whether its effects varied across different income groups. This study obtained data from the Korea Health Panel. The number of households included in the analysis was 6555 in 2008, 5859 in 2009, 5539 in 2010, and 5372 in 2011. To assess the effects of the differential copayment ceiling on utilization, out-of-pocket (OOP) payments, and catastrophic payments, various random-effects models were applied. Utilization was measured as treatment days, while catastrophic payments were defined as OOP payments exceeding 10% of household income. Among the right-hand side variables were the interaction terms of the new policy with income levels, as well as a set of household characteristics. The differential copayment ceiling contributed to increased utilization regardless of income levels both in all patients and in cancer patients. However, the new policy did not seem to reduce significantly the incidence of catastrophic payments among cancer patients, and even increased the incidence among all patients. The limited effect of the differential ceiling can be attributed to a high proportion of direct payments for services not covered by the NHI, as well as the relatively small number of households benefiting from the differential ceilings; these considerations warrant a better policy design.

  15. Evidence for sites of methylmercury formation in a flowing water system: Impact of anthropogenic barriers and water management

    International Nuclear Information System (INIS)

    Pizarro-Barraza, Claudia; Gustin, Mae Sexauer; Peacock, Mary; Miller, Matthieu

    2014-01-01

    The Truckee River, California-Nevada, USA is impacted by mercury (Hg) contamination associated with legacy gold mining. In this work, we investigated the potential for hot-spots of methylmercury (MeHg) formation in the river. Mercury concentrations in multiple media were also used to assess the impacts of anthropogenic barriers, restoration, and water management in this flowing water ecosystem. Water samples were collected on a seasonal time step over 3 years, and analyzed for total Hg (THg) and MeHg concentrations, along with a variety of other water quality parameters. In addition, we measured THg and MeHg in sediments, THg in macroinvertebrates, and THg and δ 15 N and δ 13 C concentrations in fish. Differences in stable isotopes and Hg concentrations in fish were applied to understand the mobility of fish in the river. Mercury concentrations of specific macroinvertebrate species were used to identify sites of MeHg production. In general, loads of Hg and nutrients in the river reach above the Reno–Sparks metropolitan area were similar to that reported for pristine systems, while within and below the city, water quality impacts were observed. Fish isotope data showed that in the city reach food resources were different than those upriver and downriver. Based on Hg and isotope data, mobility of the fish in the river is impacted by anthropogenic obstructions and water manipulation. Below the city, particle bound Hg, derived from the legacy mining, continues to be input to the Truckee River. This Hg is deposited in riparian habitats and areas of river restoration, where it is methylated and becomes available to biota. During spring, when flows were highest, MeHg produced and stored in the sediments is mobilized and transported downriver. Fish and macroinvertebrate concentrations increased downriver indicating passive uptake from water. The information presented here could be useful for those doing river restoration and water manipulation in mercury contaminated

  16. Road traffic fatalities - a neglected epidemic in rural northern Ghana: evidence from the navrongo demographic surveillance system.

    Science.gov (United States)

    Bawah, Ayaga; Welaga, Paul; Azongo, Daniel K; Wak, George; Phillips, James F; Oduro, Abraham

    2014-12-01

    Globally, road traffic fatalities have been on the increase, particularly in low-and-middle income countries. Much of this is attributed to increases in the acquisition, and use of motorized vehicles. However, there is very little empirical research to understand the causes and determinants of this threat. This paper investigates time trends and determinants of road traffic accidents in the Kasena-Nankana district of northern Ghana. First, we utilized causes of death data gathered by the Health and Demographic Surveillance System in Navrongo, to examine trends in deaths due to injury, particularly those related to road traffic crashes. Subsequently, we employed multivariate logistic regression to examine factors associated with deaths due to all injuries and road traffic crashes among adults 15-59 years of age. Results show a three-fold increase in mortality (18%) due to injuries in the Kasena-Nankana district in about a decade. Fatalities resulting from road traffic crashes constitute the greatest share of the burden of mortality resulting from injuries. Increases in road traffic fatalities have coincided with recent increases in motor and vehicular traffic in the region. Several factors are associated with the increased risk of deaths from road traffic accidents, principal among which include urban residence (OR = 1.74 95% CI 1.09-2.78), being male and in the prime adult ages of between 20-29 years old (OR = 4.85 95% CI 2.65-8.89), as well as people with higher levels of education (OR = 3.21 95% CI 1.75-5.87) and those in higher socioeconomic status categories (OR = 2.43 95% CI 1.21-4.88). Results suggest that road traffic fatalities have become a major cause of morbidity and mortality and brings into focus the need for measures to curb this looming crisis. There is need for strategic interventions to be adopted to avert what is sure to become one of the leading causes of death in this impoverished locality.

  17. Comparing causes of death between formal and informal neighborhoods in urban Africa: evidence from Ouagadougou Health and Demographic Surveillance System.

    Science.gov (United States)

    Soura, Abdramane Bassiahi; Lankoande, Bruno; Millogo, Roch; Bangha, Martin

    2014-01-01

    The probable coexistence of two or more epidemiological profiles in urban Africa is poorly documented. In particular, very few studies have focused on the comparison of cause-specific mortality between two types of neighborhoods that characterize contemporary southern cities: formal neighborhoods, that is, structured or delineated settlements (planned estates) that have full access to public utilities (electricity and water services), and the informal neighborhoods, that is, spontaneous and unplanned peri-urban settlements where people live in slum-like conditions, often with little or no access to public utilities. To compare the causes of death between the formal and informal neighborhoods covered by the Ouagadougou Health and Demographic Surveillance Systems (HDSS). The data used come from the INDEPTH pooled dataset which includes the contribution of Ouagadougou HDSS and are compiled for the INDEPTH Network Data repository. The data were collected between 2009 and 2011 using verbal autopsy (VA) questionnaires completed by four fieldworkers well trained in the conduction of VAs. The VA data were then interpreted using the InterVA-4 program (version 4.02) to arrive at the causes of death. Communicable diseases are the leading cause of death among children (aged between 29 days and 14 years) in both formal and informal neighborhoods, contributing more than 75% to the mortality rate. Mortality rates from non-communicable diseases (NCDs) are very low before age 15 but are the leading causes from age 50, especially in formal neighborhoods. Mortality from injuries is very low, with no significant difference between the two neighborhoods. The fact that mortality from NCDs is higher among adults in formal neighborhoods seems consistent with the idea of a correlation between modern life and epidemiological transition. However, NCDs do affect informal neighborhoods as well. They consist mainly of cardiovascular diseases and neoplasms most of which are preventable and

  18. Comparing causes of death between formal and informal neighborhoods in urban Africa: evidence from Ouagadougou Health and Demographic Surveillance System

    Directory of Open Access Journals (Sweden)

    Abdramane Bassiahi Soura

    2014-10-01

    Full Text Available Background: The probable coexistence of two or more epidemiological profiles in urban Africa is poorly documented. In particular, very few studies have focused on the comparison of cause-specific mortality between two types of neighborhoods that characterize contemporary southern cities: formal neighborhoods, that is, structured or delineated settlements (planned estates that have full access to public utilities (electricity and water services, and the informal neighborhoods, that is, spontaneous and unplanned peri-urban settlements where people live in slum-like conditions, often with little or no access to public utilities. Objective: To compare the causes of death between the formal and informal neighborhoods covered by the Ouagadougou Health and Demographic Surveillance Systems (HDSS. Design: The data used come from the INDEPTH pooled dataset which includes the contribution of Ouagadougou HDSS and are compiled for the INDEPTH Network Data repository. The data were collected between 2009 and 2011 using verbal autopsy (VA questionnaires completed by four fieldworkers well trained in the conduction of VAs. The VA data were then interpreted using the InterVA-4 program (version 4.02 to arrive at the causes of death. Results: Communicable diseases are the leading cause of death among children (aged between 29 days and 14 years in both formal and informal neighborhoods, contributing more than 75% to the mortality rate. Mortality rates from non-communicable diseases (NCDs are very low before age 15 but are the leading causes from age 50, especially in formal neighborhoods. Mortality from injuries is very low, with no significant difference between the two neighborhoods. Conclusions: The fact that mortality from NCDs is higher among adults in formal neighborhoods seems consistent with the idea of a correlation between modern life and epidemiological transition. However, NCDs do affect informal neighborhoods as well. They consist mainly of

  19. Evidence for sites of methylmercury formation in a flowing water system: Impact of anthropogenic barriers and water management

    Energy Technology Data Exchange (ETDEWEB)

    Pizarro-Barraza, Claudia [Department of Natural Resources and Environmental Sciences, University of Nevada-Reno, Reno, NV 89557 (United States); Gustin, Mae Sexauer, E-mail: mgustin@cabnr.unr.edu [Department of Natural Resources and Environmental Sciences, University of Nevada-Reno, Reno, NV 89557 (United States); Peacock, Mary [Department of Biology, University of Nevada-Reno, Reno, NV 89557 (United States); Miller, Matthieu [Department of Natural Resources and Environmental Sciences, University of Nevada-Reno, Reno, NV 89557 (United States)

    2014-04-01

    The Truckee River, California-Nevada, USA is impacted by mercury (Hg) contamination associated with legacy gold mining. In this work, we investigated the potential for hot-spots of methylmercury (MeHg) formation in the river. Mercury concentrations in multiple media were also used to assess the impacts of anthropogenic barriers, restoration, and water management in this flowing water ecosystem. Water samples were collected on a seasonal time step over 3 years, and analyzed for total Hg (THg) and MeHg concentrations, along with a variety of other water quality parameters. In addition, we measured THg and MeHg in sediments, THg in macroinvertebrates, and THg and δ{sup 15}N and δ{sup 13}C concentrations in fish. Differences in stable isotopes and Hg concentrations in fish were applied to understand the mobility of fish in the river. Mercury concentrations of specific macroinvertebrate species were used to identify sites of MeHg production. In general, loads of Hg and nutrients in the river reach above the Reno–Sparks metropolitan area were similar to that reported for pristine systems, while within and below the city, water quality impacts were observed. Fish isotope data showed that in the city reach food resources were different than those upriver and downriver. Based on Hg and isotope data, mobility of the fish in the river is impacted by anthropogenic obstructions and water manipulation. Below the city, particle bound Hg, derived from the legacy mining, continues to be input to the Truckee River. This Hg is deposited in riparian habitats and areas of river restoration, where it is methylated and becomes available to biota. During spring, when flows were highest, MeHg produced and stored in the sediments is mobilized and transported downriver. Fish and macroinvertebrate concentrations increased downriver indicating passive uptake from water. The information presented here could be useful for those doing river restoration and water manipulation in mercury

  20. Identification, mapping, and analysis of possible evidences of active petroleum systems in the Colorado Basin, offshore Argentina, South America

    Science.gov (United States)

    Loegering, Markus; Anka, Zahie; Rodriguez, Jorge; Marchal, Denis; di Primio, Rolando; Vallejo, Eduardo; Kohler, Guillermina; Pangaro, Francisco

    2010-05-01

    analysed in relation to structural and stratigraphic elements present within the syn-rift and post-rift successions. The main observed features consist of seismic vertical pipes where the seismic signal is strongly disturbed. The diameter of mapped seismic pipes ranges from 100 m up to 2000 m. Preliminary classification of these features shows two families of seismic pipes: (1) the first and principal family is mostly concentrated in the centre and innermost part of the basin and seems to be mainly controlled by the stratigraphy, ending in the Elvira Fm (Eocene). Many of these features are linked to the presence of volcanics, as demonstrated by some wells; (2) the second family is located on the oceanward outer part of the basin, reaching the seafloor and resulting in pockmark depressions or seabed mounds. These features represent possible candidates for gas chimneis. Other kinds of gas escape structures as seismic wipe-out zones and hydraulic brecciation are also tentatively observed. The present-day bathymetry from 3D seismic reflection data indicates the presence of seabed pockmarks and submarine channels on the slope of the basin. The circular to near-circular seafloor depressions initially identified on the 2D seismic-reflection profiles correspond to circular-to-elongate pockmarks mapped on the high-resolution bathymetry. Most of the pockmarks present a diameter from 200 m to 900 m and vertical length between 20 m to 100 m, and occur close to submarine channels, which range from 1000 m to 5000 m in width and from 100 m to 500 m in depth. A highly-dense vertically-faulted interval has been identified within the Colorado (Campanian) and Pedro Luro (Paleocene) Formations in the slope region of the basin. These faults correspond to polygonal fault systems that could breach Paleocene/Eocene sealing sequences, allowing fluids to flow vertically or sub-vertically across the seal. Numerical modelling of hydrocarbon generation and migration, calibrated to the observations on

  1. Late Noachian and early Hesperian ridge systems in the south circumpolar Dorsa Argentea Formation, Mars: Evidence for two stages of melting of an extensive late Noachian ice sheet

    Science.gov (United States)

    Kress, Ailish M.; Head, James W.

    2015-05-01

    The Dorsa Argentea Formation (DAF), extending from 270°-100° E and 70°-90° S, is a huge circumpolar deposit surrounding and underlying the Late Amazonian South Polar Layered Deposits (SPLD) of Mars. Currently mapped as Early-Late Hesperian in age, the Dorsa Argentea Formation has been interpreted as volatile-rich, possibly representing the remnants of an ancient polar ice cap. Uncertain are its age (due to the possibility of poor crater retention in ice-related deposits), its mode of origin, the origin of the distinctive sinuous ridges and cavi that characterize the unit, and its significance in the climate history of Mars. In order to assess the age of activity associated with the DAF, we examined the ridge populations within the Dorsa Argentea Formation, mapping and characterizing seven different ridge systems (composed of nearly 4,000 ridges covering a total area of ~300,000 km2, with a cumulative length of ridges of ~51,000 km) and performing crater counts on them using the method of buffered crater counting to determine crater retention ages of the ridge populations. We examined the major characteristics of the ridge systems and found that the majority of them were consistent with an origin as eskers, sediment-filled subglacial drainage channels. Ridge morphologies reflect both distributed and channelized esker systems, and evidence is also seen that some ridges form looping moraine-like termini distal to some distributed systems. The ridge populations fall into two age groups: ridge systems between 270° and 0° E date to the Early Hesperian, but to the east, the Promethei Planum and the Chasmata ridge systems date to the Late Noachian. Thus, these ages, and esker and moraine-like morphologies, support the interpretation that the DAF is a remnant ice sheet deposit, and that the esker systems represent evidence of significant melting and drainage of meltwater from portions of this ice sheet, thus indicating at least some regions and/or periods of wet

  2. The importance of symbolic and engaged participation in evidence-based quality improvement in a complex integrated healthcare system: response to "The science of stakeholder engagement in research".

    Science.gov (United States)

    Hamilton, Alison B; Yano, Elizabeth M

    2017-09-01

    In this commentary, we respond to the commentary provided by Goodman and Sanders Thompson regarding our paper on multilevel stakeholder engagement in a VA implementation trial of evidence-based quality improvement (EBQI) in women's health primary care. We clarify our overall approach to engagement (comprised of both symbolic and engaged participation, according to the authors' classification rubric), highlighting that symbolic participation is of more import and value than the authors suggest, especially in the context of a hierarchical healthcare system. We contend that the issue of power-and how power matters in stakeholder engagement-needs to be considered in this context rather than in global "community" terms. In response to the authors' call for greater detail, we clarify our planning processes as well as our approach to veteran engagement. We concur with Goodman and Sanders Thompson that the science of stakeholder engagement necessitates a broader understanding of best practices as well as the impact of engagement on implementation outcomes.

  3. Familial systemic lupus erythematosus: evidence for separate loci controlling C4 deficiency and formation of antibodies to DNA, nRNP, Ro and La.

    Science.gov (United States)

    Verrier Jones, J; Jones, E; Forsyth, S J; Skanes, V M; Reichlin, M; MacSween, J M; Eastwood, S; Carr, R I

    1987-04-01

    A family has been identified in the Canadian province of Prince Edward Island in which 2 sisters have systemic lupus erythematosus in a sibship of 14. Studies are reported on 11 of the siblings and 16 other family members. The affected siblings, and 4 other members of their sibship, are halfnull homozygotes for the C4A component of complement. We studied the distribution in family members of antibodies to ss and dsDNA, and to Ro(SSA), La(SSB), Sm and nRNP. Eight of 11 members of the affected sibship are antibody producers, compared to only 3 of 13 members of the parental generation. Our study provides further evidence for an association between null genes for C4A and familial lupus, and suggests, in an unusually large kindred, that several other genetic factors are involved in the production of antinuclear antibodies.

  4. A mixed-methods study of system-level sustainability of evidence-based practices in 12 large-scale implementation initiatives.

    Science.gov (United States)

    Scudder, Ashley T; Taber-Thomas, Sarah M; Schaffner, Kristen; Pemberton, Joy R; Hunter, Leah; Herschell, Amy D

    2017-12-07

    In recent decades, evidence-based practices (EBPs) have been broadly promoted in community behavioural health systems in the United States of America, yet reported EBP penetration rates remain low. Determining how to systematically sustain EBPs in complex, multi-level service systems has important implications for public health. This study examined factors impacting the sustainability of parent-child interaction therapy (PCIT) in large-scale initiatives in order to identify potential predictors of sustainment. A mixed-methods approach to data collection was used. Qualitative interviews and quantitative surveys examining sustainability processes and outcomes were completed by participants from 12 large-scale initiatives. Sustainment strategies fell into nine categories, including infrastructure, training, marketing, integration and building partnerships. Strategies involving integration of PCIT into existing practices and quality monitoring predicted sustainment, while financing also emerged as a key factor. The reported factors and strategies impacting sustainability varied across initiatives; however, integration into existing practices, monitoring quality and financing appear central to high levels of sustainability of PCIT in community-based systems. More detailed examination of the progression of specific activities related to these strategies may aide in identifying priorities to include in strategic planning of future large-scale initiatives. ClinicalTrials.gov ID NCT02543359 ; Protocol number PRO12060529.

  5. Monoacylglycerol lipase (MGLL) polymorphism rs604300 interacts with childhood adversity to predict cannabis dependence symptoms and amygdala habituation: Evidence from an endocannabinoid system-level analysis.

    Science.gov (United States)

    Carey, Caitlin E; Agrawal, Arpana; Zhang, Bo; Conley, Emily D; Degenhardt, Louisa; Heath, Andrew C; Li, Daofeng; Lynskey, Michael T; Martin, Nicholas G; Montgomery, Grant W; Wang, Ting; Bierut, Laura J; Hariri, Ahmad R; Nelson, Elliot C; Bogdan, Ryan

    2015-11-01

    Despite evidence for heritable variation in cannabis involvement and the discovery of cannabinoid receptors and their endogenous ligands, no consistent patterns have emerged from candidate endocannabinoid (eCB) genetic association studies of cannabis involvement. Given interactions between eCB and stress systems and associations between childhood stress and cannabis involvement, it may be important to consider childhood adversity in the context of eCB-related genetic variation. We employed a system-level gene-based analysis of data from the Comorbidity and Trauma Study (N = 1,558) to examine whether genetic variation in six eCB genes (anabolism: DAGLA, DAGLB, NAPEPLD; catabolism: MGLL, FAAH; binding: CNR1; SNPs N = 65) and childhood sexual abuse (CSA) predict cannabis dependence symptoms. Significant interactions with CSA emerged for MGLL at the gene level (p = .009), and for rs604300 within MGLL (ΔR2 = .007, p system and addiction (ΔR2 = .013, p = .047). Rs604300 may be related to epigenetic modulation of MGLL expression. These results are consistent with rodent models implicating 2-arachidonoylglycerol (2-AG), an endogenous cannabinoid metabolized by the enzyme encoded by MGLL, in the etiology of stress adaptation related to cannabis dependence, but require further replication. (c) 2015 APA, all rights reserved).

  6. Geochemical and isotopic evidence on the recharge and circulation of geothermal water in the Tangshan Geothermal System near Nanjing, China: implications for sustainable development

    Science.gov (United States)

    Lu, Lianghua; Pang, Zhonghe; Kong, Yanlong; Guo, Qi; Wang, Yingchun; Xu, Chenghua; Gu, Wen; Zhou, Lingling; Yu, Dandan

    2018-01-01

    Geothermal resources are practical and competitive clean-energy alternatives to fossil fuels, and study on the recharge sources of geothermal water supports its sustainable exploitation. In order to provide evidence on the recharge source of water and circulation dynamics of the Tangshan Geothermal System (TGS) near Nanjing (China), a comprehensive investigation was carried out using multiple chemical and isotopic tracers (δ2H, δ18O, δ34S, 87Sr/86Sr, δ13C, 14C and 3H). The results confirm that a local (rather than regional) recharge source feeds the system from the exposed Cambrian and Ordovician carbonate rocks area on the upper part of Tangshan Mountain. The reservoir temperature up to 87 °C, obtained using empirical as well as theoretical chemical geothermometers, requires a groundwater circulation depth of around 2.5 km. The temperature of the geothermal water is lowered during upwelling as a consequence of mixing with shallow cold water up to a 63% dilution. The corrected 14C age shows that the geothermal water travels at a very slow pace (millennial scale) and has a low circulation rate, allowing sufficient time for the water to become heated in the system. This study has provided key information on the genesis of TGS and the results are instructive to the effective management of the geothermal resources. Further confirmation and even prediction associated with the sustainability of the system could be achieved through continuous monitoring and modeling of the responses of the karstic geothermal reservoir to hot-water mining.

  7. Vaccination in paediatric patients with auto-immune rheumatic diseases : A systemic literature review for the European League against Rheumatism evidence-based recommendations

    NARCIS (Netherlands)

    Heijstek, M. W.; de Bruin, L. M. Ott; Borrow, R.; van der Klis, F.; Kone-Paut, I.; Fasth, A.; Minden, K.; Ravelli, A.; Abinun, M.; Pileggi, G.; Borte, M.; Bijl, M.; Wulffraat, N. M.

    2011-01-01

    Objectives: To analyze available evidence on vaccinations in paediatric patients with rheumatic and auto-inflammatory diseases. This evidence formed the basis of the recently constructed European League against Rheumatism (EULAR) recommendations for vaccination of these patients. Methods: A

  8. The complexity of the CaF2:Yb system: evidence that CaF2:Yb2+ is not an impurity trapped exciton system

    Science.gov (United States)

    Mackeen, Cameron; Bridges, Frank; Kozina, Michael; Mehta, Apurva; Reid, M. F.; Wells, J.-P. R.; BarandiaráN, Zoila

    Fluorite crystal structures doped with rare-earth elements exhibit an anomalous redshifted luminescence upon UV excitation, generally attributed to the relaxation of impurity trapped excitons (ITE). We find that the intensity of this luminescence decreases as the total concentration of Yb 2+ increases in unexposed samples, which is in conflict with the currently accepted ITE model. Further, using x-ray absorption spectroscopy and UV-vis studies of CaF2:Yb, we find a large (but reversible) Yb valence reduction upon x-ray exposure at 200 K - from mostly 3+ to 2+. This valence reduction is stable for long time periods at low T < 50 K, but reverts to the initial state upon warming to 300 K. After reverting to the initial valence state of 3+ the anomalous luminescence does not reappear; only after annealing at 900 K do we again observe the anomalous emission below 150 K. To explore the mechanism at work, we employ extended x-ray fine-structure absorption spectroscopy (EXAFS) to probe local structure and its role in the anomalous luminescence. The x-ray and emission studies show that CaF2:Yb is not described by the ITE model; the data appear more consistent with an intervalence charge transfer (IVCT) model. It is likely that many similar ITE systems have also been misidentified.

  9. Reported Systems Changes and Sustainability Perceptions of Three State Departments of Health Implementing Multi-Faceted Evidence-Based Fall Prevention Efforts

    Directory of Open Access Journals (Sweden)

    Matthew Lee Smith

    2017-06-01

    Full Text Available Although the concepts of systems change and sustainability are not new, little is known about the factors associated with systems change sustaining multi-state, multi-level fall prevention efforts. This exploratory study focuses on three State Departments of Health (DOH that were awarded 5-year funding from the Centers for Disease Control and Prevention to simultaneously implement four separate yet related evidence-based fall prevention initiatives at the clinical, community, and policy level. The purpose of this study was to examine changes in partnerships and collaborative activities that occurred to accomplish project goals (examining changes in the context of “before funding” and “after funding was received”. Additionally, this study explored changes in State DOH perceptions about action related to sustainability indicators in the context of “during funding” and “after funding ends.” Findings from this study document the partnership and activity changes necessary to achieve defined fall prevention goals after funding is received, and that the importance of sustainability indicator documentation is seen as relevant during funding, but less so after the funding ends. Findings from this study have practice and research implications that can inform future funded efforts in terms of sector and stakeholder engagement necessary for initiating, implementing, and sustaining community- and clinical-based fall prevention interventions.

  10. Reported Systems Changes and Sustainability Perceptions of Three State Departments of Health Implementing Multi-Faceted Evidence-Based Fall Prevention Efforts

    Science.gov (United States)

    Smith, Matthew Lee; Schneider, Ellen C.; Byers, Imani N.; Shubert, Tiffany E.; Wilson, Ashley D.; Towne, Samuel D.; Ory, Marcia G.

    2017-01-01

    Although the concepts of systems change and sustainability are not new, little is known about the factors associated with systems change sustaining multi-state, multi-level fall prevention efforts. This exploratory study focuses on three State Departments of Health (DOH) that were awarded 5-year funding from the Centers for Disease Control and Prevention to simultaneously implement four separate yet related evidence-based fall prevention initiatives at the clinical, community, and policy level. The purpose of this study was to examine changes in partnerships and collaborative activities that occurred to accomplish project goals (examining changes in the context of “before funding” and “after funding was received”). Additionally, this study explored changes in State DOH perceptions about action related to sustainability indicators in the context of “during funding” and “after funding ends.” Findings from this study document the partnership and activity changes necessary to achieve defined fall prevention goals after funding is received, and that the importance of sustainability indicator documentation is seen as relevant during funding, but less so after the funding ends. Findings from this study have practice and research implications that can inform future funded efforts in terms of sector and stakeholder engagement necessary for initiating, implementing, and sustaining community- and clinical-based fall prevention interventions. PMID:28642861

  11. First evidence of "paralytic shellfish toxins" and cylindrospermopsin in a Mexican freshwater system, Lago Catemaco, and apparent bioaccumulation of the toxins in "tegogolo" snails (Pomacea patula catemacensis).

    Science.gov (United States)

    Berry, John P; Lind, Owen

    2010-05-01

    Exposure to cyanobacterial toxins in freshwater systems, including both direct (e.g., drinking water) and indirect (e.g., bioaccumulation in food webs) routes, is emerging as a potentially significant threat to human health. We investigated cyanobacterial toxins, specifically cylindrospermopsin (CYN), the microcystins (MCYST) and the "paralytic shellfish toxins" (PST), in Lago Catemaco (Veracruz, Mexico). Lago Catemaco is a tropical lake dominated by Cylindrospermopsis, specifically identified as Cylindrospermopsis catemaco and Cylindrospermopsis philippinensis, and characterized by an abundant, endemic species of snail (Pomacea patula catemacensis), known as "tegogolos," that is both consumed locally and commercially important. Samples of water, including dissolved and particulate fractions, as well as extracts of tegogolos, were screened using highly specific and sensitive ELISA. ELISA identified CYN and PST at low concentrations in only one sample of seston; however, both toxins were detected at appreciable quantities in tegogolos. Calculated bioaccumulation factors (BAF) support bioaccumulation of both toxins in tegogolos. The presence of CYN in the phytoplankton was further confirmed by HPLC-UV and LC-MS, following concentration and extraction of algal cells, but the toxin could not be confirmed by these methods in tegogolos. These data represent the first published evidence for CYN and the PST in Lago Catemaco and, indeed, for any freshwater system in Mexico. Identification of the apparent bioaccumulation of these toxins in tegogolos may suggest the need to further our understanding of the transfer of cyanobacterial toxins in freshwater food webs as it relates to human health. Copyright 2009 Elsevier Ltd. All rights reserved.

  12. Does the national innovation system spur economic growth in Brazil, Russia, India, China and South Africa economies? Evidence from panel data

    Directory of Open Access Journals (Sweden)

    Brima Sesay

    2018-01-01

    Full Text Available The question as to whether the national innovation system (NIS plays a significant positive role in influencing economic growth has been intensely debated by academics as well as policy analysts. The main controversy, however, is the fact that the ongoing empirical evidences on the relationship between innovation and economic growth are still mixed. The aim of this paper is to provide further evidence on the relationship between the NIS and economic growth using consistent and reliable data from a sample of emerging economies (Brazil, Russia, India, China and South Africa [BRICS]. The research has a BRICS focus and constructs NIS using historical panel data set for the main variables, that is, university enrolment rate for science and engineering students, government research and development expenditure, high-tech export and the enclosure of control variables covering the period 2000Q1–2013Q4. The study employed a dynamic panel estimation technique with a view of evaluating the relative impact of the NIS on economic growth in BRICS. The results revealed that the NIS as a whole has a positive effect on economic growth in BRICS economies. An important policy implication emerging from this study is that extra efforts are needed by emerging economies to promote the development of a NIS so as to explore the potential growth-inducing effects of a well-functioning NIS. Consequently, findings from this study have offered some persuading indicators for BRICS economies to explore the development of a NIS as a potential opportunity to speed up their economic growth.

  13. New geochronology and evidence for magma mixing and comingling in the linked River Mountains-Wilson Ridge system, Nevada and Arizona

    Science.gov (United States)

    Honn, D. K.; Smith, E. I.; Simon, A. C.

    2008-12-01

    The application of micro-techniques (SIMS, LA-ICPMS, EPMA, CL and BSE imaging) provides evidence for magma mixing/comingling and supports the link between the coeval River Mountains (RM) volcanic suite and the Wilson Ridge pluton (WRP) of southern Nevada and northwestern Arizona. Previously, the RM-WRP link was based on similar lithology, structure, geochronology, magnesio-riebeckite mineralization, and geochemistry (immobile trace elements, REE distributions, Sr and Nd isotopes). New evidence for this link includes high Ba concentrations (2.9 wt. %; EPMA) in feldspars from both the RM and WRP. Ba-rich feldspars are not present in nearby igneous systems. New U/Pb SIMS dates (± 1 sigma) for zircon bracket the lifetime of magmatic activity in the RM-WRP to between 14.11 ± 0.87 Ma and 12.19 ± 0.72 Ma. This magmatic timeframe is shorter than that previously determined by using U/Pb LA-ICP-MS dates for zircon of 17.0 ± 0.6 to 13.9 ± 0.6 Ma. The longer timeframe suggested by LA-ICPMS likely reflects the presence of xenocrysts and inherited cores in the sampled population. Evidence for magma mixing and comingling in the RM-WRP includes several populations of mafic enclaves with crenulate margins, comagmatic mafic dikes, and schlieren. Detailed thin section petrography and EPMA BSE imaging demonstrate the presence of dissolution surfaces, overgrowths, and resorbed cores in feldspars. CL images of zircons show dissolution surfaces and antecrystic cores. LA-ICP-MS dates of antecrystic cores were as much as 4.2 m.y. older than their rims. EPMA rim-core-rim traverses on zircon phenocrysts indicate order of magnitude changes in Y2O3 (0.05 to 0.6 wt. %) and ThO2 (0.01 to 0.14 wt. %) within single grains, suggesting new growth of zircon during magma mixing events. Ti-in-quartz thermometry is also being used to test the magma mixing hypothesis. The sum of field and analytical data support the conclusion that the RM and WRP represent a linked volcano-plutonic complex.

  14. Errors can elicit an error positivity in the absence of an error negativity: Evidence for independent systems of human error monitoring.

    Science.gov (United States)

    Di Gregorio, Francesco; Maier, Martin E; Steinhauser, Marco

    2018-02-01

    Errors in human behavior elicit a cascade of brain activity related to performance monitoring and error detection. Whereas the early error-related negativity (Ne/ERN) has been assumed to reflect a fast mismatch or prediction error signal in the medial frontal cortex, the later error positivity (Pe) is viewed as a correlate of conscious error processing. A still open question is whether these components represent two independent systems of error monitoring that rely on different types of information to detect an error. Here, we investigated the prediction that the Ne/ERN but not the Pe requires a representation of the correct response to emerge. To this end, we created a condition in which no information about the correct response was available while error detection was still possible. We hypothesized that a Pe, but no Ne/ERN should be obtained in this case. Participants had to classify targets but ignore flankers that were always associated with an incorrect response. Targets but not flankers were masked with varying target-masking intervals. Crucially, on some trials no target at all was presented, thus preventing the representation of a correct response and the emergence of an Ne/ERN. However, because flankers were easily visible and responses to the flankers were always incorrect, detection of these flanker errors was still possible. In line with predictions of a multiple-systems account, we observed a robust Pe in the absence of an Ne/ERN for these errors. Moreover, this Pe relied on the same neural activity as that on trials with a visible target, as revealed by multivariate pattern analysis. These findings demonstrate that the mechanisms reflected by the two components use different types of information to detect errors, providing evidence for independent systems of human error monitoring. Copyright © 2018 Elsevier Inc. All rights reserved.

  15. The Quaternary uplift history of central southern England: evidence from the terraces of the Solent River system and nearby raised beaches

    Science.gov (United States)

    Westaway, Rob; Bridgland, David; White, Mark

    2006-09-01

    We have used fluvial (Solent River system) and marine terraces to reconstruct the uplift history of central southern England. In the case of the former, we make the assumption that fluvial incision has been a direct response to surface uplift, with its precise timing controlled by climatic forcing of fluvial activity, such that height of terrace gravel above modern river is a consequence of uplift since deposition. In the case of the marine sequence, we take the height of interglacial raised beaches above a calculated contemporaneous sea-level as a measure of uplift, the calculation involving an adjustment from modern sea-level using the deep oceanic oxygen isotope signal as an indication of global ice volume at the time of deposition. This exercise requires some degree of dating constraint, which is problematic for both environments. The Solent terraces have yielded little biostratigraphical evidence, whereas the south coast raised beaches have either been poorly exposed in recent years or their ages have been controversial because of disputes between biostratigraphy and geochronological data. We have supplemented the evidence available from these sources by using key aspects of the archaeological record as dating constraints, in particular the first appearances of Levallois technique (a marker for MIS 9-8) and of bout coupé handaxes (MIS 3). The first of these has been particularly useful in modelling of the Middle Pleistocene parts of the river terrace staircases of the Solent system. In undertaking this reappraisal, we have noted several inconsistencies and disagreements between past correlation schemes for the terraces of the Solent and its various tributaries. We find that versions involving shallower downstream gradients in the main Solent River are most likely to be correct and that revisions on this basis solve a number of problems in interpretation encountered previously. Our results show that most of this region has uplifted by ˜70 m since the late

  16. Cichlid Fishes in the Angolan Headwaters Region: Molecular Evidence of the Ichthyofaunal Contact between the Cuanza and Okavango-Zambezi Systems

    Science.gov (United States)

    Musilová, Zuzana; Kalous, Lukáš; Petrtýl, Miloslav; Chaloupková, Petra

    2013-01-01

    The headwaters of five large African river basins flow through the Bié Plateau in Angola and still remain faunistically largely unexplored. We investigated fish fauna from the Cuanza and Okavango-Zambezi river systems from central Angola. We reconstructed molecular phylogenies of the most common cichlid species from the region, Tilapia sparrmanii and Serranochromis macrocephalus, using both mitochondrial and nuclear markers. We found evidence for ichthyofaunal contact and gene flow between the Cuanza and Okavango-Zambezi watersheds in the Bié Plateau in central Angola. Waterfalls and rapids also appeared to restrict genetic exchange among populations within the Cuanza basin. Further, we found that the Angolan Serranochromis cichlid fishes represent a monophyletic lineage with respect to other haplochromines, including the serranochromines from the Congo and Zambezi rivers. This study represents an important initial step in a biodiversity survey of this extremely poorly explored region, as well as giving further understanding to species distributions and gene flow both between and within river basins. PMID:23724120

  17. The impact of flavour, device type and warning messages on youth preferences for electronic nicotine delivery systems: evidence from an online discrete choice experiment.

    Science.gov (United States)

    Shang, Ce; Huang, Jidong; Chaloupka, Frank J; Emery, Sherry L

    2017-11-02

    To examine the impact of flavour, device type and health warning messages on youth preference for electronic nicotine delivery systems (ENDS), and to provide evidence and data to inform the Food and Drug Administration's potential regulatory actions on ENDS. An online discrete choice experiment was conducted in September 2015. Each participant was given nine choice sets and asked to choose one out of two alternative ENDS products, with varying characteristics in three attributes (flavour, device type and warning message). The impact of the attributes on the probability of choosing ENDS was analysed using conditional and nested logit regressions, controlling for individual sociodemographic characteristics and current smoking status. A general population sample of 515 participants (50 ever-users and 465 never-users of ENDS) aged 14-17 years were recruited to complete the experiment using an online panel. Fruit/sweets/beverage flavours significantly increase the probability of choosing ENDS among youth (pe-cigarettes, increase (p<0.05) the probability of choosing ENDS among adolescent never-users. Warning messages reduce (p<0.01) the probability of choosing ENDS among never-users. Restricting fruit/sweets/beverage flavours in ENDS, regulating modifiable vaping devices and adopting strong health warning messages may reduce the uptake of ENDS among youth. © 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.

  18. Evidence That the Sympathetic Nervous System Elicits Rapid, Coordinated, and Reciprocal Adjustments of Insulin Secretion and Insulin Sensitivity During Cold Exposure.

    Science.gov (United States)

    Morton, Gregory J; Muta, Kenjiro; Kaiyala, Karl J; Rojas, Jennifer M; Scarlett, Jarrad M; Matsen, Miles E; Nelson, Jarrell T; Acharya, Nikhil K; Piccinini, Francesca; Stefanovski, Darko; Bergman, Richard N; Taborsky, Gerald J; Kahn, Steven E; Schwartz, Michael W

    2017-04-01

    Dynamic adjustment of insulin secretion to compensate for changes of insulin sensitivity that result from alteration of nutritional or metabolic status is a fundamental aspect of glucose homeostasis. To investigate the role of the brain in this coupling process, we used cold exposure as an experimental paradigm because the sympathetic nervous system (SNS) helps to coordinate the major shifts of tissue glucose utilization needed to ensure that increased thermogenic needs are met. We found that glucose-induced insulin secretion declined by 50% in rats housed at 5°C for 28 h, and yet, glucose tolerance did not change, owing to a doubling of insulin sensitivity. These potent effects on insulin secretion and sensitivity were fully reversed by returning animals to room temperature (22°C) for 4 h or by intravenous infusion of the α-adrenergic receptor antagonist phentolamine for only 30 min. By comparison, insulin clearance was not affected by cold exposure or phentolamine infusion. These findings offer direct evidence of a key role for the brain, acting via the SNS, in the rapid, highly coordinated, and reciprocal changes of insulin secretion and insulin sensitivity that preserve glucose homeostasis in the setting of cold exposure. © 2017 by the American Diabetes Association.

  19. First evidence of a potential antibacterial activity involving a laccase-type enzyme of the phenoloxidase system in Pacific oyster Crassostrea gigas haemocytes.

    Science.gov (United States)

    Luna-Acosta, Andrea; Saulnier, Denis; Pommier, Mylène; Haffner, Philippe; De Decker, Sophie; Renault, Tristan; Thomas-Guyon, Hélène

    2011-12-01

    Phenoloxidases (POs) are a group of copper proteins including tyrosinase, catecholase and laccase. In several insects and crustaceans, antibacterial substances are produced through the PO cascade, participating in the direct killing of invading microorganisms. However, although POs are widely recognised as an integral part of the invertebrate immune defence system, experimental evidence is lacking that these properties are conserved in molluscs, and more particularly in the Pacific oyster Crassostrea gigas. In the present study, Vibrio splendidus LGP32 and Vibrio aestuarianus 02/041 growths were affected, after being treated with C. gigas haemocyte lysate supernatant (HLS), and either a common substrate of POs, l-3,4-dihydroxyphenylalanine (L-DOPA), to detect catecholase-type PO activity, or a specific substrate of laccase, p-phenylenediamine (PPD), to detect laccase-type PO activity. Interestingly, a higher bacterial growth inhibition was observed in the presence of PPD than in the presence of L-DOPA. These effects were suppressed when the specific PO inhibitor, phenylthiourea (PTU), was added to the medium. Results of the present study suggest, for the first time in a mollusc species, that antibacterial activities of HLS from C. gigas potentially involve POs, and more particularly laccase catalysed reactions. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. The present status of surgery of the superficial venous system in the management of venous ulcer and the evidence for the role of perforator interruption.

    Science.gov (United States)

    O'Donnell, Thomas F

    2008-10-01

    Superficial venous hypertension has been cited as the putative etiologic factor in advanced chronic venous insufficiency with venous ulcer (CEAP C 5/6). For over a century, influenced by this belief, surgeons have ablated the superficial venous system as a treatment for venous ulcer. Incompetent perforating veins (ICPVs) have become a particular focus of this therapeutic strategy. This review examines the evidence for the surgical approach. A MEDLINE search of the literature identified only four randomized controlled trials (RCTs) directed at the surgical reduction of superficial venous hypertension. Risk ratios for ulcer healing and prevention of recurrence were calculated to determine benefits for these four RCTs, while mortality and morbidity, where available, was used to determine risk from the procedure. In addition, the quality of the trials (design and outcomes) was assessed. While two trials compared ICPV ligation to compression, the great saphenous vein (GSV) was also treated in many of these limbs, which confounds the results. By contrast, two RCTs, which compared treatment of the GSV alone to compression, demonstrated a significant reduction in the incidence of ulcer recurrence. Case series that employed hemodynamic or surrogate outcomes showed little effect on the addition of ICPV treatment to GSV stripping, while GSV ablation alone was associated with a reduction in the number of ICPVs in several studies. This review suggests a grade 1A recommendation for the treatment of venous ulcer by GSV ablation to reduce ulcer recurrence. The role of ICPV ablation alone or concomitant with GSV treatment awaits results of properly conducted RCTs.

  1. Anti-stress and nootropic activity of drugs affecting the renin-angiotensin system in rats based on indirect biochemical evidence.

    Science.gov (United States)

    Anil Kumar, K V; Nagwar, Shrasti; Thyloor, Rama; Satyanarayana, Sreemantula

    2015-12-01

    Various stress hormones are responsible for bringing out stress-related changes and are implicated in learning and memory processes. The extensive clinical experience of angiotensin receptor blockers (ARBs) and direct renin inhibitor as antihypertensive agents provides anecdotal evidence of improvements in cognition. The neurochemical basis underlying the anti-stress and nootropic effects are unclear. This study was aimed to determine the effects of aliskiren, valsartan and their combination on the neuromediators of the central nervous system (CNS) and periphery as well as on cognitive function. Groups of rats were subjected to a forced swim stress for one hour after daily treatment with aliskiren, valsartan and their combination. The 24 h urinary excretion of vanillylmandellic acid (VMA), 5-hydroxyindoleacetic acid (5-HIAA), 6-β-hydroxycortisol (6-β-OH) cortisol and homovanillic acid (HVA) was determined in all groups under normal and stressed conditions. Nootropic activity was studied using cook's pole climbing apparatus and acetylcholinesterase (AChE) inhibitory activity by Ellman's method. Administration of aliskiren (10 mg/kg), valsartan (20 mg/kg) and their combination at a dose of 5 and 10 mg/kg respectively reduced the urinary metabolite levels. Further, all drugs showed significant improvement in scopolamine-impaired performance and produced inhibition of the AChE enzyme. The present study provides scientific support for the anti-stress and nootropic activities of aliskiren, valsartan and their combination. © The Author(s) 2014.

  2. Writing System Modulates the Association between Sensitivity to Acoustic Cues in Music and Reading Ability: Evidence from Chinese-English Bilingual Children.

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    Zhang, Juan; Meng, Yaxuan; Wu, Chenggang; Zhou, Danny Q

    2017-01-01

    Music and language share many attributes and a large body of evidence shows that sensitivity to acoustic cues in music is positively related to language development and even subsequent reading acquisition. However, such association was mainly found in alphabetic languages. What remains unclear is whether sensitivity to acoustic cues in music is associated with reading in Chinese, a morphosyllabic language. The present study aimed to answer this question by measuring music (i.e., musical metric perception and pitch discrimination), language (i.e., phonological awareness, lexical tone sensitivity), and reading abilities (i.e., word recognition) among 54 third-grade Chinese-English bilingual children. After controlling for age and non-verbal intelligence, we found that both musical metric perception and pitch discrimination accounted for unique variance of Chinese phonological awareness while pitch discrimination rather than musical metric perception predicted Chinese lexical tone sensitivity. More importantly, neither musical metric perception nor pitch discrimination was associated with Chinese reading. As for English, musical metric perception and pitch discrimination were correlated with both English phonological awareness and English reading. Furthermore, sensitivity to acoustic cues in music was associated with English reading through the mediation of English phonological awareness. The current findings indicate that the association between sensitivity to acoustic cues in music and reading may be modulated by writing systems. In Chinese, the mapping between orthography and phonology is not as transparent as in alphabetic languages such as English. Thus, this opaque mapping may alter the auditory perceptual sensitivity in music to Chinese reading.

  3. Evidence for a role of the oxytocin system, indexed by genetic variation in CD38, in the social bonding effects of expressed gratitude.

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    Algoe, Sara B; Way, Baldwin M

    2014-12-01

    Oxytocin is thought to play a central role in promoting close social bonds via influence on social interactions. The current investigation targeted interactions involving expressed gratitude between members of romantic relationships because recent evidence suggests gratitude and its expression provides behavioral and psychological 'glue' to bind individuals closer together. Specifically, we took a genetic approach to test the hypothesis that social interactions involving expressed gratitude would be associated with variation in a gene, CD38, which has been shown to affect oxytocin secretion. A polymorphism (rs6449182) that affects CD38 expression was significantly associated with global relationship satisfaction, perceived partner responsiveness and positive emotions (particularly love) after lab-based interactions, observed behavioral expression of gratitude toward a romantic partner in the lab, and frequency of expressed gratitude in daily life. A separate polymorphism in CD38 (rs3796863) previously associated with plasma oxytocin levels and social engagement was also associated with perceived responsiveness in the benefactor after an expression of gratitude. The combined influence of the two polymorphisms was associated with a broad range of gratitude-related behaviors and feelings. The consistent pattern of findings suggests that the oxytocin system is associated with solidifying the glue that binds adults into meaningful and important relationships. © The Author (2014). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  4. Key process issues in Cognitive Behavioral Analysis System of Psychotherapy (CBASP): translation of an evidence-based model into clinical practice and training.

    Science.gov (United States)

    Vivian, Dina; Salwen, Jessica

    2013-09-01

    Our "desired outcome" in writing this article was to present not only key process issues stemming from the Cognitive Behavioral Analysis System of Psychotherapy (CBASP; McCullough, 2000), but to highlight those therapy maneuvers that we, a "seasoned" clinician/supervisor and a clinical trainee, find most useful in delivering treatment and in conducting supervision. We strongly believe that it is only through the translation of evidence-based therapeutic models, such as CBASP, into effective training that a true integration of science and practice can be obtained. Thus, the congruence of trainer's and trainee's views on what constitute top process issues in therapy is important in evaluating the reliability of a therapy model; with this in mind, we focus on three process issues, as follows: (1) problems are anchored to the "here and now" and to specific situational outcomes; (2) patients are encouraged to identify the role they play in affecting their distressing outcomes and to take responsibility for "fixing" them; and (3) the therapist planfully engages in the process of change via disciplined personal involvement. Research and theory supporting these maneuvers are presented, in conjunction with clinical examples. 2013 APA, all rights reserved

  5. Does autonomization of public hospitals and exposure to market pressure complement or debilitate social health insurance systems? Evidence from a low-income country.

    Science.gov (United States)

    Sepehri, Ardeshir

    2014-01-01

    Granting public hospitals greater autonomy and creating organizational arrangements that mimic the private sector and encourage competition is often promoted as a way to increase efficiency and public accountability and to improve quality of care at these facilities. The existence of good-quality health infrastructure, in turn, encourages the population to join and support the social health insurance system and achieve universal coverage. This article provides a critical review of hospital autonomization, using Vietnam's experience to assess the influence of hospital autonomy on the sustainability of Vietnam's social health insurance. The evidence suggests that a reform process based on greater autonomy of resource mobilization and on the retention and use of own-source revenues can create perverse incentives among managers and health care providers, leading to the development of a two-tiered provision of clinical care, provider-induced supply of an inefficient service mix, a high degree of duplication, wasteful investment, and cost escalation. Rather than complementing social health insurance and helping the country to achieve universal coverage, granting public hospitals greater autonomy that mimics the private sector may indeed undermine the legitimacy and sustainability of social health insurance as health care costs escalate and higher quality of care remains elusive.

  6. Deaths Ascribed to Non-Communicable Diseases among Rural Kenyan Adults Are Proportionately Increasing: Evidence from a Health and Demographic Surveillance System, 2003–2010

    Science.gov (United States)

    Phillips-Howard, Penelope A.; Laserson, Kayla F.; Amek, Nyaguara; Beynon, Caryl M.; Angell, Sonia Y.; Khagayi, Sammy; Byass, Peter; Hamel, Mary J.; van Eijk, Anne M.; Zielinski-Gutierrez, Emily; Slutsker, Laurence; De Cock, Kevin M.; Vulule, John; Odhiambo, Frank O.

    2014-01-01

    Background Non-communicable diseases (NCDs) result in more deaths globally than other causes. Monitoring systems require strengthening to attribute the NCD burden and deaths in low and middle-income countries (LMICs). Data from health and demographic surveillance systems (HDSS) can contribute towards this goal. Methods and Findings Between 2003 and 2010, 15,228 deaths in adults aged 15 years (y) and older were identified retrospectively using the HDSS census and verbal autopsy in rural western Kenya, attributed into broad categories using InterVA-4 computer algorithms; 37% were ascribed to NCDs, 60% to communicable diseases (CDs), 3% to injuries, and diseases (CVDs; 29%). The proportionate mortality from NCDs rose from 35% in 2003 to 45% in 2010 (χ2 linear trend 93.4; p<0.001). While overall annual mortality rates (MRs) for NCDs fell, cancer-specific MRs rose from 200 to 262 per 100,000 population, mainly due to increasing deaths in adults aged 65y and older, and to respiratory neoplasms in all age groups. The substantial fall in CD MRs resulted in similar MRs for CDs and NCDs among all adult females by 2010. NCD MRs for adults aged 15y to <65y fell from 409 to 183 per 100,000 among females and from 517 to 283 per 100,000 population among males. NCD MRs were higher among males than females aged both below, and at or above, 65y. Conclusions NCDs constitute a significant proportion of deaths in rural western Kenya. Evidence of the increasing contribution of NCDs to overall mortality supports international recommendations to introduce or enhance prevention, screening, diagnosis and treatment programmes in LMICs. PMID:25426945